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Seid AK, Thylstrup B, Henriksen SH, Hesse M. Met and unmet prison-based treatment needs for people who are incarcerated with a history of substance use disorder: A nationwide cohort study. J Subst Use Addict Treat 2024; 159:209264. [PMID: 38103836 DOI: 10.1016/j.josat.2023.209264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/04/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Substance use disorders (SUD) are highly prevalent among incarcerated people. However, in some prisons, only a small percentage of those who need treatment receive it. The aims of this study were to examine coverage of treatment for SUD in Danish prisons and assess whether treatment differed by substance class. Further, we examined factors associated with receiving treatment for SUD, and types of services received. DATA AND METHODS We linked multiple Danish register data using unique personal identification numbers. This study retrospectively analysed data for 49,330 individuals (aged 18-90) incarcerated in Danish prisons between 2008 and 2018. We used a multivariable logistic regression model to predict enrolment in treatment for SUD in prison. RESULTS Of incarcerated people with a history of SUD, 34.6 % received treatment care during incarceration. We observed only minor variations in terms of substance classes concerning the type of treatment. Those who were women, immigrants, had higher education, or were married were less likely to receive treatment. CONCLUSIONS Improving access and increasing treatment coverage in the Danish Prison and Probation Services is crucial to reduce the burden of SUD in incarcerated populations.
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Affiliation(s)
- Abdu K Seid
- Center for Alcohol and Drug Research, Aarhus University, Denmark; University of Bergen, Norway.
| | | | | | - Morten Hesse
- Center for Alcohol and Drug Research, Aarhus University, Denmark
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Myklebust LH, Eide D, Arnevik EA, Dadras O, De Pirro S, Ellefsen R, Fadnes LT, Hesse M, Kvamme TL, Melis F, Oldervoll A, Thylstrup B, Wusthoff LEC, Clausen T. Evaluation of heroin-assisted treatment in Norway: protocol for a mixed methods study. BMC Health Serv Res 2024; 24:398. [PMID: 38553691 PMCID: PMC10981318 DOI: 10.1186/s12913-024-10767-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/21/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Opioid agonist treatment (OAT) for patients with opioid use disorder (OUD) has a convincing evidence base, although variable retention rates suggest that it may not be beneficial for all. One of the options to include more patients is the introduction of heroin-assisted treatment (HAT), which involves the prescribing of pharmaceutical heroin in a clinical supervised setting. Clinical trials suggest that HAT positively affects illicit drug use, criminal behavior, quality of life, and health. The results are less clear for longer-term outcomes such as mortality, level of function and social integration. This protocol describes a longitudinal evaluation of the introduction of HAT into the OAT services in Norway over a 5-year period. The main aim of the project is to study the individual, organizational and societal effects of implementing HAT in the specialized healthcare services for OUD. METHODS The project adopts a multidisciplinary approach, where the primary cohort for analysis will consist of approximately 250 patients in Norway, observed during the period of 2022-2026. Cohorts for comparative analysis will include all HAT-patients in Denmark from 2010 to 2022 (N = 500) and all Norwegian patients in conventional OAT (N = 8300). Data comes from individual in-depth and semi-structured interviews, self-report questionnaires, clinical records, and national registries, collected at several time points throughout patients' courses of treatment. Qualitative analyses will use a flexible inductive thematic approach. Quantitative analyses will employ a wide array of methods including bi-variate parametric and non-parametric tests, and various forms of multivariate modeling. DISCUSSION The project's primary strength lies in its comprehensive and longitudinal approach. It has the potential to reveal new insights on whether pharmaceutical heroin should be an integral part of integrated conventional OAT services to individually tailor treatments for patients with OUD. This could affect considerations about drug treatment even beyond HAT-specific topics, where an expanded understanding of why some do not succeed with conventional OAT will strengthen the knowledge base for drug treatment in general. Results will be disseminated to the scientific community, clinicians, and policy makers. TRIAL REGISTRATION The study was approved by the Norwegian Regional Committee for Medical and Health Research Ethics (REK), ref.nr.:195733.
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Affiliation(s)
- Lars Henrik Myklebust
- Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, Kirkevegen 166, Building 45, NO-0407, Oslo, Norway.
| | - Desiree Eide
- Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, Kirkevegen 166, Building 45, NO-0407, Oslo, Norway
| | - Espen A Arnevik
- Section for Clinical Addiction Research, Oslo University Hospital, P.b 4950 Nydalen, NO-0424, Oslo, Norway
| | - Omid Dadras
- Bergen Addiction Research Group, Department of Addiction Medicine, Haukeland University Hospital, P.b 1400, NO-5021, Bergen, Norway
| | - Silvana De Pirro
- Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, Kirkevegen 166, Building 45, NO-0407, Oslo, Norway
- Department of Physiology and Pharmacology "V. Erspamer," La Sapienza, University of Rome, P. Ie Aldo Moro 5, 00185, Rome, Italy
| | - Rune Ellefsen
- Section for Clinical Addiction Research, Oslo University Hospital, P.b 4950 Nydalen, NO-0424, Oslo, Norway
| | - Lars T Fadnes
- Bergen Addiction Research Group, Department of Addiction Medicine, Haukeland University Hospital, P.b 1400, NO-5021, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, P.b 7804, NO-5020, Bergen, Norway
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, DK-8000, Aarhus, Denmark
| | - Timo L Kvamme
- Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, DK-8000, Aarhus, Denmark
| | - Francesca Melis
- Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, Kirkevegen 166, Building 45, NO-0407, Oslo, Norway
| | - Ann Oldervoll
- Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, Kirkevegen 166, Building 45, NO-0407, Oslo, Norway
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, DK-8000, Aarhus, Denmark
| | - Linda E C Wusthoff
- Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, Kirkevegen 166, Building 45, NO-0407, Oslo, Norway
- Section for Clinical Addiction Research, Oslo University Hospital, P.b 4950 Nydalen, NO-0424, Oslo, Norway
| | - Thomas Clausen
- Norwegian Centre for Addiction Research, Faculty of Medicine, University of Oslo, Kirkevegen 166, Building 45, NO-0407, Oslo, Norway
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Bukten A, Virtanen S, Hesse M, Thylstrup B, Kvamme TL, Seid AK, Chang Z, Skjærvø I, Tverborgvik T, Stavseth MR. The prevalence of substance use disorders among people in Norwegian, Danish and Swedish prisons: A multi-national cohort study, 2010-19. Addiction 2024. [PMID: 38529890 DOI: 10.1111/add.16477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 02/18/2024] [Indexed: 03/27/2024]
Abstract
AIMS We estimated the prevalence of substance use disorders (SUDs) in the Norwegian, Danish and Swedish prison populations and compared the prevalence of SUDs in the national prison populations with country-specific general population prevalence rates. DESIGN A multi-national cohort study using data from the National Prison Registries linked to the National Patient Registries in Norway, Denmark and Sweden. SETTING AND PARTICIPANTS We used data from the PriSUD-Nordic study, including national prison populations aged 19 years and older in Norway (2010-19), Denmark (2010-18) and Sweden (2010-13). A total of 119 507 Individuals (108 971 men and 10 536 women) contributing to 191 507 incarcerations were included in the study (Norway: 45432 men; 5429 women, Denmark: 42 162 men; 3370 women, Sweden: 21 377 men; 1737 women). MEASUREMENT We calculated a study prevalence and prevalence at entry to prison for all types of SUDs before imprisonment each consecutive year of observation in each prison population. We also extracted country-specific 1-year prevalence rates from the Global Burden of Diseases database to calculate comparative national prevalence ratios. FINDINGS The study prevalence of any SUD was approximately 40% [Norway: 44.0%, 95% confidence interval (CI) = 43.6-44.5%; Denmark: 39.9%, CI = 39.5-40.4%; Sweden: 39.1%, CI = 38.4-39.7%] in all three countries. Women had a significantly higher study prevalence of any SUD compared with men (Norway: 55.8 versus 42.6%, P < 0.001; Denmark 43.1 versus 39.7%, P = 0.004; Sweden: 51.7 versus 38.0%, P < 0.001). Prevalence estimates were higher for SUDs among people in prison than in the general population. We observed an increasing proportion of people with SUDs entering prison in Norway (P = 0.003), while the proportion was more stable in Denmark and Sweden. CONCLUSIONS Substance use disorders (SUDs) appear to be highly prevalent among the Scandinavian prison populations compared with the general population, especially among women. In Norway, there was a relative increase in SUDs from 2010 to 2019.
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Affiliation(s)
- Anne Bukten
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Suvi Virtanen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | | | - Abdu Kedir Seid
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ingeborg Skjærvø
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Torill Tverborgvik
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Marianne R Stavseth
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Norway
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Bukten A, Virtanen S, Hesse M, Chang Z, Kvamme TL, Thylstrup B, Tverborgvik T, Skjærvø I, Stavseth MR. The prevalence and comorbidity of mental health and substance use disorders in Scandinavian prisons 2010-2019: a multi-national register study. BMC Psychiatry 2024; 24:95. [PMID: 38317111 PMCID: PMC10840271 DOI: 10.1186/s12888-024-05540-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 01/19/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Mental health disorders are common among people in prison, but their prevalence in the Scandinavian prison population remain unclear. In this multinational register study, we examined the prevalence of mental health disorders and the comorbidity of substance use disorders (SUDs) with other mental health disorders in this population. Further, we investigated how the prevalence of mental disorders at prison entry had changed in Norway, Denmark, and Sweden over the study period. METHODS The three study cohorts included all individuals, aged 19 or older, whom had been imprisoned in Norway (2010-2019), Denmark (2011-2018), and Sweden (2010-2013). Mental disorders were defined as ICD-10 diagnoses (F-codes) registered in the national patient registers. The study prevalence was estimated based on recorded diagnoses during the entire study follow-up period in each respective country. The one-year prevalence of mental disorders was estimated for each calendar year for individuals entering prison during that year. RESULTS The Scandinavian prison cohorts included 119 507 individuals released 191 549 times during the study period. Across all three countries a high proportion of both women (61.3%-74.4%) and men (49.6%-57.9%) had at least one mental health disorder during the observation period. The most prevalent disorders were SUDs (39.1%-44.0%), depressive disorder (8.1%-17.5%), and stress related disorder (8.8%-17.1%). Women (31.8%-41.1%) had higher levels of mental health and substance use comorbidities compared to men (20.8%-27.6%). The one-year prevalence of any mental health disorder increased over time with a 33% relative increase in Norway, 8% in Denmark, and 10% in Sweden. The proportion of individuals entering prison with a comorbid SUD and other mental disorder had also increased. CONCLUSIONS While the incarceration rate has been decreasing during the past decade in the Scandinavian countries, an increasing proportion of people entering prison have a diagnosed mental health disorder. Our results suggest that prisons should provide adequate treatment and scale up services to accommodate the increasing proportion of people with complex health needs among incarcerated people.
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Affiliation(s)
- Anne Bukten
- Norwegian Centre for Addiction Research, University of Oslo, Kirkeveien 166, Oslo, N-0407, Norway.
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Suvi Virtanen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Morten Hesse
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Birgitte Thylstrup
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Torill Tverborgvik
- Norwegian Centre for Addiction Research, University of Oslo, Kirkeveien 166, Oslo, N-0407, Norway
| | - Ingeborg Skjærvø
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Marianne R Stavseth
- Norwegian Centre for Addiction Research, University of Oslo, Kirkeveien 166, Oslo, N-0407, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Hesse M. Why compulsive sexual behavior is not a form of addiction like drug addiction. Sex Med 2024; 12:qfae006. [PMID: 38450256 PMCID: PMC10915579 DOI: 10.1093/sexmed/qfae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/03/2024] [Indexed: 03/08/2024] Open
Affiliation(s)
- Morten Hesse
- Center for Alcohol and Drug Research, Aarhus University, Tuborgvej 164, Copenhagen, NV 24500, Denmark
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Melis F, Hesse M, Eide D, Thylstrup B, Tjagvad C, Brummer JE, Clausen T. Who receives heroin-assisted treatment? A comparison of patients receiving opioid maintenance treatment in Denmark. Drug Alcohol Depend 2024; 254:111051. [PMID: 38091901 DOI: 10.1016/j.drugalcdep.2023.111051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/20/2023] [Accepted: 11/26/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Since 2010, heroin-assisted treatment (HAT) has been one of the treatment options available to people with opioid use disorder (OUD) in Denmark. This study aimed to characterize HAT patients at treatment start and compare their individual characteristics to those of patients entering traditional opioid maintenance treatment (OMT) with methadone or buprenorphine during the same period. METHODS Patients who initiated HAT or OMT with methadone or buprenorphine in Denmark from 2010 to 2018 were included (n=6798). Multiple national registers were linked to compare treatment groups in terms of socio-demographic variables, previous OUD treatment episodes, hospital-based care, and criminal conviction history. RESULTS Nearly all HAT patients had a history of methadone treatment (91%) and half had residential treatment experience (48%). In the year previous to admission, HAT patients recorded the highest percentages of non-fatal overdoses (12%) and chronic hepatitis C diagnoses (16%), and the lowest percentages of psychiatric disorders (11%) compared to traditional OMT patients. Criminal convictions were also common: 39% of the HAT group had committed a property crime and 18% a drug-related crime the year before HAT entry. During the study period, an overall reduction in OMT enrollments for each year was recorded. The HAT proportion to the total remained fairly stable (4%-10%), while the buprenorphine proportion increased. CONCLUSIONS In Denmark, OMT patients exhibited numerous vulnerabilities at treatment start, and among the patient groups, HAT patients were the most burdened. HAT seems to reach the target group and adhere to formulated eligibility criteria.
