Hoggatt, Katherine J; Jamison, Andrea L; Lehavot, Keren; Cucciare, Michael A; Timko, Christine; Simpson, Tracy L
We conducted a systematic literature review on substance misuse, abuse, and dependence in women veterans, including National Guard/reserve members. We identified 837 articles published between 1980 and 2013. Of 56 included studies, 32 reported rates of alcohol misuse, binge drinking, or other unhealthy alcohol use not meeting diagnostic criteria for abuse or dependence, and 33 reported rates of drug misuse or diagnosed alcohol or drug use disorders. Rates ranged from 4% to 37% for alcohol misuse and from 7% to 25% for binge drinking; among Veterans Health Administration (VA) health-care system outpatients, rates ranged from 3% to 16% for substance use disorder. Studies comparing women veterans and civilians reported no clear differences in binge or heavy drinking. Substance misuse rates were generally lower among women veterans than men veterans. Substance misuse was associated with higher rates of trauma, psychiatric and medical conditions, and increased mortality and suicide rates. Most studies included only VA patients, and many used only VA medical record data; therefore, the reported substance misuse rates likely do not reflect true prevalence. Rates also varied by assessment method, source of data, and the subgroups studied. Further efforts to develop epidemiologically valid prevalence estimates are needed to capture the true health burden of substance misuse in women veterans, particularly those not using VA care. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.
identification, prevention and management of drug misuse and abuse. Results: A total number .... problem among families/friends, a little more than one-quarter of students ..... treatment of over-the-counter drug misuse and abuse in community ...
Norman, Ian J; Bergin, Michael; Parry, Charles D; Van Hout, Marie Claire
PURPOSE: Promoting and ensuring safe use of codeine containing medicines remains a public health issue given the rise in reporting of misuse and dependence particularly in countries where available over-the-counter (OTC). The aim of this unique study was to identify best practices in management of opioid abuse and dependence, particularly codeine, and innovations to meet challenges surrounding safe and compliant use, patient awareness-raising, reducing health harms and enhancing successful tr...
Background. Misuse of prescription and over-the-counter codeine-containing products is a global public health issue. Objectives. To investigate the extent of treatment demand related to the misuse of codeine or codeine dependence in South Africa (SA) and the profile of patients seeking treatment, so as to understand the ...
Ribble, Mike S.; Bailey, Gerald D.
Over the last two years, it has become evident that a behavior pattern of misuse and abuse with respect to technology is beginning to emerge in society. This outbreak of technology misuse and abuse is documented in continual news coverage on TV, in newspapers and on the Internet--both inside and outside of schools. The endless list of misuse and…
Have you been putting bullion in your soup? Is incorrect spelling starting to have a negative affect on your term papers? Do you wonder what someone is inferring when they tell you to pick up a dictionary? These are just a few of the commonly misunderstood words discussed and explained in Abused, Confused, and Misused Words, an entertaining and informative look at the ever-changing nature of the English language. An alphabetical list of words that are frequently misspelled or misused is accompanied by a style guide to usage rules that tells you how and why
Kristen, G; Schaefer, A; von Schlichtegroll, A
Fenetylline (CAPTAGON) is included in a list of compounds to be considered by a World Health Organization (WHO) Expert Committee in April 1985 for possible international scheduling under the Convention on Psychotropic Substances, 1971. For over 23 years, this central stimulant has been used therapeutically in hyperkinetic children and other indications in place of amphetamines and other central stimulants with higher risk levels. In good correspondence with recent animal data fenetylline also shows significant qualitative and quantitative differences compared to amphetamine in man. It has few adverse side effects, a lower abuse potential and little actual abuse compared to amphetamine. Thus its benefit/risk assessment is substantially more favourable than that of other central stimulants. For proper therapeutic use of the substance, prescription status is or should be required by national authorities.
Biggs, Jessica M; Morgan, Jill A; Lardieri, Allison B; Kishk, Omayma A; Klein-Schwartz, Wendy
The use of dietary supplements has increased and is associated with adverse effects. Indications for use include recreation, body image concerns, mood enhancement, or control of medical conditions. The risk of adverse effects may be enhanced if agents are used improperly. The objective of this study was to determine the frequency of abuse and misuse of 4 dietary substances among adolescents reported nationally to poison centers. Secondary outcomes included an assessment of medical outcomes, clinical effects, location of treatments provided, and treatments administered. This descriptive retrospective review assessed data concerning the use of garcinia (Garcinia cambogia), guarana (Paullinia cupana), salvia (Salvia divinorum), and St John's wort (Hypericum perforatum) among adolescents reported nationally to poison centers from 2003 to 2014. Adolescents with a singlesubstance exposure to one of the substances of interest coded as intentional abuse or misuse were included. Poison center calls for drug information or those with unrelated clinical effects were excluded. Data were collected from the National Poison Data System. There were 84 cases: 7 cases of Garcinia cambogia, 28 Paullinia cupana, 23 Salvia divinorum, and 26 Hypericum perforatum. Garcinia cambogia was used more frequently by females (100% versus 0%), and Paullinia cupana and Salvia divinorum were used more frequently by males (61% versus 36% and 91% versus 9%, respectively). Abuse, driven by Salvia divinorum, was more common overall than misuse. Abuse was also more common among males than females (p <0.001). Use of these agents fluctuated over time. Overall, use trended down since 2010, except for Garcinia cambogia use. In 62 cases (73.8%), the medical outcome was minor or had no effect or was judged as nontoxic or minimally toxic. Clinical effects were most common with Paullinia cupana and Salvia divinorum. Treatment sites included emergency department (n = 33; 39.3%), non-healthcare facility (n = 24
Zosel, Amy; Bartelson, Becki Bucher; Bailey, Elise; Lowenstein, Steven; Dart, Rick
Objective: To describe the characteristics and health effects of adolescent (age 13-19 years) prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS[R])) System. Method: Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all…
Treister, Roi; Trudeau, Jeremiah J; Van Inwegen, Richard; Jones, Judith K; Katz, Nathaniel P
Inappropriate use of analgesic drugs has become increasingly pervasive over the past decade. Currently, drug abuse potential is primarily assessed post-marketing; no validated tools are available to assess this potential in phase II and III clinical trials. This paper describes the development and feasibility testing of a Misuse, Abuse, and Diversion Drug Event Reporting System (MADDERS), which aims to identify potentially abuse-related events and classify them according to a recently developed classification scheme, allowing the quantification of these events in clinical trials. The system was initially conceived and designed with input from experts and patients, followed by field-testing to assess its feasibility and content validity in both completed and ongoing clinical trials. The results suggest that MADDERS is a feasible system with initial validity. It showed higher rates of the triggering events in subjects taking medications with known abuse potential than in patients taking medications without abuse potential. Additionally, experts agreed on the classification of most abuse-related events in MADDERS. MADDERS is a new systematic approach to collect information on potentially abuse-related events in clinical trials and classify them. The system has demonstrated feasibility for implementation. Additional research is ongoing to further evaluate its validity. Currently, there are no validated tools to assess drug abuse potential during clinical trials. Because of its ease of implementation, its systematic approach, and its preliminary validation results, MADDERS could provide such a tool for clinical trials. (Am J Addict 2016;25:641-651). © 2016 American Academy of Addiction Psychiatry.
Full Text Available Codeine, a weak opiate, requires increased pharmacovigilance relating to availability, heterogeneous nature of misuse, dependence and associated harm. A scoping review of literature on codeine was conducted using Arksey & O’Malley’s framework (1. Databases searched included PubMed, EBSCO Host, Science Direct, EMBASE, PsycINFO, Cochrane library and Medline from 1994 to 2014. Follow-up search strategies involved hand searching and searching of pharmaceutical, health, medical and drug related websites. Initial zscreening identified 3,105 articles with 475 meeting the inclusion criteria. Eight broad categories organised the literature, data charting and qualitative synthesis. This paper presents implications for practice and makes recommendations to address these issues. Themes identified relate to raising public and practitioner awareness, risk management, dispensing practices and monitoring and surveillance of codeine. Evidence to inform law enforcement, drug surveillance, public health initiatives, harm reduction approaches, pharmacy, clinical and treatment practices is warranted.
Vowles, Kevin E; McEntee, Mindy L; Julnes, Peter Siyahhan; Frohe, Tessa; Ney, John P; van der Goes, David N
Opioid use in chronic pain treatment is complex, as patients may derive both benefit and harm. Identification of individuals currently using opioids in a problematic way is important given the substantial recent increases in prescription rates and consequent increases in morbidity and mortality. The present review provides updated and expanded information regarding rates of problematic opioid use in chronic pain. Because previous reviews have indicated substantial variability in this literature, several steps were taken to enhance precision and utility. First, problematic use was coded using explicitly defined terms, referring to different patterns of use (ie, misuse, abuse, and addiction). Second, average prevalence rates were calculated and weighted by sample size and study quality. Third, the influence of differences in study methodology was examined. In total, data from 38 studies were included. Rates of problematic use were quite broad, ranging from addiction averaged between 8% and 12% (range, 95% CI: 3%-17%). Abuse was reported in only a single study. Only 1 difference emerged when study methods were examined, where rates of addiction were lower in studies that identified prevalence assessment as a primary, rather than secondary, objective. Although significant variability remains in this literature, this review provides guidance regarding possible average rates of opioid misuse and addiction and also highlights areas in need of further clarification.
Margaret E. Mattson
Full Text Available Case reports in medical literature suggest that the atypical antipsychotic quetiapine, a medication not previously considered to have abuse potential, is now being subject to misuse and abuse (MUA; ie, taken when not prescribed for them or used in a way other than instructed by their health professional. Here we present systematic, nationally representative data from the 2005 to 2011 Drug Abuse Warning Network (DAWN for prevalence of emergency department (ED visits among the U.S. general population involving quetiapine and related to MUA, suicide attempts, and adverse reactions. Nationally, quetiapine-related ED visits increased 90% between 2005 and 2011, from 35,581 ED visits to 67,497. DAWN data indicate that when used without medical supervision for recreational/self-medication purposes, quetiapine poses health risks for its users, especially among polydrug users and women. These findings suggest that the medical and public health communities should increase vigilance concerning this drug and its potential for MUA.
As for substance-related disorders, there were several differences between ICD-10 and DSM-IV, however, the concept of "dependence" had been essential for both criteria. DSM-5 published in 2013 had erased dependence. This confuses us. It is important to recognize dependence again. "Abuse" is the self-intake behavior of drug against the social norms. Repeated abuse results in dependence. Dependence is a state of loss of control against drug use due to craving. Abuse can produce "acute intoxication", and repeated abuse under dependence can produce "chronic intoxication". It is important to understand abuse, dependence and "intoxication" based on their relationship from the point of time course.
Spiller, Henry A; James, Kyla J; Scholzen, Steven; Borys, Douglas J
Clenbuterol is a β2-agonist approved in the United States for veterinary use in nonfood animals. Clenbuterol use is emerging among bodybuilders and fitness enthusiasts attracted to the hypertrophic and lipolytic effects. This was a retrospective chart review of clenbuterol exposures reported to 2 poison control centers. Misuse of clenbuterol for weight loss and bodybuilding was reported in 11 of 13 clenbuterol users. Reported clinical effects included tachycardia, widened pulse pressure, tachypnea, hypokalemia, hyperglycemia, ST changes on electrocardiogram (ECG), elevated troponin, elevated creatine phosphokinase (CPK), palpitations, chest pain, and tremor. Measured serum clenbuterol concentration was 2983 pg/mL post 4.5 mg ingestion. Co-ingestants included T3 and anabolic steroids. Treatments included activated charcoal, benzodiazepines, β-blockers, potassium replacement, and intravenous (IV) fluid. There is an increasing use of the Internet for illicit drug use for bodybuilding and weight loss purposes. These patients may not present as the stereotype of illicit drug abusers, but as healthy athletic low-risk patients. Clinical effects persisted greater than 24 hours with evidence of myocardial injury in 2 patients. Clenbuterol is increasingly being abused within the bodybuilding subculture. These cases illustrate the hidden dangers of clenbuterol abuse among bodybuilders and fitness enthusiasts.
Vakkalanka, J Priyanka; King, Joshua D; Holstege, Christopher P
The purpose of this study was to characterize the epidemiological trends associated with substances used in intentional exposures among children while on school property reported to the U.S. National Poison Data System (NPDS). NPDS was queried for intentional (abuse, misuse, suspected suicide, and unknown intentional) exposures reported to occur on school property between calendar years 2004 and 2013. Records were restricted to children 6-18 years of age. Demographic, exposure, and clinical characteristics were assessed. A total of 56,882 substances were intentionally used on school property by 50,379 children, of which 39.8% were females (n = 20,070), 57.7% were males (n = 29,084), and 2.4% were unknown gender (n = 1,225). The most frequent pharmaceutical exposures reported included sedatives (n = 4,096; 8.1%), analgesics (n = 4,022; 8.0%), and cough and cold preparations (n = 3,529; 7.0%). The majority of exposures were managed on site (n = 21,464; 42.6%), followed by care at a healthcare facility (n = 20,048; 39.7%). Serious outcomes (moderate or major effects and death) accounted for nine percent of all reported exposures. Compared to reference groups, female gender, teenagers 17-18 years, and pharmaceutical substances (Prevalence Ratios = 4.6, 9.4, and 9.9, respectively) were associated with suspected suicides when compared with other intentional exposures. Along with other national data about behaviors in the adolescent and teenage population, additional trends in risky behavior may be gleaned by surveillance through poison centers. With over 5,000 annual reports to the poison centers about intentional exposures on school property, school personnel and parents/guardians must be vigilant about the range of pharmaceutical and non-pharmaceutical substances that are used for abuse, misuse, or suicide.
1 Alcohol, Tobacco and Other Drug Research Unit, South African Medical ... A semi-structured interview comprising 20 questions (8 qualitative ... report on OTC and prescription-only medicines produced by the ....  Codeine misusers in rural areas in particular face many ... patients in SA, compared with 30% for Ireland.
Van Hout, Marie Claire; Rich, Eileen; Dada, Siphokazi; Bergin, Michael
Misuse of codeine-containing medicines is an emerging global public health concern. The majority of research has been conducted in developed countries (European Members States, Australia, the United States). This study aimed to gain an understanding of unique individual and collective experiences of trajectories of codeine misuse and dependence in South Africa. In-depth interviews were conducted with a purposive sample of adult codeine misusers and dependents ( n = 25). Narratives were analyzed using the empirical phenomenological psychological five-step method. Nine themes with 63 categories emerged, with two additional high levels of abstraction. Findings are illustrated: participant profile and product preferences, motives for use, transitioning to misuse and dependence, pharmacy purchasing and alternative sourcing routes, effects and withdrawal experiences, help-seeking and treatment experiences, and strategies for prevention. The study underscores the need for continued support for enhanced patient awareness of risk of habit forming use and related health consequences and professional pharmacovigilance.
Zosel, Amy; Bartelson, Becki Bucher; Bailey, Elise; Lowenstein, Steven; Dart, Rick
To describe the characteristics and health effects of adolescent (age 13-19 years) prescription drug abuse and misuse using the Researched Abuse Diversion and Addiction-Related Surveillance (RADARS(®)) System. Secondary analysis of data collected from RADARS System participating poison centers was performed. Data for all intentional exposures from 2007 through 2009 were used to describe adolescent prescription opioid (oxycodone, fentanyl, hydrocodone, hydromorphone, morphine, methadone, buprenorphine, and tramadol) and stimulant (methylphenidate and amphetamines) exposures. A total of 16,209 intentional adolescent exposures to prescription drugs were identified, 68% to opioids and 32% to stimulants. The mean age was 16.6 years (SD ± 1.7 years). Slightly more than half (52.4%) of drug mentions involved females. The five most frequently misused or abused drugs were hydrocodone (32%), amphetamines (18%), oxycodone (15%), methylphenidate (14%), and tramadol (11%). Of all exposures, 38% were classified as suspected suicidal. Of adolescents who intentionally exposed themselves to prescription drugs, 30% were treated in a health care facility, 2,792 of whom were admitted to the hospital, including 1,293 to the intensive care unit. A total of 17.2% of intentional exposures were associated with no effect, 38.9% minor effects, 23.3% moderate effects, 3.6% major effects, and 0.1% were associated with death. Oxycodone and methadone were associated with the most deaths. No deaths were associated with exposures to stimulants. Prescription drug misuse and abuse poses an important health problem and results in thousands of hospitalizations of adolescents per year. Further work is needed to develop focused interventions and educational programs to prevent prescription drug abuse and misuse by adolescents. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
PTSD, depression , 7 suicidality , lowered resilience and work performance. Studies consistently find that substantial number of Guard members misuse...including PTSD, depression , suicidality , lowered resilience and work performance. Studies consistently find that substantial number of Guard members misuse...Guard members that contributes to and complicates other problems including PTSD, depression , suicidality , lowered resilience and work performance
Bucher Bartelson, Becki; Le Lait, M Claire; Green, Jody L; Cepeda, M Soledad; Coplan, Paul M; Maziere, Jean-Yves; Wedin, Gregory P; Dart, Richard C
An unintended consequence of extended-release (ER) and long-acting (LA) prescription opioids is that these formulations can be more attractive to abusers than immediate-release (IR) formulations. The US Food and Drug Administration recognized these risks and approved the ER/LA Opioid Analgesic Risk Evaluation and Mitigation Strategy (ER/LA REMS), which has a goal of reducing opioid misuse and abuse and their associated consequences. The primary objective of this analysis is to determine whether ER/LA REMS implementation was associated with decreased reports of misuse and abuse. Data from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS(R)) System Poison Center Program were utilized. Poison center cases are assigned a reason for exposure, a medical outcome, and a level of health care received. Rates adjusted for population and drug utilization were analyzed over time. RADARS System Poison Center Program data indicate a notable decrease in ER/LA opioid rates of intentional abuse and misuse as well as major medical outcomes or hospitalizations following implementation of the ER/LA REMS. While similar decreases were observed for the IR prescription opioid group, the decreasing rate for the ER/LA opioids exceeded the decreasing rates for the IR prescription opioids and was distinctly different than that for the prescription stimulants, indicating that the ER/LA REMS program may have had an additional effect on decreases in opioid abuse and intentional misuse beyond secular trends. Copyright © 2017 John Wiley & Sons, Ltd.
Ogawa, Naoshi; Ueki, Hirofumi
Caffeine is the most widely consumed psychoactive substance and is a legal stimulant that is readily available to children. Caffeine has occasionally been considered a drug of abuse and the potential for dependence on caffeine has been debated. Presently, due to a paucity of clinical evidence on caffeine dependence or abuse, no such diagnosis is included in the Diagnostic and Statistical Manual of Mental Disorder-fourth edition. The authors present two cases of abuse or dependence on the caffeine contained in 'eutrophic' (energy/nutritional) beverages or caffeine preparations, followed by a review of clinical studies demonstrating evidence that some people can manifest a clinical syndrome of caffeine dependence or abuse. The cases suggest that caffeine can produce a clinical dependence syndrome similar to those produced by other psychoactive substances and has a potential for abuse. In a recent study using a structured interview and the Diagnostic and Statistical Manual of Mental Disorder-fourth edition criteria for substance dependence and abuse, a subset of the general population was found to demonstrate caffeine dependence or caffeine abuse. Therefore, the authors propose that companies or businesses manufacturing or marketing caffeine or products containing caffeine must meet the following guidelines: (i) clearly indicate the caffeine content of products containing comparatively higher quantities of caffeine; (ii) warn that such products should be avoided by infants and children wherever possible, and inform adult consumers about the precise quantity of caffeine that is considered safe for consumption; and (iii) clearly state that consuming large quantities of caffeine and the long-term use of caffeine carry health risks.
Ward, Rose Marie; Oswald, Barbara B.; Galante, Marina
The misuse of prescription stimulants (MPS), risky drinking, and drunkorexia are current public health concerns. The present study assessed the prevalence of MPS and drunkorexia using an online survey. Specifically, we examined alcohol consumption, the Rutgers Alcohol Problem Index, Compensatory Eating and Behaviors in Response to Alcohol…
Parry, Charles; Rich, Eileen; Van Hout, Marie-Claire; Deluca, Paolo
Background. General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector.\\ud Objectives. To investigate the perspectives of addiction treatment providers regarding treatment for codeine misuse or dependence.\\ud Method. Twenty addiction treatment providers linked to th...
Victorri-Vigneau, Caroline; Gérardin, Marie; Rousselet, Morgane; Guerlais, Marylène; Grall-Bronnec, Marie; Jolliet, Pascale
In 2004, the health authorities (French National Agency for Medicines and Health Products Safety-ANSM) modified the summary of zolpidem characteristics. Particularly it now includes the sentence "a pharmacodependence may materialize." The current article aims to show that despite this modification, zolpidem continues to be associated with problematic drug use, as the official system (Center for Evaluation and Information on Pharmacodependence-Addictovigilance network) providing information on the abuse and dependence potential of drugs informs us. The authors reviewed the literature on this topic and analyzed French data from zolpidem's postmarketing period that were collected by the Addictovigilance network from 2003 to 2010. Postmarketing data and the 30 case reports yielded from the literature review highlight a significant dependence and abuse potential for zolpidem. This survey led to propose in stronger additional rules in France to try to mitigate the abuse potential of zolpidem.
Yang, Jingxiang; Ward, Michael D; Kahr, Bart
Fake news?? The contact insecticide DDT has been reappraised as a safe, life-saving compound by special interest groups committed to repealing environmental regulations. It is shown in this essay how some specific toxicological data has been misused by those aiming to disingenuously influence public policy. Graphic: Pestroy, a DDT-laced coating marketed in 1946 by Sherwin-Williams Research Laboratories. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.
Charles D H Parry
Full Text Available Background. General practitioners are referring patients with codeine-related problems to specialist treatment facilities, but little is known about the addiction treatment providers, the kinds of treatment they provide, and whether training or other interventions are needed to strengthen this sector. Objectives. To investigate the perspectives of addiction treatment providers regarding treatment for codeine misuse or dependence. Method. Twenty addiction treatment providers linked to the South African Community Epidemiology Network on Drug Use and the South African Addiction Medicine Society were contacted telephonically and asked 20 questions. Results. While many participants had received training in pharmacological management of individuals with opioid dependence, only two had received specific training on codeine management. Between half and two-thirds of the treatment settings they worked in provided detoxification, pharmacotherapy, psychosocial treatment and aftercare. Very few treatment settings offered long-term treatment for codeine misuse and dependence. Participants indicated that over half of their codeine patients entered treatment for intentional misuse for intoxication, and dependence resulting from excessive or long-term use. The main barriers to patients entering treatment were seen as denial of having a problem, not being ready for change, mental health problems, stigma, and affordability of treatment. Participants identified a need for further training in how to manage withdrawal and detoxification, treatment modalities including motivational interviewing, and relapse prevention. Conclusions. Gaps in training among treatment providers need to centre on how to manage withdrawal from codeine use and detoxification, motivational interviewing and relapse prevention. Interventions are needed to address barriers to entering treatment, including user denial.
Wójta-Kempa, Monika; Krzyżanowski, Dominik M
Almost 90% of households in Poland buy medicines on their own initiative. The most popular OTC medicines bought by Polish consumers are painkillers and non-steroid-anti-inflammatory drugs. The aim of this article was to recognize and describe the most important predictive factors of the abuse and misuse of over-the-counter pain relievers among adults in Wrocław (Poland). The groups of users were selected and described. Some examples of misuse were analyzed. Three hundred eighty six adult inhabitants of Wrocław took part in the survey. The quota sample was representative referring to the most important socio-demographic factors (sex and median age). Almost 91% of participants declare taking OTC pain relievers, and 1.3% of them are their daily users. Only 6.2% of adult inhabitants of Wrocław never take OTC pain relievers. The category of "heavy users" embraces 11% of participants. The most important risk factors of overusing OTC pain relievers are sex (female), age over 55 years and the low health status. Only half of participants read the box label regularly and 25% of users admit they have modified recommended doses. Over 60% shortened recommended intervals between doses and 16% took two or more different pain medications (containing different substances). The non-medical purposes of using OTC pain relievers were: tiredness (7%), stressful situations (5.4%), and discomfort (18.4%). Some users take pain medications to cure hangovers (26%), or instead of the appropriate medicine (7%). About 20% take pain medications without a doctor's advice for longer than the recommended 3 days, and 10% never consult taking such medications with doctors. Pain should be treated aggressively and successfully, especially among chronically ill patients. We should monitor the consumption of OTC pain relievers and limit their current excessively supply and high availability.
Chambers, P.L.; Chambers, C.M.; Gitter, S.
The present proceedings containing 77 papers were presented at a meeting of the European Society of Toxicology held in Tel Aviv, March 21-24, 1982. The topics were: Effects of foreign substances on blood, drugs of abuse with special reference to marijuana and phencyclidine, toxic agents in food, xenobiotics, novel and new techniques in toxicology and miscellaneous toxic effects. Individual abstracts are prepared of 11 papers.
Samokhvalov, Andriy V; Popova, Svetlana; Room, Robin; Ramonas, Milita; Rehm, Jürgen
Alcohol use disorders (AUD), i.e., alcohol dependence and abuse, are major contributors to burden of disease. A large part of this burden is because of disability. However, there is still controversy about the best disability weighting for AUD. The objective of this study was to provide an overview of alcohol-related disabilities. Systematic literature review and expert interviews. There is heterogeneity in experts' descriptions of disabilities related to AUD. The major core attributes of disability related to AUD are changes of emotional state, social relationships, memory and thinking. The most important supplementary attributes are anxiety, impairments of speech and hearing. This review identified the main patterns of disability associated with AUD. However, there was considerable variability, and data on less prominent patterns were fragmented. Further and systematic research is required for increasing the knowledge on disability related to AUD and for application of interventions for reducing the associated burden. Copyright © 2010 by the Research Society on Alcoholism.
Full Text Available Substance abuse and dependence among the employed have massive cost implications for South Africa. Employers are legally obliged to provide opportunities for the treatment of substance dependence before dismissal is considered. Problem areas are the following: inadequate identification of employees with substance-abuse problems, infrequent treatment referrals, and overlooking of substance abuse in the workplace. This article attempts to address these issues by providing an overview of literature dealing with the problem of substance abuse and dependence in the workplace. Addressing this problem calls for specialist intervention measures, which are discussed in the article.
Leemans, C; Loas, S
Abuse is a complex psychosocial issue with multiple implications. This paper takes a look at the physical and psychological manifestations of domestic violence, i.e. between adult (romantic) partners as well as abuse of the elderly. Past studies have looked at the relationship between emotional dependency, the occurence and sustainability of abuse and the likehood that a victimized person will terminate a relationship. Indeed, individuals with Dependent Personality Disorder (DPD) or with dependent characteristics present a higher risk of becoming abusive (both physically and mentally) as well as becoming a victim of abuse. Regarding the elderly, the concept of "reverse violence"--where the current abuser was the victim of the senior who is being abused-, also entails dependent relationships. We identified three concepts that are necessary in the understanding of how dependent relationships underpin abuse: Rusbult's model of commitment in intimate relationships, the notion of dependency-possessiveness and Murphy et al's notion of escalating affective dependency. Thus, it is imperative that future studies in the field of domestic violence look at the dynamics of dyads rather than the individuals alone.
Hensing, G; Spak, F; Thundal, K L; Ostlund, A
To analyse dimensions of gender identity and its association to psychiatric disorders and alcohol consumption. The study was performed in two stages: an initial screening (n = 8335) for alcohol consumption, followed by a structured psychiatric interview (n = 1054). The Masculinity/Femininity-Questionnaire was used as an indicator of gender identity. The final study group included 836 women. Leadership, caring, self-assertiveness and emotionality were dimensions of gender identity found in a factor analysis. Low self-assertiveness, high emotionality and to some extent low leadership were associated with increased odds for having bipolar disorders, severe anxiety disorders and alcohol dependence and misuse. Low self-assertiveness and high emotionality were not only associated with alcohol dependence and misuse, but also with high episodic drinking. There was an association between some of the dimensions of gender identity and psychiatric disorders and alcohol consumption. Further attention is needed in both clinical work and research.
