Determinants of substance use among young people attending an urban primary health center in Delhi.

The current study examined the association among family history of substance use problems, childhood maltreatment, and age of first drug use in a sample of men and women seeking treatment for methamphetamine dependence. Various forms of childhood maltreatment were considered as mediators of the association between family history of substance use problems and age of first drug use. Participants (N = 99, 40% women, mean age 33) who were under treatment for methamphetamine dependence completed a baseline interview that obtained demographic information, past substance use by participants, history of drug/alcohol problems in their family of origin, and age at first use of any drug (excluding alcohol and tobacco). The Early Trauma Inventory Self-Report-Short Form was used to assess child maltreatment experiences before the age of 18. Family history of substance use problems and childhood physical (but not emotional or sexual) trauma significantly predicted age of first drug use. Further, childhood physical trauma mediated the association between family history of substance use problems and age of first drug use. These findings suggest that the experience of childhood physical abuse may be an important mechanism through which family history of substance use is associated with an earlier age of first drug use.

Removing the stigma of medication for opioid use disorder

Substance use in adolescents poses a complex societal challenge, undermining nation-building and socioeconomic growth. Religiosity encompasses a person's religious beliefs, habits, and involvement in spiritual activities. Family functioning refers to a family unit's overall health and operation, including communication, emotional bonding, support, roles, and behavioral control. Both aspects are pivotal in determining substance use in adolescents. This study assesses the association between religiosity and family functioning and determines factors concerning substance use among adolescents in secondary schools in high-risk areas. A cross-sectional study was conducted with 312 adolescents from selected secondary schools in substance use hotspot areas in Northern Malaysia. The tools used were Alcohol, Smoking, and Substance Involvement Screening Tool-Lite (ASSIST-Lite), Family Adaptation and Cohesion Scale version IV (FACES-IV), and Hatta Islamic Religiosity Scale (HIRS). The prevalence of substance use among adolescents was 9.6% (n = 30). Most users used a single substance (76.7%; n = 23), and only 23.3% (n = 7) used multiple substances. The mean age was 14.13 years (SD:0.67), the majority being Malays (99.0%; n = 309) with an Islamic background. Adolescent substance use was significantly associated with gender (16.3% in males and 6.3% in females, P = 0.004) and having a recent family history of substance use (16.8%, P = 0.003). No significant association between substance use and religiosity scores were elicited (W(1)=2.610, P = 0.106 and W(1)=0.092, P = 0.761 for knowledge and practices, respectively). However, substance use was found to be associated with family functioning subscales, which were chaotic family scores (W(1)=4.588, P = 0.032), and family satisfaction score (W(1)=4.831, P = 0.028). Regression analysis revealed that being male (Adj.OR=3.08, P = 0.006) and having a recent family history of substance use (Adj.OR=3.17, P = 0.004) significantly predicted substance use. This study highlights the role of chaotic family dynamics and family satisfaction and its influence onto adolescent substance use. Despite the insignificant finding between religiosity and substance use, further exploration in this area is may prove beneficial to enhance care for individuals.

Although substance use may have adverse impacts on cancer outcomes, little is known regarding patterns of concurrent substance use with cannabis among cancer patients. Our objective was to examine predictors of concurrent substance use with cannabis among cancer patients since their cancer diagnosis and explore perceptions of cannabis among these patients. Patients treated at a National Cancer Institute-designated comprehensive cancer center were invited to participate in an electronic survey regarding medical cannabis from August to November 2021. Survey data were linked to internal data resources including electronic health records and patient intake forms to obtain history of substance use (defined as within at least 3 months of cancer diagnosis) of cigarettes, injection drugs, high levels of alcohol, or clinically unsupervised prescription drugs (total n = 1094). Concurrent substance users were defined as those with any reported substance use and cannabis use at the time of cancer diagnosis. We used descriptive statistics (χ2 or exact tests) to compare groups and estimated adjusted odds ratios (AORs) with 95% confidence intervals (CIs) to identify predictors of substance use among users and nonusers of cannabis. Approximately 45% (n = 489) of the sample reported cannabis use since their cancer diagnosis. Of patients who reported using cannabis, 20% self-reported concurrent polysubstance use, while 8% of cannabis nonusers reported substance use (P < .001). Among patients who use cannabis, those who reported 2 or more self-reported treatment-related symptoms (eg, pain, fatigue) were more likely to have self-reported concurrent substance use (AOR = 3.15, 95% CI = 1.07 to 9.27) compared with those without any symptoms. Among nonusers, those with lower educational background were more likely to have a history of concurrent substance use (AOR = 3.74, 95% CI = 1.57 to 8.92). Patients who use cannabis with concurrent substance use were more likely to report improved sleep (P = .04), increased appetite (P = .03), and treatment of additional medical conditions (P = .04) as perceived benefits of cannabis use. High symptom burden may be associated with concurrent substance use with cannabis among cancer patients.

