Comment on the APA position statement on psychoactive substance use.

Background: Adolescence is a critical developmental stage during which health behaviours with long-term consequences are often established. Psychoactive substance (PAS) use commonly begins during this period, necessitating continuous monitoring and understanding of associated risk factors. Objective: To compare the prevalence, perceptions, and social determinants of PAS use among adolescents in public and private secondary schools in Uyo, Nigeria. Methods: A comparative cross-sectional mixed-methods study was conducted among 844 adolescents selected through multistage sampling from public and private secondary schools. Data were collected using a pretested, interviewer-administered questionnaire adapted from the WHO Global Assessment Programme. Quantitative data were analysed using SPSS version 25, with descriptive and inferential statistics applied. Statistical significance was set at p<0.05. Qualitative data were thematically analysed. Ethical approval was obtained from the University of Uyo Teaching Hospital Ethics Committee. Results: A total of 416 private-school and 428 public-school students participated. Mean ages were 13.1 ± 2.0 years (private) and 13.7 ± 2.2 years (public). Lifetime alcohol use was significantly higher in public schools (4.7%) than private schools (2.2%) (p<0.05). Other PAS use was low and occurred only among students with prior alcohol use. Key predictors of PAS use included family substance use and peer influence in both school types. Conclusion: PAS use was generally low but higher among public-school students. Alcohol appears to act as a gateway substance. Family and peer influences are significant determinants, highlighting the need for targeted school-based and community interventions.

Substance use can have adverse effects on many health conditions, yet little is known about the prevalence of use in individuals with type 1 diabetes (T1D). We evaluated the frequency of use and problem use of psychoactive substances in adults with T1D. Standardized instruments for assessing tobacco, alcohol, and psychoactive substance use were emailed to 4311 adult participants at 69 T1D Exchange Clinic Registry centers. A total of 936 respondents (61% female, 90% non-hispanic white, age 38±16 years) completed the survey. In the sample, tobacco use was reported by 166 (18%) participants in the past year and 51 (5%) daily (Figure 1). Past year alcohol use was reported by 742 (79%) participants, past month use by 592 (63%) and daily or near daily use by 87 (9%). Use of any other psychoactive substance in the past year was reported by 228 respondents (24%), with marijuana being the most commonly used substance (Figure 2). Past year problem use of these substances was noted in 31 (3%) respondents. Adults with T1D in the U.S. use substances at rates that meet or exceed that of the general population; problematic use occurs at rates similar to the general population. These data delineate the need to inquire about regular, intermittent and problematic use of nicotine, alcohol, and other substances in individuals with T1D. A better understanding of the impact of moderate and occasional use of substances on T1D management and clinical outcomes is also needed. Disclosure N. Petry: None. N.C. Foster: None. E. Cengiz: Advisory Panel; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Advisory Panel; Self; MannKind Corporation, ADOCIA, Arecor. W.V. Tamborlane: Consultant; Self; AstraZeneca, Boehringer Ingelheim GmbH, Eli Lilly and Company, Medtronic MiniMed, Inc., Novo Nordisk Inc., Sanofi, Takeda Pharmaceuticals U.S.A., Inc.. J. Wagner: None. S. Polsky: Research Support; Self; Dexcom, Inc.. Other Relationship; Self; T1D Exchange. Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases.

Background. The use of various psychoactive substances by adolescents and young people is the actual medical, psychological and social problem, which, unfortunately, has not yet been properly addressed. It should be noted that early diagnosis and treatment of mental disorders that occur the use of psychoactive substances (both episodic and systematic ones) for this contingent of respondents is a very complex issue, closely related to the destigmatization of psychiatric care, the success of psychoeducational projects on microsocial and family macrosocial (staff of educational institutions, social services, general practice) levels. It is periodically detection and early care in the vast majority of cases which have been determined the prognosis of mental illnesses and social consequences. Objective – based on a systematic, interdisciplinary approach we have the purpose to develop a model and the algorithm for providing medical and social care to adolescents with addictive behavior who use psychoactive substances. Materials and methods. A systematic, interdisciplinary approach is used. Results. Trends in the use of psychoactive substances by adolescents and young people will be described in such a way. Most of the respondents when taking various psychoactive substances were mainly in the area of relatively “safe” (1-7 points) or “dangerous use” (8-15 points), but without harmful effects or states of dependence. For adolescents with addictive behavior who used psychoactive substances, depending on the degree of use, we developed a model and the algorithm for medical and social care. Proposed measures were mainly psychotherapeutic and psychocorrectional in their nature. Conclusions. Based on the obtained data, the study and testing of addictive behavior of adolescents, the influence of social factors, premorbid mental disorders were developed and a model and the algorithm for providing medical and social care to adolescents who use psychoactive substances at different levels of care were tested.