Winhusen, Theresa M; Lewis, Daniel F; Riggs, Paula D; Davies, Robert D; Adler, Lenard A; Sonne, Susan; Somoza, Eugene C
Psychostimulants are effective treatments for attention-deficit/hyperactivity disorder (ADHD) but may be associated with euphoric effects, misuse/diversion, and adverse effects. These risks are perceived by some clinicians to be greater in substance-abusing adolescents relative to non-substance-abusing adults. The present study evaluates the subjective effects, misuse/diversion, and adverse effects associated with the use of osmotic-release oral system methylphenidate (OROS-MPH), relative to placebo, for treating ADHD in adolescents with a substance use disorder (SUD) as a function of substance use severity and compared these risks with those associated with the treatment of ADHD in adults without a non-nicotine SUD. Datasets from two randomized placebo-controlled trials of OROS-MPH for treating ADHD, one conducted with 303 adolescents (13-18) with at least one non-nicotine SUD and one with 255 adult smokers (18-55), were analyzed. Outcome measures included the Massachusetts General Hospital Liking Scale, self-reported medication compliance, pill counts, and adverse events (AEs). Euphoric effects and misuse/diversion of OROS-MPH were not significantly affected by substance use severity. The euphoric effects of OROS-MPH did not significantly differ between the adolescent and adult samples. Adults rated OROS-MPH as more effective in treating ADHD, whereas adolescents reported feeling more depressed when taking OROS-MPH. The adolescents lost more pills relative to the adults regardless of treatment condition, which suggests the importance of careful medication monitoring. Higher baseline use of alcohol and cannabis was associated with an increased risk of experiencing a treatment-related AE in OROS-MPH, but baseline use did not increase the risk of serious AEs or of any particular category of AE and the adolescents did not experience more treatment-related AEs relative to the adults. With good monitoring, and in the context of substance abuse treatment, OROS-MPH can
Arias, Francisco; Szerman, Nestor; Vega, Pablo; Mesias, Beatriz; Basurte, Ignacio; Morant, Consuelo; Ochoa, Enriqueta; Poyo, Félix; Babin, Francisco
The main objective of this study was to analyse the cocaine addict subgroup from the Madrid study of prevalence of dual disorders in community mental health and substance misuse services. The sample consisted of 837 outpatients from Madrid, Spain. We compared 488 subjects who had a lifetime diagnosis of cocaine abuse or dependence, and 222 subjects who did not have a cocaine substance use disorder. We used the Mini International Neuropsychiatric Interview to evaluate axis I mental disorders, and the Personality Disorder Questionnaire to evaluate personality disorders. Almost three-quarters (73.4%) of cocaine addicts had a current dual disorder. Most prevalent were mood and anxiety disorders. Almost half (49.6%) had a personality disorder. Most of them (94.9%) had other substance use disorders. Cocaine addicts did not have higher prevalence rates of dual pathology than addicts with no cocaine abuse or dependence. Cocaine addicts were associated to a diagnosis of antisocial personality disorder, agoraphobia, and post-traumatic stress disorder, and they had an early age of onset of alcohol and cannabis use. Dual pathology is no higher in cocaine addicts in treatment than in addicts who do not use cocaine, however cocaine addicts started other drugs earlier, and were associated with specific mental disorders. Copyright © 2012 SEP y SEPB. Published by Elsevier Espana. All rights reserved.
Gonzales, Nancy A; Jensen, Michaeline; Tein, Jenn Yun; Wong, Jessie J; Dumka, Larry E; Mauricio, Anne Marie
Substance abuse preventive interventions frequently target middle school students and demonstrate efficacy to prevent early onset and use of alcohol and illicit drugs. However, evidence of sustained results to prevent later patterns of alcohol misuse and more serious alcohol abuse disorders has been lacking, particularly for US Latino populations. To test whether a universal middle school prevention program can reduce the frequency of alcohol misuse and rates of alcohol use disorder 5 years after implementation with a Mexican American sample. A previous randomized clinical trial was conducted with 516 Mexican American 7th graders and at least 1 parent who identified as having Mexican origin. Three annual cohorts of families were recruited from rosters of 4 middle schools and randomized to the 9-session Bridges/Puentes family-focused group intervention or a workshop control condition. Recruitment, screening, pretest, and randomization occurred in the same academic year for each cohort: 2003-2004, 2004-2005, and 2005-2006. Data acquisition for the follow-up assessments of late-adolescent alcohol misuse and abuse, which were not included in the initial randomized clinical trial, was conducted from September 2009 to September 2014; analysis was conducted between August 2016 and July 2017. In this assessment, 420 children (81.4%) of the sample were included, when the majority were in their final year of high school. The 9-session Bridges/Puentes intervention integrated youth, parent, and family intervention sessions that were delivered in the spring semester at each school, with separate groups for English-dominant vs Spanish-dominant families. The control workshop was offered during the same semester at each school, also in English and Spanish. Primary outcomes were diagnostic assessment of lifetime alcohol use disorder in the 12th grade, 5 years after the intervention, based on the Diagnostic Interview Schedule for Children and past-year frequency of alcohol use
Arias, Francisco; Szerman, Nestor; Vega, Pablo; Mesias, Beatriz; Basurte, Ignacio; Morant, Consuelo; Ochoa, Enriqueta; Poyo, Félix; Babin, Francisco
Cannabis use has been associated to a wide variety of mental disorders, the possible causal role of this use in the etiology of severe mental disorders as schizophrenia or bipolar disorder standing out. Moreover, the cannabinoid system is involved in emotional regulation, so cannabis use could disturb this process and provoke anxiety and mood disorders. The main objective of this study was to analyze the cannabis addict subgroup from Madrid study of prevalence of dual disorders in community mental health and substance misuse services. The sample consisted of 837 outpatients under treatment in the mental health network or drug network of the Community of Madrid (Spain). Of these, 353 subjects had a lifetime diagnosis of cannabis abuse or dependence and 357 subjects did not have cannabis substance use disorder. We used the Mini International Neuropsychiatric Interview (MINI) to evaluate axis I mental disorders, and Personality Disorder Questionnaire to evaluate personality disorders. It was considered that 76.5% of the cannabis addicts had a current dual disorder. The most prevalent ones were mood and anxiety disorders. Of those addicted to cannabis, 51% had a personality disorder. Most of them had several substance use disorders. Cannabis abuse or dependence subjects had an earlier onset in consumption of other drugs such as alcohol, cocaine, and tobacco than addicts without cannabis abuse or dependence. The cannabis addicts also differed from the other addicts because of an association to antisocial personality disorder, bipolar disorder, psychosis and agoraphobia. The presence of these mental disorders was significantly associated to a lower age at initiation of cannabis use. Dual pathology is very high in cannabis addicts under treatment. Said consumption of cannabis, probably within a polysubstance use pattern, is associated to severe mental disorders as psychosis and bipolar disorder. An earlier age of onset in cannabis use is associated to a greater risk of
The nonmedical use of medications, including psychotropic drugs, is a growing health problem in Japan. According to a nationwide survey of mental hospitals, the proportion of patients with sedative (mainly benzodiazepine)-related disorders has more than doubled over the last decade. An association between psychotropic drug overdose and suicide risk has also been reported. Furthermore, over-the-counter drug abuse is still a serious problem in Japan. In recent years, pharmacists have been expected to act as gatekeepers, making timely identifications of suicide risk or substance abuse and directing these individuals to appropriate medical care facilities. In August 2012, the revised Comprehensive Suicide Measures Act identified pharmacists as one professional group that should act as gatekeepers. This article begins by reviewing the fundamental terms involved in understanding the nonmedical use of medications, including abuse, dependence, and intoxication. The current situation of substance abuse and dependence is then introduced through a summary of several epidemiological surveys conducted in Japan. Finally, the role of pharmacists as gatekeepers in preventing substance abuse and dependence on medications is discussed.
Rhemtulla, M.; Fried, E.I.; Aggen, S.H.; Tuerlinckx, F.; Kendler, K.S.; Borsboom, D.
Background: The DSM uses one set of abuse and dependence criteria to assess multiple substance use disorders (SUDs). Most SUD research aggregates across these symptoms to study the behavior of SUD as a static construct. We use an alternative approach that conceptualizes symptoms as directly
... Kids For Teens For Parents & Teachers Resolving Family Conflicts The Holidays and Alzheimer's Glossary Virtual Library Online ... Types of abuse Signs of abuse Reporting abuse Types of abuse Abuse comes in many forms: Physical: ...
McRae-Clark, Aimee L.; Brady, Kathleen T.; Hartwell, Karen J.; White, Kathleen; Carter, Rickey E.
Objective: This 8-week, open-label trial assessed the efficacy of methylphenidate transdermal system (MTS) in 14 adult individuals diagnosed with ADHD and with a history of stimulant misuse, abuse, or dependence. Method: The primary efficacy endpoint was the Wender-Reimherr Adult ADHD Scale (WRAADS), and secondary efficacy endpoints included the…
Bali, Vishal; Raisch, Dennis W; Moffett, Maurice L; Khan, Nasreen
Previous studies have found a negative association between health insurance and nonmedical use of prescription drugs (NMUPD), and abuse or dependence on prescription drugs (ADPD); and mixed associations between health insurance and use of substance abuse treatment (SAT). However, effect of health insurance in the specific subgroups of population is largely unknown. To estimate the relationship between health insurance and (1) NMUPD, (2) ADPD, and (3) use of SAT services among 12-64 years old, noninstitutionalized individuals and to see if these relationships are different in different subgroups of population. This study used cross-sectional survey data from 2007 National Survey on Drug Use and Health. Bivariate and multiple logistic regression analyses were conducted. In 2007, self-reported prevalence of NMUPD was approximately 10% (N=15,509,703). In multivariate analysis, NMUPD was negatively associated with health insurance, age, race other than non-Hispanic White, education, marital status, and income ($40,000-$74,999). Past year use of tobacco and alcohol were positively associated with NMUPD. Among those with private health insurance, Hispanics and individuals with family income less than $20,000 and $40,000-$74,999 were more likely prone to NMUPD than others. High school graduates with public health insurance were less likely prone to NMUPD. Approximately, 13% of nonmedical users reported ADPD (N=2,011,229). Health insurance and age were negatively associated with ADPD. However, people who were unmarried, reported fair/poor health, and used tobacco were more likely to report ADPD. Lastly, the use of substance abuse treatment programs was approximately 73% and 76% between NMUPD and ADPD population, respectively. Health insurance was not associated with use of substance abuse treatment. Individuals with high school education were 2.6 times more likely to use substance abuse treatment than the college graduates. Additionally, no significant interaction effects
Marie, Dannette; Fergusson, David M; Boden, Joseph M
To examine the role of ethnicity and cultural identity in alcohol use and misuse in a birth cohort of over 1000 young people. Data on ethnicity, cultural identification, alcohol use, alcohol abuse/dependence (AAD), socio-economic factors and childhood adversity were gathered as part of a longitudinal study of a New Zealand birth cohort (the Christchurch Health and Development Study). Those reporting Māori ethnicity had rates of alcohol use and AAD that were 1.47-1.63 times higher than the rates found in the non-Māori people. However, there was little evidence to suggest that rates of alcohol use and AAD differed according to Māori cultural identity. Generalized estimating equation regression analyses adjusting for socio-economic disadvantage and childhood adversity slightly reduced the magnitude of these associations, but they remained statistically significant [AAD: odds ratio = 1.52; 95% confidence interval (CI): 1.11-2.10; consumption: incidence rate ratio = 1.31; 95% CI: 1.13-1.52]. (a) Māori ethnicity was found to be associated with modestly increased risks of alcohol use and AAD (b) the higher rates of alcohol use and AAD among the Māori members of the cohort could not be explained by a combination of socio-economic factors and greater exposure to environmental factors known to influence the risk of alcohol use and misuse.
Chiappini, Stefania; Schifano, Fabrizio
A recent years' increase in both prescribing and availability of second-generation antipsychotics (SGAs) has been observed. According to the literature, typically made up by case studies/series, quetiapine seems to be the most commonly misused SGA, with both intranasal and intravenous intake modalities having been described. Another SGA that has been anecdotally reported to be misused is olanzapine. For these molecules, both a previous history of drug misuse and being an inmate have been described as factors associated with misuse. Hence, while providing here an updated literature review of the topic, we aimed at assessing all cases of quetiapine misuse/abuse/dependence/withdrawal as reported to the European Medicines Agency's EudraVigilance (EV) database; this was carried out in comparison with the reference drug olanzapine. All spontaneous, European Medicines Agency database reports relating to both quetiapine (2005-2016) and olanzapine (2004-2016) misuse/abuse/dependence/withdrawal issues were retrieved, and a descriptive analysis was performed. From the EV database, 18,112 (8.64% of 209,571) and 4178 (7.58% of 55,100) adverse drug reaction reports of misuse/abuse/dependence/withdrawal were associated with quetiapine and olanzapine, respectively. The resulting proportional reporting ratio values suggested that the misuse/abuse-, dependence-, and withdrawal-related adverse drug reactions were more frequently reported for quetiapine (1.07, 1.01, and 5.25, respectively) in comparison with olanzapine. Despite data collection limitations, present EV data may suggest that, at least in comparison with olanzapine, quetiapine misuse may be a cause for concern.
Woud, M.L.; Pawelczack, S.; Rinck, M.; Lindenmeyer, J.; Souren, P.M.; Wiers, R.W.H.J.; Becker, E.S.
Background Models of addictive behaviors postulate that implicit alcohol-related memory associations and biased interpretation processes contribute to the development and maintenance of alcohol misuse and abuse. The present study examined whether alcohol-dependent patients (AP) show an
Woud, M.L.; Pawelczak, S.; Rinck, M.; Lindenmeyer, J.; Souren, P.; Wiers, R.W.; Becker, E.S.
Background: Models of addictive behaviors postulate that implicit alcohol-related memory associations and biased interpretation processes contribute to the development and maintenance of alcohol misuse and abuse. The present study examined whether alcohol-dependent patients (AP) show an
Wu, Li-Tzy; Ringwalt, Christopher L.; Mannelli, Paolo; Patkar, Ashwin A.
The study investigates the prevalence, patterns, and correlates of adolescents' abuse, sub-threshold dependence, and dependence on prescription pain relievers (PPRs) in a nationally representative sample. Results show dependence on PPRs can take place without abuse and that sub-threshold dependence could have implications for major diagnostic…
Full Text Available Objective: Traditionally, studies on the non-medical use of pharmaceutical products have focused on controlled substances; e.g., opiates/opioids; and benzodiazepines. Although both bupropion and venlafaxine have been reported as being misused, only anecdotal reports have been made available so far. Hence, the European Monitoring Agency (EMA Adverse Drug Reactions (ADRs, misuse/abuse/dependence and withdrawal, venlafaxine- and bupropion-related, database was here analyzed.Methods: All EMA spontaneous reports relating to venlafaxine (2005–2016 and bupropion (2003–2016 notifications were here analyzed, to provide a descriptive analysis by source, gender, age, and type of report. The UK-based, 2000–2016, Yellow Card Scheme pharmacovigilance database, bupropion and venlafaxine withdrawal reports were compared as well with those pertaining to fluoxetine and paroxetine.Results: Out of 20,720 (bupropion and 47,516 (venlafaxine total number of ADRs, some 2,232 (10.8%, and 4,071 (8.5% misuse/abuse/dependence ADRs were respectively associated with bupropion and venlafaxine. Conversely, bupropion withdrawal-related ADRs were here reported in 299/20,720 (1.44% cases and in 914/47,516 (1.92% cases for venlafaxine. Overall, all bupropion and venlafaxine misuse-/abuse-/dependence- and withdrawal-ADRs were related to a respective number of 264 and 447 patients. According to the Proportional Reporting Ratio (PRR computation, in comparison with venlafaxine bupropion resulted to be more frequently misused/abused (PRR: 1.50, but less frequently associated with both dependence (PRR: 0.92 and withdrawal (PRR: 0.77 issues. Yellow Card Scheme data suggested that paroxetine and venlafaxine, in comparison with fluoxetine and bupropion, were associated with higher number of withdrawal-related reports.Conclusions: The dopaminergic, stimulant-like, bupropion activities may be associated with its possible recreational value. Present data may confirm that the occurrence
Yu. P. Sivolap
Full Text Available Alcohol abuse and alcoholism are the leading causes of worse health and increased mortality rates. Excessive alcohol consumption is the third leading cause of the global burden of diseases and a leading factor for lower lifespan and higher mortality. Alcohol abuse decreases working capacity and efficiency and requires the increased cost of the treatment of alcohol-induced disorders, which entails serious economic losses. The unfavorable medical and social consequences of excessive alcohol use determine the importance of effective treatment for alcoholism. The goals of rational pharmacotherapy of alcohol dependence are to enhance GABA neurotransmission, to suppress glutamate neurotransmission, to act on serotonin neurotransmission, to correct water-electrolyte balance, and to compensate for thiamine deficiency. Alcoholism treatment consists of two steps: 1 the prevention and treatment of alcohol withdrawal syndrome and its complications (withdrawal convulsions and delirium alcoholicum; 2 antirecurrent (maintenance therapy. Benzodiazepines are the drugs of choice in alleviating alcohol withdrawal and preventing its convulsive attacks and delirium alcoholicum. Diazepam and chlordiazepoxide are most commonly used for this purpose; the safer drugs oxazepam and lorazepam are given to the elderly and patients with severe liver lesions. Anticonvulsants having normothymic properties, such as carbamazepine, valproic acid, topiramate, and lamotrigine, are a definite alternative to benzodiazepines. The traditional Russian clinical practice (clearance detoxification has not a scientific base or significant impact on alcohol withdrawal-related states in addicts. Relapse prevention and maintenance therapy for alcohol dependence are performed using disulfiram, acamprosate, and naltrexone; since 2013 the European Union member countries have been using, besides these agents, nalmefene that is being registered in Russia. Memantine and a number of other
Fortson, Beverly L.; Scotti, Joseph R.; Chen, Yi-Chuen; Malone, Judith; Del Ben, Kevin S.
Objective: To assess Internet use, abuse, and dependence. Participants: 411 undergraduate students. Results: Ninety percent of participants reported daily Internet use. Approximately half of the sample met criteria for Internet abuse, and one-quarter met criteria for Internet dependence. Men and women did not differ on the mean amount of time…
Lv Rongbin; Liu Xingdang; Han Mei
Over the past decade, functional neuroimaging has contributed greatly to our knowledge about the neuropharmacology of substance misuse in man. In this review, discussed the application and the progress of the positron emission tomography, single photon emission computed tomography and functional magnetic resonance imaging in the substance misuse. After reading some papers, found that the dopamine transporter was significantly decreased in the brain of subjects with heroin abuse. Also observed a significant decrease of regional cerebral blood flow in bilateral cerebral frontal lobes, temporal lobes, the insula and the ipsilateral basal nuclei in substance misuse subjects. Taken together, functional images will lead the direction in future research formedication development of addiction treatment. (authors)
Furst, R Terry
This study explores strategies that Suboxone misusers utilize while in drug treatment. Ethnographic interviews were conducted with 14 patients who had cycled in and out of Suboxone treatment. The objective of the study is to identify strategies implemented by patients who intermittently use opiates/opioids while in Suboxone treatment. Findings indicate that some patients serially stop and start treatment in a Harm Reduction setting in New York City. Many patients suggest that they manage their opiate/opioid dependency through a sequential use of Suboxone and heroin to avoid withdrawal and to continue their misuse of opiates/opioids. Results are discussed in conjunction with the difficulties inherent to substance abuse treatment and suggestions for improvement are offered.
... dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. 17... of Services of Other Federal Agencies § 17.80 Alcohol and drug dependence or abuse treatment and rehabilitation in residential and nonresidential facilities by contract. (a) Alcohol and drug dependence or abuse...
Tommasello Anthony C
Full Text Available Abstract Pharmacists, the most accessible of health care professionals, are well positioned to help prevent and treat substance use disorders and should prepare themselves to perform these functions. New research improves our knowledge about the pharmacological and behavioral risks of drug abuse, supports the clinical impression that drug dependence is associated with long-lasting neurochemical changes, and demonstrates effective pharmacological treatments for certain kinds of drug dependencies. The profession is evolving. Pharmacists are engaging in new practice behaviors such as helping patients manage their disease states. Collaborative practice agreements and new federal policies set the stage for pharmacists to assist in the clinical management of opioid and other drug dependencies. Pharmacists need to be well informed about issues related to addiction and prepared not only to screen, assess, and refer individual cases and to collaborate with physicians caring for chemically dependent patients, but also to be agents of change in their communities in the fight against drug abuse. At the end of this article the pharmacist will be better able to: 1. Explain the disease concept of chemical dependence 2. Gather the information necessary to conduct a screen for chemical dependence 3. Inform patients about the treatment options for chemical dependence 4. Locate resources needed to answer questions about the effects of common drugs of abuse (alcohol, marijuana, narcotics, "ecstasy", and cocaine 5. Develop a list of local resources for drug abuse treatment 6. Counsel parents who are concerned about drug use by their children 7. Counsel individuals who are concerned about drug use by a loved one. 8. Counsel individuals who are concerned about their own drug use
Olivares Bøgeskov, Benjamin Miguel
This paper presents the result from our research on how nurse managers use and occasionally misuse inconclusive ethical arguments to engage their personnel in current reforms. The Danish health care system has undergone a series of reforms inspired by New Public Management theories, which have......, paying special attention to the way in which ethical arguments are used in relation to engagement. Our research shows that ethical arguments are extremely common, and they are used either to elicit engagement, or to demand engagement considering the result of a duty. However, most interestingly...... it was possible for us to find recurrence of fallacious arguments of different kinds. Based on these findings, I will argue that the use of fallacious arguments in order to generate engagement is in reality an abusive use of ethics, which raises important questions. I argue that depending on the degree...
Jackson, Eric R; Shanafelt, Tait D; Hasan, Omar; Satele, Daniel V; Dyrbye, Liselotte N
To explore the relationship between alcohol abuse/dependence with burnout and other forms of distress among a national cohort of medical students. In 2012, the authors completed a national survey of medical students from the American Medical Association's Physician Masterfile containing validated items assessing alcohol abuse/dependence, burnout, depression, suicidality, quality of life (QOL), and fatigue. Descriptive and comparative statistical analyses were computed, including chi-square and multivariate logistic regression, to determine relationships between variables. Of the 12,500 students, 4,402 (35.2%) responded. Of these, 1,411 (32.4%) met diagnostic criteria for alcohol abuse/dependence. Students who were burned out (P = .01), depressed (P = .01), or reported low mental (P =.03) or emotional (P = .016) QOL were more likely to have alcohol abuse/dependence. Emotional exhaustion and depersonalization domains of burnout were strongly associated with alcohol abuse/dependence. On multivariate analysis, burnout (OR 1.20; 95% CI 1.05-1.37; P $100,000 (OR 1.27 versus dependence. Burnout was strongly related to alcohol abuse/dependence among sampled medical students and increased educational debt predicted a higher risk. A multifaceted approach addressing burnout, medical education costs, and alcohol use is needed.
Ahuja, Tania; Mgbako, Ofole; Katzman, Caroline; Grossman, Allison
This case report describes the development of withdrawal from phenibut, a gamma-aminobutyric acid-receptor type B agonist. Although phenibut is not an FDA-approved medication, it is available through online retailers as a nootropic supplement. There are reports of dependence in patients that misuse phenibut. We report a case in which a patient experienced withdrawal symptoms from phenibut and was successfully treated with a baclofen taper. This case report highlights the development of phenibut use disorder with coingestion of alcohol and potential management for phenibut withdrawal. We believe clinicians must be aware of how phenibut dependence may present and how to manage the withdrawal syndrome.
Full Text Available This case report describes the development of withdrawal from phenibut, a gamma-aminobutyric acid-receptor type B agonist. Although phenibut is not an FDA-approved medication, it is available through online retailers as a nootropic supplement. There are reports of dependence in patients that misuse phenibut. We report a case in which a patient experienced withdrawal symptoms from phenibut and was successfully treated with a baclofen taper. This case report highlights the development of phenibut use disorder with coingestion of alcohol and potential management for phenibut withdrawal. We believe clinicians must be aware of how phenibut dependence may present and how to manage the withdrawal syndrome.
... physical injury, leave marks, or cause pain. Sexual abuse is any type of sexual contact between an adult and anyone younger than 18; between a significantly older child and a younger child; or if one person ...
Marotta, Phillip L
Incarcerated populations have high rates of childhood adversities and substance use problems. Moreover, childhood adversities are well-documented predictors of substance misuse. To investigate the impact of childhood sexual and physical abuse, caregiver abuse of drugs or alcohol, and time spent in foster care on several substance misuse outcomes. Data comes from a sample of 16,043 incarcerated men and women in the United States Survey of Inmates in State and Federal Facilities. Bivariate analyses revealed differences by sex in childhood adversities and socioeconomic characteristics. Logistic regression analyses assessed the data for a link between childhood adversities and substance misuse after adjusting for other variables. Analyses were stratified by sex to show differences in predictors of substance misuse between men and women. Childhood adversities increased the risk of many substance misuse outcomes. The prevalence of physical abuse, sexual abuse, foster care, and caretaker abuse of drugs or alcohol were greatest for inmates who reported injecting and sharing drugs. Growing up with a caregiver that used drugs or alcohol was a consistent predictor of increased risk of substance misuse for men and women. However, childhood sexual abuse increased risk for only women. Inmates who experience physical abuse, sexual abuse, foster care involvement and caretakers who use drugs and alcohol are at an increased risk of substance misuse, injecting drug use and syringe sharing. Implications suggest correctional HIV prevention and substance misuse programs must address unresolved trauma and important gender differences.
Reay, A M; Browne, K D
This study investigates the prevalence of, and differences in, risk factor characteristics in a sample of two select populations of carers, one of which physically abused their elderly dependants and one of which neglected them. Nineteen carers (nine who had physically abused and 10 who had neglected their elderly relatives), who were referred to clinical psychology by either their general practitioner or their psychiatrist, were invited to take part in this study. A detailed history of risk factors was obtained, including history of alcohol dependency, type and history of mental ill health, history of maltreatment earlier in life, who they were caring for, how long they had been a carer and whether they felt isolated as a carer. Subjects were then given five assessments to determine whether there were any differences between the two groups. These were the Conflict Tactic Scale, Strain Scale, Beck Depression Inventory, Beck Anxiety Inventory and Cost of Care Index. An examination of the risk factors suggests that heavy alcohol consumption and past childhood abuse by fathers were likely to lead to physical abuse. Significantly higher conflict and depression scores were also present in the physical abuse group, while the neglect group had significantly higher anxiety scores. It is suggested that these findings should be incorporated into an assessment of future risk of abuse or neglect by the carer.
Adjei, Stephen Baffour
While sociocultural scholarship has attempted an ecological explanation of intimate partner violence, it has largely been criticized for ignoring dispositional factors of both perpetrators and victims. Dependent personality and attachment-related emotional problems have been implicated in the ext......While sociocultural scholarship has attempted an ecological explanation of intimate partner violence, it has largely been criticized for ignoring dispositional factors of both perpetrators and victims. Dependent personality and attachment-related emotional problems have been implicated...... of dependency and attachment-related spousal violence as a form of a psychopathology. This article discusses partner dependency and jealousy-motivated spousal violence as socioculturally situated, dependent on contextual and relational conditions of meaning embedded in the communal society of Ghana....... It highlights Ghanaian communal personality, gendered socialization and meaning systems of marriage as salient sociocultural features for conceptualizing partner dependency and emotional-related spousal violence....
Peña-Salas, Gabriel Felipe; Bareño, José; Berbesi Fernández, Dedsy Yajaira; Gaviria, Silvia L
Having a social phobia may lead to consuming alcohol for greater social assertiveness, running the risk of leading to an abuse disorder or alcohol dependence. The aim of the study was to estimate prevalence of pathological comorbidity between social phobia and alcohol consumption in adults of the city of Medellin, and the behavior of comorbidity by gender, age, presence of a father figure in childhood, and education. Secondary analysis of the database of the first Mental Health Population Survey conducted in the city of Medellin in 2011 and 2012 based on the methodology of the World Mental Health Survey guidelines and coordinated by WHO-HARVARD. The lifetime prevalence of abuse and dependence in people with social phobia was 24.1% and 11.2%, respectively. For people with social phobia the prevalence was 13% for abuse and 4.4% for dependence (OR=2.11 for abuse, OR=2.46 for dependence). Annual prevalence of people with social phobia who abused or were dependent on alcohol was 7.8% and 5.9%, respectively, compared to those who do not suffer from this disorder, with a prevalence of 3.4% and 1.7%, respectively (OR=2.39 for abuse and OR=3.57 for dependence). There was significant correlation in the annual and lifetime prevalence between social phobia and the pathological consumption of alcohol. Statistically significant relationships were found for the variables associated with social phobia, however, more work is needed to confirm or refute these associations. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.
