Are anabolic-androgenic steroid users polysubstance users?

Aim: Young adulthood is a period when individuals experiment health risk substances such as illicit substance and tobacco use that may predispose them to sexually transmitted diseases. Minority young adults living in HIV prevalent urban communities are notably more likely to engage in these behaviors. In the United States, minority young adults over-represented with HIV infection. To resolve this problem, the United States Congress has invested over $100million in grants. In the United States, few studies have examined illicit substance and tobacco use among this vulnerable population. This study aimed to evaluate the impact of a comprehensive HIV prevention program (CIHPP) on illicit substance and tobacco use among minority young adults living in a high prevalence of HIV infection urban community. Methods: The data of illicit substance and tobacco use was collected using a survey of a random sample of minority young adults who participated in the CIHPP. for12-months. Change in illicit substance and tobacco use during 24 months of minority young adults' participation in CIHPP was recorded. The data was analyzed using the latent growth curve (LGC) model within the framework of the structural equation modeling procedure. The evaluation included the change in the intercept and slope of the Mean, Variance, covariance, and predictor variable in three waves for 24months. Result: The average score for illegal substance use of 5.411 decreased significantly over the 24months. Young adults exhibited a low rate of increase in their illicit use substance over the 24months. This finding indicates that the CIHPP was effective in decreasing the substance use of young adults under study. There were significant inter individual differences in the original score of illicit substance use between the young adults at the beginning of the implementation of the CIHPP and its change over time, as the as the minority young adult progressed from the beginning of the CIHPP intervention through the 24 months. Using gender as a predictor of change showed no difference between male and female young adults. For tobacco use, the average score for tobacco (16.631) decreased significantly over the three 24months. There was no meaningful difference between minority young adult males and minority young adult females in illicit substances use at the beginning of CIHPP. However, during CIHPP intervention, minority young adult’s males had an increase in the rate of change in tobacco use than minority young adult females. The mean estimate for tobacco use indicates that the average score for tobacco use increased significantly over the three 12-months periods. The covariance between the intercept and slope factor for tobacco use was statistically significant. Minority young adult males exhibited a higher rate of tobacco use than their female counterparts over the 24 months. This finding suggests that the Comprehensive, integrated HIV prevention program was not effective in decreasing the tobacco use of the minority young adults studied, The variance estimate related 2 Annals of Immunology & Immunotherapy Mongkuo MY, et al. Latent Growth Curve Model Evaluation of Illicit Substance and Tobacco Use among Young Adults in Cumberland County, North Carolina. Ann Immunol Immunother 2020, 2(2): 000124. Copyright© Mongkuo MY, et al. to the intercept and slope for tobacco use is statistically significant (p=.001) suggesting that there were vast inter-individual differences both at the beginning of CIHPP and the rate of change of tobacco use between the minority young adults at the beginning of the implementation of the CIHPP and its rate of change over time, as the young adult progressed from the beginning of the CIHPP intervention through the 24months. Such evidence provides sturdy support for further investigation of variability or heterogeneity related to the growth trajectory. Specifically, the incorporation of time-invariant of change into the model can explain the young adults' tobacco use variability. This incorporation involves testing the latent growth curve model with the demographic or static variable as a time-invariant predictor of change. This study incorporated gender in the LGC model as a predictor of change. The prediction module with gender as predictor found that there was no meaningful difference in illicit substance and tobacco use between minority young adult males and females.