BackgroundPsychoactive substance use among youth is an emerging public health issue in Nepal. This exploratory study aimed to better understand the drivers of psychoactive substance use among Nepalese youth in Rupandehi district of Nepal.Materials and methodsThis study used a qualitative approach for data collection. Both in-depth interviews (IDI, seven participants) and focus group discussions (FGD, 13 participants) were conducted among study participants who self-reported as psychoactive substance users or had history of psychoactive substance use. Participants for IDI were aged between 11 and 24 years and between 18 and 35 years old for FGDs. Semi-structured interview guides were prepared separately for IDIs and FDGs. Interviews were conducted in Nepali language and were audio recorded, which were there transcribed and translated into English for coding and analyses. In addition, interviews notes were taken by two research assistants. An inductive thematic analysis was used to analyze the data.ResultsThis study identified a range of drivers of psychoactive substances use among Nepalese youths. Themes included (i) socio-cultural factors, (ii) individual factors, (iii) academic environment, (iv) physical environment and the (v) influence of media. The socio-cultural factors were categorized into sub-themes of family relationships, ethnic identity and psychoactive substance use and lack of social acceptance. Individual factors included peer pressure, stress relief and coping with financial challenges. Accessibility and availability of psychoactive substances in the surrounding environment and lack of monitoring and reinforcement of rules/ law and regulations were other drivers to psychoactive substance use among this Nepalese youth cohort.ConclusionOur study identified several important drivers of psychoactive substance use among youth in the Rupandehi district of Nepal. Future works are anticipated to further explore youth initiation and use of psychoactive substances and support the design of interventions that address these risk factors to reduce and prevent subsequent harms.

Based on Social Cognitive Theory (SCT), this study investigated the factors of psychoactive substance use in terms of current use (past 30 days), lifetime use, and behavioral intention (next 12 months) in Hong Kong adolescent case-clients of social workers from July 2021 to June 2022. The prevalence of current/lifetime psychoactive substance use and behavioral intention to use psychoactive substances was 7.6%/20.9% and 8.6%, respectively. The SCT constructs of positive outcome expectancy of psychoactive substance use, the observational learning indicators, and the environmental factor (easiness to obtain psychoactive substances) were positively associated with current and lifetime psychoactive substance use. Similar associations involving negative outcome expectancy (NOE), emotional relief refusal self-efficacy (RSE), and opportunistic RSE were significant and negative. Furthermore, NOE, emotional relief RSE, and social facilitation RSE were significantly associated with behavioral intention of psychoactive substance use. Future longitudinal studies are warranted to confirm the findings and test pilot interventions.

Background: The objective of this study was to assess the effect of psychoactive substance use on academic performance among university students of Lagos undergraduates. Methods: This is a descriptive cross-sectional study to assess psychoactive substance use and its relation to academic performance among undergraduate students of the University of Lagos. A multi-stage sampling technique was used to select the participants. Data was collected using a self-administered semi-structured questionnaire adapted from WHO model core questionnaire self-administered format. Data was collected and analyzed using the free-liscence software package Epi-Info, version 7.2.2.16. Chi square and Fisher's exact were used to test for any significant association between psychoactive substances use and academic performance of the respondents. Level of significance (p) was set at 0.05. Result. Prevalence of psychoactive substance use was 28.6%. Male and female respondents were270 (69.77%) and 117(30.23%) respectively, with age range between 14 and 30 and mean age of 20.51 (SD)(±2.91) year. Alcohol was the most abused substance with 68.99%, this was followed by cigarette with 20.67% ever use prevalence. The mean age of first use of psychoactive substance was 16.31±3.89. Using the Grade Point Average system from the previous semester, majority of the respondents (87.08%) had GPA >2.50. Both frequency of studying and mean CGPA was statistically better among non-life time users and non-current users of alcohol, tobacco and cannabis in the male group. However there was no statical significance among female group. Using fischer exact test to assess the effect of age of first substance use and mean CGPA. The age of first substance use was statistically significant for tobacco p = 0.007. Conclusion. Psychoactive substance use among students was common and negatively associated with students’ academic performance especially among male gender.