Mair, Christina; Freisthler, Bridget; Ponicki, William R.; Gaidus, Andrew
Background As an increasing number of states liberalize cannabis use and develop laws and local policies, it is essential to better understand the impacts of neighborhood ecology and marijuana dispensary density on marijuana use, abuse, and dependence. We investigated associations between marijuana abuse/dependence hospitalizations and community demographic and environmental conditions from 2001–2012 in California, as well as cross-sectional associations between local and adjacent marijuana dispensary densities and marijuana hospitalizations. Methods We analyzed panel population data relating hospitalizations coded for marijuana abuse or dependence and assigned to residential ZIP codes in California from 2001 through 2012 (20,219 space-time units) to ZIP code demographic and ecological characteristics. Bayesian space-time misalignment models were used to account for spatial variations in geographic unit definitions over time, while also accounting for spatial autocorrelation using conditional autoregressive priors. We also analyzed cross-sectional associations between marijuana abuse/dependence and the density of dispensaries in local and spatially adjacent ZIP codes in 2012. Results An additional one dispensary per square mile in a ZIP code was cross-sectionally associated with a 6.8% increase in the number of marijuana hospitalizations (95% credible interval 1.033, 1.105) with a marijuana abuse/dependence code. Other local characteristics, such as the median household income and age and racial/ethnic distributions, were associated with marijuana hospitalizations in cross-sectional and panel analyses. Conclusions Prevention and intervention programs for marijuana abuse and dependence may be particularly essential in areas of concentrated disadvantage. Policy makers may want to consider regulations that limit the density of dispensaries. PMID:26154479
Blay, Sergio Luis; Fillenbaum, Gerda G.; Andreoli, Sergio Baxter; Gastal, Fabio Leite
Background Little is known about the sociodemographic correlates and health effects associated with lifetime alcohol misuse in community resident elderly in Brazil. Method Data came from a representative sample of 6961 residents aged 60+ in the State of Rio Grande do Sul, Brazil. The structured interview included a five-item lifetime alcohol use questionnaire addressing abuse and dependence, and enquiry regarding sociodemographic characteristics, lifestyle and social support, and health conditions. Results Of the sample, 10.6% (25.3% men, 2.9% women) endorsed at least one lifetime alcohol misuse question. Controlled analyses comparing a gradient of alcohol misuse (none, one, more than one item endorsed), found that men, people age 60–69 (compared to older persons), and tobacco users were more likely to endorse alcohol misuse items. Persons reporting lower income, and of nonWhite race/ethnicity did not differ from their comparison groups with respect to endorsing one item, but they were more likely to endorse two or more items. Endorsing more than one item was associated with impaired activities of daily living, the presence of respiratory problems and psychiatric disorder, but was protective against vascular conditions. Conclusions Major lifetime alcohol misuse (defined as endorsing more than one of five items reflecting alcohol abuse or dependence) is more common in certain sociodemographic groups (men, younger elderly, lower income, nonWhites). With the exception of vascular conditions, it is associated with smoking, poorer functional status, respiratory problems, and psychiatric disorder. Endorsing only one item has a reduced association, significant only for male gender, smoking, and psychiatric disorder. PMID:19141169
In conclusion, misuse of oral hypoglycaemic agents (OHA) to treat LUTS with subsequent presentation in hypoglycaemic coma should be of concern to the health care provider especially the urologist. It is of no benefit and constitutes drug abuse that should be discouraged. Keywords: drug abuse, hypoglycaemia, lower ...
Miller, Ted; Novak, Scott P; Galvin, Deborah M; Spicer, Rebecca S; Cluff, Laurie; Kasat, Sandeep
We assessed the prevalence and characteristics of prescription drug misuse among youth ages 15-25 to examine differences by student and employment status, and associations with workplace antidrug policies and programs. Multivariate logistic regressions analyzed associations in weighted data on the 20,457 young adults in the combined 2004-2008 National Surveys on Drug Use and Health. Demographic controls included sex, race, community size, and age group. After we accounted for demographic controls, at ages 15-25, students were less likely than nonstudents to misuse prescription drugs. Segmenting student from nonstudent groups, working consistently was associated with a further reduction in misuse for those ages 18-25. When we controlled for demographics and substance use history, both Employee Assistance Program (EAP) services and awareness that one's employer had a drug-free workplace policy were associated with significantly lower misuse of prescription drugs (OR = 0.85 for each program, 95% CI [0.73, 1.00] and [0.72, 1.00]). Associations of workplace antidrug policies and programs with marijuana use and with Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, criteria for alcohol abuse and dependence contrasted sharply with these patterns. All four aspects were significantly associated with lower marijuana use. None was associated with problem drinking. Protective effects of drug-free workplace policy and EAPs persist after other substance use was controlled for. Comparing the effects of workplace programs on illicit drug use and problem drinking versus prescription misuse suggests that those protective associations do not result from selection bias. Thus, drug-free workplace policies and EAPs appear to help protect younger workers against prescription misuse. If workplace substance use disorder programs focused prevention messages and interventions on prescription drug misuse, their impact on misuse might increase.
... services for veterans with alcohol or drug dependence or abuse disabilities. 17.82 Section 17.82 Pensions... Agencies § 17.82 Contracts for outpatient services for veterans with alcohol or drug dependence or abuse... sponsored residents to adjust to and maintain freedom from dependence on or involvement with alcohol or drug...
Snyder, Susan M; Smith, Rachel E
To date studies have not explored patterns of substance use exclusively among youth in the child welfare system. Consequently, little is known about polysubstance use among child welfare-involved youth. This study aimed to explore whether physical abuse, parental substance use, depression, and demographic characteristics predict distinct patterns of substance use among child welfare-involved youth using latent class analysis (LCA). The sample included 822 11-17 year olds who participated in the National Survey of Child and Adolescent Well-being (NSCAW II) study between March 2008 and September 2009. We found the following three classes: (1) polysubstance use, (2) alcohol and marijuana use, and (3) low use. Older youth and youth who experienced physical abuse were at greater risk of being in the polysubstance use class, while living with a biological parent reduced the likelihood of polysubstance use class membership. Youth in the alcohol and marijuana use class were more likely to be older and depressed. Results from this study illuminate important targets for interventions.
Babakhanian, Masuade; Sadeghi, Maliheh; Mansoori, Nader; Alam Mehrjerdi, Zahra; Tabatabai, Mahmood
Objective: The purpose of the present preliminary study was to explore the prevalence of nonmedical abuse of benzodiazepines in a group of opiate-dependent patients who were on methadone maintenance treatment (MMT) program in outpatient clinics in the south-west of Tehran, Iran. Methods: 114 male and female opiate-dependent clients who met DSM.IV-TR criteria for opiate dependence with mean age 36.5 years participated in the study from 16 clinics and completed a self-report questionnaire on demographics and substance use details. Then the participants were interviewed on the details of nonmedical abuse of benzodiazepines. Results: The study findings indicated that the current nonmedical abuse of benzodiazepines was commonly prevalent among participants. The most common current benzodiazepines abused were alprazolam (100%) followed by chlordiazepoxide (96.5%), clonazepam (94.7%), diazepam (86.8%), lorazepam (79.8%) and oxazepam (73.7%) respectively. Depression (77%) and anxiety (72.8%) were frequently reported as the most important reasons associated with consuming benzodiazepines followed by problem in anger control (44.7%), suicide thought (12.3%), self-injury (7.9%), and suicide commitment (5.3%) respectively. Conclusion: Nonmedical abuse of benzodiazepines is an important problem among opiate addicts which should be considered in treatment interventions during MMT program. PMID:24644471
Wang, Nianyang; Xie, Xin
Little is known about the impact of drug abuse/dependence on health insurance coverage, especially by race groups and income levels. In this study, we examine the disparities in health insurance predictors and investigate the impact of drug use (alcohol abuse/dependence, nicotine dependence, and illicit drug abuse/dependence) on lack of insurance across different race and income groups. To perform the analysis, we used insurance data (8057 uninsured and 28,590 insured individual adults) from the National Surveys on Drug Use and Health (NSDUH 2011). To analyze the likelihood of being uninsured we performed weighted binomial logistic regression analyses. The results show that the overall prevalence of lacking insurance was 19.6 %. However, race differences in lack of insurance exist, especially for Hispanics who observe the highest probability of being uninsured (38.5 %). Furthermore, we observe that the lowest income level bracket (annual income <$20,000) is associated with the highest likelihood of being uninsured (37.3 %). As the result of this investigation, we observed the following relationship between drug use and lack of insurance: alcohol abuse/dependence and nicotine dependence tend to increase the risk of lack of insurance for African Americans and whites, respectively; illicit drug use increases such risk for whites; alcohol abuse/dependence increases the likelihood of lack of insurance for the group with incomes $20,000-$49,999, whereas nicotine dependence is associated with higher probability of lack of insurance for most income groups. These findings provide some useful insights for policy makers in making decisions regarding unmet health insurance coverage.
Wilford, B B
An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disable...
Danielson, Carla Kmett; Amstadter, Ananda B.; Dangelmaier, Ruth E.; Resnick, Heidi S.; Saunders, Benjamin E.; Kilpatrick, Dean G.
We investigated the link between child maltreatment, including child sexual assault (CSA) and child physical assault (CPA), and addiction-related symptomatology in a subsample of adolescents from the National Survey of Adolescents, all of whom met DSM-IV criteria for substance abuse or dependence (N = 281). More than 60% of the sample reported a…
De Jong, Allan R.
Reviews previous research on the sociolegal impact of medical evaluations for child sexual abuse; offers a recommended menu of research questions, concerning process and outcomes of these evaluations, interviewing techniques, the use of medical evidence in prosecution, and knowledge level of professionals in the criminal and dependency systems.…
Lian, Huiwen; Ferris, D. Lance; Brown, Douglas J.
We predicted that the effects of abusive supervision are likely to be moderated by subordinate power distance orientation and that the nature of the moderating effect will depend on the outcome. Drawing upon work suggesting that high power distance orientation subordinates are more tolerant of supervisory mistreatment, we posited that high power…
... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Limitations on payment for alcohol and drug dependence or abuse treatment and rehabilitation. 17.83 Section 17.83 Pensions... Agencies § 17.83 Limitations on payment for alcohol and drug dependence or abuse treatment and...
To describe and critically analyse the thinking that led to the concept of an association between incontinence, care dependence and elder abuse. Coercive or abusive continence care practices include chastising a person for their incontinence and overriding their attempts to resist continence care. Neglect in continence care is characterised by withholding or delaying responding to requests for help to maintain continence or to manage incontinence, and restricting a person's access to toileting assistance, incontinence aids or hygiene care. Contemporary biomedical understandings about incontinence and influencing concepts from the fields of sociology, psychology and nursing were analysed to inform the design of a conceptual model that elucidates possible associations between incontinence, care dependence and elder abuse. Ideas generated from an analysis of the concepts led to the development of a model termed the "Model of Attributes to Abuse of Dependent Elders in Continence Care" (MADE-CC). The MADE-CC theorises factors that cause and contribute to abuse in continence care. Carer factors include physical and emotional exhaustion, frustration related to the inability to control or predict incontinence, resentment associated with constraints imposed by care dependence, disgust associated with physical contact with urine/faeces, limited knowledge and skills about incontinence and ethical conflicts concerning care. Care recipient factors include frequent and severe incontinence, cognitive impairment and a history of physical or psychological trauma. Social factors that are theorised include the stigmatised nature of incontinence, social taboos and cultural norms and the private nature of continence care. The MADE-CC illuminates the potential risk of elder abuse posed by incontinence and care dependence. It should be used to improve ethical care of older people and stimulate debate about everyday ethics in the care of older people who are care dependent and to optimise
Hall, Martin T; Howard, Matthew O; McCabe, Sean Esteban
Few empirically-based taxonomies of nonmedical prescription drug misusers have been published. This study used latent profile analysis (LPA) to identify classes of adolescent sedative/anxiolytic misusers. Interviews assessing substance use, psychiatric symptoms, antisocial traits/behavior, and traumatic life experiences were conducted with 723 Missouri youth in residential care for antisocial behavior. Sedative/anxiolytic misusers (N=247) averaged 15.8 (S.D.=1.1) years of age; a majority were male (83.8%), White (70.0%), and resided in rural/small town areas (53.8%). LPA yielded a three-class solution. Class 1 (59.1%) was comprised of youth with significantly lower levels of currently distressing psychiatric symptoms, fewer lifetime traumatic experiences, less problematic substance use histories, less frequent antisocial behavior, and less impulsivity than youth in Classes 2 and 3. Class 2 (11.3%) youth had high levels of currently distressing psychiatric symptoms and more frequent antisocial behavior compared to youth in Classes 1 and 3. Class 3 (29.5%) youth evidenced levels of psychiatric and behavioral problems that were intermediate to those of Class 1 and 2 youth. Frequency of sedative/anxiolytic misuse was significantly higher in Classes 2 and 3 compared to Class 1. Members of Class 2 and Class 3 also had the highest levels of psychiatric symptoms for which sedatives/anxiolytics are commonly prescribed. Significant differences between classes were observed across a range of health, mental health, personality, and behavioral variables. Adolescents who misused prescription sedatives/anxiolytics evidenced significant heterogeneity across measures of psychiatric and behavioral dysfunction. Youth with comparatively high levels of anxiety and depression reported significantly more intensive sedative/anxiolytic misuse than their counterparts and may be at high risk for sedative/anxiolytic abuse and dependence. 2010 Elsevier Ltd. All rights reserved.
... Psychiatric Disorders Other Substance Abuse HIV/AIDS Other Psychiatric Disorders In the current Diagnostic and Statistical Manual ... and other substance use disorders are defined as psychiatric disorders. Many individuals who misuse alcohol also abuse ...
Bhunu, C. P.
Homelessness and drug-misuse are known to exist like siamese twins. We present a model to capture the dynamics in the growth in the number of homeless (street kids and street adults) and drug misusers. The reproduction numbers of the model are determined and analyzed. Results from this study suggests that adult peer pressure plays a more significant role in the growth of drug-misuse and the number of street kids. This result suggests that in resource constrained settings intervention strategies should be tailor made to target adults whose behaviour influence others to misuse drugs and abuse children. Furthermore, numerical simulations show that homelessness and drug-misuse positively enhances, the growth of each other. Thus, to effectively control these two social problems require strategies targeting both of them.
Full Text Available Inhalant abuse is the purposeful inhalation of intoxicating gases and vapors for the purpose of achieving an altered mental state. With its propensity for being yet an under-recognized form of substance use, being gateway to hard substances, cross-cultural penetration crossing socioeconomic boundaries, and causing significant morbidity and mortality in early ages, the prevention of inhalant misuse is a highly pertinent issue. This clinical report identifies a newer perspective in the emergence of inhalant abuse initiation. We report a case of an adult female with late onset of inhalant dependence developing at workplace and recommend for greater awareness, prevention, and management of this expanding substance abuse problem.
Richter Kimber P
Full Text Available Abstract Most persons in drug treatment smoke cigarettes. Until drug treatment facilities systematically treat their patients' tobacco use, millions will flow through the drug treatment system, overcome their primary drug of abuse, but die prematurely from tobacco-related illnesses. This paper reviews the literature on the health benefits of quitting smoking for drug treatment patients, whether smoking causes relapse to other drug or alcohol abuse, the treatment of tobacco dependence, and good and bad times for quitting smoking among drug treatment patients. It also presents a conceptual model and recommendations for treating tobacco in substance abuse treatment, and provides references to internet and paper-copy tools and information for treating tobacco dependence. At present, research on tobacco treatment in drug treatment is in its infancy. Although few drug treatment programs currently offer formal services, many more will likely begin to treat nicotine dependence as external forces and patient demand for these services increases. In the absence of clear guidelines and attention to quality of care, drug treatment programs may adopt smoking cessation services based on cost, convenience, or selection criteria other than efficacy. Because research in this field is relatively new, substance abuse treatment professionals should adhere to the standards of care for the general population, but be prepared to update their practices with emerging interventions that have proven to be effective for patients in drug treatment.
Pomini, V; Mellos, L; Paparrigopoulos, T; Liappas, J
Alcohol use in Greece is traditionally diffused among its population. According to general population surveys, three out of four Greeks aged 12-64 referred to alcohol consumption during the last year and 10% reported at least one episode of alcohol abuse during the last month. Furthermore, the large majority of young people aged 13-18 reported lifetime use of alcohol and 14.8% of them reported more than three episodes of alcohol abuse during the last month. Apparently, cultural factors have influenced the pattern of alcohol consumption and the ensuing alcohol-related problems during the last two decades. The "Athena" Service is an outpatient therapeutic unit for the management of substance misusers and their families. It is a specialized abstinence-oriented service that does not administer substance substitutes; mental health professionals of the service work as a multidisciplinary team. Motivational approaches, individual cognitive-behavioural psychotherapy and family interventions of a systemic orientation are the principal therapeutic techniques applied. Adjunctive medication is prescribed whenever mild to moderate concomitant psychopathology is detected. Support measures such as provisional use of medication, use of antagonistic agents or brief hospitalization can be provided if deemed necessary. No strict time limits are applied regarding treatment duration and discharge from the program. During the period 1998-2013, a total of 1511 individuals with alcohol-related problems addressed the service. The changing pattern of substance misuse over the last fifteen years can be summarized as follows: (a) there is a gradually increasing number of women misusing substances; (b) there is an increasing proportion of young adults reporting multi-substance use with concurrent psychiatric disorders; (c) there is an increasing proportion of young adults regularly using/misusing substances; (d) there is a decreasing proportion of middle-aged individuals presenting with
Lown, E Anne; Nayak, Madhabika B; Korcha, Rachael A; Greenfield, Thomas K
Previous research has documented a relationship between child sexual abuse and alcohol dependence. This paper extends that work by providing a comprehensive description of past year and lifetime alcohol consumption patterns, consequences, and dependence among women reporting either physical and sexual abuse in a national sample. This study used survey data from 3,680 women who participated in the 2005 U.S. National Alcohol Survey. Information on physical and sexual child abuse and its characteristics were assessed in relation to 8 past year and lifetime alcohol consumption measures. Child physical or sexual abuse was significantly associated with past year and lifetime alcohol consumption measures. In multivariate analyses, controlling for age, marital status, employment status, education, ethnicity, and parental alcoholism or problem drinking, women reporting child sexual abuse vs. no abuse were more likely to report past year heavy episodic drinking (OR(adj) = 1.7; 95% CI 1.0 to 2.9), alcohol dependence (OR(adj) = 7.2; 95% CI 3.2 to 16.5), and alcohol consequences (OR(adj) = 3.6; 95% CI 1.8 to 7.3). Sexual abuse (vs. no abuse) was associated with a greater number of past year drinks (124 vs. 74 drinks, respectively, p = 0.002). Sexual child abuse was also associated with lifetime alcohol-related consequences (OR(adj) = 3.5; 95% CI 2.6 to 4.8) and dependence (OR(adj) = 3.7; 95% CI 2.6 to 5.3). Physical child abuse was associated with 4 of 8 alcohol measures in multivariate models. Both physical and sexual child abuse were associated with getting into fights, health, legal, work, and family alcohol-related consequences. Alcohol-related consequences and dependence were more common for women reporting sexual abuse compared to physical abuse, 2 or more physical abuse perpetrators, nonparental and nonfamily physical abuse perpetrators, and women reporting injury related to the abuse. Both child physical and sexual abuse were associated with many alcohol outcomes in
Winhusen, Theresa; Lewis, Daniel
Research suggests that impulsivity is a vulnerability factor for developing stimulant dependence, that women develop dependence more quickly than men, and that physical abuse can increase impulsivity and may have greater adverse health consequences in women. This study sought to tie these findings together by evaluating: (1) sex differences in disinhibition prior to lifetime initiation of stimulant abuse and (2) the relationship between physical abuse and disinhibition in stimulant-dependent patients. The Frontal Systems Behavior Scale (FrSBe) is a reliable and valid self-report assessment of three neurobehavioral domains associated with frontal systems functioning (Apathy, Disinhibition, and Executive Dysfunction, summed for a Total), that assesses pre-morbid functioning and has a specific cutoff for defining clinically significant abnormalities. Six sites evaluating 12-step facilitation for stimulant abusers obtained the FrSBe from 118 methamphetamine- and/or cocaine-dependent participants. Lifetime physical abuse was measured by the Addiction Severity Index (ASI). The proportion reporting clinically significant disinhibition was significantly higher in women (64.9%) than in men (45.0%, p=0.04), with no significant difference on the other FrSBe scales. Physical abuse in women, but not men, was associated with worse functioning, with physically abused, relative to non-abused, women having a significantly greater proportion with clinically significant disinhibition (pabuse and that physical abuse in women is associated with greater disinhibition. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Morelli, Micaela; Simola, Nicola
This chapter examines the psychostimulant actions of methylxanthines, with a focus on the consequences of their excessive use. Consumption of methylxanthines is pervasive and their use is often associated with that of substances known to produce dependence and to have abuse potential. Therefore, the consequences of this combined use are taken into consideration in order to evaluate whether, and to what extent, methylxanthines could influence dependence on or abuse of other centrally active substances, leading to either amplification or attenuation of their effects. Since the methylxanthine that mostly influences mental processes and readily induces psychostimulation is caffeine, this review mainly focuses on caffeine as a prototype of methylxanthine-produced dependence, examining, at the same time, the risks related to caffeine use.
Lang, G; Enzenhofer, E
Quality of life is largely determined by changing biographical contexts of a person's behavioural action. In later age, health and social relationships are major determinants for a "good life". A decline in health status may lead to the need for support which may result in further dependency; thus, social relations play an even more important role for older people. Relationships characterised by strain and tension may increase the risk of exposure to force and violence. This article investigates the influence of dependency and abuse on the subjective quality of life of older people. The dataset was drawn from an Austrian survey of 593 home-dwelling older women aged 60 and over (71.0 ± 8.1 years). Quality of life was assessed by the EUROHIS-QOL Scale, dependency by the degree of need for support with respect to activities of daily living and by the levels of care allowance received by this cohort. Following the Conflict Tactics Scales (CTS), six different types of abuse have been operationalised by 34 indicators. The data were analysed by descriptive statistics, confirmatory factor analysis and structural equation modelling. With increasing dependency the subjective quality of life of older women decreases. At the same time it is reduced by the experience of abuse in the close social environment. Neglect, psychological abuse and the violation of personal liberties and rights can be identified as factors which have a negative impact on quality of life. It is also noted that neglect can be found particularly among women with a greater need for support and a higher level of care allowance, which is a particularly problematic situation. Dependency and abuse are major risk factors for low quality of life in old age. The results stress the importance of raising general awareness on violence and highlight the social taboos around the issue of abuse against older people, especially in the case of increasing dependency. In addition, the results point to an increasing
Lee, June-Young; Park, E-Jin; Kwon, Min; Choi, Ji-Hye; Jeong, Jo-Eun; Choi, Jung-Seok; Choi, Sam Wook; Lee, Chang-Uk; Kim, Dai-Jin
This study examined the differences in psychiatric comorbidities and behavioral aspects in accordance with the severity of Internet addiction in male adolescents. One hundred and twenty-five adolescents from four middle and high schools in Seoul were enrolled in this study. The subjects were divided into non-addict, abuse, and dependence groups according to a diagnostic interview by psychiatrists. The psychiatric comorbidities and behavioral aspects of subjects were evaluated through psychiatric clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders (4th edition), the Children's Depression Inventory, the State-Trait Anxiety Inventory, the Internet Addiction Test, and a self-reported questionnaire about behavioral aspects. The psychiatric comorbidity distributions were significantly different in the abuse and dependence groups, particularly in terms of attention-deficit hyperactivity disorder and mood disorder items. The Children's Depression Inventory, the State-Trait Anxiety Inventory, and the Internet Addiction Test scores were also significantly different among the three groups. There were significant differences in 10 of the 20 items of the Internet Addiction Test between the non-addict, abuse, and dependence groups. There were significant differences in seven items between the non-addict and abuse groups, but no differences between subjects in the abuse and dependence groups. Significant differences were observed in three items between the abuse and dependence groups, but there were no significant differences between the non-addict and abuse groups. In terms of behavioral aspects, scores for abusive, sexual, and decreased social interest behaviors were highest in the dependence group, and lowest in the non-addict group. However, the behavioral aspects of decreased interpersonal relationships did not show this difference between groups. This study suggests that there are differences in psychiatric comorbidities and behavioral
Araújo, Priscila; Carvalho, Márcio Guilherme Nunes; van Weelden, Marlon; Lourenço, Benito; Queiroz, Lígia Bruni; Silva, Clovis Artur
To evaluate alcohol/tobacco and/or illicit drug misuse in Chronic Diseases (CDs). A cross-sectional study with 220 CDs adolescents and 110 healthy controls including: demographic/anthropometric data; puberty markers; modified questionnaire evaluating sexual function, alcohol/smoking/illicit drug misuse and bullying; and the physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk. The frequencies of alcohol/tobacco and/or illicit drug use were similar in both groups (30% vs. 34%, p=0.529), likewise the frequencies of bullying (42% vs. 41%, p=0.905). Further analysis solely in CDs patients that used alcohol/tobacco/illicit drug versus those that did not use showed that the median current age [15 (11-18) vs. 14 (10-18) years, p<0.0001] and education years [9 (5-14) vs. 8 (3-12) years, p<0.0001] were significant higher in substance use group. The frequencies of Tanner 5 (p<0.0001), menarche (p<0.0001) and spermarche (p=0.001) were also significantly higher in patients with CDs that used alcohol/tobacco/illicit, likewise sexual activity (23% vs. 3%, p<0.0001). A trend of a low frequency of drug therapy was observed in patients that used substances (70% vs. 82%, p=0.051). A positive correlation was observed between CRAFFT score and current age in CD patients (p=0.005, r=+0.189) and controls (p=0.018, r=+0.226). A later age was evidenced in CDs patients that reported licit/ilicit drug misuse. In CDs adolescent, substance use was more likely to have sexual intercourse. Our study reinforces that these patients should be systematically screened by pediatricians for drug related health behavioral patterns. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.
Gerhant, Aneta; Olajossy, Marcin
The aim of this study was to identify groups of alcohol-dependent individuals differing in the severity of childhood physical, emotional and sexual abuse and to find the personality variables that discriminate between those groups. The study included 90 individuals dependent on alcohol. The following questionnaires were used: the Temperament and Character Inventory (TCI), the Coping Inventory (COPE), the Buss and Perry Aggression Questionnaire (BPAQ), Cattell's IPAT Anxiety Scale, and the Early Trauma Inventory (ETI). Two groups of subjects addicted to alcohol were identified: group 1 with high and group 2 with low childhood physical, emotional and sexual abuse indices. The subjects in Group 1 had significantly higher scores than the subjects in Group 2 on the TCI Temperament scales of NS and HA and lower scores on the TCI character scales of SD, C2 and C4. Group 1 subjects were significantly more likely than those from Group 2 to use avoidant coping strategies; they were also less likely to use problem-focused strategies and had significantly higher scores on general anxiety, overt anxiety, latent anxiety, level of aggression, physical aggression, hostility and anger. The higher severity of childhood physical, emotional and sexual abuse in alcoholics is associated with those personality traits that seem to be crucial for maintaining abstinence and the quality of cooperation in therapy.
Tamar-Gurol, Defne; Sar, Vedat; Karadag, Figen; Evren, Cuneyt; Karagoz, Mustafa
The aim of the present study was to determine the prevalence and correlates of dissociative disorders among patients with drug dependency. The Dissociative Experiences Scale (DES) was used to screen 104 consecutive patients at an addiction treatment center. Thirty-seven patients who had scores >or=30 were compared with 21 patients who scored suicide attempt and/or childhood emotional abuse was significant predictors of a dissociative disorder. The majority (59.3%) of dissociative drug users reported that dissociative experiences had existed prior to substance use. More patients in the dissociative disorder than in the non-dissociative group stopped their treatment prematurely. A considerable proportion of drug users have a dissociative disorder, which may also interfere with treatment process. The relatively young age of this subgroup of patients and frequent reports of childhood emotional abuse underline potential preventive benefits of early intervention among adolescents with developmental trauma history and dissociative psychopathology.
McCabe, Sean Esteban; Boyd, Carol J.; Teter, Christian J.
This study used three characteristics (i.e., motive, route of administration, and co-ingestion with alcohol) of nonmedical prescription drug misuse across four separate classes (i.e., pain, sedative/anxiety, sleeping and stimulant medications) to examine subtypes and drug related problems. A Web survey was self-administered by a randomly selected sample of 3,639 undergraduate students attending a large Midwestern 4-year U.S. university. Self-treatment subtypes were characterized by motives consistent with the prescription drug's pharmaceutical main indication, oral only routes of administration, and no co-ingestion with alcohol. Recreational subtypes were characterized by recreational motives, oral or non-oral routes, and co-ingestion. Mixed subtypes consisted of other combinations of motives, routes, and co-ingestion. Among those who reported nonmedical prescription drug misuse, approximately 13% were classified into the recreational subtype, while 39% were in the self-treatment subtype, and 48% were in the mixed subtype. There were significant differences in the subtypes in terms of gender, race and prescription drug class. Approximately 50% of those in subtypes other than self-treatment screened positive for drug abuse. The odds of substance use and abuse were generally lower among self-treatment subtypes than other subtypes. The findings indicate subtypes should be considered when examining nonmedical prescription drug misuse, especially for pain medication. PMID:19278795
Storck, Michael; Black, Laura; Liddell, Morgan
Inhalant abuse is the intentional inhalation of a volatile substance for the purpose of achieving an altered mental state. As an important, yet underrecognized form of substance abuse, inhalant abuse crosses all demographic, ethnic, and socioeconomic boundaries, causing significant morbidity and mortality in school-aged and older children. This review presents current perspectives on epidemiology, detection, and clinical challenges of inhalant abuse and offers advice regarding the medical and mental health providers' roles in the prevention and management of this substance abuse problem. Also discussed is the misuse of a specific "over-the-counter" dissociative, dextromethorphan. Copyright © 2016 Elsevier Inc. All rights reserved.