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Affiliation(s)
- Francesca Melis
- Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Norway.
| | - Morten Hesse
- Centre for Alcohol and Drug, Research Aarhus UniversityTuborgvej 164, Copenhagen, NV, 2400, Denmark.
| | - Desiree Eide
- Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Norway.
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug, Research Aarhus UniversityTuborgvej 164, Copenhagen, NV, 2400, Denmark.
| | - Christian Tjagvad
- Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Norway.
| | - Julie Elizabeth Brummer
- Centre for Alcohol and Drug, Research Aarhus UniversityTuborgvej 164, Copenhagen, NV, 2400, Denmark.
| | - Thomas Clausen
- Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Norway.
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Frederiksen KS, Hesse M, Pedersen MU. Problematic parental substance use, childhood family structures and adverse outcomes in young adulthood. Nordisk Alkohol Nark 2023; 40:502-519. [PMID: 37969903 PMCID: PMC10634387 DOI: 10.1177/14550725221143177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 11/17/2022] [Indexed: 11/17/2023] Open
Abstract
Aim: The aim of the present study was to investigate the association between childhood family structures, including the presence or absence of problematic parental substance use (PPSU), and adverse outcomes during adolescence/young adulthood. Methods: The study population included 9,770 young people (aged 15-25 years) from samples drawn for two national surveys in Denmark during 2014-2015. By combining surveys with national register data, five types of childhood family structures were constructed based on whether the child experienced PPSU and/or family separation and the number of years the child lived with a parent with substance use problems. Using binary logistic regression models, the relationships between family structure and adverse outcomes in young adulthood (i.e., hospital admissions, mental disorders and criminality) were investigated. Results: Young people who experienced PPSU and did not live with both parents had higher odds of the different long-term adverse outcomes compared with young people who did not experience PPSU, and similar odds of the outcomes compared to youth who had not experienced PPSU and did not live with both parents. The highest odds of adverse outcomes were found among young people who experienced PPSU and lived with the parent with substance use problems for less than five years. Conclusions: Living with both parents protected against adverse outcomes in young adulthood, and if PPSU was present, the odds of adverse outcomes increased. The hypothesis that there would be a positive association between years living with a parent with substance use problems and adverse outcomes in young adulthood was not supported. Awareness should be raised in health service, educational and legal institutions about the risk for young people from families with PPSU who do not live with both parents.
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Gabrhelík R, Hesse M, Nechanská B, Handal M, Mravčík V, Tjagvad C, Thylstrup B, Seid AK, Bukten A, Clausen T, Skurtveit S. Large variations in all-cause and overdose mortality among >13,000 patients in and out of opioid maintenance treatment in different settings: a comparative registry linkage study. Front Public Health 2023; 11:1179763. [PMID: 37809010 PMCID: PMC10558053 DOI: 10.3389/fpubh.2023.1179763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Background Opioid maintenance treatment (OMT) has the potential to reduce mortality rates substantially. We aimed to compare all-cause and overdose mortality among OMT patients while in or out of OMT in two different countries with different approaches to OMT. Methods Two nation-wide, registry-based cohorts were linked by using similar analytical strategies. These included 3,637 male and 1,580 female patients enrolled in OMT in Czechia (years 2000-2019), and 6,387 male and 2,078 female patients enrolled in OMT in Denmark (years 2007-2018). The direct standardization method using the European (EU-27 plus EFTA 2011-2030) Standard was employed to calculate age-standardized rate to weight for age. All-cause and overdose crude mortality rates (CMR) as number of deaths per 1,000 person years (PY) in and out of OMT were calculated for all patients. CMRs were stratified by sex and OMT medication modality (methadone, buprenorphine, and buprenorphine with naloxone). Results Age-standardized rate for OMT patients in Czechia and Denmark was 9.7/1,000 PY and 29.8/1,000 PY, respectively. In Czechia, the all-cause CMR was 4.3/1,000 PY in treatment and 10.8/1,000 PY out of treatment. The overdose CMR was 0.5/1,000 PY in treatment and 1.2/1,000 PY out of treatment. In Denmark, the all-cause CMR was 26.6/1,000 PY in treatment and 28.2/1,000 PY out of treatment and the overdose CMR was 7.3/1,000 PY in treatment and 7.0/1,000 PY out of treatment. Conclusion Country-specific differences in mortality while in and out of OMT in Czechia and Denmark may be partly explained by different patient characteristics and treatment systems in the two countries. The findings contribute to the public health debate about OMT management and may be of interest to practitioners, policy and decision makers when balancing the safety and accessibility of OMT.
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Affiliation(s)
- Roman Gabrhelík
- First Faculty of Medicine, Department of Addictology, Charles University, Prague, Czechia
- Department of Addictology, General University Hospital in Prague, Prague, Czechia
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Blanka Nechanská
- First Faculty of Medicine, Department of Addictology, Charles University, Prague, Czechia
- Department of Addictology, General University Hospital in Prague, Prague, Czechia
| | - Marte Handal
- Norwegian Institute of Public Health, Oslo, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Viktor Mravčík
- First Faculty of Medicine, Department of Addictology, Charles University, Prague, Czechia
- Department of Addictology, General University Hospital in Prague, Prague, Czechia
| | - Christian Tjagvad
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Abdu Kedir Seid
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Anne Bukten
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Thomas Clausen
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Svetlana Skurtveit
- Norwegian Institute of Public Health, Oslo, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
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Wasser F, Zähter Ş, Sokol M, Rivers M, Atzeni S, Condamine FP, Cristoforetti G, Fauvel G, Fischer N, Gizzi LA, Hannasch A, Hesse M, Laštovička T, Lutz P, Rubovič P, Schaumann G, Schott N, Singh RL, Theobald W, Weber S, Ditmire T, Forner T, Roth M. Full aperture backscatter diagnostics for characterization of laser plasma instabilities at the extreme light infrastructure (ELI) beamlines. Rev Sci Instrum 2023; 94:093503. [PMID: 37737696 DOI: 10.1063/5.0153874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023]
Abstract
We report on the commissioning of a full aperture backscatter diagnostics station for the kilojoule, nanosecond high repetition rate L4n laser operating at a wavelength of 527 nm at the Extreme Light Infrastructure (ELI) - Beamlines, Dolni Brezany, Czech Republic. Light scattered back from laser-plasma interaction into the cone of the final focusing lens is captured and split into different channels to measure the signatures of laser plasma instabilities from stimulated Brillouin scattering, stimulated Raman scattering, and two plasmon decay with respect to back scattered energy, its spectrum, and its temporal profile. The performance was confirmed in a commissioning experiment with more than 800 shots at laser intensities ranging from 0.5 × 1013 to 1.1 × 1015 W cm-2. These diagnostics are permanently installed at ELI Beamlines, and can be used to understand the details of laser-plasma interactions in experiments with kJ and 527 nm light. The large number of shots that can be collected in an experimental campaign will allow us to study the details of the laser-plasma interaction with a high level of confidence.
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Affiliation(s)
- F Wasser
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
- IU Internationale Hochschule GmbH, Darmstädter Landstrasse 110, 60598 Frankfurt am Main, Germany
| | - Ş Zähter
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - M Sokol
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - M Rivers
- University of Texas, 110 Inner Campus Dr., Austin, Texas 78712, USA
| | - S Atzeni
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - F P Condamine
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | | | - G Fauvel
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | - N Fischer
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - L A Gizzi
- Intense Laser Irradiation Laboratory, INO-CNR, Pisa, Italy
| | - A Hannasch
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - M Hesse
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - T Laštovička
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | - P Lutz
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - P Rubovič
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | - G Schaumann
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - N Schott
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
- Technische Universität Darmstadt, Schlossgartenstrasse 9, 64289 Darmstadt, Germany
| | - R L Singh
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | - W Theobald
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - S Weber
- Extreme Light Infrastructure ERIC, ELI-Beamlines Facility, 25241 Dolní Břežany, Czech Republic
| | - T Ditmire
- University of Texas, 110 Inner Campus Dr., Austin, Texas 78712, USA
| | - T Forner
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
| | - M Roth
- Focused Energy GmbH, Im Tiefen See 45, 64293 Darmstadt, Germany
- Technische Universität Darmstadt, Schlossgartenstrasse 9, 64289 Darmstadt, Germany
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Eide D, Skurtveit S, Clausen T, Hesse M, Mravčík V, Nechanská B, Rolová G, Thylstrup B, Tjagvad C, Seid AK, Odsbu I, Gabrhelík R. Cause-Specific Mortality among Patients in Treatment for Opioid Use Disorder in Multiple Settings: A Prospective Comparative Cohort Study. Eur Addict Res 2023; 29:272-284. [PMID: 37385232 PMCID: PMC10614278 DOI: 10.1159/000530822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/18/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION Among people receiving current or previous opioid maintenance treatment (OMT), the leading cause of premature death is an opioid overdose. However, other causes of mortality remain high in this group. An understanding of causes of deaths across multiple settings can be useful in informing more comprehensive prevention responses. The aim of this study was to describe all non-overdose causes of death in three national cohorts (Czechia, Denmark, and Norway) among OMT patients and to explore associations of non-overdose mortality with age and gender. METHODS This prospective comparative cohort study used national mortality registry databases for OMT patients from Czechia (2000-2019), Denmark (2000-2018), and Norway (2010-2019). Crude mortality rates and age-standardized mortality rates (ASMRs) were calculated as deaths per 1,000 person years for cause-specific mortality. RESULTS In total, 29,486 patients were included, with 5,322 deaths recorded (18%). We found variations in causes of death among the cohorts and within gender and age groups. The leading non-overdose causes of death were accidents in Czechia and Denmark, and neoplasms in Norway. Cardiovascular deaths were highest in Czechia, particularly for women in OMT (ASMR 3.59 vs. 1.24 in Norway and 1.87 in Denmark). CONCLUSION This study found high rates of preventable death among both genders and all age groups. Different demographic structures, variations in risk exposure, as well as variations in coding practices can explain the differences. The findings support increased efforts towards screening and preventative health initiatives among OMT patients specific to the demographic characteristics in different settings.
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Affiliation(s)
- Desiree Eide
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Svetlana Skurtveit
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
| | - Thomas Clausen
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Viktor Mravčík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Blanka Nechanská
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Gabriela Rolová
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Christian Tjagvad
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Abdu Kedir Seid
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Ingvild Odsbu
- Norwegian Institute of Public Health, Oslo, Norway
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Roman Gabrhelík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
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11
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Andersen K, Nielsen B, Hesse M, Mejldal A, Bilberg R, Nielsen AS. Screening of coexisting depression or anxiety disorders among Danish patients with alcohol use disorder in outpatient treatment. Nord J Psychiatry 2023:1-9. [PMID: 37093109 DOI: 10.1080/08039488.2023.2200764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND Depression and anxiety are highly prevalent among patients seeking outpatient treatment for alcohol use disorders (AUD) and if depression and anxiety are addressed the prognosis is improved. Screening instruments for depression and anxiety have been validated in populations suffering from drug use disorders, but not in populations suffering from AUD. The aim of this study was to validate four self-administrated screening instruments (PHQ-9, GAD-7, Kessler-6, and SRQ) and calculate the optimal cut-off value for identifying depression and anxiety. METHODS The study included 73 patients with self-reported depression or anxiety during AUD treatment. Each patient filled out the above-mentioned instruments and was subsequently interviewed by trained clinicians blinded to the results of the instruments with the Present State Examination to establish a diagnosis of depression or anxiety according to ICD-10. ROC curves were constructed for each instrument and the area under the curve (AUC) was calculated using patients with no depression or anxiety as reference. Youden's index was calculated to assess the optimal cut-off for each instrument. RESULTS A total of 33 (45.2%) were diagnosed with depression or anxiety. The AUC for PHQ-9, GAD-7, Kessler-6, and SRQ were 0.767, 0.630, 0.793, and 0.698 respectively. Kessler-6, the instruments performing best based on the AUC, identified 27 (82%) of the 33 patients using a cut-off of 10 points. CONCLUSION Kessler-6 seems to be valid and reliable in identifying patients requiring treatment for depression or anxiety among patients seeking treatment for AUD who are reporting depression or anxiety.
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Affiliation(s)
- Kjeld Andersen
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
- Department of Psychiatry Odense, Region of Southern Denmark, Odense C, Denmark
| | - Bent Nielsen
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
- Department of Psychiatry Odense, Region of Southern Denmark, Odense C, Denmark
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Department of Psychological and Behavioral Sciences, Aarhus University, Copenhagen S, Denmark
| | - Anna Mejldal
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
- Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Randi Bilberg
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Department of Clinical Research, University of Southern Denmark, Odense C, Denmark
- Department of Psychiatry Odense, Region of Southern Denmark, Odense C, Denmark
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12
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Hesse M, Jones S, Pedersen MM, Skov KBE, Thylstrup B, Pedersen MU. The predictive value of brief measures of externalizing behavior and internalizing problems in young people receiving substance use treatment: A secondary analysis. Addict Behav 2023; 139:107574. [PMID: 36565530 DOI: 10.1016/j.addbeh.2022.107574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/10/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Identifying people at risk of poor outcomes following treatment for substance use disorders is important for developing tailored services. The aim of this study was to test whether a brief measure of internalizing and externalizing behavior could identify young adults at high risk of psychiatric care episodes and criminal offending up to four years after enrolment in treatment for substance use disorder. METHODS Clients aged 15-25 years from a randomized multicenter study were included (N = 457). At baseline, all completed the YouthMap12 screener, a measure of internalizing symptoms (IP6) and externalizing problems (EP6). We used accelerated failure time regression to assess time to psychiatric care and criminal offending, adjusting for baseline occurrence, gender, age, treatment group, and uptake area. Youden's J was used to assess optimal cut-points for risk of events. RESULTS The IP6 was associated with shorter time to psychiatric care following treatment enrolment (beta = -0.71, 95% confidence interval [CI] = -0.94 to -0.48; adjusted beta = -0.45, 95% CI = -0.66 to -0.25). The EP6 was associated with shorter time to criminal offending, coefficient = -0.32, 95% CI = -0.44 to -0.19; adjusted coefficient = -0.18, 95% CI = -0.30 to -0.06). Optimal cut-points were two or more for the IP6 and three or more for the EP6. CONCLUSIONS The IP6 and the EP6, two simple and easily administered instruments, can identify young adults who are at an increased risk of future criminal offending or in need of psychiatric care. The findings lend support to using the 12-item YouthMap, as it identifies relevant risks, is compatible with local service delivery needs, and is theoretically and empirically supported.