Psychoactive substance use among adolescents has been identified as an important health issue in Nepal. Therefore, this study examined the psychoactive substance use and factors associated with its use among adolescent students in the Rupandehi district of Nepal. A school-based cross-sectional study was conducted from December 2017 to July 2018 with 460 school students aged between 15 to 19 years across sampled public and private schools in the Rupandehi district of Nepal. Structured interview schedule was used to collect information on psychoactive substance use. The generalized estimating equation was used to identify the factors associated with the use of psychoactive substances. Over a quarter (27.4%) of school-going adolescents used at least one type of psychoactive substance. Commonly used psychoactive substance included tobacco products (59.3%) followed by cannabis (55.6%), marijuana (35.8%), hashish (23.5%), alcohol (22.2%), heroin (18.5%), nitrogen tablets (14.8%), sulfa (13.6%) and opium (13.6%), respectively. Being male (AOR=2.0, 95% CI: 1.19-3.36), having peers (AOR=1.8, 95% CI: 1.13-3.03) or family members (AOR=2.2, 95% CI: 1.40-3.54) that used psychoactive substances and father's education level (AOR=2.5, 95% CI: 1.05-5.78) were significantly associated with the psychoactive substance use. This study identified that over a quarter of school-going adolescents reported the use of at least one illegal psychoactive substance. This study provided details on the extent of behaviours, and can be used to develop a comprehensive prevention and control program. Such programs should address the socio-cultural factors that enable substance use and address gaps in knowledge to prevent and control of psychoactive substance use.

Context: Substance use is a widely recognized and pressing public health issue with grave consequences. It is important to prevent mishaps of substance use among the police. Aim: This study assessed the prevalence and factors associated with 12-month psycho-active substance use among police officers in Kano, Nigeria. Settings and Design: A cross-sectional study was conducted among police officers serving within metropolitan Kano. Methods and Materials: Pre-validated, adapted, semi-structured questionnaires were used to collect socio-demographic, work-related data and information on psycho-active substance use. Statistical Analysis Used: Multi-variate logistic regression modeling was used to determine factors associated with psycho-active substance use. All analyses were performed using STATA/IC 15.0. Results: Among 275 officers with a mean age of 35.1 ± 7.7 years, 14.9% (n = 41) recently used one or more psycho-active substances within the last 12 months, and tobacco was the most commonly used (n = 41, 100%). A lower likelihood of substance use was found among officers who were in their fifth decade of life (aOR = 0.29, 95% CI: 0.10–0.55), had tertiary education (aOR = 0.32, 95% CI: 0.14–0.77), were inspectors (aOR = 0.15, 95% CI: 0.16–0.61), were at the rank of ASP or higher (aOR = 0.58, 95% CI: 0.30–0.78), and had been in service between 16 and 20 years (aOR = 0.23, 95% CI: 0.11–0.65). Conclusion: Demographic and work-related characteristics influence the use of psycho-active substances among police officers in Nigeria. There is a need to revamp existing substance monitoring strategies to avoid catastrophic consequences of substance use among the society's gatekeepers.