Bartoli, Ettore; Rossi, Luca; Sola, Daniele; Castello, Luigi; Sainaghi, Pier Paolo; Smirne, Carlo
Resolution of edema requires a correct interpretation of body fluids-related renal function, to excrete the excess volume while restoring systemic hemodynamics and avoiding renal failure. In heart failure, the intensive diuresis should be matched by continuous fluids refeeding from interstitium to plasma, avoiding central volume depletion. The slowly reabsorbed ascites cannot refeed this contracted volume in cirrhosis: the ensuing activation of intrathoracic receptors, attended by increased adrenergic and Renin release, causes more avid sodium retention, producing a positive fluid and Na balance in the face of continuous treatment. High-dose-furosemide creates a defect in tubular Na causing diuresis adequate to excrete the daily water and electrolyte load in Chronic Renal Failure. Diuretic treatment requires care, caution and bedside "tricks" aimed at minimizing volume contraction by correctly assessing the homeostatic system of body fluids and related renal hemodynamics. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Agrawal, A; Neale, M C; Jacobson, K C; Prescott, C A; Kendler, K S
Drug use and abuse/dependence are stages of a complex drug habit. Most genetically informative models that are fit to twin data examine drug use and abuse/dependence independent of each other. This poses an interesting question: for a multistage process, how can we partition the factors influencing each stage specifically from the factors that are common to both stages? We used a causal-common-contingent (CCC) model to partition the common and specific influences on drug use and abuse/dependence. Data on use and abuse/dependence of cannabis, cocaine, sedatives, stimulants and any illicit drug was obtained from male and female twin pairs. CCC models were tested individually for each sex and in a sex-equal model. Our results suggest that there is evidence for additive genetic, shared environmental and unique environmental influences that are common to illicit drug use and abuse/dependence. Furthermore, we found substantial evidence for factors that were specific to abuse/dependence. Finally, sexes could be equated for all illicit drugs. The findings of this study emphasize the need for models that can partition the sources of individual differences into common and stage-specific influences.
Micallef-Roll, Joëlle; Lapeyre-Mestre, Maryse
The second meeting of the French CEIP (Centres d'Evaluation et d'Information sur la Pharmacodépendance) was organized during the annual congress of the French Society of Pharmacology Therapeutics and Physiology in 2008. The aim of this meeting was to update the knowledge on abuse and dependence of the anxiolytics and hypnotics from different points of view (pharmacoepidemiology, epidemiology and treatment). The first part of this meeting summarized the pharmacological data obtained by the pharmacoepidemiological tools developed by the CEIP network. Even if the abuse liability of these agents is not a new problem, it remains always present and characterized by differences of misuse between drugs in real-life settings. The second part targeted to a subtype of consumers, the elderly population, because older patients are more likely to be prescribed with multiple prescriptions and also more at risk for prescription abuse. Despite this evidence, there is a scarcity of information on the factors associated with a such behaviour and its screening, assessment, diagnosis and treatment.
Gutowicz, Marzena; Kaźmierczak, Beata; Barańczyk-Kuźma, Anna
Heroin is an illicit narcotic abused by millions of people worldwide. In our earlier studies we have shown that heroin intoxication changes the antioxidant status in human brain. In the present work we continued our studies by estimating the effect of heroin abuse on reduced glutathione (GSH) and enzymes related to this cofactor, such as glutathione S-transferase detoxifying electrophilics (GST) and organic peroxides (as Se-independent glutathione peroxidase-GSHPx), and Se-dependent glutathione peroxidase (Se-GSHPx) specific mainly for hydrogen peroxide. Studies were conducted on human brains obtained from autopsy of 9 heroin abusers and 8 controls. The level of GSH and the activity of glutathione-related enzymes were determined spectrophotometrically. The expression of GST pi on mRNA and protein level was studied by RT-PCR and Western blotting, respectively. The results indicated significant increase of GST and GSHPx activities, unchanged Se-GSHPx activity, and decreased level of GSH in frontal, temporal, parietal and occipital cortex, brain stem, hippocampus, and white matter of heroin abusers. GST pi expression was increased on both mRNA and protein levels, however the increase was lower in brain stem than in other regions. Heroin affects all regions of human brain, and especially brain stem. Its intoxication leads to an increase of organic rather then inorganic peroxides in various brain regions. Glutathione S-transferase plays an important role during heroin intoxication, however its protective effect is lower in brain stem than in brain cortex or hippocampus. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.
Carolina D. Wiener
Full Text Available Objective: To evaluate the prevalence of alcohol abuse and/or dependence in a population-based sample of young adults and assess the prevalence of comorbid mood disorders, anxiety, and suicide risk in this population. Methods: This cross-sectional, population-based study enrolled 1,953 young adults aged 18-35 years. The CAGE questionnaire was used to screen for alcohol abuse and/or dependence, with CAGE scores ≥ 2 considered positive. Psychiatric disorders were investigated through the structured Mini International Neuropsychiatric Interview (MINI. Results: Alcohol abuse and/or dependence was identified in 187 (9.60% individuals (5.10% among women and 15.20% among men. Alcohol abuse and/or dependence were more prevalent among men than women, as well as among those who used tobacco, illicit drugs or presented with anxiety disorder, mood disorder, and suicide risk. Conclusion: These findings suggest that alcohol abuse and/or dependence are consistently associated with a higher prevalence of psychiatric comorbidities, could be considered important predictors of other psychiatric disorders, and deserve greater public heath attention, pointing to the need for alcohol abuse prevention programs.
Wiener, Carolina D; Moreira, Fernanda P; Zago, Alethea; Souza, Luciano M; Branco, Jeronimo C; Oliveira, Jacqueline F de; Silva, Ricardo A da; Portela, Luis V; Lara, Diogo R; Jansen, Karen; Oses, Jean P
To evaluate the prevalence of alcohol abuse and/or dependence in a population-based sample of young adults and assess the prevalence of comorbid mood disorders, anxiety, and suicide risk in this population. This cross-sectional, population-based study enrolled 1,953 young adults aged 18-35 years. The CAGE questionnaire was used to screen for alcohol abuse and/or dependence, with CAGE scores ≥ 2 considered positive. Psychiatric disorders were investigated through the structured Mini International Neuropsychiatric Interview (MINI). Alcohol abuse and/or dependence was identified in 187 (9.60%) individuals (5.10% among women and 15.20% among men). Alcohol abuse and/or dependence were more prevalent among men than women, as well as among those who used tobacco, illicit drugs or presented with anxiety disorder, mood disorder, and suicide risk. These findings suggest that alcohol abuse and/or dependence are consistently associated with a higher prevalence of psychiatric comorbidities, could be considered important predictors of other psychiatric disorders, and deserve greater public heath attention, pointing to the need for alcohol abuse prevention programs.
Gregory L. Stuart
Full Text Available There is considerable theoretical and empirical support for a link between substance misuse and perpetration and victimization of intimate partner violence. This review briefly summarizes this literature and highlights current research that addresses the interface between treatment for substance abuse and intimate partner violence. Suggestions for future research and clinical implications are provided.
Zhang, Chenshu; Brook, Judith S.; Leukefeld, Carl G.; Brook, David W.
Aims The objective of this study was to examine the associations between compulsive buying (CB) and substance dependence/abuse, major depressive episode (MDE), and generalized anxiety disorder (GAD) at mean age 43. Methods Participants came from a community-based random sample of residents in two New York counties (N=548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (SD=2.8). Fifty five percent of the participants were females. Over 90% of the participants were white. The prevalence of substance dependence/abuse, MDE, and GAD (during the past 5 years before the interviews) was 6.6%, 13.7, and 11.5%, respectively. Results Logistic regression analyses showed that CB was significantly associated with substance dependence/abuse [Adjusted Odds Ratio (A.O.R.) = 1.60], MDE (A.O.R. = 1.70), and GAD (A.O.R. = 1.63), despite controlling for substance dependence/abuse, MDE, and GAD, respectively, at mean age 37, and demographic factors. Discussion Since the study sample is limited to predominantly white participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, MDE, and GAD consider the role of CB. PMID:27215919
Oliveto, A H; Feingold, A; Schottenfeld, R; Jatlow, P; Kosten, T R
Cocaine abuse occurs in 40% to 60% of patients entering opioid maintenance treatment, and effective pharmacotherapies are needed for this combined dependence. This 13-week, randomized, double-blind, placebo-controlled trial evaluated the efficacy of desipramine hydrochloride (0 or 150 mg/d) plus buprenorphine hydrochloride (12 mg/d) or methadone hydrochloride (65 mg/d) in 180 opioid-dependent cocaine abusers (124 men, 56 women). Supervised urine samples were obtained thrice weekly, and self-reported cocaine and heroin use was reported once weekly. Desipramine plasma levels were determined at weeks 4 and 10. In men, opioid abstinence was increased more rapidly over time when treated with methadone than with buprenorphine, whereas cocaine abstinence was increased more with buprenorphine than with methadone. In women, opioid abstinence was increased the least rapidly when treated with buprenorphine plus placebo, while cocaine abstinence was increased more rapidly over time when treated with methadone than with buprenorphine. Regardless of sex or opioid medication, desipramine increased opioid and cocaine abstinence more rapidly over time than placebo. Self-reported opioid use confirmed these findings. Desipramine plasma levels were higher in women than in men, particularly those on buprenorphine maintenance. Higher desipramine plasma levels were associated with greater opioid, but not cocaine, abstinence. Desipramine may be a useful adjunctive medication in facilitating opioid and cocaine abstinence in opioid-maintained patients. The efficacy of opioid medications to treat opioid or cocaine dependence may differ by sex. These findings highlight the importance of including sex as a factor when examining treatment outcome in these types of trials.
Roncero, Carlos; Abad, Alfonso C; Padilla-Mata, Antonio; Ros-Cucurull, Elena; Barral, Carmen; Casas, Miquel; Grau-López, Lara
In the field of dual diagnosis, physicians are frequently presented with pharmacological questions. Questions about the risk of developing psychotic symptoms in cocaine users who need treatment with dopaminergic drugs could lead to an undertreatment. Review the presence of psychotic symptoms in patients with cocaine abuse/dependence, in treatment with dopaminergic drugs. Systematic PubMed searches were conducted including December 2014, using the keywords: "cocaine", dopaminergic drug ("disulfuram-methylphenidate-bupropion-bromocriptine-sibutramineapomorphine- caffeine") and ("psychosis-psychotic symptoms-delusional-paranoia"). Articles in English, Spanish, Portuguese, French, and Italian were included. Articles in which there was no history of cocaine abuse/dependence, absence of psychotic symptoms, systematic reviews, and animal studies, were excluded. 313 papers were reviewed. 7 articles fulfilled the inclusion-exclusion criteria. There is a clinical trial including 8 cocaine-dependent patients using disulfiram in which 3 of them presented psychotic symptoms and 6 case-reports: disulfuram (1), methylphenidate (1), disulfiram with methylphenidate (2), and bupropion (2), reporting psychotic symptoms, especially delusions of reference and persecutory ideation. Few cases have been described, which suggests that the appearance of these symptoms is infrequent. The synergy of dopaminergic effects or the dopaminergic sensitization in chronic consumption are the explanatory theories proposed by the authors. In these cases, a relationship was found between taking these drugs and the appearance of psychotic symptoms. Given the low number of studies found, further research is required. The risk of psychotic symptoms seems to be acceptable if we compare it with the benefits for the patients but a closer monitoring seems to be advisable.
Loukas, A; Krull, J L; Chassin, L; Carle, A C
The current study had two goals. The first goal was to test the mediational role of young adult personality in the relation between parental alcoholism and young adult alcoholism. The second was to examine the associations between personality and alcohol use motives and reasons to limit drinking in order to explore possible mechanisms by which personality may influence alcohol abuse/dependence. Multilevel modeling techniques were used to analyze data obtained from a community sample of young adult children of alcoholics and demographically matched controls. Results revealed that young adult neuroticism and agreeableness each, in part, mediated the effect of parental alcoholism on young adult alcoholism. Moreover, individuals high in neuloticism reported stronger coping motives to use alcohol, individuals low in agreeableness reported stronger coping motives and weaker upbringing reasons to limit drinking, and individuals low in conscientiousness reported stronger coping and enhancement motives to use alcohol, and weaker performance reasons to limit drinking.
Ersche, Karen D; Bullmore, Edward T; Craig, Kevin J; Shabbir, Shaila S; Abbott, Sanja; Müller, Ulrich; Ooi, Cinly; Suckling, John; Barnes, Anna; Sahakian, Barbara J; Merlo-Pich, Emilio V; Robbins, Trevor W
There are no effective pharmacotherapies for stimulant dependence but there are many plausible targets for development of novel therapeutics. We hypothesized that dopamine-related targets are relevant for treatment of stimulant dependence, and there will likely be individual differences in response to dopaminergic challenges. To measure behavioral and brain functional markers of drug-related attentional bias in stimulant-dependent individuals studied repeatedly after short-term dosing with dopamine D(2)/D(3) receptor antagonist and agonist challenges. Randomized, double-blind, placebo-controlled, parallel-groups, crossover design using pharmacological functional magnetic resonance imaging. Clinical research unit (GlaxoSmithKline) and local community in Cambridge, England. Stimulant-dependent individuals (n = 18) and healthy volunteers (n = 18). Amisulpride (400 mg), pramipexole dihydrochloride (0.5 mg), or placebo were administered in counterbalanced order at each of 3 repeated testing sessions. Attentional bias for stimulant-related words was measured during functional magnetic resonance imaging by a drug-word Stroop paradigm; trait impulsivity and compulsivity of dependence were assessed at baseline by questionnaire. Drug users demonstrated significant attentional bias for drug-related words, which was correlated with greater activation of the left prefrontal and right cerebellar cortex. Attentional bias was greater in people with highly compulsive patterns of stimulant abuse; the effects of dopaminergic challenges on attentional interference and related frontocerebellar activation were different between high- and low-compulsivity subgroups. Greater attentional bias for and greater prefrontal activation by stimulant-related words constitute a candidate neurocognitive marker for dependence. Individual differences in compulsivity of stimulant dependence had significant effects on attentional bias, its brain functional representation, and its short-term modulation
Carfora, Anna; Cassandro, Paola; Feola, Alessandro; La Sala, Francesco; Petrella, Raffaella; Borriello, Renata
Different immunotherapeutic approaches are in the pipeline for the treatment of drug dependence. "Drug vaccines" aim to induce the immune system to produce antibodies that bind to drugs and prevent them from inducing rewarding effects in the brain. Drugs of abuse currently being tested using these new approaches are opioids, nicotine, cocaine, and methamphetamine. In human clinical trials, "cocaine and nicotine vaccines" have been shown to induce sufficient antibody levels while producing few side effects. Studies in humans, determining how these vaccines interact in combination with their target drug, are underway. However, although vaccines can become a reasonable treatment option for drugs of abuse, there are several disadvantages that must be considered. These include i) great individual variability in the formation of antibodies, ii) the lack of protection against a structurally dissimilar drug that produces the same effects as the drug of choice, and iii) the lack of an effect on the drug desire that may predispose an addict to relapse. In addition, a comprehensive overview of several crucial ethical issues has not yet been widely discussed in order to have not only a biological approach to immunotherapy of addiction. Overall, immunotherapy offers a range of possible treatment options: the pharmacological treatment of addiction, the treatment of overdoses, the prevention of toxicity to the brain or the heart, and the protection of the fetus during pregnancy. So far, the results obtained from a small-scale experiment using vaccines against cocaine and nicotine suggest that a number of important technical challenges still need to be overcome before such vaccines can be approved for clinical use.
Merianos, Ashley L.; King, Keith A.; Vidourek, Rebecca A.; Hardee, Angelica M.
The study purpose was to examine the effect alcohol abuse/dependence and school experiences have on depression among a nationwide sample of adolescents. A secondary analysis of the 2013 National Survey on Drug Use and Health was conducted. The results of the final multivariable logistic regression model revealed that adolescents who reported…
de Bruijn, Carla; van den Brink, Wim; de Graaf, Ron; Vollebergh, Wilma A. M.
Aims: To investigate whether DSM-IV abuse and dependence criteria and the ICD-10 criterion for craving differentially predict a chronic course of alcohol use disorders (AUD) in the general population. Methods: Data were derived from the Netherlands Mental Health Survey and Incidence Study, a large
Kerridge, Bradley T; Saha, Tulshi D; Smith, Sharon; Chou, Patricia S; Pickering, Roger P; Huang, Boji; Ruan, June W; Pulay, Attila J
Prior research has demonstrated the dimensionality of Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria. The purpose of this study was to examine the dimensionality of hallucinogen and inhalant/solvent abuse and dependence criteria. In addition, we assessed the impact of elimination of the legal problems abuse criterion on the information value of the aggregate abuse and dependence criteria, another proposed change for DSM-IV currently lacking empirical justification. Factor analyses and item response theory (IRT) analyses were used to explore the unidimisionality and psychometric properties of hallucinogen and inhalant/solvent abuse and dependence criteria using a large representative sample of the United States (U.S.) general population. Hallucinogen and inhalant/solvent abuse and dependence criteria formed unidimensional latent traits. For both substances, IRT models without the legal problems abuse criterion demonstrated better fit than the corresponding model with the legal problem abuse criterion. Further, there were no differences in the information value of the IRT models with and without the legal problems abuse criterion, supporting the elimination of that criterion. No bias in the new diagnoses was observed by sex, age and race-ethnicity. Consistent with findings for alcohol, nicotine, cannabis, cocaine and amphetamine abuse and dependence criteria, hallucinogen and inhalant/solvent criteria reflect underlying dimensions of severity. The legal problems criterion associated with each of these substance use disorders can be eliminated with no loss in informational value and an advantage of parsimony. Taken together, these findings support the changes to substance use disorder diagnoses recommended by the DSM-V Substance and Related Disorders Workgroup, that is, combining DSM-IV abuse and dependence criteria and eliminating the legal problems abuse
Shahrzad Bazargan-Hejazi, PhD
Full Text Available Introduction: We examine the association between self-reported alcohol misuse and alcohol usewithin 2 hours of having sex and the number of sexual partners among a sample of African-Americanand Latino emergency department (ED patients.Methods: Cross-sectional data were collected prospectively from a randomized sample of all EDpatients during a 5-week period. In face-to-face interviews, subjects were asked to report their alcoholuse and number of sexual partners in the past 12 months. Data were analyzed using multiple variablenegative binomial regression models, and effect modification was assessed through inclusion ofinteraction terms.Results: The 395 study participants reported an average of 1.4 (standard error¼0.11 sexual partnersin the past 12 months, 23% reported misusing alcohol, and 28% reported consuming alcohol beforesex. There was no statistically significant association between alcohol misuse and the number ofsexual partners; however, alcohol before sex was associated with a larger number of sexual partners inthe past year. Moreover, among those who misused alcohol, participants who reported alcohol beforesex were 3 times more likely to report a higher number of sexual partners (risk ratio¼3.2; confidenceinterval [CI]¼1.9–5.6. The association between alcohol use before sex and number of sexual partnersis dependent upon whether a person has attributes of harmful drinking over the past 12 months.Overall, alcohol use before sex increases the number of sexual partners, but the magnitude of thiseffect is significantly increased among alcohol misusers.Conclusion: Alcohol misusers and those who reported having more than 1 sexual partner were morelikely to cluster in the same group, ie, those who used alcohol before sex. Efforts to reduce the burdenof sexually transmitted diseases, including human immunodeficiency virus, and other consequences ofrisky sexual behavior in the ED population should be cognizant of the interplay of alcohol and
Zhang, Chenshu; Brook, Judith S; Leukefeld, Carl G; Brook, David W
The objective of this study was to examine the associations between compulsive buying and substance dependence/abuse, major depressive episodes, and generalized anxiety disorder at the mean age of 43. Participants came from a community-based random sample of residents in 2 New York counties in 1975 (N = 548). The participants were followed from adolescence to early midlife. The mean age of participants at the most recent interview was 43.0 (standard deviation = 2.8). Of the participants, 55% were females. Over 90% of the participants were Caucasian. The prevalence of substance dependence/abuse, major depressive episodes, and generalized anxiety disorder (during the past 5 years before the interviews) was 6.6, 13.7, and 11.5%, respectively. Logistic regression analyses showed that compulsive buying was significantly associated with substance dependence/abuse (adjusted odds ratio = 1.60), major depressive episodes (adjusted odds ratio = 1.70), and generalized anxiety disorder (adjusted odds ratio = 1.63), despite controlling for substance dependence/abuse, major depressive episodes, and generalized anxiety disorder, respectively, at the mean age of 37, and demographic factors. Since the study sample is limited to predominantly Caucasian participants (over 90%) with a close association to a small geographic area, the findings may not be generalizable to racial/ethnic minority groups or individuals living in other parts of the country. Nevertheless, it is important that clinicians treating substance dependence/abuse, major depressive episodes, and generalized anxiety disorder consider the role of compulsive buying.
Havens, Jennifer R; Oser, Carrie B; Leukefeld, Carl G; Webster, J Matthew; Martin, Steven S; O'Connell, Daniel J; Surratt, Hilary L; Inciardi, James A
We compared the prevalence of prescription opiate misuse among 2 cohorts of felony probationers (N = 1525). Multiple logistic regression was utilized to determine the independent correlates of prescription opiate misuse among rural (n = 782) and urban (n = 743) probationers participating in an HIV-intervention study. After adjustment for differences in demographic and drug use characteristics, rural participants were almost five times more likely than their urban counterparts to have misused prescription opiates. The prevalence of prescription opiate misuse was significantly higher among the rural probationers; however, given the paucity of illicit opiates and relatively recent emergence of prescription opiates in rural areas, rural substance abuse treatment may be ill-prepared to treat prescription opiate misuse.
Fernando Espi Martinez
Full Text Available Anticholinergic drugs are frequently used in psychiatry for the prophylaxis and treatment of extrapiramidal symptoms caused by neuroleptics. Abuse of anticholinergic agents has been reported in patients with psychotic disorders, on treatment with neuroleptics, and polysubstance use disorders. We are reporting the case of a patient who presented with hypoactive delirium as a consequence of biperiden dependence. The clinician must pay special attention to detect anticholinergic misuse in patients presenting with delirium of unknown cause.
Full Text Available The paper is devoted to psychological consequences of sexual abuse in children and adolescents. It presents review of domestic and foreign research of psychological injury in minors. The article gives results of complex psychological and psychiatric examination of 183 juvenile victims of sexual abuse. Psychological effects of sexual abuse in children and adolescents are identified and described on the basis of age, gender, clinical characteristics of the mental state of the victim, as well as the type and duration of the abuse. Intensity and expressiveness of post-traumatic response as well as coverage of personality spheres increase with aging. The data on the gender specificity of the sexual abuse effects suggest that girls more demonstrate internal forms, while external manifestations dominate in boys. The type and duration of sexual abuse determine a wide range of possible psychological consequences. It is noted that the severity of the psychological effects of sexual abuse in victims with mental disorders associated with the trauma is higher than in victims qualified to be mentally sane or having a mental illness, non-associated with psychologically traumatic situations. Psychological consequences exhibited by mentally sane victims show a decrease in their quality of life.
Martin-Storey, Alexa; Serbin, Lisa A; Stack, Dale M; Ledingham, Jane E; Schwartzman, Alex E
While childhood behaviors such as aggression, social withdrawal and likeability have been linked to substance abuse outcomes in adolescence and adulthood, the mechanisms by which these variables relate are not yet well established. Self and peer perceptions of childhood behaviors in men and women were compared to assess the role of context in the prediction of drug and alcohol abuse and dependence. Participants (N=676) in an ongoing longitudinal project examining the relation between childhood behavior and adult mental health outcomes completed the Structured Clinical Interview for the DSM IV regarding their histories of substance abuse in mid-adulthood (mean age=34, SD=2). In women, higher levels of both self and peer reported aggression were associated with drug and alcohol abuse and dependence, and higher levels of peer reported aggression were associated with higher levels of alcohol abuse and dependence. As well, higher levels of self-perceived likeability were protective regarding substance abuse and dependence outcomes. In men, higher levels of peer perceived social withdrawal were protective regarding substance abuse and dependence outcomes. Findings support the comparison of self and peer perceptions of childhood behavior as a method of assessing the mechanisms by which childhood behaviors impact adult outcomes, and suggest the importance of gender in the relation between childhood behaviors and adult substance abuse and dependence. Copyright © 2011 Elsevier Ltd. All rights reserved.
Frauger, Elisabeth; Moracchini, Christophe; Le Boisselier, Reynald; Braunstein, David; Thirion, Xavier; Micallef, Joëlle
It is important to assess drug abuse liability in 'real life' using different surveillance systems. Some are based on specific population surveys, such as individuals with drug abuse or dependence, or under opiate maintenance treatment, because this population is very familiar with drugs and is more likely to divert or abuse them. In France, an original surveillance system based on this specific population and called 'Observation of illegal drugs and misuse of psychotropic medications (OPPIDUM) survey' was set up in 1990 as the first of its kind. The aim of this article is to describe this precursor of French drug abuse surveillance using different examples, to demonstrate its ability to effectively give health authorities and physicians interesting data on drug abuse. OPPIDUM is an annual, cross-sectional survey that anonymously collects information on abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. From 1990 to 2010, a total of 50,734 patients were included with descriptions of 102,631 psychoactive substance consumptions. These data have outlined emergent behaviors such as the misuse of buprenorphine by intravenous or nasal administration. It has contributed to assess abuse liability of emergent drugs such as clonazepam or methylphenidate. This surveillance system was also able to detect the decrease of flunitrazepam abuse following implementation of regulatory measures. OPPIDUM's twenty years of experience clearly demonstrate that collection of valid and useful data on drug abuse is possible and can provide helpful information for physicians and health authorities. © 2013 The Authors Fundamental and Clinical Pharmacology © 2013 Société Française de Pharmacologie et de Thérapeutique.
Goyal, Shrigopal; Ambekar, Atul; Ray, Rajat
Substance abuse among medical professionals is a cause for concern. Certain psychotropic substances such as ketamine are at easy dispense to anesthesiologists increasing the likelihood of misuse and dependence and raise several issues including safety of patients. We discuss a case demonstrating ketamine dependence in an anesthesiologist from India. The reported psychotropic effects of ketamine ranged from dissociation and depersonalization to psychotic experiences. There was also development...