This article was migrated. The article was marked as recommended. Background: The General Medical Council state illicit substance use by medical students is an example of unprofessional behaviour. Previous research has shown the use of illicit substances to exist amongst medical students in the United Kingdom. This research aimed to determine the prevalence of illicit substance use amongst a single cohort of medical students and gather information concerning perceptions of this behaviour. The study sought to quantify the prevalence of illicit substance use within each year of study and gender identity. Methods: An anonymous online questionnaire was employed to conduct this quantitative research. This included nine questions regarding illicit substance use amongst medical students, with three additional demographic questions. The Statistical Product and Service Solutions was utilised to interrogate the data. Results: Out of 927 students in the medical school 201 (21.7%) people completed the questionnaire. 50.7% of respondents reported an any lifetime use of illicit substances, with 20.9% of the cohort reflecting recent illicit substance use within the previous 30 days. Drug use included amphetamines, amyl nitrate, cocaine and ecstasy amongst others. Cannabis was the most commonly used illicit substance, with a lifetime use of 45.8%. Statistical significance was determined for use of illicit use of substances within the male gender and older cohort years of the medical school. Conclusions: The current cohort had a greater prevalence of cannabis use than previously determined amongst medical students. Males and students in older years had higher rates of illicit substance use than their respective demographics. As such, further research may be necessary to investigate the underlying reasons for these findings.

To explore how current substance use, including the use of sports supplements and illicit drugs, may impact upon a person's future intentions to use anabolic-androgenic steroids (AAS). Web-based survey. Two hundred fourteen exercising males (mean age, 30 years; range, 17-61 years) recruited from 5 gymnasia in Sydney, Australia, completed a web-based survey. The survey contained questions relating to sport supplement use, illicit substance use, reasons for currently not using AAS, and reasons for intending to use AAS in the future. Participants completed a structured interview schedule that included questions regarding licit and illicit substance use, reasons for non-AAS use, and, where appropriate, reasons for intended future AAS use. The planned main outcome measure was positive intention to use AAS. Sixteen percent of the sample indicated that they would use AAS in the future. Reasons for future AAS use included increasing muscle size (80%), improving appearance (74%), and increasing strength (57%). Four-fifths (80%) of the sample reported use of sports supplements, with vitamins and protein supplements commonly reported (83% and 67%, respectively); more than one-third (36%) reported use of creatine in the past 6 months. Half (52%) of the sample reported use of illicit substances in the preceding 6 months, with amphetamines and cannabis commonly reported (66% and 62%, respectively). Significant predictors of intending to use AAS included past 6-month use of creatine and knowing AAS users. The use of sport supplements and/or illicit substances may remove barriers for the future use of such drugs as AAS. Future research is necessary to explore in depth whether such substances may act as a "gateway" to future AAS use.

Substance use disorders during pregnancy are a concern both to the public and medical community, because the negative consequences can be detrimental to both mother and the fetus. The accurate identification of prenatal drug exposure is necessary to determine appropriate medical and psychosocial intervention, and to identify risk factors that may affect outcomes for the mother and her newborn. The prevalence of prenatal drug exposure is very difficult to estimate because of flaws in all methods of identification. The study is designed to identify risk factors and demographic variables that contribute to nondisclosure of illicit and nonillicit substance use. In addition, this study aims to determine if nondisclosure leads to adverse neonatal outcomes. Newborns delivered with a positive meconium or urine toxicology, and/or known maternal exposure to illicit and nonillicit substances, were identified. Maternal records were reviewed for disclosure of substance use during pregnancy at admission for delivery along with other medical and demographic variables. Women with antenatal prescription drug use that may alter toxicology screens were excluded from analysis. Pediatric records were also reviewed to obtain neonatal variables. One hundred sixty-eight newborns were identified as having prenatal exposure to an illicit or nonillicit substance over the 4-year period. Eighty-six per cent (145/168) of women tested positive or their newborn tested positive for at least 1 illicit substance, and 49% (82/168) tested positive for multiple illicit substances. Fifty-four per cent (91/168) of women did not disclose using at least one illicit drug for which she or her newborn tested positive.With regards to maternal characteristics, there was no statistically significant difference between age (P = 0.958), parity (P = 0.300), or race (P = 0.531), and disclosure or failure to disclose about illicit drug use. However, patients who did not report prenatal illicit drug use (33/82 = 40%) were less likely (P = 0.049) to receive complete prenatal care (defined as 3 or more visits) compared with those who acknowledged their substance use (40/70 = 57%). Substance use disorders during pregnancy are an often underestimated cause of maternal, fetal, and neonatal complications. Limited studies have examined the relationship between maternal characteristics and associated illicit or nonillicit drug use. The absence of correlation between maternal demographics and disclosure of illicit substance use demonstrates the fact that all antepartum patients are at risk for these behaviors. Furthermore, the fact that women who did not disclose their illicit drug use were less likely to seek complete prenatal care reflects the need for physicians to provide a destigmatized healthcare environment, encouraging pregnant women to disclose their substance use so they can be provided with appropriate counseling and treatment.