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Affiliation(s)
- Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, School of Business and Social Sciences, Bartholins Allé 10, 8000 Aarhus C, Denmark.
| | - Sheila Jones
- Department of Social Work, School of Health and Welfare, Dalarna University, Sweden.
| | | | | | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Aarhus University, School of Business and Social Sciences, Bartholins Allé 10, 8000 Aarhus C, Denmark.
| | - Mads Uffe Pedersen
- Department of Social Work, School of Health and Welfare, Dalarna University, Sweden.
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13
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Brummer J, Bloomfield K, Karriker-Jaffe KJ, Pedersen MM, Hesse M. Using the alcohol use disorders identification test to predict hospital admission for alcohol-related conditions in the Danish general population: a record-linkage study. Addiction 2023; 118:86-94. [PMID: 35993432 PMCID: PMC10087303 DOI: 10.1111/add.16034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Most studies validating the alcohol use disorders identification test (AUDIT) have either assessed its factor structure and/or test-retest reliability or used diagnostic interviews as validators of current alcohol use disorders. The aim of the present study was to determine whether AUDIT and AUDIT-Consumption (AUDIT-C) scores are associated with subsequent risk of hospital admission for alcohol-related disorders and diseases (ARDDs). DESIGN We used a historical cohort study. Using national registers, survey respondents were tracked from 1 September 2011 to hospitalization for an ARDD, emigration, death, or 31 December 2018, whichever occurred first. SETTING Denmark. PARTICIPANTS Respondents (n = 4522) from a Danish national survey conducted in autumn 2011. MEASUREMENTS Outcome was incident ARDD admission recorded in the National Patient Register. Predictors were AUDIT and AUDIT-C scores, and covariates were age, gender, highest level of education and previous psychiatric disorder. FINDINGS During the study period, 56 respondents had a first-time ARDD admission. Respondents who scored above the 8-point AUDIT cut-off and respondents who scored above the 5-point AUDIT-C cut-off had a significantly increased risk of being admitted for an ARDD compared with respondents who scored below the cut-offs, (AUDIT: hazard ratio (HR), 4.72; 95% CI, 2.59-8.60; AUDIT-C: HR, 7.97; 95% CI, 3.66-17.31). CONCLUSIONS Scores above alcohol use disorders identification test (AUDIT) and AUDIT-Consumption (AUDIT-C) cut-offs are associated with an increased risk of long-term alcohol-related hospital admissions. At widely used cut-offs, the AUDIT-C is a better predictor of alcohol-related hospitalizations among members of the general population than the full AUDIT.
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Affiliation(s)
- Julie Brummer
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark.,Alcohol Research Group, Public Health Institute, Emeryville, CA, USA.,Institute of Biometry and Clinical Epidemiology, Charité- Universitaetsmedizin Berlin, Berlin, Germany
| | | | | | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark
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14
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Ranganath P, Hjetland GJ, Finserås TR, Brunborg GS, Hesse M, Skogen JC. Negative experiences, social exclusion and unwanted attention on social media: exploring the association with adolescent alcohol use. BMC Public Health 2022; 22:2361. [PMID: 36527010 PMCID: PMC9756586 DOI: 10.1186/s12889-022-14679-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adolescents' presence on Social Media (SoMe) facilitates peer connections making them susceptible to peer-influences and approval. Negative experiences on SoMe can affect adolescent stress and wellbeing, impelling their use of alcohol. This paper provides a novel understanding of the relationship between negative experiences on SoMe and key indicators of alcohol use in adolescents. METHODS Data was collected from upper secondary school students (n = 3528, ages 16-19, 45% boys) in Bergen (Norway) using a web-based questionnaire during school-hours in 2020 and 2021. Dependent variables were alcohol consumption, binge drinking and scoring ≥ 2 points on the CRAFFT instrument screening for substance use problems in adolescents. Independent variables were two scales indicating "negative acts and exclusion" and "unwanted attention from others". Covariates included age, gender, country of birth and subjective socioeconomic status. Results are presented as relative risk ratios (RRR), odds ratios (OR) and incidence rate ratios (IRR) with 95% confidence intervals. RESULTS Using multinomial logistic regression models, "negative acts and exclusion" and "unwanted attention" were positively associated with trying alcohol (OR: 1.50 (95% CI 1.28-1.76) and 1.86 (95% CI 1.66-2.09) respectively, both p ≤ 0.001), with frequency and amount of alcohol consumed. Findings from logistic regression models indicated that "negative acts and exclusion" and "unwanted attention" were positively associated with i. CRAFFT-caseness (OR: 2.13 and 1.86) and ii. frequent binge drinking (OR: 1.55 and 1.89). CONCLUSION Both exclusion and unwanted attention on SoMe were associated with indicators of problematic drinking, including frequency, quantity, and consequences related to alcohol.
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Affiliation(s)
- Priya Ranganath
- grid.7048.b0000 0001 1956 2722Center for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Gunnhild Johnsen Hjetland
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway ,grid.418193.60000 0001 1541 4204Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Turi Reiten Finserås
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Geir Scott Brunborg
- grid.418193.60000 0001 1541 4204Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway ,grid.4714.60000 0004 1937 0626 Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Morten Hesse
- grid.7048.b0000 0001 1956 2722Center for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Jens Christoffer Skogen
- grid.418193.60000 0001 1541 4204Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway ,grid.418193.60000 0001 1541 4204Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway ,grid.412835.90000 0004 0627 2891Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway
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15
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Hesse M, Thylstrup B, Skogen JC. Commentary on Chai et al: Drug use, self-harm, suicide, and use of registry data in epidemiological research. Addiction 2022; 117:1950-1951. [PMID: 35475588 PMCID: PMC9320798 DOI: 10.1111/add.15901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Morten Hesse
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Department of Psychology and Behavioural SciencesAarhus UniversityDenmark
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Department of Psychology and Behavioural SciencesAarhus UniversityDenmark
| | - Jens C. Skogen
- Department of Health PromotionNorwegian Institute of Public HealthBergenNorway,Alcohol and Drug Research Western NorwayStavanger University HospitalStavangerNorway
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16
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Seid AK, Hesse M, Houborg E, Thylstrup B. Substance Use and Violent Victimization: Evidence from a Cohort of >82,000 Patients Treated for Alcohol and Drug Use Disorder in Denmark. J Interpers Violence 2022; 37:NP12427-NP12452. [PMID: 33719700 DOI: 10.1177/0886260521997456] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Although the association between substance use and violence has been well established, knowledge on predictors for violent victimization of individuals treated for alcohol use disorder (AUD) or drug use disorder (DUD) is lacking. Using Goldstein's tripartite conceptual framework, this study examines the relationship between substance use and violent victimization. Data were derived from national registers on persons aged between 15 and 75 years, living in Denmark, and admitted for AUD or DUD treatment during 2006-2016 (n = 82,767). Rates of new incidence of violent victimization were estimated per 10,000 person years for the patient cohort, and for an age- and gender-matched control group of 492,397 people with no history of treatment for drug and alcohol problems. The incidence of victimization for the AUD/DUD sample was 145.6 per 10,000 person years and 5.4 per 10,000 person years for the comparison cohort. Results of multivariate Cox regression on specific types of substance use supported Goldstein's psychopharmacological and economic compulsive models of victimization, but not the systemic model. Gender-stratified results showed that the use of cannabis and methadone was associated with victimization in women treated for AUD and DUD. Patients with a non-Western background were more likely to experience victimization than Danish patients. The study highlights the strong association between substance use disorder and victimization, and the important role that service providers play in addressing the high levels of victimization experienced by patients with AUD or DUD.
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17
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Hasegawa H, Denton RE, Nakamura TKM, Genestreti KJ, Phan TD, Nakamura R, Hwang K, Ahmadi N, Shi QQ, Hesse M, Burch JL, Webster JM, Torbert RB, Giles BL, Gershman DJ, Russell CT, Strangeway RJ, Wei HY, Lindqvist P, Khotyaintsev YV, Ergun RE, Saito Y. Magnetic Field Annihilation in a Magnetotail Electron Diffusion Region With Electron-Scale Magnetic Island. J Geophys Res Space Phys 2022; 127:e2022JA030408. [PMID: 36248013 PMCID: PMC9541864 DOI: 10.1029/2022ja030408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/27/2022] [Accepted: 06/20/2022] [Indexed: 06/16/2023]
Abstract
We present observations in Earth's magnetotail by the Magnetospheric Multiscale spacecraft that are consistent with magnetic field annihilation, rather than magnetic topology change, causing fast magnetic-to-electron energy conversion in an electron-scale current sheet. Multi-spacecraft analysis for the magnetic field reconstruction shows that an electron-scale magnetic island was embedded in the observed electron diffusion region (EDR), suggesting an elongated shape of the EDR. Evidence for the annihilation was revealed in the form of the island growing at a rate much lower than expected for the standard X-type geometry of the EDR, which indicates that magnetic flux injected into the EDR was not ejected from the X-point or accumulated in the island, but was dissipated in the EDR. This energy conversion process is in contrast to that in the standard EDR of a reconnecting current sheet where the energy of antiparallel magnetic fields is mostly converted to electron bulk-flow energy. Fully kinetic simulation also demonstrates that an elongated EDR is subject to the formation of electron-scale magnetic islands in which fast but transient annihilation can occur. Consistent with the observations and simulation, theoretical analysis shows that fast magnetic diffusion can occur in an elongated EDR in the presence of nongyrotropic electron effects. We suggest that the annihilation in elongated EDRs may contribute to the dissipation of magnetic energy in a turbulent collisionless plasma.
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Affiliation(s)
- H. Hasegawa
- Institute of Space and Astronautical ScienceJapan Aerospace Exploration AgencySagamiharaJapan
| | - R. E. Denton
- Department of Physics and AstronomyDartmouth CollegeHanoverNHUSA
| | - T. K. M. Nakamura
- Space Research InstituteAustrian Academy of SciencesGrazAustria
- Institute of PhysicsUniversity of GrazGrazAustria
| | | | - T. D. Phan
- Space Sciences LaboratoryUniversity of CaliforniaBerkeleyCAUSA
| | - R. Nakamura
- Space Research InstituteAustrian Academy of SciencesGrazAustria
| | - K.‐J. Hwang
- Southwest Research InstituteSan AntonioTXUSA
| | - N. Ahmadi
- Laboratory for Atmospheric and Space PhysicsUniversity of ColoradoBoulderCOUSA
| | - Q. Q. Shi
- Shandong Provincial Key Laboratory of Optical Astronomy and Solar‐Terrestrial EnvironmentInstitute of Space SciencesShandong UniversityWeihaiChina
| | - M. Hesse
- NASA Ames Research CenterMoffett FieldCAUSA
| | - J. L. Burch
- Southwest Research InstituteSan AntonioTXUSA
| | | | - R. B. Torbert
- Institute of PhysicsUniversity of GrazGrazAustria
- Physics DepartmentUniversity of New HampshireDurhamNHUSA
| | - B. L. Giles
- NASA Goddard Space Flight CenterGreenbeltMDUSA
| | | | - C. T. Russell
- Department of Earth, Planetary, and Space SciencesUniversity of CaliforniaLos AngelesCAUSA
| | - R. J. Strangeway
- Department of Earth, Planetary, and Space SciencesUniversity of CaliforniaLos AngelesCAUSA
| | - H. Y. Wei
- Department of Earth, Planetary, and Space SciencesUniversity of CaliforniaLos AngelesCAUSA
| | | | | | - R. E. Ergun
- Department of Astrophysical and Planetary SciencesUniversity of ColoradoBoulderCOUSA
| | - Y. Saito
- Institute of Space and Astronautical ScienceJapan Aerospace Exploration AgencySagamiharaJapan
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18
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Hesse M, del Palacio-Gonzalez A, Thylstrup B. Impulsive Lifestyle Counselling versus treatment as usual to reduce offending in people with co-occurring antisocial personality disorder and substance use disorder: a post hoc analysis. BMC Psychiatry 2022; 22:392. [PMID: 35689188 PMCID: PMC9188147 DOI: 10.1186/s12888-022-04025-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/30/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To assess the impact of a short psychoeducation intervention for antisocial personality disorder on offending after randomization to treatment. DESIGN Multicentre, superiority, non-blinded randomized controlled trial. Random assignment was conducted in blocks of varying sizes at a central randomization centre. Participants were followed using national register data until 365 days after randomization, migration, or death, whichever occurred first. SETTING Thirteen outpatient uptake areas in Denmark. PARTICIPANTS Patients with antisocial personality disorder in treatment for substance use disorders were randomized to treatment as usual (TAU, n = 80) or Impulsive Lifestyle Counselling (ILC, n = 96). A total of 165 patients could be linked to criminal records (TAU, n = 74; ILC, n = 91). INTERVENTION ILC is a brief psychoeducational program targeting antisocial behavior. The trial was conducted between January 2012 and June 2014. OUTCOMES Number of criminal offences leading to convictions based on national registers. RESULTS The mean number of offences was 2.76 in the TAU group (95% Poisson confidence interval [CI] = 2.39, 3.16) and 1.87 in the ILC group (95% CI = 0.97, 1.43). Negative binomial regression was used to assess total number of convictions, as well as convictions for violent, property, driving under the influence, and drug-related crimes. In both adjusted and unadjusted analyses, random assignment to ILC was associated with a lower number of total offences (incidence rate risk ratio [IRR] = 0.43, p = .013; adjusted IRR = 0.45, p < .001) and convictions related to violence (IRR = 0.19, p = .001 adjusted IRR = 0.19, p = .007) and property offences (unadjusted IRR = 0.30, p = 0.003, adjusted IRR = 0.42, p = 0.010). Differences between conditions were not significant for driving under the influence (unadjusted IRR = 0.49, p = .370; adjusted IRR = 0.53, p = .417) or drug offences (unadjusted IRR = 1.06, p = .907; adjusted IRR = 0.55, p = .223). CONCLUSIONS The ILC program shows promise in reducing offending behavior in people with comorbid substance use and antisocial personality disorder. TRIAL REGISTRATION ISRCTN registry, ISRCTN67266318 , 15/10/2012.