Full Text Available Li-Tzy Wu1, George E Woody2, Chongming Yang3, Paolo Mannelli1, Dan G Blazer11Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Duke University Medical Center, Durham, NC, USA; 2Department of Psychiatry, University of Pennsylvania School of Medicine, University of Pennsylvania and Treatment Research Institute, Philadelphia, PA, USA; 3Social Science Research Institute, Duke University, Durham, NC, USAObjectives: To examine patterns of onset and abuse/dependence episodes of prescription opioid (PO and heroin use disorders in a national sample of adults, and to explore differences by gender and substance abuse treatment status.Methods: Analyses of data from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093.Results: Of all respondents, 5% (n = 1815 reported a history of nonmedical PO use (NMPOU and 0.3% (n = 150 a history of heroin use. Abuse was more prevalent than dependence among NMPOUs (PO abuse, 29%; dependence, 7% and heroin users (heroin abuse, 63%; dependence, 28%. Heroin users reported a short mean interval from first use to onset of abuse (1.5 years or dependence (2.0 years, and a lengthy mean duration for the longest episode of abuse (66 months or dependence (59 months; the corresponding mean estimates for PO abuse and dependence among NMPOUs were 2.6 and 2.9 years, respectively, and 31 and 49 months, respectively. The mean number of years from first use to remission from the most recent episode was 6.9 years for PO abuse and 8.1 years for dependence; the mean number of years from first heroin use to remission from the most recent episode was 8.5 years for heroin abuse and 9.7 years for dependence. Most individuals with PO or heroin use disorders were remitted from the most recent episode. Treated individuals, whether their problem was heroin or POs, tended to have a longer mean duration of an episode than untreated individuals.Conclusion: Periodic remissions
Cochran, Gerald; Bacci, Jennifer L; Ylioja, Thomas; Hruschak, Valerie; Miller, Sharon; Seybert, Amy L; Tarter, Ralph
Opioid pain medication misuse is a major concern for US public health. The purpose of this article is to: 1) describe the demographic and physical, behavioral, and mental health characteristics of patients who fill opioid medications in community pharmacy settings; and 2) describe the extent of opioid medication misuse behaviors among these patients. We recruited and screened a convenience sample of patients with the use of a tablet computer-based assessment protocol that examined behavioral, mental, and physical health. Descriptive and inferential statistics were calculated to describe respondents and their opioid medication misuse and health characteristics. Patients were screened in 2 urban and 2 rural community pharmacies in southwestern Pennsylvania. Survey participants were adult patients filling opioid pain medications who were not currently receiving treatment for a cancer diagnosis. None. Validated screening measures included the Prescription Opioid Misuse Index, Alcohol Use Disorders Identification Test C, Short Form 12, Drug Abuse Screening Test 10, Primary Care Post-traumatic Stress Disorder (PTSD) screen, and the Patient Health Questionnaire 2. A total of 333 patients were screened (71.2% response rate). Nearly the entire population reported pain above and general health below national norms. Hydrocodone (19.2%) and morphine (20.8%) were found to be the medications with the highest rates of misuse-with hydrocodone having more than 4 times higher odds of misuse compared with other medications (adjusted odds ratio [AOR] 4.48, 95% confidence interval [CI] 1.1-17.4). Patients with positive screens for illicit drug use (AOR 8.07, 95% CI 2.7-24.0), PTSD (AOR 5.88, 95% CI 2.3-14.7), and depression (AOR 2.44, 95% CI 1.0-5.9) also had significantly higher odds for misuse compared with those with negative screening results. These findings provide important foundational data that suggest implementation of regular opioid misuse screening protocols within
Wilford, B B
An estimated 3% of the United States population deliberately misuse or abuse psychoactive medications, with severe consequences. According to the National Institute on Drug Abuse, more than half of patients who sought treatment or died of drug-related medical problems in 1989 were abusing prescription drugs. Physicians who contribute to this problem have been described by the American Medical Association as dishonest--willfully misprescribing for purposes of abuse, usually for profit; disabled by personal problems with drugs or alcohol; dated in their knowledge of current pharmacology or therapeutics; or deceived by various patient-initiated fraudulent approaches. Even physicians who do not meet any of these descriptions must guard against contributing to prescription drug abuse through injudicious prescribing, inadequate safeguarding of prescription forms or drug supplies, or acquiescing to the demands or ruses used to obtain drugs for other than medical purposes. PMID:2349801
Full Text Available The study was to survey and assess the drug dependence and abuse potential of tramadol with no history of substance abuse. Subjects of tramadol dependence with no prior history of substance abuse were surveyed by interview. Physical dependence of tramadol was assessed using 10 items opiate withdrawal scale (OWS, and psychological dependence was assessed by Addiction Research Center Inventory—Chinese Version (ARCI-CV. Twenty-three male subjects (the median age was 23.4±4.1 years referred to the addiction unit in Medical Hospital of Guangzhou with tramadol abuse problems were included in this cross-sectional study. The control group included 87 heroin addicts, 60 methamphetamine (MA abusers, and 50 healthy men. The scores of OWS of tramadol were 0.83–2.30; the mean scores of identifying euphoric effects–MBG, sedative effects–PCAG, and psychotomimetic effects–LSD of ARCI were 8.96±3.08, 6.52±3.25, and 6.65±2.50, respectively, F = 4.927, P0.05 but were higher than those in healthy men (P<0.05. Tramadol with no history of substance abuse has a clear risk of producing high abuse potential under the long-term infrequent abuse and the high doses.
Romero-Martínez, Ángel; Moya-Albiol, Luis
Neuropsychological impairments of the executive functions, memory, attention, intelligence quotient, and empathy have been found in perpetrators of domestic violence (intimate partner violence). These impairments could be partially explained by alcohol abuse, dependence, or traumatic brain injuries. This study reviews the neuropsychological deficits of perpetrators of intimate partner violence. At the same it seeks to integrate and relate these main points with their neuroanatomical correlates. We have also established the relationship between alcohol abuse, dependence, brain damage (including traumatic brain injuries) and those deficits. Scientific literature has been reviewed by means of Google Scholar, PsycINFO, PubMed, Medline and ISI Web of Knowledge. Perpetrators of domestic violence present high mental rigidity, as well as low levels of inhibition, processing speed, verbal and attention skills, and abstract reasoning. Additionally, perpetrators show working and long play memory impairments. Moreover, those deficits could be impaired by traumatic brain injuries and alcohol abuse and/or dependence. Nonetheless, these both variables are not enough to explain the deficits. Functional abnormalities on the prefrontal and occipital cortex, fusiform gyrus, posterior cingulate gyrus, hippocampus, thalamus and amygdala could be associated with these impairments. An analysis of these mechanisms may assist in the development of neuropsychological rehabilitation programmes that could help improve current therapies.
Walters, Glenn D; Espelage, Dorothy L
This study was designed to address two research questions. The first research question asked whether physical abuse victimization at the hands of parents/guardians, bullying victimization at the hands of peers, and the abuse x bullying interaction encouraged early involvement in substance misuse. The second research question inquired as to whether the victimization‒substance misuse relationship was mediated by variables proposed by various theories and research studies-specifically, cognitive impulsivity, negative affect, and low self-esteem. A moderated mediation hypothesis was tested in a group of 865 (417 boys, 448 girls) schoolchildren from the Illinois Study of Bullying and Sexual Violence who were 10 to 15 years of age at the time of initial contact. A path analysis performed with three waves of data revealed that physical abuse and bullying victimization predicted substance misuse with mediation by cognitive impulsivity, but there was no evidence of moderation. On the basis of these results, it was concluded that victimization, whether through parental physical abuse or peer bullying, increases cognitive impulsivity, and that cognitive impulsivity, in turn, encourages early involvement in substance misuse. The practical implications of these results are that interventions designed to counter cognitive impulsivity and encourage cognitive control may be effective in preventing children traumatized by physical abuse and bullying from entering the early stages of a drug or substance using lifestyle. Copyright © 2018 Elsevier Ltd. All rights reserved.
Full Text Available Kamal Ali, Na’eem Ahmed, Anne GreenoughDivision of Asthma, Allergy, and Lung Biology, Medical Research Council and Asthma UK Center in Allergic Mechanisms of Asthma, King’s College Hospital, London, United KingdomAbstract: In the developed world, sudden infant death syndrome (SIDS remains the leading cause of death in the post neonatal period. This review highlights the association between maternal substance misuse and SIDS, and discusses whether the increased risk is explained by abnormalities of respiratory control. Substance misuse during pregnancy is common, and although the incidence of smoking has declined in recent years among pregnant women, an increasing proportion of mothers of infants who have died of SIDS smoke. The risk of SIDS is increased in women who take opiates, but not cocaine or marijuana, although infants exposed to either of these drugs suffer morbidity, including reduced birth weight. Nicotine exposure increases the risk of SIDS, particularly if both parents smoke, and there is a dose-dependent effect. A variety of respiratory abnormalities have been described in the infants of substance abuse mothers, which may increase their risk of SIDS. These abnormalities include a reduced ability to recover from prolonged apnea and a blunted response to hypoxia and hypercarbia. These results are consistent with postmortem brainstem abnormalities reported among SIDS victims.Keywords: sudden infant death syndrome, nicotine, opiates
Rusbult, Caryl E.; Martz, John M.
Analyzes the nature of interdependence in ongoing relationships, using an investment model to understand decisions to remain in abusive relationships. Found that feelings of commitment were greater among women who had poorer-quality economic alternatives, were more heavily invested in their relationship, and who experienced less dissatisfaction…
Kraanen, Fleur L; Emmelkamp, Paul M G
Substance abuse has often been associated with committing sex offenses. In this article, the following will be reviewed: 1) studies that assessed substance abuse in sex offenders; 2) differences in substance abuse among different types of sex offenders; 3) differences in substance abuse between sex offenders and nonsexual offenders and substance abuse in the normal population; 4) sex offenders' intoxication at the time of the offense; and 5) differences in intoxication at the time of the offense among different types of sex offenders. Studies will be discussed according to the method they used to assess substance abuse, i.e., file research, screening instruments or semi-structured interviews. This review shows that about half of the sex offenders has a history of substance abuse, a quarter to half of the sex offenders has a history of alcohol misuse and that about one fifth to a quarter of the sex offenders has a history of drug misuse. Furthermore, about a quarter to half of the sex offenders appeared to be intoxicated at the time of the offense. The review results in recommendations for future research. Because of the high prevalence of substance abuse in sex offenders it is advisable to routinely screen for substance abuse and, if necessary, to treat substance abuse. Copyright © 2010 Elsevier Ltd. All rights reserved.
Garland, Eric L; Howard, Matthew O
Volatile substance misuse is among the most prevalent and toxic forms of psychoactive drug use, and often results in highly deleterious social, psychological and medical consequences. The prevalence of this pernicious form of substance misuse owes in part to the fact that volatile substances of misuse are ubiquitous in the natural environment. Commonly misused commercial products include glue, shoe polish, nail polish remover, butane lighter fluid, gasoline and computer duster spray. National samples of volatile substance misusers tend to exhibit high rates of psychiatric problems and antisocial behaviour. In addition, cognitive impairments and affective dysregulation are often observed among these individuals. Volatile substances exert their complex neuropharmacological effects on dopaminergic, glutamatergic, GABAergic and serotoninergic receptor systems, as well as on cell membranes and ion channels. Concomitantly, pharmacotherapies for volatile substance abuse might profitably target a number of mechanisms, including reward circuitry in the brain, symptoms of craving and withdrawal, neuropsychiatric and emotional impairments that promote volatile substance abuse, and cognitive enhancement to rectify deficits in executive function. This review details the modes of use, subjective effects, epidemiology, adverse consequences, neuropsychopharmacology and drug treatment of volatile substance misuse, and discusses the potential role of novel forms of pharmacological intervention for this oft-overlooked public health threat of epidemic proportions.
Kaley, Sean; Mancino, Michael J; Messias, Erick
Exposure to drugs is unfortunately common among high school students and its use has been linked to depression and suicide risk. We used the 2011 Arkansas Youth Risk Behavior Survey to estimate the prevalence of drug abuse and to measure its association with teen suicidality. Three types of substance misuse were reported by more than 10% of Arkansas high school students: cannabis (33.3% ever use). inhalants (18.7% ever use). and prescription drugs without a prescription (13.2% ever use). We found in all suicide outcomes a stronger association with prescription drug abuse, followed by inhalant abuse, then cannabis abuse.
Austin, Anna E; Shanahan, Meghan E; Zvara, Bharathi J
Previous research has examined the association of childhood abuse with opioid misuse and dependence in adulthood. However, little research has focused specifically on prescription opioids, and no studies have examined associations with prescription opioid use, a potential pathway to later opioid misuse and dependence. The aim of the present study was to examine the association of childhood emotional, physical, and sexual abuse with prescription opioid use in early adulthood. We used data from Waves I (12-18years) and IV (24-32years) of the National Longitudinal Study of Adolescent to Adult Health. At Wave IV, respondents reported experiences of childhood abuse occurring prior to age 18years and prescription opioid use in the last four weeks. We conducted multivariable logistic regression to examine associations of childhood abuse with recent prescription opioid use. In multivariable models adjusted for respondent sex, race/ethnicity, age, and socioeconomic status, childhood emotional abuse (OR=1.57, 95% CI 1.29, 1.90), physical abuse (OR=1.46, 95% CI 1.14, 1.87), and any childhood abuse (OR=1.51, 95% CI 1.24, 1.82) were significantly associated with recent prescription opioid use. Given continued increases in prescription opioid use and opioid-related morbidity and mortality in the U.S., understanding upstream social and environmental factors associated with prescription opioid use is important to strengthening and expanding current prevention and intervention strategies. Future research is needed to examine factors potentially mediating the association between childhood abuse and prescription opioid use in order to provide additional insights for prevention and intervention efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.
Bull, M J; Stroup, K B; Gerhart, S
Correct use of car seats for small children is essential to prevent serious injuries and death from automotive accidents. Failure to use a car seat properly can contribute to serious injury or death of a child. A case study in which misuse of a car seat occurred is reported. The infant died of hemorrhage and shock secondary to liver laceration which resulted from excessive pressure over the abdomen sustained on impact. Surveys of car seat use for small children prior to and following a child restraint law are also reported. Observers noted types of car seats and specific forms of misuse. Survey results suggest that parents are more likely to misuse car seats for infants than toddlers. Medical professionals can reinforce the importance of proper car seat use by incorporating specific car seat use questions into the patient interview and by providing educational materials.
Full Text Available ABSTRACT:Drug abuse is the willful misuse of either licit or illicit drugs for the purpose of recreation, perceived necessity or convenience. Drug abuse is a more intense and often willful misuse of drugs often to the point of addiction. In the eastern world the incidence shows a decline or a static pattern but the number of drug addicts is still enormous.. The major drug of abuse are heroin and marijuana but designer drugs are shown to be on the increase. The aim of the study is to determine the ratio of the drug abuse in student. For this purpose we selected different institutions including “the university of Lahore”, “Forman Christian college”(private sector and Punjab university(Govt sector and conducted survey in 500 student. High proportion of students was found abusing drugs. From this study, we came across multiple factors which are the main cause of drug abuse in medical student including depression, anxiety, schizophrenia, as well as personality disorder like antisocial personality disorder. The most commonly abused drugs include stimulants, opioids, and benzodiazepines, antihistamines. Although survey have indicated high rate of illicit and prescription drugs misuse among college students, few have assessed the negative consequences, personel concerns, or interest in intervention for drugs use. Drug abuse although regarded as a personality disorder, may also be seen as worldwide epidemic with evolutionary genetic, physiology and environmental influences Controlling and affecting human behavior. Globally, the use has reached all time high. The study showed males are more drug abusers as compared to females. The drug abuse ratio in students of private sector is more as compared to Govt sector.
Damian, April Joy; Mendelson, Tamar
Alcohol use is a pervasive and costly public health problem in the United States. Relapse rates from alcohol use disorders are high. Although exercise has been proposed as a strategy to prevent relapse, lifestyle modification is the least studied aspect of relapse prevention programs, especially among racial/ethnic minority populations. The current study assessed whether being physically active was associated with remission from alcohol abuse or dependence among Black (African American and Afro Caribbean) adults in the U.S. We utilized data on Black adult participants (n = 4,828) from the nationally representative National Survey of American Life (NSAL) conducted in 2001-2003. Logistic regression models were estimated to assess the odds of being in 12-month remission or currently meeting DSM-IV criteria for alcohol abuse or dependence based on level of physical activity, adjusting for socio-demographic and neighborhood characteristics. People who endorsed being physically active had higher odds of being in 12-month remission from alcohol use problems (OR: 1.67, 95% CI: 1.28, 2.17) than people who were physically inactive, adjusting for individual- and neighborhood-level characteristics. People who were physically active did not differ significantly from those who were inactive with respect to odds of currently meeting DSM-IV criteria for alcohol abuse or dependence. Conclusions/Importance: Physical activity was positively associated with being in 12-month remission from alcohol use problems. Longitudinal studies are needed to establish temporal ordering and to explore exercise as a potential relapse prevention strategy for alcohol use problems.
Valsson, Omar [Department of Chemistry and Applied Biosciences, ETH Zurich and Facoltà di Informatica, Instituto di Scienze Computationali, Università della Svizzera italiana, Via Giuseppe Buffi 13, CH-6900 Lugano (Switzerland); Filippi, Claudia, E-mail: firstname.lastname@example.org [MESA+ Institute for Nanotechnology, University of Twente, P.O. Box 217, 7500 AE Enschede (Netherlands); Casida, Mark E., E-mail: email@example.com [Laboratoire de Chimie Théorique, Département de Chimie Moléculaire (DCM), Institut de Chimie Moléculaire de Grenoble (ICMG), Université Joseph Fourier, Grenoble I, F-3801 Grenoble (France)
The excited-state relaxation of retinal protonated Schiff bases (PSBs) is an important test case for biological applications of time-dependent (TD) density-functional theory (DFT). While well-known shortcomings of approximate TD-DFT might seem discouraging for application to PSB relaxation, progress continues to be made in the development of new functionals and of criteria allowing problematic excitations to be identified within the framework of TD-DFT itself. Furthermore, experimental and theoretical ab initio advances have recently lead to a revised understanding of retinal PSB photochemistry, calling for a reappraisal of the performance of TD-DFT in describing this prototypical photoactive system. Here, we re-investigate the performance of functionals in (TD-)DFT calculations in light of these new benchmark results, which we extend to larger PSB models. We focus on the ability of the functionals to describe primarily the early skeletal relaxation of the chromophore and investigate how far along the out-of-plane pathways these functionals are able to describe the subsequent rotation around formal single and double bonds. Conventional global hybrid and range-separated hybrid functionals are investigated as the presence of Hartree-Fock exchange reduces problems with charge-transfer excitations as determined by the Peach-Benfield-Helgaker-Tozer Λ criterion and by comparison with multi-reference perturbation theory results. While we confirm that most functionals cannot render the complex photobehavior of the retinal PSB, do we also observe that LC-BLYP gives the best description of the initial part of the photoreaction.
Ogai, Yasukazu; Senoo, Eiichi; Gardner, Fumiyuki Chin; Haraguchi, Ayako; Saito, Tamaki; Morita, Nobuaki; Ikeda, Kazutaka
The aim of the present study was to clarify the association between child abuse experiences and drug addiction severity among Japanese drug-dependent patients using the Addiction Severity Index-Japanese version (ASI-J). One hundred and eleven inpatients and outpatients with drug dependence participated in the study. Some of the questions on the ASI-J asked about lifetime experiences of abuse. A higher percentage of female participants experienced child abuse compared with male participants. Male participants who experienced child abuse (MEA) had a significantly higher severity of drug use than men who did not experience it (MNEA). Female participants who experienced child abuse (FEA) had significantly more serious problems in family/social relationships than female participants who did not experience it (FNEA). Patients in the MEA group were arrested less frequently for drug charges, experienced more serious problems with their fathers, and experienced more severe anxiety in their lifetime compared with the MNEA group. The FEA group experienced more serious troubles with their sexual partners, close friends, and families and experienced more severe psychiatric problems in their lifetime compared with the FNEA group. These results suggest gender differences in the problems experienced by drug-dependent patients with child abuse experiences, and gender-specific interventions may be more effective in treating their drug dependence. PMID:25741639
Full Text Available The aim of the present study was to clarify the association between child abuse experiences and drug addiction severity among Japanese drug-dependent patients using the Addiction Severity Index-Japanese version (ASI-J. One hundred and eleven inpatients and outpatients with drug dependence participated in the study. Some of the questions on the ASI-J asked about lifetime experiences of abuse. A higher percentage of female participants experienced child abuse compared with male participants. Male participants who experienced child abuse (MEA had a significantly higher severity of drug use than men who did not experience it (MNEA. Female participants who experienced child abuse (FEA had significantly more serious problems in family/social relationships than female participants who did not experience it (FNEA. Patients in the MEA group were arrested less frequently for drug charges, experienced more serious problems with their fathers, and experienced more severe anxiety in their lifetime compared with the MNEA group. The FEA group experienced more serious troubles with their sexual partners, close friends, and families and experienced more severe psychiatric problems in their lifetime compared with the FNEA group. These results suggest gender differences in the problems experienced by drug-dependent patients with child abuse experiences, and gender-specific interventions may be more effective in treating their drug dependence.
Ogai, Yasukazu; Senoo, Eiichi; Gardner, Fumiyuki Chin; Haraguchi, Ayako; Saito, Tamaki; Morita, Nobuaki; Ikeda, Kazutaka
The aim of the present study was to clarify the association between child abuse experiences and drug addiction severity among Japanese drug-dependent patients using the Addiction Severity Index-Japanese version (ASI-J). One hundred and eleven inpatients and outpatients with drug dependence participated in the study. Some of the questions on the ASI-J asked about lifetime experiences of abuse. A higher percentage of female participants experienced child abuse compared with male participants. Male participants who experienced child abuse (MEA) had a significantly higher severity of drug use than men who did not experience it (MNEA). Female participants who experienced child abuse (FEA) had significantly more serious problems in family/social relationships than female participants who did not experience it (FNEA). Patients in the MEA group were arrested less frequently for drug charges, experienced more serious problems with their fathers, and experienced more severe anxiety in their lifetime compared with the MNEA group. The FEA group experienced more serious troubles with their sexual partners, close friends, and families and experienced more severe psychiatric problems in their lifetime compared with the FNEA group. These results suggest gender differences in the problems experienced by drug-dependent patients with child abuse experiences, and gender-specific interventions may be more effective in treating their drug dependence.
Pingault, J-B; Côté, S M; Galéra, C; Genolini, C; Falissard, B; Vitaro, F; Tremblay, R E
Numerous prospective studies have shown that children diagnosed with attention deficit/hyperactivity disorder (ADHD) are at higher risk of long-term substance abuse/dependence. However, there are three important limits to these studies: (a) most did not differentiate the role of hyperactivity and inattention; (b) most did not control for associated behavioral problems; and (c) most did not consider females. Our aim was to clarify the unique and interactive contributions of childhood inattention and hyperactivity symptoms to early adulthood substance abuse/dependence. Behavioral problems of 1803 participants (814 males) in a population-based longitudinal study were assessed yearly between 6 and 12 years by mothers and teachers. The prevalence of substance abuse/dependence at age 21 years was 30.7% for nicotine, 13.4% for alcohol, 9.1% for cannabis and 2.0% for cocaine. The significant predictors of nicotine dependence were inattention (odds ratio (OR): 2.25; 95% confidence interval (CI): 1.63-3.11) and opposition (OR: 1.65; 95%: 1.20-2.28). Only opposition contributed to the prediction of cannabis dependence (OR: 2.33; 95% CI: 1.40-3.87) and cocaine dependence (OR: 2.97; 95% CI: 1.06-8.57). The best behavioral predictor of alcohol abuse/dependence (opposition) was only marginally significant (OR: 1.38; 95% CI: 0.98-1.95). Frequent oppositional behaviors during elementary school were clearly the most pervasive predictors of substance abuse/dependence in early adulthood. The association of childhood ADHD with substance abuse/dependence is largely attributable to its association with opposition problems during childhood. However, inattention remained an important predictor of nicotine dependence, in line with genetic and molecular commonalities between the two phenotypes suggested in the literature.
Kutlu, Munir Gunes; Gould, Thomas J.
It has long been hypothesized that conditioning mechanisms play major roles in addiction. Specifically, the associations between rewarding properties of drugs of abuse and the drug context can contribute to future use and facilitate the transition from initial drug use into drug dependency. On the other hand, the self-medication hypothesis of drug abuse suggests that negative consequences of drug withdrawal result in relapse to drug use as an attempt to alleviate the negative symptoms. In thi...
Full Text Available Patients with chronic pain and depression are more likely to develop opioid abuse compared to patients without depression. It is not known if this association differs by pain location. We compared the strength of association between depression and opioid misuse in patients with chronic low back pain (CLBP vs. chronic pain of other location (CPOL. Chart abstracted data was obtained from 166 patients seeking care in a family medicine clinic. Depression was measured by the PHQ-9 and opioid misuse was measured using the Current Opioid Misuse Measure. Pain severity and interference questions came from the Brief Pain Inventory. Cross-tabulations were computed to measure the association between depression and opioid misuse stratified on pain location. Exploratory logistic regression modeled the association between depression and opioid misuse after adjusting for pain location and pain severity and interference. Depression was significantly associated with opioid misuse in CPOL but not in CLBP. Regression results indicate pain interference partly accounts for the depression–opioid misuse association. These preliminary results from a small patient sample suggest depression may co-occur with opioid misuse more often in CPOL than in CLBP. Further research is needed to compare this comorbidity in specific pain diagnoses such as arthritis, fibromyalgia and CLBP.
McCabe, Sean Esteban; West, Brady T; Boyd, Carol J
The objective of this study was to examine the prevalence and patterns associated with past-year medical use, medical misuse, and nonmedical use of prescription opioids (NMUPO) among adolescents over a 2-year time period and to examine substance abuse, sleeping problems, and physical pain symptoms associated with these patterns of medical use, medical misuse, and NMUPO. A Web-based survey was self-administered by a longitudinal sample of 2050 middle and high school students in 2009-2010 (Year 1) and again in 2010-2011 (Year 2). The study was set in 2 southeastern Michigan school districts. The longitudinal sample consisted of 50% females, 67% Whites, 28% African-Americans, and 5% from other racial/ethnic categories. Main outcome measures were past-year medical use, medical misuse, and NMUPO. Of those reporting appropriate medical use of prescription opioids in Year 1, approximately 34% continued medical use in Year 2. Of those reporting past-year NMUPO in Year 1, approximately 25% continued NMUPO in Year 2. Appropriate medical use and NMUPO for pain relief was more prevalent among girls than boys. Multiple logistic regression analyses indicated that the odds of a positive screen for substance abuse in Year 2 were greater for adolescents who reported medical misuse or NMUPO for non-pain-relief motives in Year 1 compared with those who did not use prescription opioids. The findings indicate an increased risk for substance abuse among adolescents who report medical misuse or NMUPO for non-pain-relief motives over time. The findings have important clinical implications for interventions to reduce medical misuse and NMUPO among adolescents. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
McCabe, Sean Esteban; West, Brady T.; Boyd, Carol J.
Objective To examine the prevalence and patterns associated with past-year medical use, medical misuse, and nonmedical use of prescription opioids (NMUPO) among adolescents over a two-year time period and to examine substance abuse, sleeping problems, and physical pain symptoms associated with these patterns of medical use, medical misuse, and NMUPO. Design A Web-based survey was self-administered by a longitudinal sample of 2,050 middle and high school students in 2009–2010 (Year 1) and again in 2010–2011 (Year 2). Setting Two southeastern Michigan school districts. Participants The longitudinal sample consisted of 50% females, 67% Whites, 28% African- Americans, and 5% from other racial/ethnic categories. Main Outcome Measures Past-year medical use, medical misuse, and NMUPO. Results Of those reporting appropriate medical use of prescription opioids in Year 1, approximately 34% continued medical use in Year 2. Of those reporting past-year NMUPO in Year 1, approximately 25% continued NMUPO in Year 2. Appropriate medical use and NMUPO for pain relief was more prevalent among girls than boys. Multiple logistic regression analyses indicated that the odds of a positive screen for substance abuse in Year 2 were greater for adolescents who reported medical misuse or NMUPO for non-pain relief motives in Year 1 compared with those who did not use prescription opioids. Conclusions The findings indicate an increased risk for substance abuse among adolescents who report medical misuse or NMUPO for non-pain relief motives over time. The findings have important clinical implications for interventions to reduce medical misuse and NMUPO among adolescents. PMID:23433943
Cerdá, Magdalena; Wall, Melanie; Keyes, Katherine M; Galea, Sandro; Hasin, Deborah
Marijuana is the most frequently used illicit substance in the United States. Little is known of the role that macro-level factors, including community norms and laws related to substance use, play in determining marijuana use, abuse and dependence. We tested the relationship between state-level legalization of medical marijuana and marijuana use, abuse, and dependence. We used the second wave of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a national survey of adults aged 18+ (n=34,653). Selected analyses were replicated using the National Survey on Drug Use and Health (NSDUH), a yearly survey of ∼68,000 individuals aged 12+. We measured past-year cannabis use and DSM-IV abuse/dependence. In NESARC, residents of states with medical marijuana laws had higher odds of marijuana use (OR: 1.92; 95% CI: 1.49-2.47) and marijuana abuse/dependence (OR: 1.81; 95% CI: 1.22-2.67) than residents of states without such laws. Marijuana abuse/dependence was not more prevalent among marijuana users in these states (OR: 1.03; 95% CI: 0.67-1.60), suggesting that the higher risk for marijuana abuse/dependence in these states was accounted for by higher rates of use. In NSDUH, states that legalized medical marijuana also had higher rates of marijuana use. States that legalized medical marijuana had higher rates of marijuana use. Future research needs to examine whether the association is causal, or is due to an underlying common cause, such as community norms supportive of the legalization of medical marijuana and of marijuana use. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Full Text Available According to the International Olympic Committee, the abuse of anabolic androgenic steroids (AASS is found in over 50% of positive doping tests. AASS abuse is not restricted to the organized sports andwidespread use. It remains as an unsolved public-health problem.Lower black market price, easier access to AASS, bodybuilding clubs and internet advertising are factors of this increasingly misuse. There is not real data about the prevalence of AASS abuse in various populations or countries, because most of athletes or students, due to their prohibition or ethical aspects do not admit to AASS abuse. Often they are aware of the risks of their choice and yet, are eager to put themselves at risk without deeper consideration. The abusers use them to improve their physical fitness and appearance.Present article has been collected to elucidate the risks and adverse effects of AASS and explanation of mechanisms of these events.