Illicit Substance Use Disparities Among Lesbian, Gay, and Bisexual High School Students in the U.S. in 2017

Introduction: There is a strong association between the use of substances and criminal behaviour. The use of illicit substances is not only a criminal act, but it also predisposes a person to other crimes. As the use of illicit substances is quite common among criminals, similarly the rate of crimes is also high among substance users. Objectives: To document the rates of different crimes among prisoners and the rates of the use of different substances among them before and during imprisonment. Materials & Methods: In this observational study, 327 sample size was achieved through systematic probability sampling technique from central prison Haripur from November to December 2022. Data were analyzed for descriptive statistics through SPSS 24; rates and percentages were calculated for categorical variables, while the mean and standard deviation were calculated for continuous variables. Results: The prisoners were almost all males (99.1%) with only 0.9% females. The mean age of the prisoners was 38.64 ± 12.57 years. The most common crime was murder (44.5%). The lifetime rate of the use of tobacco before imprisonment was 63.3% while it increased up to 67.3% during imprisonment. Almost 32.75% reported the use of illicit substances before imprisonment while 23.5% were still using illicit substances inside the prison. Conclusion: Imprisonment does not cessate the habit of substance use by prisoners, it merely alters the pattern and magnitude of the problem, in relation to ease of access of illicit substances.

Background and aims Adolescence is a period of physical, psychological and socio-cultural transformation, but also of curiosity, experimentation and acquisition. It is mainly during adolescence that people are introduced to the use of legitimate psychoactive substances, such as alcohol and tobacco, as well as illicit substances such as cannabis. Studying its predictors could help deal with this problem more efficiently. We aimed to determine the prevalence of life time illicit substance use and its predictors among Tunisian adolescents. Methods We conducted a cross-sectional study in two public schools in the governorate of Sousse during the 2017/2018 school year. The data were collected by anonymous self-administered questionnaire, then processed and analyzed using the SPSS software version 20. Results A total of 294 students were included. The mean age was of 17.03 years (standard deviation = 1.51). Females represented 56.1% of participants (sex ratio was 0.78). Among respondents: 60 (20.4%) had used illicit substance at least once. Cannabis was the main substance used by 35 (58.3%) students. The average age of the illicit substance use initiation was 16.3 (±1.1) years while it was 15.7 (±1.5) and 14.7 (±1.8) years for alcohol and tobacco use initiation respectively. Proportions of male students and academic failure were significantly more important among illicit substance users than among non users. While the most influential factors on illicit substance use were: alcohol use, and tobacco use (p < 10-3). However, no significant association was found between illicit substance use and video games and internet use. Conclusions This study highlights the strong association between the other risk behaviors and illicit drug use. Future interventions should focus on the whole risk behaviors simultaneously at late adolescence with regard to the environmental context. Key messages Our results highlight the need to better understand behaviors at risk in Tunisia and the perceptions of prevention policies among students. Mainly during adolescence that people are introduced to the use of illicit substances.