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Affiliation(s)
- Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000, Aarhus C, Denmark.
| | - Adriana del Palacio-Gonzalez
- grid.7048.b0000 0001 1956 2722Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus C, Denmark
| | - Birgitte Thylstrup
- grid.7048.b0000 0001 1956 2722Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus C, Denmark
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19
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Phan TD, Verniero JL, Larson D, Lavraud B, Drake JF, Øieroset M, Eastwood JP, Bale SD, Livi R, Halekas JS, Whittlesey PL, Rahmati A, Stansby D, Pulupa M, MacDowall RJ, Szabo PA, Koval A, Desai M, Fuselier SA, Velli M, Hesse M, Pyakurel PS, Maheshwari K, Kasper JC, Stevens JM, Case AW, Raouafi NE. Parker Solar Probe Observations of Solar Wind Energetic Proton Beams Produced by Magnetic Reconnection in the Near-Sun Heliospheric Current Sheet. Geophys Res Lett 2022; 49:e2021GL096986. [PMID: 35864893 PMCID: PMC9286436 DOI: 10.1029/2021gl096986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/21/2022] [Accepted: 03/30/2022] [Indexed: 06/09/2023]
Abstract
We report observations of reconnection exhausts in the Heliospheric Current Sheet (HCS) during Parker Solar Probe Encounters 08 and 07, at 16 R s and 20 R s , respectively. Heliospheric current sheet (HCS) reconnection accelerated protons to almost twice the solar wind speed and increased the proton core energy by a factor of ∼3, due to the Alfvén speed being comparable to the solar wind flow speed at these near-Sun distances. Furthermore, protons were energized to super-thermal energies. During E08, energized protons were found to have leaked out of the exhaust along separatrix field lines, appearing as field-aligned energetic proton beams in a broad region outside the HCS. Concurrent dropouts of strahl electrons, indicating disconnection from the Sun, provide further evidence for the HCS being the source of the beams. Around the HCS in E07, there were also proton beams but without electron strahl dropouts, indicating that their origin was not the local HCS reconnection exhaust.
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Affiliation(s)
- T. D. Phan
- SSLUniversity of CaliforniaBerkeleyCAUSA
| | | | - D. Larson
- SSLUniversity of CaliforniaBerkeleyCAUSA
| | - B. Lavraud
- Laboratoire d'Astrophysique de BordeauxUniversity BordeauxPessacFrance
- IRAPCNRSCNESUniversité de ToulouseToulouseFrance
| | | | | | | | - S. D. Bale
- SSLUniversity of CaliforniaBerkeleyCAUSA
- Physics DepartmentUniversity of CaliforniaBerkeleyCAUSA
| | - R. Livi
- SSLUniversity of CaliforniaBerkeleyCAUSA
| | | | | | - A. Rahmati
- SSLUniversity of CaliforniaBerkeleyCAUSA
| | - D. Stansby
- Mullard Space Science LaboratoryUniversity College LondonDorkingUK
| | - M. Pulupa
- SSLUniversity of CaliforniaBerkeleyCAUSA
| | | | - P. A. Szabo
- NASA Goddard Space Flight CenterGreenbeltMDUSA
| | - A. Koval
- NASA Goddard Space Flight CenterGreenbeltMDUSA
- University of MarylandBaltimore CountyBaltimoreMDUSA
| | - M. Desai
- Southwest Research InstituteSan AntonioTXUSA
| | | | - M. Velli
- University of CaliforniaLos AngelesCAUSA
| | - M. Hesse
- NASA Ames Research CenterMoffett FieldCAUSA
| | | | | | - J. C. Kasper
- Climate and Space Sciences and EngineeringUniversity of MichiganAnn ArborMIUSA
| | | | - A. W. Case
- Smithsonian Astrophysical ObservatoryCambridgeMAUSA
| | - N. E. Raouafi
- Johns Hopkins University Applied Physics LaboratoryLaurelMDUSA
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20
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Hamina A, Muller AE, Clausen T, Skurtveit S, Hesse M, Tjagvad C, Thylstrup B, Odsbu I, Zoega H, Jónsdóttir HL, Taipale H. Prescription opioids among older adults: ten years of data across five countries. BMC Geriatr 2022; 22:429. [PMID: 35578167 PMCID: PMC9112605 DOI: 10.1186/s12877-022-03125-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 05/09/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Opioid use has increased globally in the recent decade. Although pain remains a significant problem among older adults, susceptibility to opioid-related harms highlights the importance of careful opioid therapy monitoring on individual and societal levels. We aimed to describe the trends of prescription opioid utilisation among residents aged ≥65 in all Nordic countries during 2009-2018. METHODS We conducted cross-sectional measurements of opioid utilisation in 2009-2018 from nationwide registers of dispensed drugs in Denmark, Finland, Iceland, Norway, and Sweden. The measures included annual opioid prevalence, defined daily doses (DDDs) per 1000 inhabitants per day (DIDs), and morphine milligram equivalents (MMEs) per user per day. RESULTS From 2009 to 2018, an average of 808,584 of adults aged ≥65 used opioids yearly in all five countries; an average annual prevalence of 17.0%. During this time period, the prevalence decreased in Denmark, Norway, and Sweden due to declining codeine and/or tramadol use. Iceland had the highest opioid prevalence in 2009 (30.2%), increasing to 31.7% in 2018. In the same period, DIDs decreased in all five countries, and ranged from 28.3 in Finland to 58.5 in Denmark in 2009, and from 23.0 in Finland to 54.6 in Iceland in 2018. MMEs/user/day ranged from 4.4 in Iceland to 19.6 in Denmark in 2009, and from 4.6 in Iceland to 18.8 in Denmark in 2018. In Finland, Norway, and Sweden, MMEs/user/day increased from 2009 to 2018, mainly due to increasing oxycodone utilisation. CONCLUSIONS The stable or decreasing opioid utilisation prevalence among a majority of older adults across the Nordic countries coincides with an increase in treatment intensity in 2009-2018. We found large cross-national differences despite similarities across the countries' cultures and healthcare systems. For the aged population, national efforts should be placed on improving pain management and monitoring future trends of especially oxycodone utilisation.
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Affiliation(s)
- A. Hamina
- grid.5510.10000 0004 1936 8921Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, PO Box 1171, 0218 Oslo, Norway ,grid.9668.10000 0001 0726 2490School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - A. E. Muller
- grid.418193.60000 0001 1541 4204Division of Reviews and Health Technology Assessments, Norwegian Institute of Public Health, Oslo, Norway
| | - T. Clausen
- grid.5510.10000 0004 1936 8921Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, PO Box 1171, 0218 Oslo, Norway
| | - S. Skurtveit
- grid.5510.10000 0004 1936 8921Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, PO Box 1171, 0218 Oslo, Norway ,grid.418193.60000 0001 1541 4204Department of Mental Disorders, Division of Mental and Physical Health, the Norwegian Institute of Public Health, Oslo, Norway
| | - M. Hesse
- grid.7048.b0000 0001 1956 2722Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - C. Tjagvad
- grid.5510.10000 0004 1936 8921Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, PO Box 1171, 0218 Oslo, Norway
| | - B. Thylstrup
- grid.7048.b0000 0001 1956 2722Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - I. Odsbu
- grid.418193.60000 0001 1541 4204Department of Mental Disorders, Division of Mental and Physical Health, the Norwegian Institute of Public Health, Oslo, Norway
| | - H. Zoega
- grid.1005.40000 0004 4902 0432Centre for Big Data Research in Health, Faculty of Medicine & Health, UNSW Sydney, Sydney, Australia ,grid.14013.370000 0004 0640 0021Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - H. L. Jónsdóttir
- grid.14013.370000 0004 0640 0021Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland ,grid.14013.370000 0004 0640 0021Faculty of Psychology, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - H. Taipale
- grid.9668.10000 0001 0726 2490School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland ,grid.4714.60000 0004 1937 0626Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden ,grid.466951.90000 0004 0391 2072Niuvanniemi Hospital, Kuopio, Finland
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21
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Hellum R, Bilberg R, Andersen K, Bischof G, Hesse M, Nielsen AS. Primary Outcome from a cluster-randomized trial of three formats for delivering Community Reinforcement and Family Training (CRAFT) to the significant others of problem drinkers. BMC Public Health 2022; 22:928. [PMID: 35538465 PMCID: PMC9087923 DOI: 10.1186/s12889-022-13293-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/04/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Community Reinforcement and Family Training (CRAFT) is an intervention designed to help the concerned significant others (CSOs) of people with alcohol problems who are reluctant to seek treatment. It aims to improve the well-being of CSOs and teach them how to change their behavior in order to positively influence the "identified patient" (IP) to seek treatment. METHODS The aim of the present pragmatic cluster-randomized trial was to compare the effectiveness of three formats for delivering CRAFT in real life settings: group sessions, individual sessions, and written material only (control group). Eighteen public treatment centers for alcohol use disorders were randomly assigned to deliver CRAFT in one of the three formats as part of their daily clinical routine. CSOs were recruited via pamphlets, general practitioners, and advertisements on social media. Trained clinicians delivered CRAFT in individual and group format, and self-administered CRAFT was limited to handing out a self-help book. The primary outcome was treatment engagement of the IP after three months. RESULTS A total of 249 CSOs were found to be eligible and randomly assigned to receive CRAFT delivered in group, individual, or self-administered format. The three-month follow-up rate was 60%. At three months follow-up, 29% (n = 32) of the CSOs who received group/individual CRAFT reported that their IP had engaged in treatment. The corresponding rate for the CSOs who received self-administered CRAFT was lower (15%; n = 5) but did not differ significantly from the other group of CSOs (Odds ratio (OR) = 2.27 (95% CI: 0.80, 6.41)). CONCLUSION We hypothesized that CSOs receiving CRAFT in a group format would improve the most, but although our findings pointed in this direction, the differences were not statistically significant. TRIAL REGISTRATION Clinical trials.gov ID: NCT03281057 . Registration date:13/09/2017.
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Affiliation(s)
- Rikke Hellum
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark
| | - Randi Bilberg
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark.
| | - Kjeld Andersen
- Psychiatric Department, Region of Southern Denmark, Odense, Denmark
| | - Gallus Bischof
- The Department of Psychiatry and Psychotherapy, University of Luebeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Department of Psychological and Behavioral Sciences, Aarhus University, Artillerivej 90, 2, 2300, Copenhagen S, Denmark
| | - Anette Søgaard Nielsen
- The Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws vej 18, 5000, Odense C, Denmark
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22
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Brummer J, Bloomfield K, Karriker-Jaffe KJ, Hesse M. Hazardous drinking and violence-related hospitalizations in the Danish general population: A historical cohort study. Drug Alcohol Depend 2022; 233:109338. [PMID: 35152098 DOI: 10.1016/j.drugalcdep.2022.109338] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/04/2022] [Accepted: 01/23/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND It is well documented by case-control and case-crossover studies that hazardous drinking and the risk of experiencing violence-related injuries are related. The present study investigated this relationship in a cohort of general population survey respondents in Denmark using subsequent hospital admissions for violence. METHODS The cohort consisted of participants in the 2011 Danish national survey on alcohol and drugs (N = 5126). Survey responses were used to identify those with hazardous alcohol use. Register data on the cohort's hospital admissions for violence from 2010 through 2018 served as the outcome. The relationship between respondents' hazardous drinking and counts of subsequent hospital admissions was investigated using a Poisson regression model. RESULTS After controlling for confounding, respondents with hazardous consumption (Alcohol Use Disorders Identification Test Consumption [AUDIT-C] cut off: 5 points) had an increased rate of hospital admissions for violence, with an incidence rate ratio (IRR) of 2.28 (95% CI: 1.16-4.50) compared to respondents without hazardous alcohol use. Each additional AUDIT-C point was associated with a 20% increase in the incidence rate for violence-related admission (IRR=1.20, 95% CI: 1.06-1.37). Furthermore, interaction analyses showed a significant interaction between gender and AUDIT-C score on hospital admissions for violence (IRR=0.69, 95% CI: 0.53-0.90). CONCLUSIONS Results provide evidence that hazardous alcohol use is associated with subsequent hospital admissions for violence in the Danish general population and that gender moderates this relationship.