Tangney, June P.; Folk, Johanna B.; Graham, David M.; Stuewig, Jeffrey B.; Blalock, Daniel V.; Salatino, Andrew; Blasko, Brandy B.; Moore, Kelly E.
Purpose To assess changes in inmates’ misuse of substances from pre- to post-incarceration. Methods In Study 1, professionals (n = 162) and laypersons (n = 50) predicted how jail inmates’ substance misuse would change from pre-incarceration to post-release. In Study 2, a longitudinal study of 305 jail inmates, we examined actual changes in substance use and dependence from pre-incarceration to the first year post-incarceration, as well as whether changes varied as a function of demographic, criminal justice, treatment, and personality factors. Results Professionals and laypersons predicted little change in substance misuse whereas, in fact, inmates’ frequency of substance use and dependence decreased substantially from pre-incarceration to post-release. Sharper decreases were observed for inmates who were female, younger, more educated, serving longer sentences, enrolled in substance abuse treatment, high in shame-proneness, and low in criminogenic thinking. Race, first time incarceration, transfer to other correctional facilities, mandated community supervision (probation), and guilt-proneness did not predict changes in substance use or dependence. Conclusions Although substance misuse decreased, this remains a population high in need of substance abuse treatment both upon arrest and at one year post-incarceration; 60% of former inmates met at least one DSM-IV criterion for substance dependence at one year post-release. PMID:27458324
Milliken, William G.; And Others
Following Governor Milliken's address, Dr. Dana Farnsworth defines the problem in terms of who's involved, to what extent, and with which drugs. His presentation focuses primarily on the motives of affluent young people who experiment with or become dependent upon hallucinogens, marihuana and amphetamines. He deals extensively with the drastically…
Higgins, C; Smith, B H; Matthews, K
The prevalence and incidence of chronic conditions, such as pain and opioid dependence, have implications for policy development, resource allocation, and healthcare delivery. The primary objective of the current review was to estimate the incidence of iatrogenic opioid dependence or abuse after treatment with opioid analgesics. Systematic electronic searches utilised six research databases (Embase, Medline, PubMed, Cinahl Plus, Web of Science, OpenGrey). A 'grey' literature search and a reference search of included articles were also undertaken. The PICOS framework was used to develop search strategies and the findings are reported in accordance with the PRISMA Statement. After eligibility reviews of 6164 articles, 12 studies (involving 310 408 participants) were retained for inclusion in the meta-analyses. A random effects model (DerSimonian-Laird method) generated a pooled incidence of opioid dependence or abuse of 4.7%. There was little within-study risk of bias and no significant publication bias; however, substantial heterogeneity was found among study effects (99.78%). Sensitivity analyses indicated that the diagnostic criteria selected for identifying opioid dependence or abuse (Diagnostic Statistical Manual (DSM-IV) vs International Classification of Diseases (ICD-9)) accounted for 20% and duration of exposure to opioid analgesics accounted for 18% of variance in study effects. Longer-term opioid analgesic exposure, and prescription of strong rather than weak opioids, were associated with a significantly lower incidence of opioid dependence or abuse. The incidence of iatrogenic opioid dependence or abuse was 4.7% of those prescribed opioids for pain. Further research is required to confirm the potential for our findings to inform prevention of this serious adverse event. Copyright © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.
Boschloo, Lynn; Vogelzangs, Nicole; Smit, Johannes H.; van den Brink, Wim; Veltman, Dick J.; Beekman, Aartjan T. F.; Penninx, Brenda W. J. H.
BACKGROUND: Alcohol use disorders are highly prevalent but often remain unrecognized among depressed and/or anxious persons. This study examines the performance of the Alcohol Use Disorder Identification Test (AUDIT) in detecting alcohol abuse and dependence in this high-risk group and compares it
Golden, Shawn M.
This article describes the disparate research findings regarding the effects of stimulant medication in subsequent substance abuse and dependence. A minimum of 4 to 5% of children in the United States will be diagnosed with ADHD; thus it is important for parents to be informed when making decisions about the use of stimulant medication to treat…
Büyükbayraktar, Çagla Girgin; Er, Rukiye Konuk; Kesici, Sahin
The purpose of this research is to determine what students and families should do in order to prevent sexual abuse in students who need special education, depending on the opinions of teachers of mentally handicapped students. The qualitative research technique was used in this research. The study population of the research consisted of the…
Taubenfeld, Stephen M; Muravieva, Elizaveta V; Garcia-Osta, Ana; Alberini, Cristina M
Addicts repeatedly relapse to drug seeking even after years of abstinence, and this behavior is frequently induced by the recall of memories of the rewarding effects of the drug. Established memories, including those induced by drugs of abuse, can become transiently fragile if reactivated, and during this labile phase, known as reconsolidation, can be persistently disrupted. Here we show that, in rats, a morphine-induced place preference (mCPP) memory is linked to context-dependent withdrawal as disrupting the reconsolidation of the memory leads to a significant reduction of withdrawal evoked in the same context. Moreover, the hippocampus plays a critical role in linking the place preference memory with the context-conditioned withdrawal, as disrupting hippocampal protein synthesis and cAMP-dependent-protein kinase A after the reactivation of mCPP significantly weakens the withdrawal. Hence, targeting memories induced by drugs may represent an important strategy for attenuating context-conditioned withdrawal and therefore subsequent relapse in opiate addicts.
Milivojevic, Verica; Sinha, Rajita; Morgan, Peter T; Sofuoglu, Mehmet; Fox, Helen C
As sex differences in substance dependence may impinge upon the perception and regulation of emotion, we assess emotional intelligence (EI) as a function of gender, menstrual cycle (MC) phase and hormonal changes in early abstinent cocaine-dependent individuals who abuse alcohol (CDA). Study 1: The Mayer, Salovey, and Caruso Emotional Intelligence Test (MSCEIT) was administered to 98 CDA (55 M/43 F) and 56 healthy (28 M/28 F) individuals. Performance in women was also assessed by MC phase. Study 2: The MSCEIT was administered to 28 CDA (19 M/9 F) who received exogenous progesterone (400 mg/day) versus placebo for 7 days (study 2). Study 1: Healthy females were better than healthy males at facilitating thought and managing emotions. This gender discrepancy was not observed in the CDA group. Additionally, all women in the high compared with the low progesterone phase of their MC were better at managing their emotions. Study 2: Exogenous progesterone improved ability to facilitate thought in both males and females. CDA women may be vulnerable to difficulties managing and regulating emotions. Gonadal hormones may contribute to this gender effect, as increases in both endogenous and exogenous progesterone improved selective aspects of EI. Copyright © 2014 John Wiley & Sons, Ltd.
Deborah C. Mash
Full Text Available Ibogaine may be effective for transitioning opioid and cocaine dependent individuals to sobriety. American and European self-help groups provided public testimonials that ibogaine alleviated drug craving and opioid withdrawal symptoms after only a single dose administration. Preclinical studies in animal models of addiction have provided proof-of-concept evidence in support of these claims. However, the purported therapeutic benefits of ibogaine are based on anecdotal reports from a small series of case reports that used retrospective recruitment procedures. We reviewed clinical results from an open label case series (N = 191 of human volunteers seeking to detoxify from opioids or cocaine with medical monitoring during inpatient treatment. Whole blood was assayed to obtain pharmacokinetic measures to determine the metabolism and clearance of ibogaine. Clinical safety data and adverse events (AEs were studied in male and female subjects. There were no significant adverse events following administration of ibogaine in a dose range that was shown to be effective for blocking opioid withdrawal symptoms in this study. We used multi-dimensional craving questionnaires during inpatient detoxification to test if ibogaine was effective in diminishing heroin and cocaine cravings. Participants also completed standardized questionnaires about their health and mood before and after ibogaine treatment, and at program discharge. One-month follow-up data were reviewed where available to determine if ibogaine’s effects on drug craving would persist outside of an inpatient setting. We report here that ibogaine therapy administered in a safe dose range diminishes opioid withdrawal symptoms and reduces drug cravings. Pharmacological treatments for opioid dependence include detoxification, narcotic antagonists and long-term opioid maintenance therapy. Our results support product development of single oral dose administration of ibogaine for the treatment of opioid
Christoph, G.G; Jackson, K.A.; Neuman, M.C.; Siciliano, C.L.B.; Simmonds, D.D.; Stallings, C.A.; Thompson, J.L.
An effective method for detecting computer misuse is the automatic auditing and analysis of on-line user activity. This activity is reflected in the system audit record, by changes in the vulnerability posture of the system configuration, and in other evidence found through active testing of the system. In 1989 we started developing an automatic misuse detection system for the Integrated Computing Network (ICN) at Los Alamos National Laboratory. Since 1990 this system has been operational, monitoring a variety of network systems and services. We call it the Network Anomaly Detection and Intrusion Reporter, or NADIR. During the last year and a half, we expanded NADIR to include processing of audit and activity records for the Cray UNICOS operating system. This new component is called the UNICOS Real-time NADIR, or UNICORN. UNICORN summarizes user activity and system configuration information in statistical profiles. In near real-time, it can compare current activity to historical profiles and test activity against expert rules that express our security policy and define improper or suspicious behavior. It reports suspicious behavior to security auditors and provides tools to aid in follow-up investigations. UNICORN is currently operational on four Crays in Los Alamos` main computing network, the ICN.
Hall, W; Carter, L
A "cocaine vaccine" is a promising immunotherapeutic approach to treating cocaine dependence which induces the immune system to form antibodies that prevent cocaine from crossing the blood brain barrier to act on receptor sites in the brain. Studies in rats show that cocaine antibodies block cocaine from reaching the brain and prevent the reinstatement of cocaine self administration. A successful phase 1 trial of a human cocaine vaccine has been reported. The most promising application of a cocaine vaccine is to prevent relapse to dependence in abstinent users who voluntarily enter treatment. Any use of a vaccine to treat cocaine addicts under legal coercion raises major ethical issues. If this is done at all, it should be carefully trialled first, and only after considerable clinical experience has been obtained in using the vaccine to treat voluntary patients. There will need to be an informed community debate about what role, if any, a cocaine vaccine may have as a way of preventing cocaine addiction in children and adolescents.
Fisher, William H.; Clark, Robin; Baxter, Jeffrey; Barton, Bruce; O’Connell, Elizabeth; Aweh, Gideon
Persons who abuse opioids or are dependent on opioids are at elevated risk for arrest. Co-occurring behavioral health problems may exacerbate that risk, although the extent of any such increase has not been described. This study examines such risk factors among 40,238 individuals with a diagnosis of opioid abuse or dependence who were enrolled in the Massachusetts Medicaid program in 2010. Medicaid data were merged with statewide arrest data to assess the effects of co-existing mental illness, substance abuse, and previous arrests on arrest during 2010. Persons with serious mental illnesses (psychotic and bipolar disorders) and those with two or more pre-2010 arrests had significantly increased greater odds of arrest. We believe this to be the first study examining effects of co-occurring risk factors on arrest in a large population with opioid dependency/abuse. These findings identify predictors of arrest that could be used to design interventions targeting specific co-occurring risk factors. PMID:25012550
Elsayed Yasser A
Full Text Available Abstract Background A lot of studies were directed to explore the relation between drug abuse and neuropsychological functions. Some studies reported that even after a long duration of disappearance of withdrawal or intoxication symptoms, many patients have obvious deterioration of cognitive functions. The aim of this study was to explore the relationship between the substance use disorders and the executive functions. Methods Two groups were selected for this study. An experimental group consisted of 154 patients and further subdivided according to the substance used into three different subgroups: opioid, amphetamine and alcohol groups which included 49, 56 and 49 patients respectively. The control group was selected matching the experimental group in the demographic characteristics and included 100 healthy persons. Tools used were: Benton visual retention tests, color trail making test, Stroop colors-word test, symbol digit modalities test, the five dots cognitive flexibility test, and TAM verbal flexibility test. All the data were subjected to statistical analysis Results The study showed that the group of drug-dependent subjects performed significantly worse than the comparison group on all measures Also, there were significant differences among the subgroups as the alcoholic group was much worse followed by the amphetamine then the opioids groups. Patients with longer duration of dependence and multiple hospital readmissions were much worse in comparison to patients with shorter duration of dependence and less readmission. Conclusion The study confirmed that the functions of specific brain regions underlying cognitive control are significantly impaired in patients of drug addiction. This impairment was significantly related to type of substance, duration of use and number of hospitalization and may contribute to most of behavioral disturbances found in addicts and need much attention during tailoring of treatment programs.
Full Text Available Sexual abuse is defined as use of child or adolescent by the adults for satisfying of sexual urges and needs with forcing, threatening or tricking. Sexual abuse can be in the form of sexual abuse without touch, sexual touch, interfemoral intercourse, sexual penetration, and sexual exploitation. The prevalence of sexual abuse is reported as 10-40%. It is seen in female four times more than in males. Abusers are frequently male, only 5-15% of them are female. The abuse by females is usually towards male child. Thirty-fifty percent of abuse cases among child and adolescent are outside the family including strangers or familiar person. Some features of abusers are introvert personality, pedophilic and antisocial personality. Most of the abusers have a history of sexual abuse or aggression during childhood. Sexual intercourse between two people who are not allowed to marry by law is called as incest. Family pattern of incest is defined globally as disorganized and dysfunctional. The most commonly reported familial pattern is rigid and patriarchal family pattern with a harsh father using force quite frequently. The clinical features and impacts of the sexual abuse on the child varies according to the relation between abusers and the child, form of abuse, duration of abuse, presence of physical assault, developmental phase, child age and psychological development before the abuse. Sexual abuse history may result in psychiatric disorders including anxiety, depression, substance dependence, suicide act, borderline personality disorder, posttraumatic stress disorder. Abuse negatively affects interpersonal relationships and self esteem of abused individuals. Several studies reported close association between risky sexual behaviors in adulthood and a history of of sexual abuse during childhood. Four traumatic dynamics including traumatic sexuality with abuse, feeling of betrayal, weakness, and stigmatization exist in childhood abuse. Trauma can cause
Bogner, Jennifer; French, Louis M; Lange, Rael T; Corrigan, John D
Explore relationships among traumatic brain injury (TBI), substance misuse and other mental health disorders in US service members and to identify risk factors for substance misuse. Service members (n = 93 in final sample) injured while deployed to Operation Enduring Freedom or Operation Iraqi Freedom. Longitudinal survey at 6 and 12 months post-intake. The following measures were used: problem substance use, Alcohol Expectancies Questionnaire-III, MINI International Neuropsychiatric Interview Substance Abuse Modules, Ohio State University TBI Identification Method, Neurobehavioural Symptom Inventory, Rivermead Post-Concussion Symptoms Questionnaire, Buss-Perry Aggression Questionnaire, Post-Traumatic Stress Disorder Checklist-Civilian Version, Beck Depression Inventory-II, Beck Anxiety Inventory. More severe TBI and post-traumatic stress disorder (PTSD) symptoms at 6 months post-enrolment were associated with decreased odds of substance misuse 12 months after study enrolment. Alcohol expectancies and incurring a TBI at a younger age increased the odds of substance misuse. While the ability to generalize the current findings to a larger population is limited, the results provide direction for future studies on the prevention and treatment of substance misuse following TBI. The unexpected protective effect of more severe TBI may result from prospective attention to the injury and its consequences. Greater preventive benefit may result from identifying more service members with elevated risk. Lifetime history of TBI and alcohol expectancies may be candidate indicators for greater attention.
Myra Siv Merete
Full Text Available BACKGROUND – Use of coercion against pregnant women who misuse substances was legalised in Norway in 1996. The background for the law was that substance abuse during pregnancy represents a significant health problem for the child.
Harris Hyun-Soo Kim
Full Text Available Research indicates that mobile phone dependency (MPD is associated with various behavioral and internalizing problems. While a significant amount of findings points to its negative outcomes, there is a dearth of evidence concerning the determinants of MPD. This study focuses on this critical, yet understudied, subject by analyzing the associations between abusive parenting style, neighborhood characteristics, and MPD among youths in South Korea, a country with one of the highest mobile broadband penetration rates in the world. Based on the secondary analysis of two waves of Korean Children and Youth Panel Survey (KCYPS, a government-funded multiyear study, we investigate individual- and contextual-level factors underlying MPD. Findings show that, net of a host of time-lagged controls (including baseline dependency from the previous year, abusive parenting style significantly increases adolescent MPD. After adjusting for individual level characteristics, however, no contextual-level effect is found, i.e., residing in a neighborhood with a relatively higher proportion of parental abuse is not related to greater MPD. Finally, two cross-level interaction effects are observed. First, the association between parental abuse and MPD is weaker in a neighborhood context with better educated inhabitants (more college graduates. Second, it is reinforced in demographically "aged" communities with more elderly residents.
Kim, Harris Hyun-Soo; Chun, JongSerl
Research indicates that mobile phone dependency (MPD) is associated with various behavioral and internalizing problems. While a significant amount of findings points to its negative outcomes, there is a dearth of evidence concerning the determinants of MPD. This study focuses on this critical, yet understudied, subject by analyzing the associations between abusive parenting style, neighborhood characteristics, and MPD among youths in South Korea, a country with one of the highest mobile broadband penetration rates in the world. Based on the secondary analysis of two waves of Korean Children and Youth Panel Survey (KCYPS), a government-funded multiyear study, we investigate individual- and contextual-level factors underlying MPD. Findings show that, net of a host of time-lagged controls (including baseline dependency from the previous year), abusive parenting style significantly increases adolescent MPD. After adjusting for individual level characteristics, however, no contextual-level effect is found, i.e., residing in a neighborhood with a relatively higher proportion of parental abuse is not related to greater MPD. Finally, two cross-level interaction effects are observed. First, the association between parental abuse and MPD is weaker in a neighborhood context with better educated inhabitants (more college graduates). Second, it is reinforced in demographically "aged" communities with more elderly residents.
Radcliffe, Polly; Gilchrist, Gail
Studies have shown rates of IPV-perpetration among men in substance misuse treatment at rates far higher than the general population. There is poor evidence for the effectiveness of IPV perpetrator programmes. An analysis of drugs and alcohol policy documents 1998-2015 was conducted using discourse analysis to examine how English drug and alcohol policy has addressed IPV among substance misusers. Transcripts of interviews with 20 stake holders were analysed thematically. How policy 'frames' IPV-perpetration among drug and alcohol misusers has implications for service provision. IPV has increasingly been framed in terms of its implications for child safeguarding, and has been 'folded in' to policies targeting Troubled Families. With increasing 'localism' in English drug and alcohol policy there has been little specification of services for substance misusing IPV-perpetrators. Policy and literature produced by IPV perpetrator and victim organisations has framed IPV-perpetration as an individual choice with intoxication as a post hoc excuse for violence with limited implications for effective service development. Interviews with stake holders indicate a range of understandings/explanations for IPV among substance misusing men. Stake holders suggest that not all staff have the confidence or skills to ask men about their relationships and that there are few referral routes for substance misusing men who seek help for their IPV perpetration. There are gaps and contradictions in the extent to which English drug and alcohol policy has sought to address IPV-perpetration among substance misusers. Recent National Institute for Health and Care Excellence guidance provide an opportunity to include domestic abuse training for all front line social care staff including in the substance misuse sector. There is a need for further research into effective services for substance misusing perpetrators and the development of training for front-line staff. Copyright © 2016 The Authors
Dell, Colleen Anne; Gust, Steven W; MacLean, Sarah
This special issue of Substance Use & Misuse addresses the public health issue of volatile substance misuse (VSM), the inhalation of gases or vapors for psychoactive effects, assessing the similarities and differences in the products misused, patterns, prevalence, etiologies, and impacts of VSM by examining it through sociocultural epidemiology, neuroscience, and interventions research. The Canadian, US, and Australian guest editors contend that, when compared with other drugs used at a similar prevalence, VSM has attracted relatively little research effort. The authors and editors call for further research to develop evidence-based policies and comprehensive interventions that respect culture and context-specific knowledge.
Farag, A G A; Basha, M A; Amin, S A; Elnaidany, N F; Elhelbawy, N G; Mostafa, M M T; Khodier, S A; Ibrahem, R A; Mahfouz, R Z
Tramadol, one of the most commonly abused drugs in Middle East, impacts spermatogenesis and disturbs reproductive hormones in animal studies. We aimed to investigate tramadol impact on sperm quality and on levels of testosterone, prolactin and gonadotropins, in tramadol abusers (n = 30) to age-matched control (n = 30). Abusers had significantly low percentages of sperm motility, normal forms and vitality compared with control (95% CI -40.7 to -19.3, -13.5 to -9.3 and -31.9 to -9.7 respectively). Hypoandrogenism (95% CI -4.5 to -2.8), hyperprolactinaemia (CI (95%) 4.9 to 9.4) and hypergonadotropinaemia (95% CI 2.9 to 7.2 for FSH and 2.0 to 7.8 for LH) were observed in tramadol abusers vs controls. Smokers (26 of 30), concurrently abusing other drugs (11 of 30) and asymptomatic leucocytospermic (15 of 30) patients subgroups significantly abused tramadol beyond 3 years (p = .02, 450 mg/day (p = .02, = .01, = .005 respectively). Progressive motility (a + b%) was significantly low in young men <25 years old (p = .03) subgroup. Tramadol abuse is associated with poor sperm quality, hyperprolactinaemia and hypergonadotropic hypogonadism. We recommend semen analysis for tramadol long-intakes, question sperm donors and follow-up studies to prevent and reverse tramadol-induced testicular damage. © 2018 Blackwell Verlag GmbH.
Full Text Available The aim of this study was to evaluate suicide probability in Iranian males with substance abuse or dependence disorder and to investigate the predictors of suicide probability based on trait mindfulness, reasons for living and severity of general psychiatric symptoms.Participants were 324 individuals with substance abuse or dependence in an outpatient setting and prison. Reasons for living questionnaire, Mindfulness Attention Awareness Scale and Suicide probability Scale were used as instruments. Sample was selected based on convenience sampling method. Data were analyzed using SPSS and AMOS.The life-time prevalence of suicide attempt in the outpatient setting was35% and it was 42% in the prison setting. Suicide probability in the prison setting was significantly higher than in the outpatient setting (p<0.001. The severity of general symptom strongly correlated with suicide probability. Trait mindfulness, not reasons for living beliefs, had a mediating effect in the relationship between the severity of general symptoms and suicide probability. Fear of social disapproval, survival and coping beliefs and child-related concerns significantly predicted suicide probability (p<0.001.It could be suggested that trait mindfulness was more effective in preventing suicide probability than beliefs about reasons for living in individuals with substance abuse or dependence disorders. The severity of general symptom should be regarded as an important risk factor of suicide probability.
Full Text Available Scott P Novak,1 Cristie Glasheen,1 Carl L Roland,2 1Behavioral Health Epidemiology, RTI International, 2Clinical Sciences and Outcomes Evidence, Pfizer Inc., Durham, NC, USA Background: The primary aim of this work was to present the prevalence data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC, a representative 3-year longitudinal survey (ages 18+ years that captured information on patterns of self-reported pain interference and prescription pain reliever misuse. A second aim was to assess the degree to which the risk of various types of opioid misuse (onset, desistance, and incidence of dependence was related to the longitudinal course of self-reported pain interference over the 3-year period. Methods: We used a two-wave, nationally representative sample of adults (aged 18+ years in which the baseline data were collected during 2001–2002 and a single follow-up was obtained ~3 years later (2004–2005 with 34,332 respondents with complete data on study variables for both waves. Results: Our findings indicated that ~10% reported high pain interference in the past month at each wave. There was tremendous stability in levels of pain, with ~5% reporting consistent levels of high impairment over the 3-year study, a proxy for chronic pain. Levels of pain were more strongly associated with prescription pain reliever misuse concurrently rather than prospectively, and the association was largely linear, with the likelihood of misuse increasing with levels of pain. Finally, health service factors were also prominent predictors of onset, but not the outcomes, of desistance or transitions to problem use. Conclusion: This study is the first to use a nationally representative sample with measures of pain and drug use history collected over an extended period. These results may help provide clinicians with an understanding that the risk of misuse is greatest when pain is active and may help guide the selection of
Zweig, Janine M.; Dank, Meredith; Yahner, Jennifer; Lachman, Pamela
To date, little research has documented how teens might misuse technology to harass, control, and abuse their dating partners. This study examined the extent of cyber dating abuse--abuse via technology and new media--in youth relationships and how it relates to other forms of teen dating violence. A total of 5,647 youth from ten schools in three…
Australia's Aborigines lived in isolation from the rest of humanity as successful hunter-gatherers for tens of thousands of years. That isolation ended abruptly with British colonization in the late 18th century and was followed by a traumatic 200 years for Aborigines who are now seriously disadvantaged, socio-economically and in terms of their health standards. It has often been assumed that the Aborigines had no access to psychotropic substances before permanent European contact but several pieces of evidence dispute this view. The history of Aboriginal contact with and usage of intoxicating substances, including alcohol, is extremely complex and affected by a maze of restrictive government policies. These interact with a wide range of other Federal and State policies which have changed rapidly since the late 1960s when Aborigines were first granted the franchise; access to unrestricted drinking followed soon afterwards. Today Aborigines suffer disproportionately to other Australians from the physical and social consequences of excess alcohol consumption, tobacco usage, petrol and other solvent sniffing, usage of marijuana, amphetamines, cocaine and heroin, as well as other drugs. The Aboriginal population is dispersed in cities, towns, fringe settlements, rural and remote areas over this vast continent and there are different patterns of drug usage from place to place. This review attempts to synthesize some of this information in order to give an overview to the history, background, current status of substance misuse by Aborigines as well as some strategies being used to try to overcome this serious problem.
Curtis, Andrew; Gerrard, David; Burt, Peter; Osborne, Hamish
Drug misuse in elite sport is a world-wide phenomenon. This article explores the culture of contemporary sport, provides estimates of doping prevalence, discusses dietary supplementation and highlights major factors influencing high-performance athletes and their support personnel. The aim is to stimulate discussion, informed by the World Anti-Doping Code (WADC), which is particularly relevant to doctors caring for athletes. Online databases were searched for relevant peer-reviewed research from 2009 to 2015. Comparative New Zealand data have been included. Estimates of the prevalence of sports doping range from less than 1% to as high as 52%, dependent upon the demographics of the identified cohort. The culture of elite sport, personal stressors, competitive demands, financial reward and the influence of an 'entourage' of support personnel were identified as critical determinants of drug misuse. The culture of elite contemporary sport is seductive to many aspiring young athletes. To combat drug misuse, effective education should embody moral, ethical and clinical dangers, recognising the importance of support at times of increased athlete vulnerability. Inadvertent doping from product contamination is a recognised risk of unsupervised dietary supplementation. Doctors responsible for the care of high-performance athletes must be cognisant of these issues and the provisions of the WADC.
Fisher, Sherri L; Bucholz, Kathleen K; Reich, Wendy; Fox, Louis; Kuperman, Samuel; Kramer, John; Hesselbrock, Victor; Dick, Danielle M; Nurnberger, John I; Edenberg, Howard J; Bierut, Laura J
Previous studies have shown that when assessing child psychopathology, parents tend to report more symptoms than children for externalizing disorders such as attention deficit hyperactivity disorder (ADHD), whereas children tend to report more symptoms for internalizing disorders such as major depression. Whether for clinical or research purposes, parents are also frequently asked to report on their children's experiences with alcohol and drugs. The purpose of this study was to analyze correspondence between adolescent and parent reports of adolescent substance use and abuse or dependence. In the current study, 591 subjects 12 to 17 years old were interviewed using the child version of the Semi-Structured Assessment for the Genetics of Alcoholism (C-SSAGA) as part of the Collaborative Study on the Genetics of Alcoholism (COGA). One parent was also interviewed about each adolescent using the parent version of the C-SSAGA. Sensitivities, specificities, and kappa coefficients were calculated to assess parental agreement with adolescent reports of lifetime substance use and Diagnostic and Statistical Manual of Mental Disorders-Third Revision substance abuse or dependence. The results indicate that parents are somewhat knowledgeable about their children's use of substances, particularly those that are used most commonly. For example, 55% of adolescents who had smoked cigarettes, 50% who had used alcohol, and 47% who had used marijuana had a parent who knew that they used. However, parents were less aware of substance-related problems experienced by their offspring, agreeing with adolescent reports only 27% of the time for diagnoses of alcohol abuse or dependence and 26% of the time for diagnoses of marijuana abuse or dependence. Parent reports added few cases of substance use for 12- to 13 year-olds and essentially no cases for 16- to 17-year-olds. Parent reports added a nominal number of diagnoses of substance abuse or dependence for older adolescents. Whether for
... Cocaine Heroin Inhalants Marijuana Prescription drugs, including opioids Drug abuse also plays a role in many major social problems, such as drugged driving, violence, stress, and child abuse. Drug abuse can lead to ...