Introduction The ageing of baby boomers is expected to confront addiction care with new challenges. This cohort had greater exposure to psychoactive substances in youth than earlier cohorts. In this study, we aimed to investigate whether Berlin addiction care is confronted with a sustained change in its clientele initiated by the baby boomers. Methods Using data from Berlin outpatient addiction care facilities, we contrasted type of primary substance use disorder and number of comorbid substance use disorders in baby boomers with an earlier and a later cohort. To isolate cohort effects, two-level random intercept regression models were applied in the overlapping age groups of the baby boomer cohort with each of the other cohorts. Results Compared with the earlier cohort, alcohol use disorder lost importance whereas illicit substance use disorder gained importance in the baby boomers. Baby boomers presented a higher number of comorbid substance use disorders than the earlier cohort. Comparing baby boomers with the later cohort, these relationships pointed in the opposite direction. Discussion and conclusions Outpatient addiction care faces a sustained change to more illicit and comorbid substance use disorders. With increasing life expectancy and the ageing of baby boomers marked by higher substance use than previous cohorts, older clients, who had been under-represented in outpatient addiction care, will gain relevance. Hence, addiction care has to adapt its offers to appropriately meet the changing needs of its clientele.

Background Evidence shows that sexual minorities are more vulnerable to substance use and psychological distress as a result of minority stress compared with heterosexuals. So far, research conducted outside North America or Western Europe has been underrepresented. This research compares for the first time the substance use, quality of mental health and life satisfaction between the sexual minority people and heterosexuals using a nationally representative probability sample in the Czech population. Methods Sample of the general population aged 15+ years surveyed within the National Survey on Substance Use in 2016 in randomly selected households (N = 3,601, F2F interviews). Prevalence of licit and illicit substance use, psychological distress (MHI-5 scale) and life satisfaction (SWLS scale) were analyzed by respondents' self-reported sexual identity and behaviors. Logistic regressions were applied to evaluate the differences between groups. Adjustment for basic sociodemographic characteristics was performed. Results 2.8% of adults identified as sexual minorities, including 0.5% lesbians or gays and 2.3% bisexuals. Sexual minorities were more likely to experiment with (illicit) substance use in the last 12 months (OR = 1.74, 95% CI: 1.03-2.94), more often experience psychological distress (OR = 2.56, 95% CI: 1.50-4.38), and were slightly less often satisfied with their lives (OR = 0.79, 95% CI: 0.46-1.37) compared to heterosexuals. Sexual minority status was not found as a significant predictor for daily tobacco smoking nor for frequent excessive/binge alcohol consumption. Conclusions In accordance with international evidence, sexual minorities represent a vulnerable group from the perspective of substance use and psychological distress. Factors influencing life satisfaction of sexual minority people living in geographically underrepresented regions need to be further investigated using measures more sensitive to local cultural circumstances.

Screening illicit substance use in college students: The Chinese version of the Drug Abuse Screening Test

The American College of Obstetricians and Gynecologists (ACOG) recommends providers screen their prenatal patients for 11 psychosocial issues because they affect patient mental and physical well-being. The prevalence and co-occurrence of these issues have rarely been compared among pregnant women who do and do not report recent illicit substance use. Seven psychosocial issues identified by ACOG were operationalized using National Survey on Drug Use and Health variables. We report weighted prevalence and adjusted risk ratios (ARR) for these issues in pregnant women who did versus did not report past-month illicit substance use. Pregnant women (n = 3,657) who reported past-month illicit substance use (6.3%; 95% CI [5.4-7.3]) had significantly higher prevalence of almost all psychosocial issues examined, including past-month cigarette smoking (44.9% versus 9.5%; ARR = 2.84, 95% CI [2.21-3.65]); past-month alcohol use, 36.1% versus 7.9%; ARR = 4.71 (3.59-6.18); serious past-month distress, 23.0% versus 5.0%; ARR = 3.51 (2.39-5.15); no health insurance, 11.7% versus 6.2%; ARR = 1.71 (1.07-2.74); and receipt of food stamps, 45.0% versus 24.0%; ARR = 1.40 (1.18-1.67). Moving 3 + times in the past year followed a similar pattern, but results were compatible with there being no difference, 10.6% versus 5.5%; ARR = 1.39 (0.86-2.25). The majority of pregnant women reporting illicit substance use endorsed experiencing ≥ 2 psychosocial issues while the majority of those who did not report illicit substance use did not endorse any. Pregnant women who use illicit substances experience higher prevalence and greater co-occurrence of psychosocial issues compared to those who do not, reinforcing recommendations for multidisciplinary approaches to care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Due to specific risks associated with illicit drug use, the preanaesthetic detection of illicit substances is essential. This prospective observational study evaluated oral fluid testing and self reporting of illicit drug use compared with confirmatory blood testing. Consecutively enrolled preanaesthetic and emergency room patients (n=939) completed a paper-based lifestyle questionnaire. An oral fluid sample was obtained and analysed for illicit substance use by a point-of-care testing device (Dräger Drugtest® 5000). Patients who tested positive by self reporting or oral fluid testing underwent confirmatory blood testing (n=117). Self reporting revealed more overall illicit substance use and more users of cannabinoids, amphetamines, opioids, cocaine and benzodiazepines than oral fluid testing. Self reporting was more sensitive than blood testing for the detection of overall illicit substance use, and for use of cannabinoids and benzodiazepines. Self reporting revealed higher rates of illicit substance use than oral fluid testing in preanaesthetic patients, and may lead to more interventions and more appropriately tailored treatment and anaesthesia compared with oral fluid testing.