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Affiliation(s)
- Julie Brummer
- Centre for Alcohol and Drug Research, Emdrup Campus, Aarhus BSS, Aarhus University, Tuborgvej 164, Building A, 2nd Floor, 2400 Copenhagen NV, Denmark.
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Emdrup Campus, Aarhus BSS, Aarhus University, Tuborgvej 164, Building A, 2nd Floor, 2400 Copenhagen NV, Denmark; Alcohol Research Group, Public Health Institute, 6001 Shellmound St Suite 450, Emeryville, CA 94608, USA.
| | | | - Morten Hesse
- Centre for Alcohol and Drug Research, Emdrup Campus, Aarhus BSS, Aarhus University, Tuborgvej 164, Building A, 2nd Floor, 2400 Copenhagen NV, Denmark.
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23
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Bukten A, Lokdam NT, Skjærvø I, Ugelvik T, Skurtveit S, Gabrhelík R, Skardhamar T, Lund IO, Havnes IA, Rognli EB, Chang Z, Fazel S, Friestad C, Hesse M, Lothe J, Ploeg G, Dirkzwager AJE, Clausen T, Tjagvad C, Stavseth MR. PriSUD-Nordic-Diagnosing and Treating Substance Use Disorders in the Prison Population: Protocol for a Mixed Methods Study. JMIR Res Protoc 2022; 11:e35182. [PMID: 35320114 PMCID: PMC8987966 DOI: 10.2196/35182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 11/20/2022] Open
Abstract
Background A large proportion of the prison population experiences substance use disorders (SUDs), which are associated with poor physical and mental health, social marginalization, and economic disadvantage. Despite the global situation characterized by the incarceration of large numbers of people with SUD and the health problems associated with SUD, people in prison are underrepresented in public health research. Objective The overall objective of the PriSUD (Diagnosing and Treating Substance Use Disorders in Prison)-Nordic project is to develop new knowledge that will contribute to better mental and physical health, improved quality of life, and better life expectancies among people with SUD in prison. Methods PriSUD-Nordic is based on a multidisciplinary mixed method approach, including the methodological perspectives of both quantitative and qualitative methods. The qualitative part includes ethnographic fieldwork and semistructured interviews. The quantitative part is a registry-based cohort study including national registry data from Norway, Denmark, and Sweden. The national prison cohorts will comprise approximately 500,000 individuals and include all people imprisoned in Norway, Sweden, and Demark during the period from 2000 to 2019. The project will investigate the prison population during three different time periods: before imprisonment, during imprisonment, and after release. Results PriSUD-Nordic was funded by The Research Council of Norway in December 2019, and funding started in 2020. Data collection is ongoing and will be completed in the first quarter of 2022. Data will be analyzed in spring 2022 and the results will be disseminated in 2022-2023. The PriSUD-Nordic project has formal ethical approval related to all work packages. Conclusions PriSUD-Nordic will be the first research project to investigate the epidemiology and the lived experiences of people with SUD in the Nordic prison population. Successful research in this field will have the potential to identify significant areas of benefit and will have important implications for ongoing policy related to interventions for SUD in the prison population. International Registered Report Identifier (IRRID) DERR1-10.2196/35182
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Affiliation(s)
- Anne Bukten
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Nicoline Toresen Lokdam
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingeborg Skjærvø
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Thomas Ugelvik
- Department of Criminology and Sociology of Law, University of Oslo, Oslo, Norway
| | - Svetlana Skurtveit
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.,Department of Mental Disorders, Division of Mental and Physical Health, The Norwegian Institute of Public Health, Oslo, Norway
| | - Roman Gabrhelík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Torbjørn Skardhamar
- Department of Sociology and Human Geography, University of Oslo, Oslo, Norway
| | - Ingunn Olea Lund
- Department of Mental Disorders, Division of Mental and Physical Health, The Norwegian Institute of Public Health, Oslo, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingrid Amalia Havnes
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Adult Psychiatry Unit, University of Oslo, Oslo, Norway
| | - Eline Borger Rognli
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Christine Friestad
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,University College of Norwegian Correctional Service, Lillestrøm, Norway
| | - Morten Hesse
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Johan Lothe
- WayBack, Foundation for Life After Imprisonment, Oslo, Norway
| | - Gerhard Ploeg
- Directorate of Norwegian Correctional Service, Lillestrøm, Norway
| | - Anja J E Dirkzwager
- Netherlands Institute for the Study of Crime and Law Enforcement, Amsterdam, Netherlands
| | - Thomas Clausen
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Christian Tjagvad
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Marianne Riksheim Stavseth
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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24
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Frederiksen KS, Hesse M, Brummer J, Pedersen MU. The impact of parental substance use disorder and other family-related problems on school related outcomes. Drug Alcohol Depend Rep 2022; 3:100041. [PMID: 36845994 PMCID: PMC9948819 DOI: 10.1016/j.dadr.2022.100041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/11/2022] [Accepted: 03/11/2022] [Indexed: 11/18/2022]
Abstract
Aims To identify young people with different levels of family-related problems, including parental substance use disorder (PSUD), and investigate differences in grades at graduation from compulsory school and further enrollment in education. Methods Participants included 6784 emerging adults (aged 15-25 years) from samples drawn for two national surveys in Denmark 2014-2015. Latent classes were constructed using the following parental variables: PSUD, offspring not living with both parents, and parental criminality, mental disorders, chronic diseases and long-term unemployment. The characteristics were analyzed using an independent one-way ANOVA. Differences in grade point average and further enrollment were analyzed using linear regression and logistic regression, respectively. Results Four classes of families were identified: 1. "Low adverse childhood experiences (ACE) families", 2. "Families with PSUD", 3. "Families with unemployment" and 4. "High ACE families". There were significant differences in grades, with the highest average among youth from "Low ACE families" (males = 6.83; females = 7.40) and significant lower averages among both males and females from the other types of families, but lowest among young people from "High ACE families" (Males = 5.58; females = 5.79). Youth from "Families with PSUD" (Males: OR = 1.51; 95% CI: 1.01-2.26; females: OR = 2.16; 95% CI: 1.22-3.85) and "High ACE families" (Males: OR = 1.78; 95% CI: 1.11-2.26) were significantly more likely not to be enrolled in further education compared with "Low ACE families". Conclusions Young people who experience PSUD, both as the primary family-related problem as well as among multiple family-related problems, are at increased risk for negative school-related outcomes.
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25
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Niemann P, Schiffer M, Carls E, Geisen C, Hesse M, Mohammadi MM, Bakhtiary F, Fleischmann BK, Roell W. Inducible Overexpression of Connexin 43 in Cardiac Myofibroblasts to Mitigate Postinfarct Electrical Vulnerability. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1742853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- P. Niemann
- Institute of Physiology 1, Universität Bonn, Bonn, Deutschland
| | - M. Schiffer
- Department of Cardiac Surgery, Universitätsklinikum Bonn, Bonn, Deutschland
| | - E. Carls
- Department of Cardiac Surgery, Universitätsklinikum Bonn, Bonn, Deutschland
| | - C. Geisen
- Department of Cardiac Surgery, Universitätsklinikum Bonn, Bonn, Deutschland
| | - M. Hesse
- Institute of Physiology 1, Universität Bonn, Bonn, Deutschland
| | | | - F. Bakhtiary
- Department of Cardiac Surgery, Universitätsklinikum Bonn, Bonn, Deutschland
| | - B. K. Fleischmann
- Institute of Physiology 1, University of Bonn, Medical Faculty, Bonn, Deutschland
| | - W. Roell
- Department of Cardiac Surgery, Universitätsklinikum Bonn, Bonn, Deutschland
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26
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Mårtensson S, Johansen KS, Hesse M, Jobe LB, Düring SW. Changes in co-occurring substance diagnosis among patients admitted to psychiatric treatment over a twenty-year period. Acta Psychiatr Scand 2022; 145:226-228. [PMID: 35044687 DOI: 10.1111/acps.13389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/17/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Solvej Mårtensson
- Competence Centre for Dual Diagnosis, Mental Health Services Capital Region of Denmark, Kobenhavn, Denmark
| | - Katrine S Johansen
- Competence Centre for Dual Diagnosis, Mental Health Services Capital Region of Denmark, Kobenhavn, Denmark
| | - Morten Hesse
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Lei B Jobe
- Competence Centre for Dual Diagnosis, Mental Health Services Capital Region of Denmark, Kobenhavn, Denmark
| | - Signe W Düring
- Competence Centre for Dual Diagnosis, Mental Health Services Capital Region of Denmark, Kobenhavn, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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27
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Sander S, Ebert T, Hartnagel D, Hesse M, Pan X, Schaumann G, Šmíd M, Falk K, Roth M. Microstructured layered targets for improved laser-induced x-ray backlighters. Phys Rev E 2021; 104:065207. [PMID: 35030937 DOI: 10.1103/physreve.104.065207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
We present the usage of two-layer targets with laser-illuminated front-side microstructures for x-ray backlighter applications. The targets consisted of a silicon front layer and copper back side layer. The structured layer was irradiated by the 500-fs PHELIX laser with an intensity above 10^{20}Wcm^{-2}. The total emission and one-dimensional extent of the copper Kα x-ray emission as well as a wide spectral range between 7.9 and 9.0 keV were recorded with an array of crystal spectrometers. The measurements show that the front-side modifications of the silicon in the form of conical microstructures maintain the same peak brightness of the Kα emission as flat copper foils while suppressing the thermal emission background significantly. The observed Kα source sizes can be influenced by tilting the conical microstructures with respect to the laser axis. Overall, the recorded copper Kα photon yields were in the range of 10^{11}sr^{-1}, demonstrating the suitability of these targets for probing applications without subjecting the probed material to additional heating from thermal line emission.
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Affiliation(s)
- S Sander
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - T Ebert
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - D Hartnagel
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - M Hesse
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - X Pan
- Helmholtz-Zentrum Dresden-Rossendorf, 01328 Dresden, Germany
- Technische Universität Dresden, 01062 Dresden, Germany
| | - G Schaumann
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
| | - M Šmíd
- Helmholtz-Zentrum Dresden-Rossendorf, 01328 Dresden, Germany
| | - K Falk
- Helmholtz-Zentrum Dresden-Rossendorf, 01328 Dresden, Germany
- Technische Universität Dresden, 01062 Dresden, Germany
- Institute of Physics of the ASCR, 182 21 Prague, Czech Republic
| | - M Roth
- Institut für Kernphysik, Fachbereich Physik, Technische Universität Darmstadt, 64289 Darmstadt, Germany
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28
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Hesse M, Thomsen KR, Thylstrup B, Andersen CU, Reitzel LA, Worm-Leonhard M, Lindholst C. Purity of street-level cocaine across Denmark from 2006 to 2019: Analysis of seized cocaine. Forensic Sci Int 2021; 329:111050. [PMID: 34736046 DOI: 10.1016/j.forsciint.2021.111050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 09/29/2021] [Accepted: 10/05/2021] [Indexed: 10/20/2022]
Abstract
Cocaine-related emergency department admissions are increasing, and cocaine seizures are at an all-time high in Europe. Our aim was to investigate the trends in purity and adulterants over time in cocaine available to cocaine users at street level in Denmark. We used a representative sample of cocaine seized at street level and analyzed by the national departments of forensic medicine between 2006 and 2019 (n = 1460). Latent profile analysis was used to classify the samples based on cocaine, levamisole, and phenacetin content. Low purity cocaine comprised most of the cocaine seizures in early years, but its share began to decline in 2013, and from 2016 to 2019, the high purity profile was dominant. While the total number of samples containing adulterants decreased, levamisole remained a common and dangerous adulterant. The findings underline the need to inform the public, medical doctors, and service providers for people with drug use disorders about the higher potency of street cocaine.
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Affiliation(s)
- Morten Hesse
- Aarhus University, Center for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark.
| | - Kristine Rømer Thomsen
- Aarhus University, Center for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark.
| | - Birgitte Thylstrup
- Aarhus University, Center for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark.
| | - Charlotte Uggerhøj Andersen
- Aarhus University, Department of Forensic Medicine, Palle Juul-Jensens Boulevard 99, Building Z, 3.017, 8200 Aarhus N, Denmark.
| | | | | | - Christian Lindholst
- Aarhus University, Department of Forensic Medicine, Palle Juul-Jensens Boulevard 99, Building Z, 3.017, 8200 Aarhus N, Denmark.
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29
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Abad-Jorge A, Hesse M, Torisky D, Akers J. Implementing Online Best Practices and Learning Community during the Pandemic in a Nutrition Course for Nutrition and Health Sciences Majors. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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30
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Hesse M, Ebert T, Zimmer M, Scheuren S, Schaumann G, Roth M. Spatially resolved online particle detector using scintillators for laser-driven particle sources. Rev Sci Instrum 2021; 92:093302. [PMID: 34598491 DOI: 10.1063/5.0052507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
Laser-based particle accelerators have been an active field of research for over two decades moving from laser systems capable of one shot every hour to systems able to deliver repetition rates in the Hz regime. Based on the advancements in laser technology, the corresponding detection methods need to develop from single to multiple use with high readout speed. Here, we present an online compact tracker of particles using scintillators with nine resolvable energy levels and a spatial resolution of 3.6 × 3.6 mm2 over the whole active area. This paper describes the design and construction of the detector, which is based on pixellated scintillators embedded inside an absorber matrix. The scintillator pixels are fiberoptically coupled to a camera system for online readout and analysis. Calibration with a radioactive source and first experimental data measuring laser accelerated ions at the PHELIX laser at GSI, Darmstadt, Germany, are presented and discussed.