Full Text Available BACKGROUND: History of drug abuse which included Gutka/cannabis and not alcohol intake has been found in psychiatric patients attending Psychiatry outpatients. AIMS: To find out prevalence of cannabis/Gutka misuse among psychiatric patients , to find out socio - demographic variables , and pattern of psychiatric disorders among cannabis/g utka misusers. METHOD: Out of 150 psychiatric patients 18 were identified for cannabis/gutka misuse. These patients were examined and categorized according to socio - demographic characteristics and types of mental disorders diagnosed by using DSM - IV. RESULT S: Most of the psychiatric patients who had history of cannabis/Gutka intake were male (96.4% and 76% were in age group of 15 - 35 years. 48.6% bipolar type - 1 , 23% schizophreniform psychosis , 14% had drug induced psychosis and 1.4% psychosis NOS patients we re found in this study. CONCLUSIONS: Young male patients were more commonly involved in drug misuse and most of them belong to rural area.
Cherian, Roy; Westbrook, Marisa; Ramo, Danielle
Background Prescription opioid misuse has doubled over the past 10 years and is now a public health epidemic. Analysis of social media data may provide additional insights into opioid misuse to supplement the traditional approaches of data collection (eg, self-report on surveys). Objective The aim of this study was to characterize representations of codeine misuse through analysis of public posts on Instagram to understand text phrases related to misuse. Methods We identified hashtags and searchable text phrases associated with codeine misuse by analyzing 1156 sequential Instagram posts over the course of 2 weeks from May 2016 to July 2016. Content analysis of posts associated with these hashtags identified the most common themes arising in images, as well as culture around misuse, including how misuse is happening and being perpetuated through social media. Results A majority of images (50/100; 50.0%) depicted codeine in its commonly misused form, combined with soda (lean). Codeine misuse was commonly represented with the ingestion of alcohol, cannabis, and benzodiazepines. Some images highlighted the previously noted affinity between codeine misuse and hip-hop culture or mainstream popular culture images. Conclusions The prevalence of codeine misuse images, glamorizing of ingestion with soda and alcohol, and their integration with mainstream, popular culture imagery holds the potential to normalize and increase codeine misuse and overdose. To reduce harm and prevent misuse, immediate public health efforts are needed to better understand the relationship between the potential normalization, ritualization, and commercialization of codeine misuse. PMID:29559422
... means feeling withdrawal symptoms when not taking the drug. Addiction is a chronic brain disease that causes a person to compulsively seek out drugs, even though they cause harm. The risks of dependence and addiction are higher if you abuse the medicines. Abuse ...
Stone, Amanda M; Merlo, Lisa J
Mental illness stigma remains a significant barrier to treatment. However, the recent increase in the medical and nonmedical use of prescription psychiatric medications among college students seems to contradict this phenomenon. This study explored students' attitudes and experiences related to psychiatric medications, as well as correlates of psychiatric medication misuse (ie, attitudes toward mental illness and beliefs about the efficacy of psychiatric medications). Data were collected anonymously via self-report questionnaires from April 2008 to February 2009. Measures included the Michigan Alcoholism Screening Test, the Drug Abuse Screening Test, Day's Mental Illness Stigma Scale, the Attitudes Toward Psychiatric Medication scale, and the Psychiatric Medication Attitudes Scale. Participants included 383 university students (59.2% female), recruited on the campus of a large state university or through online classes offered through the same university. High rates of psychiatric medication misuse were shown (13.8%) when compared to rates of medical use (6.8%), and students with prescriptions for psychiatric drugs were also more likely to be misusers (χ(2) = 20.60, P mental illness, including lower anxiety around the mentally ill (t = 3.26, P mental illness (t = -2.11, P mental illness, the appropriate use of psychiatric medications, and the potential consequences associated with abuse of these potent drugs. © Copyright 2011 Physicians Postgraduate Press, Inc.
Kutlu, Munir Gunes; Gould, Thomas J
It has long been hypothesized that conditioning mechanisms play major roles in addiction. Specifically, the associations between rewarding properties of drugs of abuse and the drug context can contribute to future use and facilitate the transition from initial drug use into drug dependency. On the other hand, the self-medication hypothesis of drug abuse suggests that negative consequences of drug withdrawal result in relapse to drug use as an attempt to alleviate the negative symptoms. In this review, we explored these hypotheses and the involvement of the hippocampus in the development and maintenance of addiction to widely abused drugs such as cocaine, amphetamine, nicotine, alcohol, opiates, and cannabis. Studies suggest that initial exposure to stimulants (i.e., cocaine, nicotine, and amphetamine) and alcohol may enhance hippocampal function and, therefore, the formation of augmented drug-context associations that contribute to the development of addiction. In line with the self-medication hypothesis, withdrawal from stimulants, ethanol, and cannabis results in hippocampus-dependent learning and memory deficits, which suggest that an attempt to alleviate these deficits may contribute to relapse to drug use and maintenance of addiction. Interestingly, opiate withdrawal leads to enhancement of hippocampus-dependent learning and memory. Given that a conditioned aversion to drug context develops during opiate withdrawal, the cognitive enhancement in this case may result in the formation of an augmented association between withdrawal-induced aversion and withdrawal context. Therefore, individuals with opiate addiction may return to opiate use to avoid aversive symptoms triggered by the withdrawal context. Overall, the systematic examination of the role of the hippocampus in drug addiction may help to formulate a better understanding of addiction and underlying neural substrates. © 2016 Kutlu and Gould; Published by Cold Spring Harbor Laboratory Press.
Kutlu, Munir Gunes
It has long been hypothesized that conditioning mechanisms play major roles in addiction. Specifically, the associations between rewarding properties of drugs of abuse and the drug context can contribute to future use and facilitate the transition from initial drug use into drug dependency. On the other hand, the self-medication hypothesis of drug abuse suggests that negative consequences of drug withdrawal result in relapse to drug use as an attempt to alleviate the negative symptoms. In this review, we explored these hypotheses and the involvement of the hippocampus in the development and maintenance of addiction to widely abused drugs such as cocaine, amphetamine, nicotine, alcohol, opiates, and cannabis. Studies suggest that initial exposure to stimulants (i.e., cocaine, nicotine, and amphetamine) and alcohol may enhance hippocampal function and, therefore, the formation of augmented drug-context associations that contribute to the development of addiction. In line with the self-medication hypothesis, withdrawal from stimulants, ethanol, and cannabis results in hippocampus-dependent learning and memory deficits, which suggest that an attempt to alleviate these deficits may contribute to relapse to drug use and maintenance of addiction. Interestingly, opiate withdrawal leads to enhancement of hippocampus-dependent learning and memory. Given that a conditioned aversion to drug context develops during opiate withdrawal, the cognitive enhancement in this case may result in the formation of an augmented association between withdrawal-induced aversion and withdrawal context. Therefore, individuals with opiate addiction may return to opiate use to avoid aversive symptoms triggered by the withdrawal context. Overall, the systematic examination of the role of the hippocampus in drug addiction may help to formulate a better understanding of addiction and underlying neural substrates. PMID:27634143
Radacsi, Gergely; Hardi, Peter
All sectors of society should be involved in reducing substance misuse, including businesses. However, the business sector is typically involved only to the extent that their products compel them to be (e.g., alcohol producers promoting responsible alcohol consumption). This article examines why business participation has been limited and how embedding prevention within a framework of health promotion could increase participation. It reviews both Hungarian and international cases, concluding that although corporate social responsibility (CSR) offers a framework to approach substance misuse reduction, a different perception of the role of the business sector is necessary to make it viable.
... their drinking causes distress and harm. It includes alcoholism and alcohol abuse. Alcoholism, or alcohol dependence, is a disease that causes ... the liver, brain, and other organs. Drinking during pregnancy can harm your baby. Alcohol also increases the ...
Yuan, Nicole P.; Duran, Bonnie M.; Walters, Karina L.; Pearson, Cynthia R.; Evans-Campbell, Tessa A.
This study examined associations between alcohol misuse and childhood maltreatment and out-of-home placement among urban lesbian, gay, and bisexual (referred to as two-spirit) American Indian and Alaska Native adults. In a multi-site study, data were obtained from 294 individuals who consumed alcohol during the past year. The results indicated that 72.3% of men and 62.4% of women engaged in hazardous and harmful alcohol use and 50.8% of men and 48.7% of women met criteria for past-year alcohol dependence. The most common types of childhood maltreatment were physical abuse among male drinkers (62.7%) and emotional abuse (71.8%) among female drinkers. Men and women reported high percentages of out-of-home placement (39% and 47%, respectively). Logistic multiple regressions found that for male drinkers boarding school attendance and foster care placement were significant predictors of past-year alcohol dependence. For female drinkers, being adopted was significantly associated with a decreased risk of past-year drinking binge or spree. Dose-response relationships, using number of childhood exposures as a predictor, were not significant. The results highlight the need for alcohol and violence prevention and intervention strategies among urban two-spirit individuals. PMID:25317980
Nicole P. Yuan
Full Text Available This study examined associations between alcohol misuse and childhood maltreatment and out-of-home placement among urban lesbian, gay, and bisexual (referred to as two-spirit American Indian and Alaska Native adults. In a multi-site study, data were obtained from 294 individuals who consumed alcohol during the past year. The results indicated that 72.3% of men and 62.4% of women engaged in hazardous and harmful alcohol use and 50.8% of men and 48.7% of women met criteria for past-year alcohol dependence. The most common types of childhood maltreatment were physical abuse among male drinkers (62.7% and emotional abuse (71.8% among female drinkers. Men and women reported high percentages of out-of-home placement (39% and 47%, respectively. Logistic multiple regressions found that for male drinkers boarding school attendance and foster care placement were significant predictors of past-year alcohol dependence. For female drinkers, being adopted was significantly associated with a decreased risk of past-year drinking binge or spree. Dose-response relationships, using number of childhood exposures as a predictor, were not significant. The results highlight the need for alcohol and violence prevention and intervention strategies among urban two-spirit individuals.
Vargas Navarro, Pedro; Parra Vera, Mario Danilo; Arévalo Zamora, Caterín; Cifuentes Gaitán, Luisa Karen; Valero Carvajal, Jaime; Sierra de Jaramillo, Margarita
To determine the family type, family structure in a group of patients with a diagnosis of substance abuse or dependence who were at a rehabilitation center for addiction during the period between August and October 2009. Through a descriptive qualitative-interpretative methodology 10 patients who met inclusion criteria for substance dependence or abuse were studied. The fieldwork and transcripts were made for three months by non-participant observation, non-structured interviews and examination of patients' clinical history. Seven of the families interviewed were single-parent families with an unconventional organization on "gender roles". Single-parent families favored loneliness, difficulty in rule-setting, de-idealization of the place of the father in the family structure and a constant search for complicity. In the analysis by categories, we found that in 10 families in the study of individuals with addictions it is common to find family structure characteristics such as inadequate communication, lack of authority rules and limits, presence of triangulations, the lack of cohesion due to the existence of a disconnected relationship pattern and changed roles compared to conventional gender. The search for the affection of the mother at her emotional overload absence of roles and lack of father, raised by the separation of the couple, was found as an essential aspect underlying the addictive behavior. A pattern of parental abandonment is configured. The findings confirmed what has been mentioned by various authors regarding the characteristics of the family typology structure and personal factors in patients with addictions, in addition to their need for affection combined with the desire for the mother's presence. The family typology does not determine for itself the abuse of psychoactive substances, but the influence of other factors such as family structure, especially deficient affective interactions, which should be considered in the development of
Yu, Chunjiang; Narasipura, Srinivas D; Richards, Maureen H; Hu, Xiu-Ti; Yamamoto, Bryan; Al-Harthi, Lena
Emerging evidence suggests that cell senescence plays an important role in aging-associated diseases including neurodegenerative diseases. HIV leads to a spectrum of neurologic diseases collectively termed HIV-associated neurocognitive disorders (HAND). Drug abuse, particularly methamphetamine (meth), is a frequently abused psychostimulant among HIV+ individuals and its abuse exacerbates HAND. The mechanism by which HIV and meth lead to brain cell dysregulation is not entirely clear. In this study, we evaluated the impact of HIV and meth on astrocyte senescence using in vitro and several animal models. Astrocytes constitute up to 50% of brain cells and play a pivotal role in marinating brain homeostasis. We show here that HIV and meth induce significant senescence of primary human fetal astrocytes, as evaluated by induction of senescence markers (β-galactosidase and p16 INK 4A ), senescence-associated morphologic changes, and cell cycle arrest. HIV- and meth-mediated astrocyte senescence was also demonstrated in three small animal models (humanized mouse model of HIV/NSG-huPBMCs, HIV-transgenic rats, and in a meth administration rat model). Senescent astrocytes in turn mediated neuronal toxicity. Further, we show that β-catenin, a pro-survival/proliferation transcriptional co-activator, is downregulated by HIV and meth in human astrocytes and this downregulation promotes astrocyte senescence while induction of β-catenin blocks HIV- and meth-mediated astrocyte senescence. These studies, for the first time, demonstrate that HIV and meth induce astrocyte senescence and implicate the β-catenin pathway as potential therapeutic target to overcome astrocyte senescence. © 2017 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.
Transtornos mentais como fatores de risco para o desenvolvimento de abuso/dependência de cocaína: estudo caso-controle Mental disorders as risk factors for the development of cocaine abuse/dependence: case-control study
Claudia S Lopes
Full Text Available OBJETIVO: Avaliar o papel dos transtornos mentais e da dependência ao álcool como possíveis fatores de risco para o abuso/dependência de cocaína. MÉTODOS: Utilizou-se o desenho caso-controle e a técnica de bola-de-neve (snowball technique para selecionar uma amostra de usuários de cocaína não tratados na comunidade (casos e parear casos e controles por sexo, idade e amizade. A coleta de dados foi feita através da utilização do questionário CIDI (Composite International Diagnostic Interview que gera diagnósticos de acordo com os critérios do Diagnostic and Statistical Manual of Mental Disorders-III-R. A análise dos dados foi feita através de regressão logística condicional. RESULTADOS: O estudo incluiu 208 indivíduos. Os principais resultados mostraram que história passada de dependência ao álcool era o principal fator associado a um aumento no risco de desenvolvimento de abuso de cocaína (OR=15,1; IC 95% 3,8-60,2; nenhum outro transtorno mental isolado manteve-se significativamente associado ao aumento deste risco após a análise multivariada. Aumento no risco de abuso de cocaína também foi encontrado entre os indivíduos que relataram pensamentos suicidas (OR=3,1; IC 95% 0,91-10,8, sugerindo associação entre quadros mais graves de depressão e abuso de cocaína. CONCLUSÕES: Esses achados sugerem que os programas voltados para a prevenção e tratamento do abuso de cocaína devem estar preparados para o manejo de questões relacionadas à co-morbidade do abuso de drogas com o álcool e outros distúrbios psiquiátricos.OBJECTIVE: To evaluate the role of psychiatric disorders and alcohol dependence as possible risk factors for cocaine abuse/dependence. METHODS: The case-control study used the "snowball" technique in order to select untreated cocaine users (cases and to match sex, age and friendship. Information was gathered using the Composite International Diagnostic Interview (CIDI, and computer diagnosis were
Yahya Ayhan Acar
Full Text Available Benzydamine hydrochloride is a locally acting nonsteroidal anti-inflammatory drug. Benzydamine hydrochloride overdose can cause stimulation of central nervous system, hallucinations, and psychosis. We presented a young man with psychotic symptoms due to benzydamine hydrochloride abuse. He received a total dose of 1000 mg benzydamine hydrochloride with alcohol for its hallucinative effects. Misuse of benzydamine hydrochloride must be considered in differential diagnosis of first-episode psychosis and physicians should consider possibility of abuse in prescribing.
Downey, Ann M.
Explored the hypothesis that the increased use, misuse, and abuse of drugs is one of the myriad explanations for the escalation in youth suicidal behavior during the past 25 years. Used clinical case histories and research results to exemplify the impact of heightened drug usage as an argument for the upsurge in youth suicide. (Author/LLL)
A Randomized Controlled Trial Assessing the Efficacy of Cognitive Behavioral Therapy for Substance-Dependent Domestic Violence Offenders: An Integrated Substance Abuse-Domestic Violence Treatment Approach (SADV).
Easton, Caroline J; Crane, Cory A; Mandel, Dolores
The current study evaluates a therapy for substance-dependent perpetrators of partner violence. Sixty-three males arrested for partner violence within the past year were randomized to a cognitive behavioral substance abuse-domestic violence (SADV; n = 29) or a drug counseling (DC; n = 34) condition. Seventy percent of offenders completed eight core sessions with no differences between SADV and DC conditions in the amount of substance or aggression at pretreatment. SADV participants had fewer cocaine-positive toxicology screens and breathalyzer results during treatment, were less likely to engage in aggressive behavior proximal to a drinking episode, and reported fewer episodes of violence than DC participants at posttreatment follow-up. SADV shows promise in decreasing addiction and partner violence among substance-dependent male offenders. © 2017 American Association for Marriage and Family Therapy.
Albertson, Timothy E
The use of recreational drugs of abuse continues to expand without limitations to national boundaries, social status, race, or education. Beyond the prevalence of illicit drug use and dependence, their contribution to the global burden of disease and death are large and troubling. All medical providers should be aware of the evolving drugs of abuse and their medical and social consequences. In addition to heroin and stimulants such as cocaine and methamphetamine, new designer stimulants called "bath salts" and cannabinoids called "spice," along with the abuse of prescription drugs and volatile substances, are now widely recognized problems in many societies. The wide variety and continuingly expanding clinical manifestations of toxicity of recreational drugs of abuse is not widely appreciated by clinicians. This edition attempts to summarize six major classes of drugs of abuse and their clinical effects with special emphasis on their immunological and respiratory effects.
... is when you pour the product into a bag, hold it over your mouth and nose, and inhale. How is inhalant abuse diagnosed? If you think your child is abusing inhalants, talk to them. Be honest and open. Tell them ...
... Safe Videos for Educators Search English Español Abusive Relationships KidsHealth / For Teens / Abusive Relationships Print en español Relaciones de maltrato Healthy Relationships = Respect & Trust Healthy relationships involve respect, trust, and ...
Gisquet-Verrier, Pascale; Tolédano, Daniel; Le Dorze, Claire
Post-traumatic stress disorder (PTSD) and addiction to drugs of abuse are two common diseases, showing high comorbidity rates. This review presents a number of evidence showing similarities between these two pathologies, especially the hyper-responsiveness to environmental cues inducing a reactivation of the target memory leading either to re-experiencing (PTSD), or drug craving. Accordingly, PTSD and addiction to drug of abuse might by considered as memory pathologies, underlined by the same physiological process. We propose that these two pathologies rely on an uncoupling of the monoaminergic systems. According to this hypothesis, exposure to extreme conditions, either negative (trauma) or positive (drugs) induced a loss of the reciprocal control that one system usually exerts on the other monoaminergic system, resulting to an uncoupling between the noradrenergic and the serotonergic systems. Results obtained in our laboratory, using animal models of these pathologies, demonstrate that after a trauma, such as after repeated drug injections, rats developed both a behavioral sensitization (increases of the locomotion in response to a stimulation of the monoaminergic systems) and a pharmacological sensitization (increases of noradrenergic release within the prefrontal cortex). These results support our hypothesis and led us to propose new and innovative therapeutic approaches consisting either to induce a re-coupling of the monoaminergic systems, or to modify the pathological memories by using an emotional memory remodeling. Extremely encouraging results have already been obtained in rats and in humans, opening new and promising therapeutic avenues. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.
Foreman, Susan; Seligman, Linda
Discusses legal and developmental aspects of adolescent abuse, as distinguished from child abuse. The role of the school counselor in identifying and counseling abused adolescents and their families is discussed and several forms of intervention and support services are described. (JAC)
Elder abuse takes many forms and occurs in a variety of settings; it is both under-recognised and under-reported. Despite a lack of statutory guidelines or legislation, effective management is possible. More could be done to recognise abuse, and healthcare workers need to be vigilant, paying attention to both the circumstances in which abuse occurs and its warning signs.
Cherian, Roy; Westbrook, Marisa; Ramo, Danielle; Sarkar, Urmimala
Prescription opioid misuse has doubled over the past 10 years and is now a public health epidemic. Analysis of social media data may provide additional insights into opioid misuse to supplement the traditional approaches of data collection (eg, self-report on surveys). The aim of this study was to characterize representations of codeine misuse through analysis of public posts on Instagram to understand text phrases related to misuse. We identified hashtags and searchable text phrases associated with codeine misuse by analyzing 1156 sequential Instagram posts over the course of 2 weeks from May 2016 to July 2016. Content analysis of posts associated with these hashtags identified the most common themes arising in images, as well as culture around misuse, including how misuse is happening and being perpetuated through social media. A majority of images (50/100; 50.0%) depicted codeine in its commonly misused form, combined with soda (lean). Codeine misuse was commonly represented with the ingestion of alcohol, cannabis, and benzodiazepines. Some images highlighted the previously noted affinity between codeine misuse and hip-hop culture or mainstream popular culture images. The prevalence of codeine misuse images, glamorizing of ingestion with soda and alcohol, and their integration with mainstream, popular culture imagery holds the potential to normalize and increase codeine misuse and overdose. To reduce harm and prevent misuse, immediate public health efforts are needed to better understand the relationship between the potential normalization, ritualization, and commercialization of codeine misuse. ©Roy Cherian, Marisa Westbrook, Danielle Ramo, Urmimala Sarkar. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 20.03.2018.
Garcia-Guasch, Roser; Roigé, Jaume; Padrós, Jaume
Anaesthesiologists have a significantly higher frequency of substance abuse by a factor of nearly 3 when compared with other physicians. This is still a current problem that must be reviewed. Many hypotheses have been formulated to explain why anaesthesiologists appear to be more susceptible to substance abuse than other medical professionals (genetic differences in sensitivity to opioids, stress, the association between chemical dependence and other psychopathology or the second-hand exposure hypothesis). Environmental exposure and sensitization may be an important risk factor in physician addiction. There is a long debate about returning to work for an anaesthetist who has been depending on opioid drugs, and recent debates are discussed. Institutional efforts have been made in many countries and physician health programmes have been developed. As drug abuse among anaesthesiologists has continued, new studies have been conducted to know the theories about susceptibility. Written substance abuse policies and controls must be taken in place and in all countries.
Dorst, J.P.; Johns Hopkins Medical Institutions, Baltimore, MD
Child abuse is common in most, if not all, Western nations; it probably occurs worldwide. It may be a major factor in the increase in violence throughout much of the world. Radiologists who treat children should think of the possibilitys of abuse whenever they diagnose a fracture, intracranial bleed, ar visceral injury, especially when the history is not compatible with their findings. Metaphyseal 'corner' fractures in infants usually are caused by abuse. Less than 20% of abused children, however, present injuries that can be recognized by radiologic techniques. Consequently normal roentgenograms, nuclear medicine scans, ultrasound studies, and computed tomograms do not exclude child abuse. (orig.)
Child abuse is common in most, if not all, Western nations; it probably occurs worldwide. It may be a major factor in the increase in violence throughout much of the world. Radiologists who treat children should think of the possibilitys of abuse whenever they diagnose a fracture, intracranial bleeding or visceral injury, especially when the history is not compatible with their findings. Metaphyseal 'corner' fractures in infants usually are caused by abuse. Less than 20% of abused children, however, present injuries that can be recognized by radiologic techniques. Consequently normal roentgenograms, nuclear medicine scans, ultrasound studies, and computed tomograms do not exclude child abuse.
Békaert, J; Podevin, G
High dose buprenorphine (HDB), commonly known as Subutex(®), is nowadays largely prescribed as a replacement therapy for major opiate dependence. Its sublingual administration allows a decrease in the withdrawal syndrome accompanying opiate abuse cessation. Over the past few decades, epidemiological data on people on replacement therapy have emphasized an increase in the misuse of Subutex(®) and more specifically intravenous injections of HDB. These growing practices pave the way to major physical consequences or even death. Several studies have highlighted the infectious, vascular, venous and arterial (pseudo-aneurysm) complications stemming from this habit. Among the possible vascular complications, we can notice the presence of abscess, venous thrombosis, phlegmons, skin necrosis, cellulite, and profound and superficial thrombophlebitis at injection sites. These can evolve into chronic edemas of the tips and subcutaneous nodules. The Popeye syndrome is one of the possible complications of this misuse. This syndrome is characterized by the swelling of both sides of the forearms and hands. These edemas tend to become persistent and to be paired with tissue changes such as skin thickening. Besides, the increase in the hands volume can occur bilaterally or sometimes in an asymmetrical way, accentuated on the hand of the non-dominant limb. This syndrome does not decrease, or just a little, after the stoppage of injections. It can have a psychological, social, psychopathological and esthetic impact. In this article, we will focus on the clinical case of a 43-year-old man, who is hospitalized in an addictology unit for massive injections of HDB. This patient suffers from a Popeye syndrome as well as from an alcoholic dependence. Following the description of psychopathological disorders, our analysis will originate from a clarification relative to the specificities of the practice of intravenous HDB injection to better sharpen the understanding of these misuses in
Ling, Walter; Mooney, Larissa; Hillhouse, Maureen
Prescription opioid misuse in the USA has increased over threefold since 1990 to epidemic proportions, with substantial increases in prescription opioid use also reported in other countries, such as Australia and New Zealand. The broad availability of prescription pain medications, coupled with public misconceptions about their safety and addictive potential, have contributed to the recent surge in non-medical use of prescription opioids and corresponding increases in treatment admissions for problems related to opioid misuse. Given competing pressures faced by physicians to both diagnose and treat pain syndromes and identify individuals at risk for addictive disorders, the use of opioids in the treatment of pain poses a significant clinical challenge. This paper reviews the interaction between pain and opioid addiction with a focus on clinical management issues, including risk factors for opioid dependence in patients with chronic pain and the use of assessment tools to identify and monitor at-risk individuals. Treatment options for opioid dependence and pain are reviewed, including the use of the partial µ agonist buprenorphine in the management of concurrent pain and opioid addiction. Physicians should strive to find a reasonable balance between minimising potential adverse effects of opioid medications without diminishing legitimate access to opioids for analgesia. The article discusses the need to identify methods for minimising risks and negative consequences associated with opioid analgesics and poses research directions, including the development of abuse-deterrent opioid formulations, genetic risk factors for opioid dependence and opioid-induced hyperalgesia as a potential target for medication therapy. © 2011 Australasian Professional Society on Alcohol and other Drugs.
Pressman, Mark R
Sleep driving is most often classified as a variant of sleepwalking, but should be distinguished from impaired driving due to misuse or abuse of sedative/hypnotic drugs. Z-drugs; zolpidem and zopiclone in particular, have been associated with the majority of reported cases of impaired driving. Numerous studies have found z-drugs in driving under influence (DUI) related police stops, arrests and accidents. Impaired drivers are reported to have 1) blood levels of z-drugs that exceed therapeutic ranges 2) failed to take the medication at the correct time or remain in bed for sufficient time and/or 3) combined z-drugs with other central nervous system (CNS) depressants and/or alcohol. Consistent with CNS depression, z-drug-impaired drivers may demonstrate cognitive function at low levels with drivers still able to understand and respond to questions while sleepwalkers are completely unable to understand or interact with police. Z-drug-impaired drivers are often severely physically impaired, unable to stand up or maintain balance while sleepwalkers are able to stand and walk unaided. Sleep driving and impaired driving due to z-drugs may overlap. Sleep driving and drug-impaired driving are statistically rare events, but due to the billions of doses prescribed each year may still result in numerous DUI related arrests and accidents. Copyright © 2010 Elsevier Ltd. All rights reserved.
Sussman, Steve; Stacy, Alan W; Johnson, C Anderson; Pentz, Mary Ann; Robertson, Elizabeth
This article introduces the scope of the Special Issue. A variety of scientific disciplines are brought together to establish theoretical integration of the arenas of drug use, misuse, "abuse," and drug misuse prevention. Transdisciplinary scientific collaboration (TDSC) is utilized as a process of integration. Introductory comments regarding the strengths and limitations of TDSC are presented. Then, the relevance of genetics to substance misuse and substance misuse prevention is presented. Next, the relevance of cognition for prevention is discussed. Specifically, neurologically plausible distinctions in cognition and implicit cognition and their relevance for prevention are discussed. At a relatively molar social-level of analysis, social network theory, systems dynamic models, geographic information systems models, cultural psychology, and political science approaches to drug misuse and its prevention are introduced. The uses of both quantitative and qualitative statistical approaches to prevention are mentioned next. Finally, targeted prevention, bridging the efficacy-effectiveness gap, and a statement on overcoming disbalance round out the Special Issue. The bridges created will serve to propel drug misuse "prevention science" forward in the years to come. Advances in understanding etiological issues, translation to programs, and ecological fit of programming are desired results.