substance abuse is the use of a drug that affects both the function and the structure of the brain by altering the activity neurotransmitters of particular pathways in the central nervous system that affect the mood, perception, and consciousness of the person. a cross-sectional study design was employed among 422 high school students. Study participants were selected by simple random sampling from all five high school students. A self-reported questionnaire was used that included alcohol, smoking, and substance involvement screening test, Oslo-3 social support, and other instruments. Data were checked, coded, and entered into Epi-Data version 4.6.2 then exported to the statistical package for social sciences version 20 for analysis. Bi-variable and multi-variable logistic regression analyses were used to identify factors associated with substance use. Adjusted odds ratios with 95% confidence intervals were determined and predictors with a p-value of <0.05 were counted as significantly associated. a total of 406 students have participated with an overall response rate of 96.2% (n=406). Of the participants 235 were female and 171 were male. The mean age was 17.51 with a standard deviation of ±1.42. The prevalence of substance use among study participants was 52.5%. Being male aOR: 1.77, 95% CI 1.11-2.77, family history of substance use aOR: 3.07, 95% CI 1.57-6.01, and having close friends´ pressure aOR: 5.77, 95% CI 2.39-13.89 were significantly associated with substances use among high school students. the prevalence of substance use among high school students was high. Being male, family history of substance use, and having peer pressures were strongly associated with substance use.

Introduction: Prevalence rates of Substance Use Disorders (SUDs) in patients with schizophrenia are reported to be about twice of that of the general population. Co-morbid SUDs in these patients can affect the natural course of the illness, quality of life and treatment compliance. Increased rates of hospital admissions, longer duration of inpatient stay, more severe psychopathology, increased rates of criminal activity and violent behaviour have also been reported in this group of patients. Data from the region on substance use in patients with schizophrenia is sparse. Aim: To study the prevalence of SUD’s in patients with schizophrenia and the risk factors associated with SUD’s and patient Explanatory Models (EM) regarding the same. Materials and Methods: The present cross-sectional study was conducted in the Psychiatry Outpatient Clinic at Christian Medical College, Vellore, Tamil Nadu, India, from November 2016 to May 2017 in 103 consecutive patients with schizophrenia. Symptom severity was assessed using the Positive and Negative Symptom Scale (PANSS), substance use patterns with the Drug Abuse Screening Test (DAST), Alcohol Use Disorders Identification Test (AUDIT) and Fagerstrom’s Test for Nicotine Dependence (FTND) and patient EMs for substance use with a semistructured questionnaire. Socio-demographic and clinical details were also recorded. Data was analysed using Statistical Package for Social Sciences (SPSS) software version 16.0.1. Chi-square test and the student’s t-test were used to assess the significance of association for categorical and continuous variables respectively. The Pearson’s correlation coefficient was employed to assess the statistical significance of the association between two continuous variables. A p-value &lt;0.05 was considered as statistically significant. Results: The mean age of the participants was 37.54 years. The majority of the participants were males (n=60, 58.3%), 62 (60.2%) were married, 97 (94.2%) were literates and 54 (52.4%) participants were employed. The prevalence of substance use was seen in 30 (29.1%) participants. Nicotine was the most common substance of abuse (n=21, 20.4%) followed by alcohol (n=19, 18.4%). Male gender, being employed and a family history of substance use were factors significantly associated with any substance use with p-values 0.001, 0.001 and 0.01, respectively. Patient’s explanations for the use of the nicotine included the feeling of relaxation it produced (n=13, 61.9%), and feeling more energetic and active (n=12, 57.1%). Making one more relaxed and social (n=14, 73.7%) was the most common patient explanation for alcohol use. Conclusion: Alcohol and nicotine were common substances of abuse among the participants in this study. It is useful to understand patient’s explanations for substance use in order to develop effective intervention programmes tailored to the individual patient’s beliefs.