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Affiliation(s)
- M Hesse
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - T Ebert
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - M Zimmer
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - S Scheuren
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - G Schaumann
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
| | - M Roth
- Technische Universität Darmstadt, Department of Physics, Institut für Kernphysik, Schlossgartenstr. 9, 64289 Darmstadt, Germany
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Del Palacio-Gonzalez A, Hesse M, Thylstrup B, Pedersen MU, Pedersen MM. Effects of contingency management and use of reminders for drug use treatment on readmission and criminality among young people: A linkage study of a randomized trial. J Subst Abuse Treat 2021; 133:108617. [PMID: 34544626 DOI: 10.1016/j.jsat.2021.108617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 07/14/2021] [Accepted: 08/25/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION An increasing number of adolescents and emerging adults are entering treatment for drug use disorders in high-income countries. This fact points not only to a need to evaluate treatment outcomes related to drug use reduction, but also to evaluate other indicators of treatment success. The aim of this study was to examine treatment effects on predicting readmission to drug use treatment and being convicted for a criminal offence among youth. A second aim was to examine whether a psychiatric history had an impact on these outcomes. METHODS Participants were 460 youth aged 15-25 who took part in the YouthDAT, a randomized pragmatic clinical trial for outpatient drug use treatment. The trial compared four treatment conditions consisting of 12 sessions of a manualized treatment based on cognitive behavioral therapy and motivational interviewing. Condition one was the standard (only the manual); condition two consisted of standard treatment and contingency management (CM) (Vouchers); condition three included standard treatment, text reminders, and low-intensity aftercare (Reminders+LIA); and condition four combined the standard treatment, CM, text reminders, and low-intensity aftercare (Combined+LIA). The study linked participants to register data on psychiatric history, drug use treatment history, and criminal convictions. RESULTS Treatment conditions Reminders+LIA (aB = 0.42, p = .026) and Combined+LIA (aB = 0.69, p = .000) predicted longer time to readmission compared to standard treatment. The Vouchers condition predicted a lower risk for criminal convictions (aIRR = 0.26, p = .001). Half of the participants had a psychiatric history. The treatments with additional strategies were useful in delaying readmission and reducing convictions for these youth. The results remained significant in the adjusted models accounting for relevant participant characteristics. CONCLUSIONS Additional treatment strategies in outpatient drug use treatment, such as CM, text reminders, and low-intensity aftercare, predicted delayed readmission to treatment and fewer legal problems. Mental health problems were common among youth. However, the treatments with additional strategies were effective with youth with a psychiatric history. Overall, while the additional strategies may be resource demanding for clinical settings, they support treatment success and may also help to decrease other public costs. TRIAL REGISTRATION ISRCTN registry ISRCTN27473213.
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Affiliation(s)
- Adriana Del Palacio-Gonzalez
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Mads Uffe Pedersen
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Michael Mulbjerg Pedersen
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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Hesse M, Thylstrup B, Seid AK, Tjagvad C, Clausen T. A retrospective cohort study of medication dispensing at pharmacies: Administration matters! Drug Alcohol Depend 2021; 225:108792. [PMID: 34118551 DOI: 10.1016/j.drugalcdep.2021.108792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/26/2021] [Accepted: 03/27/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Opioid agonist treatment (OAT) for opioid use disorders may be delivered at treatment clinics or dispensed from pharmacies, however the type of delivery may be associated with different risks and benefits. The aim of the study was to investigate whether dispensing of methadone or buprenorphine at pharmacies during treatment for opioid use disorders was associated with adverse outcomes. METHODS Retrospective cohort study using a national, linked, population-level data set from Denmark. Patients included were between 18 and 75 years, living in Denmark, and admitted for treatment for opioid use disorders during 2000-2016 (n = 9299). Cox proportional hazards regression was estimated for convictions, non-fatal overdoses, and death, after the first dispensing of either methadone or buprenorphine from a pharmacy after starting treatment. FINDINGS Of all patients, 68 % had methadone and 31 % had buprenorphine dispensed at a pharmacy. Compared with the time prior to pharmacy dispension, the risk of criminal convictions increased after having methadone dispensed from a pharmacy (adjusted hazard ratio (aHR) = 1.22, 95 % confidence interval (CI) = 1.16-1.28), non-fatal overdoses (aHR = 1.55, CI 1.41-1.71), and all-cause mortality (aHR = 1.54, CI = 1.43-1.76). After having buprenorphine dispensed at a pharmacy, risk of criminal convictions increased (aHR = 1.08, CI = 1.01-1.16) and non-fatal overdoses (aHR = 1.31, CI = 1.18-1.45), but not all-cause mortality (aHR = 1.07, CI = 0.94-1.23). CONCLUSIONS For almost all outcomes investigated across medication type, the risk of adverse events increased following a switch from clinic dispension to pharmacy dispension of medications in OAT. Medically responsible and safe provision of OAT may often require more clinical follow-up than what is typically provided when medication is dispensed at pharmacies.
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Affiliation(s)
- Morten Hesse
- Center for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000, Aarhus C, Denmark.
| | - Birgitte Thylstrup
- Center for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000, Aarhus C, Denmark.
| | - Abdu Kedir Seid
- Center for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000, Aarhus C, Denmark.
| | - Christian Tjagvad
- Norwegian Centre for Addiction Research (SERAF), University of Oslo, Bygg 45, Ullevål sykehus, Kirkeveien 166, 0450, Oslo, Norway.
| | - Thomas Clausen
- Norwegian Centre for Addiction Research (SERAF), University of Oslo, Bygg 45, Ullevål sykehus, Kirkeveien 166, 0450, Oslo, Norway.
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Frederiksen KS, Hesse M, Grittner U, Pedersen MU. Estimating perceived parental substance use disorder: Using register data to adjust for non-participation in survey research. Addict Behav 2021; 119:106897. [PMID: 33878599 DOI: 10.1016/j.addbeh.2021.106897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 11/18/2022]
Abstract
AIMS To estimate the prevalence of parental substance use disorder (PSUD) in the general population based on young adults' reports adjusted for non-participation using register-based indicators of PSUD. DESIGN A national sample survey study combined with a retrospective register-based study. Setting Denmark. Participants 10,414 young people (aged 15-25 years) invited to two national sample surveys in 2014 and 2015 (5,755 participants and 4,659 non-participants). MEASUREMENTS A crude prevalence of PSUD was calculated based on participants' reports. Parental data from medical, mortality, prescription, and treatment registers (from the young adults' birth until the time of the surveys) were used to estimate a register-based prevalence of PSUD for both participants and non-participants. Differences between participants and non-participants were analysed using bivariate comparisons. Inverse probability weighting was used to adjust for bias due to non-participation. The crude prevalence of PSUD based on survey data was adjusted using the ratio of incidence proportion of the register-based PSUD compared with the survey-based PSUD. FINDINGS A total of 731 (12.7%) of the 5,755 survey participants reported PSUD. Register-based PSUD was more common among non-participants (856/4,659; 18.4%) compared with participants (738/5,755; 12.8%, OR = 1.53, 95% CI 1.38-1.70). The adjusted estimate of the survey-based PSUD increased by 2.5 percentage points, from 12.7% to 15.2%. CONCLUSIONS In the absence of register data, youth-reported PSUD is likely to underestimate the number of young people experiencing PSUD.
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Affiliation(s)
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
| | - Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Germany; Berlin Institute of Health, Berlin, Germany
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Hesse M, Thylstrup B, Karsberg S, Mulbjerg Pedersen M, Pedersen MU. Voucher Reinforcement Decreases Psychiatric Symptoms in Young People in Treatment for Drug Use Disorders - A Post Hoc Secondary Analysis of a Randomized Controlled Trial. J Dual Diagn 2021; 17:257-266. [PMID: 34289330 DOI: 10.1080/15504263.2021.1942379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This multicenter, parallel randomized, open study examined the effect of using vouchers and session reminders as an added element to outpatient treatment for drug use disorders in youth. It was hypothesized that being randomly assigned to a contingency management condition would lead to a reduction of psychiatric symptoms, and that this reduction would be mediated through abstinence and treatment completion. METHODS A total of 460 participants aged 15 to 25 years from nine outpatient sites were randomized to one of four treatment conditions (standard treatment alone [STD], i.e., 12 sessions using motivational interviewing and cognitive behavioral therapy, STD plus vouchers for attendance [VOU], STD plus text reminders [REM], or STD plus vouchers and text reminders [REM + VOU]). Participants' symptoms of psychological distress were assessed using the YouthMap 12 instrument at intake, and at 3, 6, and 9 months post-treatment initiation. Interviewers were blinded to interventions. RESULTS 114 participants were randomized to STD, 112 to REM, 113 to VOU, and 121 to VOU + REM. 69 clients were never interviewed for follow-up, leaving 391 for analysis (n = 90, n = 94, n = 99, n = 108). The mean age was 20.5 years (SD = 2.6), 23% were female, and 34% reported having a psychiatric diagnosis. Random effects regression showed that participants randomized to one of the two voucher-based conditions experienced significantly steeper declines in symptoms compared with STD (p < .01). Structural equation modeling results indicated that the effects of contingency management on symptoms were mediated through abstinence, but not sessions attended. CONCLUSIONS Adding contingency management to interventions for drug use disorders can reduce symptoms of psychological and emotional distress among populations of treatment-seeking youth, in part due to indirect effects through abstinence at follow-up. The data is collected from a clinical trial registered as ISRCTN27473213, at https://www.isrctn.com/.
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Affiliation(s)
- Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
| | | | - Sidsel Karsberg
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
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Brummer J, Hesse M, Frederiksen KS, Karriker-Jaffe KJ, Bloomfield K. How Do Register-Based Studies Contribute to Our Understanding of Alcohol's Harms to Family Members? A Scoping Review of Relevant Literature. J Stud Alcohol Drugs 2021; 82:445-456. [PMID: 34343075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
OBJECTIVE This review maps the research literature on register-based studies of alcohol's harms to family members and identifies areas for future research. METHOD Using a scoping review methodology, the PubMed/MEDLINE, EMBASE, and PsycINFO databases were searched in August 2019 with keywords to identify studies that included register-based outcome sources, a family relationship, and an exposure to heavy drinking. In total, 5,961 records were screened, 403 full-text articles were assessed for eligibility, and 91 studies were included in the final review. RESULTS Register-based research on alcohol's harms to family members has largely drawn on hospital records to identify heavy drinkers and has primarily focused on children of heavy drinkers; 79 of the included studies solely investigated harms to children, whereas 2 focused on partners and 10 on multiple first-degree or unspecified relatives. Register-based studies show that children of heavy drinkers are at a higher risk for mental disorders, disease and injury hospitalizations, infant and child mortality, criminality, poor employment and educational outcomes, abuse/neglect, and placement in residential/foster care, among other negative outcomes. CONCLUSIONS A substantial body of register-based research shows that children of parents with the most severe alcohol problems are at an increased risk for numerous adverse experiences. Register-based studies have investigated diverse, yet precisely defined outcomes, using large samples followed over long periods, and have examined the contribution of genetic, biological, and environmental factors. Our understanding of alcohol's harms to families could be enhanced by further register-based research on other household family members of heavy drinkers.
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Affiliation(s)
- Julie Brummer
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
| | | | - Katherine J Karriker-Jaffe
- Alcohol Research Group, Public Health Institute, Emeryville, California
- RTI International, Berkeley, California
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
- Alcohol Research Group, Public Health Institute, Emeryville, California
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Brummer J, Hesse M, Frederiksen KS, Karriker-Jaffe KJ, Bloomfield K. How Do Register-Based Studies Contribute to Our Understanding of Alcohol's Harms to Family Members? A Scoping Review of Relevant Literature. J Stud Alcohol Drugs 2021. [DOI: 10.15288/jsad.2021.82.445] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Julie Brummer
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
| | | | - Katherine J. Karriker-Jaffe
- Alcohol Research Group, Public Health Institute, Emeryville, California
- RTI International, Berkeley, California
| | - Kim Bloomfield
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
- Alcohol Research Group, Public Health Institute, Emeryville, California
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Bonsaksen T, Thørrisen MM, Skogen JC, Hesse M, Aas RW. Are Demanding Job Situations Associated with Alcohol-Related Presenteeism? The WIRUS-Screening Study. Int J Environ Res Public Health 2021; 18:6169. [PMID: 34200397 PMCID: PMC8201186 DOI: 10.3390/ijerph18116169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/04/2021] [Accepted: 06/05/2021] [Indexed: 11/25/2022]
Abstract
Alcohol-related presenteeism (impaired work performance caused by alcohol use) is an important but under-researched topic. The aim of this study was to explore whether psychosocial work environment factors were associated with alcohol-related presenteeism. A cross sectional study of Norwegian employees (n = 6620) was conducted. Logistic regression analyses were used for estimating associations with alcohol-related presenteeism, which was reported among 473 (7.1%) of the employees. Adjusted by age, gender, education level and managerial level, higher levels of overcommitment to work were associated with alcohol-related presenteeism. Higher age, male gender and higher education were also associated with alcohol-related presenteeism. Occupational health services and employers should especially focus on overcommitted employees when designing workplace health promotion programs. Modifying attitudes towards alcohol-related presenteeism among overcommitted employees may be of importance for safety at work.