Introduction The World Health Organization (WHO) defines dual diagnosis (DD) as “the coexistence of psychoactive substance use and another psychiatric disorder in the same person” [1]. Clinicians, researchers, and policymakers are concerned with this issue due to the difficulties involved in managing dual diagnoses, including high relapse rates, reduced participation in treatment, and less favourable treatment results [2]. The literature indicates a higher risk of psychoactive substance use disorders in individuals who have grown up with psychiatric disorders [3]. Although psychiatric comorbidity in adults with substance abuse issues is well documented, it has been less thoroughly investigated in adolescents [4]. Nevertheless, it remains a highly relevant issue for national drug and mental health policies. Adolescents with dual diagnoses place a significant social and economic burden on the public healthcare system, as the interaction between substance use and psychiatric disorders creates a vicious cycle that further worsens later difficulties, such as family conflicts, academic problems, and criminal behavior [2]. The aim of the study is to estimate the prevalence of National Health Service users (0-18 years old) who have been diagnosed with psychiatric disorders related to substance abuse in Lombardy between 2016 and 2022. Methods Data Sources and Study Population The data used for this study were drawn from the administrative healthcare utilization databases of the Lombardy Region, which are routinely employed for reimbursement purposes. The observation period spanned from January 1, 2016, to December 31, 2022. The study population included all individuals aged 0–18 years as of December 31 of each year, residing in the Lombardy Region. Case Definition An individual was classified as a case if, at least once during a given year, they either accessed the Emergency Department or were hospitalized. Case identification was based on the presence of specific ICD-9-CM codes (291–292, 303–305), which indicate psychiatric conditions associated with psychoactive substance use. Emergency Department visits were included if any of the above codes were recorded as a diagnosis. Hospitalizations were considered when any of the specified codes appeared in one of the six diagnosis fields of the hospital discharge records. This definition allowed for the identification of adolescents (aged 0–18 years) who had contact with healthcare services for issues related to the comorbidity of psychiatric disorders and psychoactive substance use. Statistical Analysis Annual and monthly prevalence rates (per 1,000 individuals) were calculated by gender, by age group (0–2, 3–5, 6–10, 11–13, and 14–18 years) and observation year, using the number of identified cases as the numerator and the total population aged 0–18 in Lombardy as the denominator. A negative binomial regression model was applied to estimate the monthly number of prevalent cases, stratified by gender and age group. The model included month as a categorical variable, year as a continuous variable, and period as a categorical variable (January 2016–December 2019, January 2020–December 2021, and January 2022–December 2022). The natural logarithm of the population count was included as an offset term. Results In 2022, 87 cases involving hospital admissions or Emergency Department visits for psychiatric disorders related to substance and alcohol abuse were recorded. From 2016 to 2022, prevalence showed variable trends: an increase from 2016 to 2018, a decline until 2020, followed by fluctuations in the last two years, without returning to 2016 levels. Stratification by sex revealed fluctuating prevalence before the pandemic, with females peaking in 2018 and males in 2017 and 2019. Both sexes reached their lowest levels in 2020, with a more pronounced rebound in females during the final two years. By age group, the highest prevalence was consistently observed among adolescents aged 14–18, peaking in 2018, dipping sharply in 2020, and partially recovering in 2021. Younger age groups (0–2 and 3–5 years) showed stable or gradually decreasing prevalence, while the 6–10 and 11–13 groups maintained very low rates throughout the period. Conclusions The rise in prevalence from 2016 to 2018 may reflect increased adolescent substance use, growing attention to youth mental health, and the impact of social media and cyberbullying [5]. The 2020 decline likely relates to COVID-19, with a rebound in 2021 and slight drop in 2022 due to case re-emergence and service adjustments [6,7]. By sex, females peaked in 2018, possibly due to binge drinking and psychotropic use; males peaked in 2017 and 2019, linked to social media and cyberbullying. Post-COVID sex differences may stem from different coping strategies. Adolescents are the most affected age group, followed by infants (0–2), possibly due to prenatal exposure [8]. Children aged 6–13 show low prevalence, likely due to limited exposure. Further investigations are currently underway to assess the relationship between case distribution and socio-economic factors across Lombardy’s provinces.

The costs to the individual and to society of psychoactive substance use is of growing concern in Bhutan. This study aimed to assess the relation between the demographic variables of patients admitted to the National Referral Hospital for first-time detoxification and the psychoactive substances used. The demographic variables and types of psychoactive substance used by 284 substance users were reviewed. Data were collected through patients' history sheets and admission registers, and analysed through descriptive statistics, one-way analysis of variance and independent t test. The commonest psychoactive substance used was alcohol, followed by cannabis, nitrazepam, dextropropoxyphene, glue (inhaled) and chlorphenamine/ pseudoephedrine/codeine-containing cough syrup. Only 14% of participants were aged 45 years or older. Most patients used more than one substance; the mean number of psychoactive substances used was highest among males, individuals aged 15-24 years and those who were unemployed. Among patients admitted for first-time detoxification, harmful use of alcohol is the most common, followed by cannabis and illicit prescription drugs. Preventive measures should be prioritized on a need-based strategy. The findings of this study indicate that some of these preventive measures should be focused on males, unemployed groups and youth, and should involve raising awareness of harmful use of substances and the services available to treat substance use disorders.

The aim of the study was to investigate whether the prevalence of self-declared depressive symptoms among adolescents attending secondary schools in Krakow is associated with increased frequency and type of psychoactive substance use, and whether depressive symptoms, viewed as a categorical or dimensional variable, may be important in detecting risk of psychoactive substance use among adolescents. A cross-sectional analysis was performed in a group of 1,515 17-year-old students with the use of the Beck Depression Inventory and an original Stimulants questionnaire. The analysis of the risk of using psychoactive substances was carried out in relation to independent variables expressed as continuous variables. In the group of boys, each additional point on the Beck scale increased the overall risk of substance use by 3.3%, cigarette smoking by 2.7%, drinking alcohol by 2.7%, and drug use by 4%. In the group of girls, each additional point on the Beck scale increased the risk of substance abuse - overall by 3.7%, cigarette smoking by 3.6%, drinking alcohol by 3.1%, and drug use by 5.9%. Depressive symptoms, approached as a continuous variable, increase the risk of psychoactive substance use in both boys and girls, in particular a strong relationship is observed in the group of girls with low severity of symptoms. The presence of declared depressive symptoms increases the risk of using psychoactive substances, especially alcohol and tobacco, and to a lesser extent drugs, in both boys and girls. The use of a dimensional approach made it possible to identify the relationship between increasing depressive symptoms and psychoactive substance use in the group of girls regarded as 'healthy' ('with a negative screening diagnosis') in the categorical approach.