BackgroundSubstance use disorder is an important public health problem and one of the major causes of disability worldwide. Substance use and criminal behavior are closely related and there is a significant association between substance misuse and crime, but little is known about substance use disorder among prisoners, in particular in low-income countries. Therefore, we investigated substance use disorder and associated factors in inmates of a correctional institution in Jimma, Southwest Ethiopia.MethodsWe used a cross-sectional study design to collect data from 336 prisoners from June 5 to July 5, 2017. Study participants were selected from the total of 1460 prisoners eligible for the study by a systematic random sampling technique, i.e., one participant was randomly selected from every four consecutive admissions in the registration book. Alcohol use disorder, nicotine dependence, khat abuse, cannabis use disorder, psychopathy, adverse traumatic life events, and social support were assessed. Data were entered into EpiData version 3.1 and analyzed in bivariate and multivariable logistic regression models with the Statistical Package for Social Science version 21. Variables with a P value < 0.05 in the final fitting model were declared to be associated with the outcome variable.ResultsThe overall prevalence of substance use disorder was 55.9%. The prevalence of khat abuse was 41.9%; alcohol use disorder, 36.2%; nicotine dependence, 19.8%; and cannabis use disorder, 3.6%. Poor social support, living in urban areas, psychopathy, and a family history of substance use were positively associated with substance use disorder.ConclusionsSubstance use disorder is prevalent among prisoners. The increased morbidity and unpleasant psychosocial consequences associated with substance use disorder, together with our finding that 66.3% of prisoners with substance use disorder were interested in obtaining treatment, suggest a need to establish prison-based treatment in this correctional institution in Jimma.

To find out the prevalence of substance use and associated factors among adolescents of the rural area of Jaipur, Rajasthan. This cross-sectional study was carried out in 461 adolescents of rural area Achrol of Jaipur using systematic random sampling technique. Sample size of 461 was calculated using 4PQ/L2 with a prevalence of substance use at 15.8 %. We utilized a pre-developed, pre-validated, semi-structured questionnaire based on the WHO steps questionnaire with specific adaptations was used. The data was analyzed using SPSS Software version 23, and the Chi-square test was employed for qualitative data analysis. The findings revealed that the average (Mean) age of the study participants was 14.1±2.1. Maximum of the study participants (53.3 %) were in the age group of 14-16 years. Males were more (69.6 %) as compared to females (30.3 %). The overall prevalence of substance use was 26.4 % among the study participants. About one fourth (22.2 %) of participants had consumed alcohol in the past. Only (2.1 %) of them were daily smokers. Majority (95.8 %) of the study participants had never consumed any type of Intravenous drug. Factors like family history of substance abuse, high body mass index, low physical activity were statistically significantly associated with different forms of substance use. The study population exhibited a high prevalence of substance use and related risk factors. Important risk factors for different forms of substance use prevalent in the study population included male gender, obesity, family history of substance use, and low levels of physical activity.

This study explored gender‐related symptoms and correlates of alcohol dependence in a cross‐sectional study of 150 men and 150 women with a lifetime diagnosis of alcohol use disorders (AUD). Participants were recruited in equal numbers from treatment settings, correctional centres and the general community. Standardized measures were used to determine participants' use of substances, history of psychiatric disorders and psychosocial stress, their sensation seeking and family history of substance use and mental health disorders. Multivariate analyses were used to detect patterns of variables associated with gender and the lifetime severity of AUD. Men had a longer history of severe AUD than women. Women had similar levels of alcohol dependence and medical and psychological sequelae as men, despite 6 fewer years of AUD. More women than men had a history of severe psychosocial stress, severe dependence on other substances and antecedent mental health problems, especially mood and anxiety disorders. There were differences in family history of alcohol‐related problems approximating same‐gender aggregation. The severity of a lifetime AUD was predicted by its earlier age at onset and the occurrence of other disorders, especially anxiety, among both men and women. The limitations in the generalizability of these findings due to sample idiosyncrasies are discussed.

Substance use disorders in pregnancy: clinical, ethical, and research imperatives of the opioid epidemic: a report of a joint workshop of the Society for Maternal-Fetal Medicine, American College of Obstetricians and Gynecologists, and American Society of Addiction Medicine