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Affiliation(s)
- Tore Bonsaksen
- Department of Health and Nursing Science, Inland University of Applied Sciences, 2418 Elverum, Norway
- Faculty of Health Studies, VID Specialized University, 4306 Sandnes, Norway
| | - Mikkel Magnus Thørrisen
- Department of Occupational Therapy, Oslo Metropolitan University, 0130 Oslo, Norway;
- Department of Public Health, University of Stavanger, 4036 Stavanger, Norway;
| | - Jens Christoffer Skogen
- Department of Public Health, University of Stavanger, 4036 Stavanger, Norway;
- Center for Alcohol & Drug Research, Stavanger University Hospital, 4068 Stavanger, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, 5015 Bergen, Norway
| | - Morten Hesse
- Center for Alcohol and Drug Research, Aarhus University, 2300 Copenhagen, Denmark;
| | - Randi Wågø Aas
- Department of Occupational Therapy, Oslo Metropolitan University, 0130 Oslo, Norway;
- Department of Public Health, University of Stavanger, 4036 Stavanger, Norway;
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Gabrhelík R, Handal M, Mravčík V, Nechanská B, Tjagvad C, Thylstrup B, Hesse M, Minařík J, Jarkovský J, Bukten A, Clausen T, Skurtveit S. Opioid maintenance treatment in the Czech Republic, Norway and Denmark: a study protocol of a comparative registry linkage study. BMJ Open 2021; 11:e047028. [PMID: 33972343 PMCID: PMC8112418 DOI: 10.1136/bmjopen-2020-047028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Opioid maintenance treatment (OMT) varies across settings and between countries. We plan to use data from several nationwide health and population registers to further improve the knowledge base established from earlier studies. Our aim is to study OMT adherence trajectories and to identify factors associated with improved outcomes for OMT patients across the Czech Republic, Norway and Denmark, in order to further improve OMT and our understanding of the key elements of treatment success. METHODS AND ANALYSIS The registry-based cohort approach across the three countries allows us to link data from a range of registers on the individual level, by using personal identifiers in nationwide cohorts of OMT and non-OMT patients and the general non-using populations. A total of ~21 500 OMT patients over the last two decades in all three countries will be included in the study. The following outcome variables (based on the International Classification of Diseases, 10th Revision codes) will be obtained from relevant registers: treatment adherence to OMT, comorbidity (somatic and mental health), and all-cause and cause-specific mortality. Outcomes of the country-specific analyses will be pooled. ETHICS AND DISSEMINATION The national OMT cohorts have been approved by the ethics committees in the respective countries. Data will be stored according to national and local guidelines and treated confidentially, and all data will be analysed separately for each country and compared across countries. Findings will be disseminated in peer-reviewed scientific journals, national and international conferences, and in briefings to inform clinical decision-making.
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Affiliation(s)
- Roman Gabrhelík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Marte Handal
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Norwegian Institute of Public Health, Oslo, Norway
| | - Viktor Mravčík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Blanka Nechanská
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Christian Tjagvad
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Birgitte Thylstrup
- Centre For Alcohol And Drug Research, Aarhus University, Aarhus, Denmark
| | - Morten Hesse
- Centre For Alcohol And Drug Research, Aarhus University, Aarhus, Denmark
| | - Jakub Minařík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiří Jarkovský
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Anne Bukten
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Thomas Clausen
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Svetlana Skurtveit
- Norwegian Institute of Public Health, Oslo, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
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Hesse M, Thylstrup B, Karsberg SH, Pedersen MM, Pedersen MU. ILC-OPI: impulsive lifestyle counselling versus cognitive behavioral therapy to improve retention of patients with opioid use disorders and externalizing behavior: study protocol for a multicenter, randomized, controlled, superiority trial. BMC Psychiatry 2021; 21:183. [PMID: 33827495 PMCID: PMC8028234 DOI: 10.1186/s12888-021-03182-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 03/24/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Substance use disorders show a high comorbidity with externalizing behavior difficulties, creating treatment challenges, including difficulties with compliance, a high risk of conflict, and a high rate of offending post-treatment. Compared with people with other substance use disorders those with opioid use disorders have the highest risk of criminal activity, but studies on the evidence base for psychosocial treatment in opioid agonist treatment (OAT) are scarce. The Impulsive Lifestyle Counselling (ILC) program may be associated with better retention and outcomes among difficult-to-treat patients with this comorbidity. METHODS The study is a multicenter, randomized, controlled, superiority clinical trial. Participants will be a total of 137 hard-to-treat individuals enrolled in opioid agonist treatment (OAT). Participants will be randomized to either a standard treatment (14 sessions of individual manual-based cognitive behavioral therapy and motivational interviewing (MOVE-I)) or six sessions of ILC followed by nine sessions of MOVE-I. All participants will receive personalized text reminders prior to each session and vouchers for attendance, as well as medication as needed. The primary outcome is retention in treatment. Secondary measures include severity of drug use and days of criminal offending for profit three and nine months post-randomization. A secondary aim is, through a case-control study, to investigate whether participants in the trial differ from patients receiving treatment as usual in municipalities where ILC and MOVE-I have not been implemented in OAT. This will be done by comparing number of offences leading to conviction 12 months post-randomization recorded in the national criminal justice register and number of emergency room contacts 12 months post-randomization recorded in the national hospital register. DISCUSSION This is the first randomized, controlled clinical trial in OAT to test the effectiveness of ILC against a standardized comparison with structural elements to increase the likelihood of exposure to the elements of treatment. Results obtained from this study may have important clinical, social, and economic implications for publicly funded treatment of opioid use disorder. TRIAL REGISTRATION ISRCTN, ISRCTN19554367 , registered on 04/09/2020.
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Affiliation(s)
- Morten Hesse
- Centre for Alcohol and Drug Research, Bartholins Allé 10, 8000, Aarhus C, Denmark.
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark
| | | | | | - Mads Uffe Pedersen
- Centre for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark
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Karsberg S, Hesse M, Pedersen MM, Charak R, Pedersen MU. The impact of poly-traumatization on treatment outcomes in young people with substance use disorders. BMC Psychiatry 2021; 21:140. [PMID: 33685430 PMCID: PMC7941934 DOI: 10.1186/s12888-021-03129-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 02/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders. However, knowledge on the effect of the number of trauma experiences is scarce. METHODS Using data from drug use disorder (DUD) treatment in Denmark, we assessed the impact of having experienced multiple potentially traumatic experiences on DUD treatment efficacy. Baseline and follow-up data from 775 young participants (mean age = 20.2 years, standard deviation = 2.6) recruited at nine treatment centers were included in analyses. RESULTS Analyses showed that participants who were exposed multiple trauma experiences also reported a significantly higher intake of cannabis at treatment entry, and a lower well-being score than participants who reported less types or no types of victimization experiences. During treatment, patients with multiple types of trauma experiences showed a slower rate of reduction of cannabis than patients with few or no trauma experiences. The number of trauma types was not associated with number of sessions attended or the development of well-being in treatment. CONCLUSION Overall, the results show that although traumatized youth in DUD treatment show up for treatment, helping them to reduce substance use during treatment is uniquely challenging. TRIAL REGISTRATION ISRCTN88025085 , date of registration: 29.08.2016, retrospectively registered.
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Affiliation(s)
- Sidsel Karsberg
- grid.7048.b0000 0001 1956 2722Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000, Aarhus, Denmark.
| | - Michael Mulbjerg Pedersen
- grid.7048.b0000 0001 1956 2722Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
| | - Ruby Charak
- grid.449717.80000 0004 5374 269XDepartment of Psychological Science, The University of Texas Rio Grande Valley, 1201 W. University Dr, Edinburg, TX USA
| | - Mads Uffe Pedersen
- grid.7048.b0000 0001 1956 2722Centre for Alcohol and Drug Research, Aarhus University, Bartholins Allé 10, 8000 Aarhus, Denmark
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Karsberg SH, Pedersen MU, Hesse M, Thylstrup B, Pedersen MM. Group versus individual treatment for substance use disorders: a study protocol for the COMDAT trial. BMC Public Health 2021; 21:413. [PMID: 33637061 PMCID: PMC7913269 DOI: 10.1186/s12889-021-10271-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Alcohol and other drug use disorders contribute substantially to the global burden of illness. The majority of people with substance use disorders do not receive any treatment for their problems, and developing treatments that are attractive and effective to patients should be a priority. However, whether treatment is best delivered in a group format or an individual format has only been studied to a very limited degree. The COMDAT (Combined Drug and Alcohol Treatment) trial evaluates the feasibility, acceptability, and cost effectiveness of MOVE group (MOVE-G) treatment versus MOVE individual (MOVE-I) treatment in four community-based outpatient treatment centres in Denmark. METHODS A two-arm non-inferiority trial comparing MOVE-I (Pedersen et al., Drug Alcohol Depend 218:108363, 2020) with MOVE-G a combined group treatment for both alcohol use disorder and drug use disorder. The primary objective is to examine whether MOVE-G is non-inferior to MOVE-I in relation to abstinence from drug and/or alcohol, number of sessions received, and completion of treatment as planned. All participants will receive treatment based on cognitive behavioral therapy and motivational interviewing, vouchers for attendance and text reminders, as well as medication as needed (MOVE). Participants (n = 300) will be recruited over a one-year period at four public treatment centers in four Danish municipalities. A short screening will determine eligibility and randomization status. Hereafter, participants will be randomized to the two treatment arms. A thorough baseline assessment will be conducted approximately 1 week after randomization. Follow-up assessments will be conducted at 9 months post-randomization. In addition, patients' use of drugs and alcohol, and patients' wellbeing will be measured in all sessions. The main outcome measures are drug and alcohol intake at 9 months follow-up, number of sessions attended, and dropout from treatment. DISCUSSION The present study will examine the potential and efficacy of combined groups (patients with alcohol and drug disorders in the same group) versus individually based treatment both based on the treatment method MOVE (Pedersen et al., Drug Alcohol Depend 218:108363, 2020). TRIAL REGISTRATION ISRCTN88025085 , registration date 30/06/2020.
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Affiliation(s)
| | - Mads Uffe Pedersen
- Centre for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Bartholins Allé 10, 8000 Aarhus C, Denmark
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Pedersen MU, Hesse M, Thylstrup B, Jones S, Pedersen MM, Frederiksen KS. Vouchers versus reminders to prevent dropout: Findings from the randomized youth drug abuse treatment project (youthDAT project). Drug Alcohol Depend 2021; 218:108363. [PMID: 33153829 DOI: 10.1016/j.drugalcdep.2020.108363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/14/2020] [Accepted: 10/10/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Over the last few decades, evidence-based treatments for emerging adults with drug use disorder (DUD) have been developed, but dropout and inconsistent session attendance persist. This study assessed the efficacy of voucher reinforcement and/or text reminders for treatment attendance and completion in emerging adults with DUD in Denmark. METHODS The study compared four levels of treatment intensity, with participants randomly assigned to standard outpatient counseling only (STD), outpatient counseling plus vouchers for attendance (VOU), outpatient counseling plus text reminders (REM), or outpatient counseling plus vouchers and text reminders (REM + VOU). A total of 460 individuals aged 15-25 years seeking treatment for DUD were randomly assigned to the four treatment conditions across nine sites. RESULTS STD counseling had the lowest completion rate (25%), followed by REM (39%), VOU (46%), and REM + VOU (49%). Additionally, post hoc comparisons indicated that clients randomized to the REM + VOU condition differed in terms of zero no-shows from clients who were randomized to the VOU condition (χ2(1) = 6.90, p = 0.009) and the REM condition (χ2(1) = 5.87, p = 0.015). CONCLUSIONS Vouchers and text reminders contribute to reduced dropout and increased treatment attendance in emerging adults with DUD. The combination of vouchers and reminders in particular has the potential to reduce the number of no-shows.
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Affiliation(s)
- Mads Uffe Pedersen
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark.
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Sheila Jones
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
| | - Michael Mulbjerg Pedersen
- Centre for Alcohol and Drug Research, Department of Psychology and Behavioural Sciences, Aarhus University, Aarhus, Denmark
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Chen LJ, Wang S, Le Contel O, Rager A, Hesse M, Drake J, Dorelli J, Ng J, Bessho N, Graham D, Wilson LB, Moore T, Giles B, Paterson W, Lavraud B, Genestreti K, Nakamura R, Khotyaintsev YV, Ergun RE, Torbert RB, Burch J, Pollock C, Russell CT, Lindqvist PA, Avanov L. Lower-Hybrid Drift Waves Driving Electron Nongyrotropic Heating and Vortical Flows in a Magnetic Reconnection Layer. Phys Rev Lett 2020; 125:025103. [PMID: 32701350 DOI: 10.1103/physrevlett.125.025103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 06/11/2020] [Indexed: 06/11/2023]
Abstract
We report measurements of lower-hybrid drift waves driving electron heating and vortical flows in an electron-scale reconnection layer under a guide field. Electrons accelerated by the electrostatic potential of the waves exhibit perpendicular and nongyrotropic heating. The vortical flows generate magnetic field perturbations comparable to the guide field magnitude. The measurements reveal a new regime of electron-wave interaction and how this interaction modifies the electron dynamics in the reconnection layer.