Psychoactive substance use among Chinese non-engaged youth: The application of the Health Belief Model

Background:Several studies have examined the prevalence and pattern of substance use among medical students in Nigeria. Few of these studies have specifically examined the relationship between the psychological distress and psychoactive substance use among these students. Yet, evidence world-wide suggests that substance use among medical students might be on the rise and may be related to the level of stress among them.Aim:The present study is the first study aimed to determine the prevalence, pattern and factors associated with psychoactive substance use among medical students of Olabisi Onabanjo University, Ogun State, Nigeria.Subjects and Methods:The World Health Organization student drug use questionnaire was used to evaluate for substance use among 246 clinical medical students between September and October 2011. General health questionnaire (GHQ) 12 was used to assess for psychological distress among these students. Statistical analysis was performed using the SPSS version 16. (Chicago, USA). Proportions were compared using the Chi-square test while a value of P < 0.05 was considered statistically significant. Fisher exact test was used instead of Chi-square when the number in the cell is less than 5.Results:Lifetime prevalence of substance use among medical students was 65% (165/246). It was found that the most commonly used substances were alcohol 63.4% (156/246), mild stimulants 15.6% (38/246), tobacco 15% (37/246) and sedatives 6.1% (15/246). Substance use was associated with gender, frequency of participation in religious activities and GHQ scores.Conclusion:Psychoactive substance use is a major problem among medical students. Psychological well-being plays a significant role in substance use among these students. There is a need for adequate screening and assessment for substance use disorders among these students and incorporating stress management strategies in their curriculum.

Background: Bullying and substance use are behaviours that occur among adolescents and have potentially adverse implications for normal development, health, and functioning in adulthood. This study aimed to determine the pattern of psychoactive substance use and its relationship with bullying among adolescents in Calabar, Nigeria. Methods: In this cross-sectional study, 420 adolescents were randomly recruited from eight secondary schools in Calabar. After informed consent was obtained, a sociodemographic questionnaire, the Adolescent Peer Relations Instrument, and a screening tool for psychoactive substance use were administered. Data was analysed using SPSS version 22, and the alpha level was set at 0.05. Results: Respondents were 201 (47.9%) males and 219 (52.1%) females, with a mean age of 13.98 (SD = 1.79). Prevalence of past-year use was 18.8% for alcohol, 12.4% for inhalants, 6% for stimulants, 6% for cocaine, and 3.3% for cannabis; use of tobacco, opioids, sedatives, and hallucinogens was below 3%. Mean bullying and victimisation scores were 28.8 and 31.4, respectively. Drug users had significantly higher mean scores on both dimensions (p &lt; 0.05). In regression analysis, illicit drug use independently predicted bullying (B = 6.71, 95% CI: 3.66– 9.77, p &lt; 0.001) and victimisation (B = 5.84, 95% CI: 1.98–9.71, p = 0.003) scores, after adjusting for age, gender, and school type. Conclusion: Bullying behaviour and psychoactive substance use are prevalent among adolescents in Calabar. Illicit drug use significantly increases the likelihood of both perpetrating and experiencing bullying, highlighting the need for targeted, school-based mental health and substance use interventions.

BACKGROUND: The extent of (ab)use of the Novel Psychoactive substances has been thoroughly mapped in the developed world, particularly in the US, Canada, UK, Western Europe, Australia, and New Zealand. However, there are still untapped geographic locations particularly in the developing world including the Middle East.MATERIALS AND METHODS: This study is observational in nature and cross-sectional in design; it is based on a survey that will aim is to estimate the level of knowledge and the extent of (ab)use of psychoactive substances, traditional and novel, in a population of undergraduate medical students from Iraq. There will be an implementation of inferential statistical analyses for the purpose of hypothesis testing. Ethical approvals were granted from the College of Medicine at the University of Baghdad and the University of Hertfordshire.RESULTS: There was some degree of knowledge in connection with psychoactive substances among a population of medical students. However, the extent of (ab)use is still minimal when compared to that of the developed countries. In general, the knowledge and the extent of NPS (ab)use did not vary substantially as the students progressed through the medical college.CONCLUSION: The use of observational analytic tools for assessing the diffusion of the phenomenon of psychoactive and novel psychoactive substances is indispensable. The extent of knowledge and (ab)use of NPS in the Middle East may still be considered minute or insignificant. Further analyses are required in the Middle East; different populations are to be targeted including; students, academics, researchers, medical and paramedical staff, psychiatric patients, prisoners, military and para-military organisations, and even terrorists.