ABSTRACTFamily history (FH) of substance use disorders (SUDs) and stressful life events (SLEs) are known risk factors for SUDs in adolescents and young adults. Cross‐sectional studies suggest that FH and SLEs affect adolescent white matter (WM) development and form abnormal WM patterns. Here, we examined the effects of FH, SLEs and their interaction on WM integrity in youths in the Adolescent Cognitive Brain Development (ABCD) study at baseline and 2‐ and 4‐year follow‐ups. ABCD youths (N = 8939, age ± SD = 9.9 ± 0.6 years, 4302 female) completed baseline diffusion tensor imaging, of which 5661 repeated the scan at 2‐year follow‐up (age ± SD = 12.0 ± 0.7 years, 2634 female) and 2177 at 4‐year follow‐up (age ± SD = 14.1 ± 0.7 years, 1007 female). FH was measured as the weighted sum of biological parents and grandparents with alcohol and/or drug problems. SLEs were measured with parental report of life events. WM integrity was measured with fractional anisotropy (FA) of 23 WM tracts. Linear mixed effect models were used to examine the effects of FH, SLEs and their interaction on FA at baseline and longitudinally, modelling family and study site as random intercepts and correcting for multiple comparisons with false discovery rate (FDR) q = 0.05. At baseline, there were no significant effects of FH, SLEs and their interaction on FA after multiple comparison correction when controlling for race, family income and parental education. From baseline to 4‐year follow‐up, FH significantly negatively interacted with newly occurred SLEs on FA in 19 out of 23 tracts, so that FA at 4‐year was lower in youths with both FH and newly occurred SLEs when controlling for baseline FA (βinteraction = −0.049 − −0.018, pFDR = 6.2 × 10−5 − 4.7 × 10−2). These negative interactions were not significant with shorter time spans (baseline to 2‐year follow‐up and 2‐ to 4‐year follow‐up). In conclusion, we replicated findings from cross‐sectional cohorts of the effects of FH and SLEs on lower WM integrity in youths. The study utilized Big Data longitudinal design to show that FH‐by‐SLE interaction, rather than their independent effects was responsible for developmental WM changes associated with FH of SUDs and life stressors.

In recent years substance use has increased greatly throughout the world. Adolescence is the critical period when the first initiation of substance use takes place. Interventions at the adolescent age are effective to bring about lifestyle modifications. A community-based, cross-sectional study was carried out among 260 randomly selected adolescents in an urban slum area, with the objective of studying the prevalence and determinants of substance use among adolescents. The adolescent age group was selected as defined by the World Health Organization (WHO) (10 - 19 years). The overall prevalence of substance use was 32.7%. About 31% initiated substance use at 13 - 15 years of age, and the reason was peer pressure in 52.9%. Education of the study subject, education of parents, and substance use by parents and by peers were significantly associated with substance use. Children and parents should be educated to prevent substance use. There was a need to change the social environment.

Socio-cultural subgroups of Latina/o immigrants: A latent profile analysis

This study sought to ascertain if family histories of alcohol (FHPA) and drug problems (FHPD) are more prevalent among certain healthcare professions than others, and if an association between FHPA or FHPD and current alcohol and drug use exists. As part of a larger mail survey during the summer of 2002, 479 (response 68.7%) dentists, nurses, pharmacists and physicians from a north‐eastern US state completed self‐report items on FHPA, FHPD, monthly alcohol and past‐year drug use. Nurses reported a higher prevalence of FHPA than other groups of healthcare professionals (HCPs). Contrary to our prediction, FHPA in nursing was not associated with drinking level. Nurses also reported significantly higher FHPD than dentists and physicians, but not pharmacists. FHPD was significantly associated with past‐year drug use among physicians. To our knowledge, this is the first study to assess quantitatively FHPA and FHPD across multiple groups of HCPs. The results of this study suggest that FHPA and FHPD differ across groups of HCPs and a significant number choose nursing as a profession. To delineate the association between nursing and family history of substance use, more research into the familial dynamics/individual differences among these individuals is necessary.

Objective: To analyze the psychopathology and pattern of remission in cannabis-induced psychotic disorder with treatment.Methods: This was a prospective cohort study of a group of patients admitted with new-onset psychosis, cannabis use, and no evidence of other drug abuse from January 1 to June 31, 2019, to the psychiatry inpatient department of a multispecialty tertiary care hospital in Kerala, India. Patients were evaluated at admission and after 1 week in the hospital and 1 month after discharge using the Structured Clinical Interview for the Positive and Negative Syndrome Scale and the Clinical Global Impressions-Severity of illness scale.Results: Fifty-six male subjects were recruited for the study. The mean age of the subjects was 22.2 years, and the majority were active smokers of nicotine and cannabis. Total duration of abuse and family history of substance use in first-degree relatives correlated with severity of psychosis. Hostility, excitement, and grandiosity were the predominant positive symptoms, and these symptoms showed a steady reduction toward the end of the study. The most frequent negative symptoms were emotional withdrawal, passive or apathetic social withdrawal, and difficulty in abstract thinking, and these symptoms also showed significant improvement (P < .001 for all). For symptoms such as somatic concern and guilt feelings, significant treatment response was noted only in the initial week (P < .001).Conclusions: Cannabis-induced psychosis in the Indian setting presents with predominant positive symptoms and minimal affective symptoms. The steady improvement noted with complete cessation of cannabis indicates a possible contributory role for cannabis in precipitating psychosis.