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Affiliation(s)
- L-J Chen
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - S Wang
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
- University of Maryland, College Park, Maryland 20747, USA
| | - O Le Contel
- CNRS/Ecole Polytechnique/Sorbonne Université/Univ. Paris Sud/Observatoire de Paris, Paris F91128, France
| | - A Rager
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - M Hesse
- University of Bergen, Bergen 5020, Norway
| | - J Drake
- University of Maryland, College Park, Maryland 20747, USA
| | - J Dorelli
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - J Ng
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
- University of Maryland, College Park, Maryland 20747, USA
| | - N Bessho
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
- University of Maryland, College Park, Maryland 20747, USA
| | - D Graham
- Swedish Institute of Space Physics, Uppsala SE-75121, Sweden
| | - Lynn B Wilson
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - T Moore
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - B Giles
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - W Paterson
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
| | - B Lavraud
- Institut de Recherche en Astrophysique et Planétologie, Université de Toulouse (UPS), CNRS, CNES, Toulouse 31027 Cedex 4, France
| | - K Genestreti
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - R Nakamura
- Space Research Institute, Austrian Academy of Sciences, Graz A-8042, Austria
| | | | - R E Ergun
- University of Colorado, Boulder, Colorado 80305, USA
| | - R B Torbert
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - J Burch
- Southwest Research Institute, San Antonio, Texas 78238, USA
| | - C Pollock
- Denali Scientific, Healy, Alaska 99743, USA
| | - C T Russell
- University of California, Los Angeles, Los Angeles, California 90095, USA
| | - P-A Lindqvist
- KTH Royal Institute of Technology, Stockholm SE-11428, Sweden
| | - L Avanov
- NASA Goddard Space Flight Center, Greenbelt, Maryland 20771, USA
- University of Maryland, College Park, Maryland 20747, USA
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Hesse M, Vallentin-Holbech L, Thomsen KR. Which Youth Are at Risk for Cannabis Use Disorders? Boys and Girls Are Not the Same! J Adolesc Health 2020; 67:7-8. [PMID: 32564808 DOI: 10.1016/j.jadohealth.2020.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
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45
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Hahn T, Torkler S, van der Bolt R, Gammel N, Hesse M, Möller A, Preylowski B, Hubracht V, Patzsch K, Zibek S. Determining different impact factors on the xylonic acid production using Gluconobacter oxydans DSM 2343. Process Biochem 2020. [DOI: 10.1016/j.procbio.2020.04.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hesse M, Thylstrup B, Seid AK, Skogen JC. Suicide among people treated for drug use disorders: a Danish national record-linkage study. BMC Public Health 2020; 20:146. [PMID: 32005222 PMCID: PMC6995113 DOI: 10.1186/s12889-020-8261-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/22/2020] [Indexed: 12/02/2022] Open
Abstract
Background Substance use disorders are a major risk factor for suicide. However, less is known about specific risk factors for suicide in people with substance use disorders. Methods This population cohort study assessed suicide among people treated for drug use disorders in Denmark 2000–2010, and described risk factors for completed suicide. Data from 27,942 individuals enrolled in treatment were linked to national registers and matched with controls without drug use disorder and with (n = 138,136) or without psychiatric history (n = 1574). Competing risk regression was used to identify risk factors of completed suicide. Results There were 163 suicides among patients with a history of drug treatment (0.6% of patients). Increased risk was associated with younger age at enrolment (hazard ratio [HR] = 0.97, 95% confidence interval (CI): 0.95, 0.98), history of psychiatric care (HR = 1.96, CI 95%: 1.39, 2.77), opioid use (HR = 1.81, 95% CI: 1.23, 2.68), and alcohol use (HR = 1.56, 95% CI: 1.09, 2.23). Lower risk was associated with cannabis use (HR = 0.69, 95% CI: 0.50, 0.96). Compared with age- and gender-matched controls without a history of treatment for substance use disorders or recent psychiatric care, the standardized mortality ratio due to suicide was 7.13 for people with drug use disorder without a history of psychiatric care (95% CI: 5.81, 8.44), 13.48 for people with drug use disorder and psychiatric history (95% CI: 9.75, 17.22), and 13.61 for people with psychiatric history only (95% CI: 6.72, 20.50). Conclusions Risk of suicide is increased among people with drug use disorders. Access to treatment for co-morbid mental health problems for people with drug use disorders could potentially reduce risk of suicide.
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Affiliation(s)
- Morten Hesse
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark.
| | - Birgitte Thylstrup
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Abdu Kedir Seid
- Center for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Heradstveit O, Skogen JC, Edland-Gryt M, Hesse M, Vallentin-Holbech L, Lønning KJ, Sivertsen B. Self-Reported Illicit Drug Use Among Norwegian University and College Students. Associations With Age, Gender, and Geography. Front Psychiatry 2020; 11:543507. [PMID: 33362594 PMCID: PMC7758438 DOI: 10.3389/fpsyt.2020.543507] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 11/16/2020] [Indexed: 11/17/2022] Open
Abstract
Background and Aims: Several studies have pointed to relatively high levels of illicit drug use among students in higher education compared to the general population. The aim of the present study was to provide an updated examination of self-reported illicit drug use among Norwegian University and college students. Methods: Data stem from the SHoT study (Students' Health and Well-being Study), a nationwide cross-sectional survey for higher education in Norway including Norwegian full-time students aged 18-35. Self-reported illicit drug use across a range of specified drugs comprised the outcome variables. Information on gender, age, and study location (geographical area) was also collected and used as stratification variables. The SHoT-survey from 2018 (N = 50,054) was used for the analyses of associations between demographical variables and illicit drug use, while trends in illicit drug use were estimated by comparing the 2018-results with data from the SHoT-surveys conducted in 2010 and 2014. Results: The proportion of students reporting having ever tried illicit drugs increased from 2014 to 2018, for both males (30.8 vs. 36.7%) and females (17.5 vs. 24.0%, both p < 0.001), while only minimal changes occurred between 2010 and 2014. The most commonly used illicit drugs during the past 12 months in 2018 were cannabis (15.2%), followed by MDMA (4.0%), cocaine (3.0%), and LSD/psilocybin (2.1%). Illicit drug use showed both linear increase with age, and inverted U-shaped relationships that peaked in the age span from 23 to 28 years of age. Males reported higher illicit drug use compared with females for all drugs. Proportions of illicit drug use varied across geographical areas within the country, with the highest use being reported in the Oslo area (the largest city and capital of Norway). Conclusions: The present study reports an increase from 2010 to 2018 among Norwegian University and college students in the proportion of those reporting to have tried illicit drugs. Despite varying proportions of use across type of drug, age, gender, and geographical location, the overall high levels of illicit drug use past 12 months confirm the need to address illicit drug use in this population.
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Affiliation(s)
- Ove Heradstveit
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway.,Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Jens Christoffer Skogen
- Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Marit Edland-Gryt
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Morten Hesse
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Lotte Vallentin-Holbech
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Kari-Jussie Lønning
- Norwegian Medical Association, Oslo, Norway.,The Student Welfare Association of Oslo and Akershus (SiO), Oslo, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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Thylstrup B, Hesse M, Jørgensen M, Thiesen H. One opioid user saving another: the first study of an opioid overdose-reversal and naloxone distribution program addressing hard-to-reach drug scenes in Denmark. Harm Reduct J 2019; 16:66. [PMID: 31805969 PMCID: PMC6896775 DOI: 10.1186/s12954-019-0328-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 09/06/2019] [Indexed: 02/06/2023] Open
Abstract
Background Overdose education and naloxone distribution programs decrease opioid overdose deaths. However, no studies of such programs have been carried out in Denmark. The aim of this study was to evaluate the feasibility and the effect of a broader “training-the-trainers” model in low-threshold settings after participation in the “Danish Save Lives” [SL] program. Methods Between May 2013 and November 2015, 552 participants from four municipalities took part in the SL program. The program is built on the train-the-trainers model where a central trainer trains others (trainers), who in turn train others (helpers). Participants were 30 police officers (5%), 188 people who use opioids (34%), 23 significant others (4%), and 217 social workers (39%). Ninety-four participants could not be classified (17%). At follow-up, participants were interviewed to determine the number and outcomes of opioid overdoses. Logistic regression was used to assess predictors of treating an overdose. Results In all, 37 (7%) participants had intervened in 45 opioid overdose events (two trainers and 35 helpers). Detailed descriptions of the overdose event were available from 32 follow-up interviews (70%). In 16 cases, the person who intervened was already present at the site when the overdose occurred, and in 17 cases, the overdose victim recovered without complications. All overdose victims survived except one. People who used opioids were more likely to have treated an overdose than other participants (adjusted odds ratio [AOR] = 8.50, p = 0.001), and the likelihood of treating and overdose declined over time AOR = 0.37 (0.13, 0.93), p = 0.034). Conclusions Prevention programs that target people who use opioids are more likely to be effective than programs that target professionals, especially in high-risk settings that can be hard for paramedics to reach. A future goal is to explore how prevention programs can be adapted to new user groups. Trial registration The Danish Data Protection Agency, 2015-57-0002, Aarhus University, 2016-051-000001, 184, retrospectively registered
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Affiliation(s)
- Birgitte Thylstrup
- Centre for Alcohol and Drug Research, Bartholins Allé 10, 8000, Aarhus C, Denmark.
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Bartholins Allé 10, 8000, Aarhus C, Denmark
| | - Marian Jørgensen
- HealthTeam for Homeless, Save Lives Program, Sundholmsvej 18, 2300, København S, Denmark
| | - Henrik Thiesen
- HealthTeam for Homeless, Save Lives Program, Sundholmsvej 18, 2300, København S, Denmark
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Skogen JC, Thørrisen MM, Olsen E, Hesse M, Aas RW. Evidence for essential unidimensionality of AUDIT and measurement invariance across gender, age and education. Results from the WIRUS study. Drug Alcohol Depend 2019; 202:87-92. [PMID: 31325821 DOI: 10.1016/j.drugalcdep.2019.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 06/21/2019] [Accepted: 06/30/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Globally, alcohol use is among the most important risk factors related to burden of disease, and commonly emerges among the ten most important factors. Also, alcohol use disorders are major contributors to global burden of disease. Therefore, accurate measurement of alcohol use and alcohol-related problems is important in a public health perspective. The Alcohol Use Identification Test (AUDIT) is a widely used, brief ten-item screening instrument to detect alcohol use disorder. Despite this the factor structure and comparability across different (sub)-populations has yet to be determined. Our aim was to investigate the factor structure of the AUDIT-questionnaire and the viability of specific factors, as well as assessing measurement invariance across gender, age and educational level. METHODS We employed data (N = 4,318) from the ongoing screening study in the Norwegian national WIRUS project. We used Confirmatory Factor Analysis (CFA) to establish the factor structure of the AUDIT. Next, we investigated the viability of specific factors in a bi-factor model, and assessed measurement invariance of the preferred factor structure. RESULTS Our findings indicate the AUDIT is essentially unidimensional, and that comparisons can readily be done across gender, age and educational attainment. CONCLUSION We found support for a one-factor structure of AUDIT. To the best of our knowledge, this is the first study to investigate the viability of specific factors in a bi-factor model as well as evaluating measurement invariance across gender, age and educational attainment for the AUDIT questionnaire. Therefore, further studies are needed to replicate our findings related to essential unidimensionality.
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Affiliation(s)
- Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway; Alcohol & Drug Research Western Norway, Stavanger University Hospital, Stavanger, Norway; Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.
| | - Mikkel Magnus Thørrisen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Espen Olsen
- UiS Business School, University of Stavanger, Stavanger, Norway
| | - Morten Hesse
- Centre for Alcohol and Drug Research, Aarhus University, Denmark
| | - Randi Wågø Aas
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway; Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
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50
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Rømer Thomsen K, Lindholst C, Thylstrup B, Kvamme S, Reitzel LA, Worm-Leonhard M, Englund A, Freeman TP, Hesse M. Changes in the composition of cannabis from 2000-2017 in Denmark: Analysis of confiscated samples of cannabis resin. Exp Clin Psychopharmacol 2019; 27:402-411. [PMID: 31219274 DOI: 10.1037/pha0000303] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Globally, recent studies report increases in Δ-9-tetrahydrocannabinol (THC) concentration in seized samples of cannabis for human consumption. This is important, because use of cannabis with a high concentration of THC has been linked to a number of adverse health outcomes. The objective of this study was to assess recent changes in the composition of seized cannabis resin in Denmark by (a) examining THC concentration in samples from Danish forensic laboratories from 2000 to 2017 (N = 430) and (b) examining cannabidiol (CBD) concentration and the THC:CBD concentration ratio in samples from the forensic laboratory in Western Denmark from 2008 to 2017 (N = 147). Cannabis resin samples were analyzed using a gas chromatographic analysis with flame ionization detection quantifying the total THC and CBD concentration. Results showed that the THC concentration increased 3-fold from 2000 (mean: 8.3%) to 2017 (mean: 25.3%). Significant increases occurred in all areas of Denmark. After 2011, we found a dramatic increase in cannabis resin samples with high THC concentration and the near disappearance of cannabis resin samples with medium- and low THC concentration. Furthermore, the THC:CBD concentration ratio increased significantly from 1.4 in 2008 to 4.4 in 2017. Whereas THC concentration increased, CBD concentration remained stable at ∼6%. In conclusion, the THC concentration of cannabis resin, and THC:CBD concentration ratio, have increased dramatically in Denmark, potentially leading to higher risk of harm to users. Policymakers, treatment professionals, and educators should be aware of this change. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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