205 Background: Rates of illicit substance use and misuse of opioid medications are high in the adolescent and young adult (AYA) general population. Despite this, screening for substance use and opioid misuse is not standard in the care of AYA oncology supportive/palliative care. To inform our clinical practice, we sought to determine the prevalence of illicit substance use and potential opioid misuse in AYA cancer patients relative to adult patients and to examine correlates of use and misuse. Methods: We conducted retrospective chart review of patients newly referred to an outpatient palliative care clinic between 2014 and 2016. Results: Consecutive patients (N = 963) underwent urine drug testing as part of their initial visit; 16% of patients were between 18 and 39 years of age. Rate of illicit drug use was 31% for AYAs and 19% for adults. AYAs were nearly 2 times more likely to have positive results for marijuana (OR = 1.79; 95% CI = 1.19 – 2.69) and nearly 3 times more likely to test positive for amphetamines (OR = 2.94; 95% CI = 1.15 – 7.49). AYAs were no more likely than adults to test positive for cocaine, barbiturates or heroin. In univariate analyses, only male sex and being single, and no clinical characteristics or symptom scores, were significantly associated with illicit substance use (ps < .05). AYAs were no more likely than adults to test positive for the presence of opioids, not currently prescribed (OR = 1.07; 95% CI = 0.70 – 1.65). No symptoms scores or demographic and clinical characteristics were significantly associated with misuse. Conclusions: AYA patients demonstrated a high rate of illicit substance use and similar rate of potential opioid misuse relative to adult patients. Findings suggest AYAs may benefit from consistent screening, support and treatment for substance use and potential opioid misuse during anticancer and cancer-related therapies.

Efficacy of mindfulness-based relapse prevention in a sample of veterans in a substance use disorder aftercare program: A randomized controlled trial

To analyze data from a nationally representative sample of high school students to investigate the relationship between substance use and violent behavior among adolescents and to examine this relationship in both male and female adolescents. Cross-sectional analyses of the 1991 Centers for Disease Control and Prevention's Youth Risk Behavior Survey. Public and private schools in the 50 states. The participants were 12,272 high school students. To determine the prevalence of weapon carrying and physical fighting among male and female adolescents. A significant increase in the number of male and female adolescents carrying weapons and physically fighting was associated with all forms of substance use. Reports of carrying a weapon increased with recent alcohol consumption (34% vs 17%, P < .001) and use of marijuana (48% vs 22%, P < .001), cocaine (71% vs 25%, P < .001), and anabolic steroids (62% vs 25%, P < .001). The prevalence of physical fighting was also significantly higher among adolescents who used illicit substances than among adolescents who denied drug use. The risk of violent behavior increased significantly, and was of equal magnitude, for adolescent females and males who were illicit substance users. Alcohol and illicit substance use are highly associated with an increased risk of violent behavior. These data also demonstrate that the risk of violence by adolescent females who are substance users is substantial.