Nutt, David; King, Leslie A; Saulsbury, William; Blakemore, Colin
Drug misuse and abuse are major health problems. Harmful drugs are regulated according to classification systems that purport to relate to the harms and risks of each drug. However, the methodology and processes underlying classification systems are generally neither specified nor transparent, which reduces confidence in their accuracy and undermines health education messages. We developed and explored the feasibility of the use of a nine-category matrix of harm, with an expert delphic procedure, to assess the harms of a range of illicit drugs in an evidence-based fashion. We also included five legal drugs of misuse (alcohol, khat, solvents, alkyl nitrites, and tobacco) and one that has since been classified (ketamine) for reference. The process proved practicable, and yielded roughly similar scores and rankings of drug harm when used by two separate groups of experts. The ranking of drugs produced by our assessment of harm differed from those used by current regulatory systems. Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse.
Roy, Dijendra Nath; Goswami, Ritobrata
Substances of abuse induce alteration in neurobehavioral symptoms, which can lead to simultaneous exacerbation of liver injury. The biochemical changes of liver are significantly observed in the abused group of people using illicit drugs or drugs that are abused. A huge amount of work has been carried out by scientists for validation experiments using animal models to assess hepatotoxicity in cases of drugs of abuse. The risk of hepatotoxicity from these psychostimulants has been determined by different research groups. Hepatotoxicity of these drugs has been recently highlighted and isolated case reports always have been documented in relation to misuse of the drugs. These drugs induce liver toxicity on acute or chronic dose dependent process, which ultimately lead to liver damage, acute fatty infiltration, cholestatic jaundice, liver granulomas, hepatitis, liver cirrhosis etc. Considering the importance of drug-induced hepatotoxicity as a major cause of liver damage, this review emphasizes on various drugs of abuse and addiction which induce hepatotoxicity along with their mechanism of liver damage in clinical aspect as well as in vitro and in vivo approach. However, the mechanisms of drug-induced hepatotoxicity is dependent on reactive metabolite formation via metabolism, modification of covalent bonding between cellular components with drug and its metabolites, reactive oxygen species generation inside and outside of hepatocytes, activation of signal transduction pathways that alter cell death or survival mechanism, and cellular mitochondrial damage, which leads to alteration in ATP generation have been notified here. Moreover, how the cytokines are modulated by these drugs has been mentioned here. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Filip, Malgorzata; Spampinato, Umberto; McCreary, Andrew C.; Przegalinski, Edmund
The present review provides an overview on serotonin (5-hydroxytryptamine; 5-HT)(2C) receptors and their relationship to drug dependence. We have focused our discussion on the impact of 5-HT2C receptors on the effects of different classes of addictive drugs, illustrated by reference to data using
McCann, Terence V; Lubman, Dan I
To explore the coping strategies used by affected family members of a relative with substance misuse. Families play an important role in supporting a relative with substance misuse. However, the experience often has an adverse effect on their general well-being, the extent of which depends largely on their coping strategies. An interpretative phenomenological analysis study. Data were collected between January - December 2015. Semistructured, audio-recorded qualitative interviews were conducted with 31 affected family members. Three main themes and related subthemes were abstracted from the data illustrating how participants coped with their relative's substance misuse: (1) Seeking timely access to evidence-based information; (2) Enhancing personal coping strategies and (3) Accessing informal and formal support. Greater investment is needed in support services for affected family members, particularly in regional and rural areas. A wide range of accessible evidence-based information and informal and formal support, including telephone and online support, is needed to assist them to cope in this crucial support-giving role. Affected family members need to adopt a flexible set of coping strategies while supporting a relative with substance misuse. Family and friends, alcohol and other drug services, mental health nurses and other clinicians have a critical role providing emotional, instrumental and educational support to affected family members to enhance their adaptive coping strategies. © 2017 John Wiley & Sons Ltd.
Kertesz Stefan G
Full Text Available Abstract Background Comorbid psychiatric illness can undermine outcomes among homeless persons undergoing addiction treatment, and psychiatric specialty care is not always readily available. The prognosis for nonsubstance abuse psychiatric diagnoses among homeless persons receiving behaviorally-based addiction treatment, however, is little studied. Results Data from an addiction treatment trial for 95 cocaine-dependent homeless persons (1996–1998 were used to profile psychiatric diagnoses at baseline and 6 months, including mood-related disorders (e.g. depression and anxiety-related disorders (e.g. post-traumatic stress disorder. Treatment interventions, including systematic reinforcement for goal attainment, were behavioral in orientation. There was a 32% reduction in the prevalence of comorbid non-addiction psychiatric disorder from baseline to 6 months, with similar reductions in the prevalence of mood (-32% and anxiety-related disorders (-20% (p = 0.12. Conclusion Among cocaine-dependent homeless persons with psychiatric comorbidity undergoing behavioral addiction treatment, a reduction in comorbid psychiatric disorder prevalence was observed over 6 months. Not all participants improved, suggesting that even evidence-based addiction treatment will prove insufficient for a meaningful proportion of the dually diagnosed homeless population.
Substance use - resources, Drug abuse - resources; Resources - chemical dependence ... are a good resource for information on drug dependence: National Council on Alcoholism and Drug Dependence -- ncadd. ...
Baek, Seung S
.... This thesis uses misuse cases to identify such misuses of a sharing system. We show that an appropriate distributed role-based access control model imposed upon information brokers can prevent enumerate misuse cases...
Full Text Available Benzodiazepines belong to the hypnotic-sedative class of drugs which have anxiolytic, sedative, and hypnotic properties. These drugs have been in clinical use for at least half a century. The propensity for development of dependence, especially on prescription benzodiazepines, coupled with the risk of falls and cognitive impairment due to benzodiazepines makes the elderly population susceptible to adverse outcomes with the use of benzodiazepines, and hence, cautious use is desired in this population. This review discusses the various aspects pertaining to benzodiazepine abuse in the elderly including pharmacology, prevalence of abuse, adverse consequences of benzodiazepine abuse, and subsequently assessment and management of elderly patients with benzodiazepine abuse.
... People Abuse » Other Drugs of Abuse Other Drugs of Abuse Listen There are many other drugs of abuse, ... and Rehab Resources About the National Institute on Drug Abuse (NIDA) | About This Website Tools and Resources | Contact ...
Thorsen, Line; Budde, Birgitte Bjørn; Henrichsen, Lars
at temperature abuse has not been investigated previously. Results of the present study indicate that storage at 5 and 8 °C will not lead to emetic intoxications, however the time at, and choice of chill temperature will determine the amount of cereulide produced in a temperature abuse situation. These results...
Frauger, Elisabeth; Pochard, Liselotte; Boucherie, Quentin; Giocanti, Adeline; Chevallier, Cécile; Daveluy, Amélie; Gibaja, Valérie; Caous, Anne-Sylvie; Eiden, Céline; Authier, Nicolas; Le Boisselier, Reynald; Guerlais, Marylène; Jouanjus, Émilie; Lepelley, Marion; Pizzoglio, Véronique; Pain, Stéphanie; Richard, Nathalie; Micallef, Joëlle
It is important to assess drug abuse liability in 'real life' using different surveillance systems. OPPIDUM ('Observation of illegal drugs and misuse of psychotropic medications') surveillance system anonymously collects information on drug abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. The aim of this article is to demonstrate the utility of OPPIDUM system using 2015 data. OPPIDUM is a cross-sectional survey repeated each year since 1995. In 2015, 5003 patients described the modality of use of 10,159 psychoactive drugs. Among them, 77% received an opiate maintenance treatment: 68% methadone (half of them consumed capsule form) and 27% buprenorphine (39% consumed generic form). Brand-name buprenorphine is more often injected than generic buprenorphine (10% vs. 2%) and among methadone consumers 7% of methadone capsule consumers have illegally obtained methadone (vs. 9% for syrup form). The proportion of medications among psychoactive drugs injected is important (42%), with morphine representing 21% of the total psychoactive drugs injected and buprenorphine, 16%. OPPIDUM highlighted emergent behaviors of abuse with some analgesic opioids (like tramadol, oxycodone or fentanyl), pregabalin, or quetiapine. OPPIDUM highlighted variations of drugs use regarding geographic approaches or by drug dependence care centers (like in harm reduction centers). OPPIDUM clearly demonstrated that collection of valid and useful data on drug abuse is possible, these data have an interest at regional, national and international levels. Copyright © 2017 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.
Full Text Available Substance misuse and abuse among adolescents and young adults, especially students, remain a significant public health issue, often associated with serious academic, psychological and health problems. Theoretical models of social behaviour emphasize the importance of peer behaviour as a modelling or normative influence. The processes by which social influence factors contribute to substance misuse behaviour have been described in models derived from the social learning paradigm, including both socio-environmental (e.g. social modelling, perceived norms and coping skills and cognitive variables (e.g. self-efficacy, outcome expectancies. However, this growing body of the literature often reveals contradictory findings regarding the precise mechanisms of processes by which social and cognitive variables may influence substance misuse in youth populations. This review critically examines the literature on different forms of peer influence and accordingly provides suggestions for intervention strategies that take into consideration the relevant research findings on social learning constructs.
... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Misuse of alcohol. 120.19 Section 120.19... AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS DRUG AND ALCOHOL TESTING PROGRAM Air Traffic Controllers § 120.19 Misuse of alcohol. (a) This section applies to covered employees who...
... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Misuse of alcohol. 120.37 Section 120.37... AND OPERATORS FOR COMPENSATION OR HIRE: CERTIFICATION AND OPERATIONS DRUG AND ALCOHOL TESTING PROGRAM... Under Â§ 91.147 of This Chapter and Safety-Sensitive Employees § 120.37 Misuse of alcohol. (a) General...
Walter, Frank; Lam, Catherine K.; van der Vegt, Geert; Huang, X.; Miao, Q.
Drawing from moral exclusion theory, this article examines outcome dependence and interpersonal liking as key boundary conditions for the linkage between perceived subordinate performance and abusive supervision. Moreover, it investigates the role of abusive supervision for subordinates' subsequent,
Ellickson, S L; Tucker, J S; Klein, D J; McGuigan, K A
This longitudinal study investigated Grade-7 and Grade-10 risk factors for alcohol misuse at Grade 12. Alcohol misuse was conceptualized as problem-related drinking (e.g., missing school), high-risk drinking (e.g., drunk driving) and high consumption. Prospective analyses using two-part models predicted any alcohol misuse and the amount of misuse (given that some has occurred) for over 4,200 (52% male) participants in the RAND Adolescent Panel Study. Predictor variables were demographics, substance use and exposure, prodrug attitudes, rebelliousness and deviant behavior, self-esteem, family structure and relations, and grades. Grade-7 predictors of alcohol misuse 5 years later included early drinking onset, parental drinking, future intentions to drink, cigarette offers, difficulty resisting pressures to smoke, being white, being male, having an older sibling, deviant behavior and poor grades. By Grade 10, predictors of alcohol misuse 2 years later included drinking and marijuana use by self and peers, future intentions to drink, difficulty resisting pressures to drink and use marijuana, being male, coming from a disrupted family and deviant behavior. Somewhat different predictors were identified for problem-related, high-risk and high consumption drinking, emphasizing the importance of investigating multiple dimensions of misuse. The high social acceptability of alcohol use makes prevention difficult. Curbing alcohol misuse may be a more attainable goal than preventing any use. These results indicate that predictors of misuse in late adolescence can be identified by Grade 7 and are generally visible and modifiable. Prevention efforts should begin by early adolescence, address both familial and peer influences to drink and use other substances, and take into account problems that predict alcohol misuse (e.g., poor academic performance and early deviant behavior).
Full Text Available Substance misuse is frequently encountered in the psychiatric emergency service (PES and may take many forms, ranging from formal DSM-IV diagnoses to less obvious entities such as hazardous consumption. Detecting such patients using traditional screening instruments has proved problematic. We therefore undertook this study to more fully characterize substance misuse in the PES and to determine whether certain variables might help better screen these patients. We used a prospectively acquired database of over 18,000 visits made to four PESs during a 2-year period in the province of Quebec, Canada. One of the variables acquired was a subjective rating by the nursing staff as to whether substance misuse was a contributing factor to the visit (graded as direct, indirect, or not at all. Substance misuse accounted for 21% of all diagnoses and alcohol was the most frequent substance used. Patients were divided into those with primary (PSM, comorbid (CSM or no substance misuse (NSM. Depressive disorders were the most frequent primary diagnoses in CSM, whereas personality and substance misuse disorders were frequent secondary diagnoses in PSM. Although many variables significantly differentiated the three groups, few were sufficiently detailed to be used as potential screening tools. Those situations that did have sufficient details included those with a previous history of substance misuse, substance misuse within 48 hours of the visit, and visits graded by the nursing staff as being directly and/or indirectly related to substance misuse. Variables related to substance misuse itself were the primary predictors of PSM and, less significantly, CSM. The nursing staff rating, although promising, was obtained in less than 30% of all visits, rendering its practical use difficult to assess.
Gasior, Maciej; Bond, Mary; Malamut, Richard
Prescription opioid analgesics are an important treatment option for patients with chronic pain; however, misuse, abuse and diversion of these medications are a major global public health concern. Prescription opioid analgesics can be abused via intended and non-intended routes of administration, both intact or after manipulation of the original formulation to alter the drug-delivery characteristics. Available data indicate that ingestion (with or without manipulation of the prescribed formulation) is the most prevalent route of abuse, followed by inhalation (snorting, smoking and vaping) and injection. However, reported routes of abuse vary considerably between different formulations. A number of factors have been identified that appear to be associated with non-oral routes of abuse, including a longer duration of abuse, younger age, male sex and a rural or socially deprived location. The development of abuse-deterrent formulations of prescription opioid analgesics is an important step toward reducing abuse of these medications. Available abuse-deterrent formulations aim to hinder extraction of the active ingredient, prevent administration through alternative routes and/or make abuse of the manipulated product less attractive, less rewarding or even aversive. There are currently five opioid analgesics with a Food and Drug Administration abuse-deterrent label, and a number of other products are under review. A growing body of evidence suggests that introduction of abuse-deterrent opioid analgesics in the USA has been associated with decreased rates of abuse of these formulations. The availability of abuse-deterrent formulations therefore appears to represent an important step toward curbing the epidemic of abuse of prescription opioid analgesics, while ensuring the availability of effective pain medications for patients with legitimate medical need.
Cláudio Jerônimo da Silva
Full Text Available Este artigo descreve o estado atual da Terapia Cognitiva, Comportamental, Prevenção de Recaída e Treinamento de Habilidades no tratamento de usuários de drogas. O objetivo é apresentar uma revisão sobre teorias e técnicas da Terapia Cognitiva e outras abordagens que dela derivam. Terapias Cognitiva e Comportamental, bem como Prevenção da Recaída e Treinamento de Habilidades, são tratamentos limitados no tempo, orientados em uma meta, e que utilizam sessões estruturadas, assumindo, assim, uma postura diretiva e ativa. Nós salientamos algumas diferenças entre Terapia Cognitiva, Prevenção de Recaída e Treinamento de Habilidades. A Terapia Cognitiva tem seu foco prioritariamente nos pensamentos, crenças, sentimentos e circunstâncias, como base do comportamento disfuncional. A Prevenção de Recaída e o Treinamento de Habilidades baseiam-se nas teorias comportamentais, além da teoria Cognitiva. Esperamos apresentar os últimos achados científicos para ajudar o psiquiatra geral a melhorar o tratamento da dependência química.This article describes the current status of Cognitive and Behavioral Therapy as well Relapse Prevention and Coping Skill approaches applied in drug abuse treatments. The objective is show a review about theories and technique used by Cognitive Therapy and others approaches derived that, specifically Relapse Prevention and Coping Skill Treatments. Cognitive and Behavioral Therapy, Coping Skill, and Relapse Prevention are a short-time, goal-oriented and structured treatments. Thus, they assume a posture directive and active. We pointed out some difference between the theories about Cognitive Therapy, Relapse Prevention and Coping Skill. The Cognitive Therapy accentuated the focus in patient’s thought, feeling and circumstances that get in a dysfunctional behavioral. Relapse Prevention and Coping Skill are based in behavioral theories besides of the Cognitive. We, finally, look forward to introduce the
Simon, T.R.; Seastrunk, J.W.; Malone, G.; Knesevich, M.A.; Hickey, D.C.
This paper reports that this study used SPECT to examine patients who have abused drugs to determine whether SPECT could identify abnormalities and whether these findings have clinical importance. Fifteen patients with a history of substance abuse (eight with cocaine, six with amphetamine, and one with organic solvent) underwent SPECT performed with a triple-headed camera and Tc-99m HMPAO both early for blood flow and later for functional information. These images were then processed into a 3D videotaped display used in group therapy. All 15 patients had multiple areas of decreased tracer uptake peppered throughout the cortex but mainly affecting the parietal lobes, expect for the organic solvent abuser who had a large parietal defect. The videotapes were subjectively described by a therapist as an exceptional tool that countered patient denial of physical damage from substance abuse. Statistical studies of recidivism between groups is under way
Conclusions: Effective and efficient treatment of victims of sexual abuse requires a systematic approach to the patient, starting with a thorough history, and continuing with a clinical investigation, diagnosis, treatment and prevention of the consequences of sexual abuse. The complete management must include sampling of any potential biological traces from the body of the victim. The key to success is a coordinated cooperation with investigators and forensics.
The term spouse abuse is commonly used to refer to Aggressive, violent and/or controlling behaviours that take place between two people involved in an intimate Relationship. Spouse abuse is a high frequency crime resulting in victims from all social classes, ethnicities, genders and educational backgrounds. Preventative methods at societal and community levels are required in addition to more traditional intervention approaches in order to adequately address this problem. This entry will prov...
Full Text Available Employees who abuse Internet privileges have become a major concern among today's employers. Employees misuse Internet at the workplace due to the overcrowded schedule, pressures at work, etc. Internet for private purposes is also used as a release or escape from work, escape from the reality of the workplace or due to poor organizational climate; it can be used as an efficient use of time at work but it can also be excessively used when the employees are not monitored. The survey results show that there is a correlation between Internet addiction and misuse of the Internet in the workplace. Electronic monitoring has a strong impact on the abuse of the Internet. More electronic monitoring will decrease the abuse of the internet services in the workplace and vice versa. Organizational climate, relations in the working organization, the Internet policy and demographic factors do not affect the abuse of Internet services in the workplace.
Ling, W; Wesson, D R
Treating opiate-dependent patients can be difficult for many physicians because the patients' life-styles, values, and beliefs differ from those of the physicians. Primary care physicians, however, are often involved in the treatment of the medical complications of opiate abuse, and physicians must often manage a patient's opiate dependence until appropriate referral to a drug abuse treatment program can be arranged. Treatment is guided by an understanding of the patient's addictive disease, ...
Chang, Zheng; Lichtenstein, Paul; Halldner, Linda; D'Onofrio, Brian; Serlachius, Eva; Fazel, Seena; Långström, Niklas; Larsson, Henrik
There are persistent concerns of long-term effects of stimulant ADHD medication on the development of substance abuse. Using Swedish national registers, we studied all individuals born between 1960 and 1998 and diagnosed with ADHD (26,249 men and 12,504 women). We investigated the association between stimulant ADHD medication in 2006 and substance abuse during 2009. Substance abuse was indexed by substance-related death, crime, or hospital visits. ADHD medication was not associated with increased rate of substance abuse. Actually, the rate during 2009 was 31% lower among those prescribed ADHD medication in 2006, even after controlling for medication in 2009 and other covariates (hazard ratio: 0.69; 95% confidence interval: 0.57-0.84). Also, the longer the duration of medication, the lower the rate of substance abuse. Similar risk reductions were suggested among children and when investigating the association between stimulant ADHD medication and concomitant short-term abuse. We found no indication of increased risks of substance abuse among individuals prescribed stimulant ADHD medication; if anything, the data suggested a long-term protective effect on substance abuse. Although stimulant ADHD medication does not seem to increase the risk for substance abuse, clinicians should remain alert to the potential problem of stimulant misuse and diversion in ADHD patients. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.
The impact of the Good Behavior Game, a universal classroom-based preventive intervention in first and second grades, on high-risk sexual behaviors and drug abuse and dependence disorders into young adulthood.
Kellam, Sheppard G; Wang, Wei; Mackenzie, Amelia C L; Brown, C Hendricks; Ompad, Danielle C; Or, Flora; Ialongo, Nicholas S; Poduska, Jeanne M; Windham, Amy
The Good Behavior Game (GBG), a method of teacher classroom behavior management, was tested in first- and second-grade classrooms in 19 Baltimore City Public Schools beginning in the 1985-1986 school year. The intervention was directed at the classroom as a whole to socialize children to the student role and reduce aggressive, disruptive behaviors, confirmed antecedents of a profile of externalizing problem outcomes. This article reports on the GBG impact on the courses and interrelationships among aggressive, disruptive behavior through middle school, risky sexual behaviors, and drug abuse and dependence disorders through ages 19-21. In five poor to lower-middle class, mainly African American urban areas, classrooms within matched schools were assigned randomly to either the GBG intervention or the control condition. Balanced assignment of children to classrooms was made, and teachers were randomly assigned to intervention or control. Analyses involved multilevel growth mixture modeling. By young adulthood, significant GBG impact was found in terms of reduced high-risk sexual behaviors and drug abuse and dependence disorders among males who in first grade and through middle school were more aggressive, disruptive. A replication with the next cohort of first-grade children with the same teachers occurred during the following school year, but with minimal teacher mentoring and monitoring. Findings were not significant but generally in the predicted direction. A universal classroom-based prevention intervention in first- and second-grade classrooms can reduce drug abuse and dependence disorders and risky sexual behaviors.
Szerman Bolotner, Néstor; Arias Horcajadas, Francisco; Vega Astudillo, Pablo; Babín Vich, Francisco; Mesías Perez, Beatriz; Basurte Villamor, Ignacio; Morant, Consuelo; Ochoa Mangado, Enriqueta; Poyo Calvo, Félix
To evaluate retrospectively the comorbidity of mental and addictive disorders in community mental health and substance misuse services in Madrid. The medical records of 400 patients from mental health and substance misuse services in Madrid were evaluated. Records were examined for the last 20 patients from each service unit. Dual pathology was constituted when a current diagnosis of mental and addictive disorders, excluding nicotine addiction, appeared on the patient's records. Prevalence of dual pathology was 34%. There were differences in the prevalence figures for the two kinds of service: 36.78% in substance misuse services, and 28.78% in mental health services. There was an association of dual diagnosis with alcohol or cocaine dependence, but not with opioid dependence. The mental disorders more prevalent in dually diagnosed than in non-dually diagnosed patients were mood disorders, personality disorders, and schizophrenia. There is a high prevalence of dual pathology in those seeking treatment, being higher in substance misuse services than in mental health services, and higher in patients with alcohol or cocaine dependence. These findings could be of help in the planning of care resource policies for these patients.
... Elder abuse Emotional and verbal abuse Financial abuse Harassment Human trafficking Physical abuse Sexual coercion Stalking Violence ... A teacher, counselor, or principal at your child’s school. An adult at your child’s school can help ...
Coller, Janet K; Hutchinson, Mark R
In the past two decades a trickle of manuscripts examining the non-neuronal central nervous system immune consequences of the drugs of abuse has now swollen to a significant body of work. Initially, these studies reported associative evidence of central nervous system proinflammation resulting from exposure to the drugs of abuse demonstrating key implications for neurotoxicity and disease progression associated with, for example, HIV infection. However, more recently this drug-induced activation of central immune signaling is now understood to contribute substantially to the pharmacodynamic actions of the drugs of abuse, by enhancing the engagement of classical mesolimbic dopamine reward pathways and withdrawal centers. This review will highlight the key in vivo animal, human, biological and molecular evidence of these central immune signaling actions of opioids, alcohol, cocaine, methamphetamine, and 3,4-methylenedioxymethamphetamine (MDMA). Excitingly, this new appreciation of central immune signaling activity of drugs of abuse provides novel therapeutic interventions and opportunities to identify 'at risk' individuals through the use of immunogenetics. Discussion will also cover the evidence of modulation of this signaling by existing clinical and pre-clinical drug candidates, and novel pharmacological targets. Finally, following examination of the breadth of central immune signaling actions of the drugs of abuse highlighted here, the current known common immune signaling components will be outlined and their impact on established addiction neurocircuitry discussed, thereby synthesizing a common neuroimmune hypothesis of addiction. Copyright © 2012 Elsevier Inc. All rights reserved.
Silva Vilma A da
Full Text Available OBJECTIVES: To investigate developmental and environmental factors associated to substance misuse in adolescents seen at a university day-hospital in Brazil and to verify the correlations between those factors and adherence to treatment. To compare factors associated to substance misuse in adolescents with the available scientific literature and to suggest specific preventive interventions for a national policy in Brazil. METHODS: Eighty-six adolescent's guardians were evaluated at admission to the service by using a semistructured interview including sociodemographic data, family relationship, perinatal and pregnancy histories, psychomotor and educational development, social relations, history of previous illnesses and family diseases, including drug abuse. RESULTS: The sample was predominantly male (90%. Adolescents referred from the criminal justice were older than those originating from other sources (16.4 x 15.4 years old p=.00. Forty-four percent of adolescents reported school failure, a level which is two times higher than Brazilian statistics. Forty percent of the sample had criminal involvement, mainly drug dealing. Cannabis was the most prevalent reported drug. Living with both parents was protective, delaying the age of initiation by one year. Domestic violence was more frequent among parents with illicit drugs abuse (38.1% x 12.5%, p<.05. Alcoholism and drug addiction in parents and relatives were about four times higher than those reported for the Brazilian population. No correlation was found between the investigated factors and adherence to treatment. CONCLUSION: Our results indicate that the programs must include treatment of adults and education of parents and parents to be. Withdrawal of treatment occurs in the first month, and seems to be related to factors extrinsic to the adolescent.
More than half of the world's population is living in urban areas, but the evidence about urban-rural differences in drug use is not clearly defined. The present paper aims to review the international literature addressing the role of urbanization and related parameters in association with substance misuse. In particular, the evidence of urbanization being a risk factor for substance misuse is examined. Although it has been suggested that substance misuse is typically a characteristic of large urban areas, this did not appear to be a consistent observation from the literature review. Furthermore, the urban context may offer a relative proximity of health services and prompter emergency intervention in case of overdose. Although more efforts have to be put into explaining substance misuse in general, identifying which characteristics of the urban context are modifiable, and under what circumstances, is an important theoretical, empirical, and public health question.
N S Jimam
Full Text Available Background: Cannabis can be used for its medicinal properties when used appropriately. However, the misuse of the product can cause some unwanted effects such as psychological dependence, and therefore addiction. Objective: The objective of the study was to determine the extent of misuse of Cannabis sativa in Jos and environs. Materials and Methods: The use and misuse of C. sativa in Jos metropolis was studied using a structured self-administered questionnaire which was administered to 400 respondents in the metropolis. Result: The result showed that 59.9% of the participants were male while 40.1% were female with 88.2% of the population being youth between the ages of 20-35 years. The result also shows that at least 31.3% of the studied population had used C. sativa, for different reasons including among others: to boost confidence (11.4%, 5.1% take it to increase alertness, 5.1% take it to decrease fatigue, 0.3% take it to decrease stress, 5.4% take it to get high while 4% take it for other reasons. Conclusion: The result of the study showed an observed high incidence of C. sativa intake among the study population who were mostly youths for different purposes, including to: Boost confidence, feel high, increase alertness, and decrease fatigue. Similarly, a high percentage of the respondents said the drug is used for hair treatment.
Full Text Available Epidemiological studies of drug misusers have until recently relied on two main forms of sampling: probability and convenience. The former has been used when the aim was simply to estimate the prevalence of the condition and the latter when in depth studies of the characteristics, profiles and behaviour of drug users were required, but each method has its limitations. Probability samples become impracticable when the prevalence of the condition is very low, less than 0.5% for example, or when the condition being studied is a clandestine activity such as illicit drug use. When stratified random samples are used, it may be difficult to obtain a truly representative sample, depending on the quality of the information used to develop the stratification strategy. The main limitation of studies using convenience samples is that the results cannot be generalised to the whole population of drug users due to selection bias and a lack of information concerning the sampling frame. New methods have been developed which aim to overcome some of these difficulties, for example, social network analysis, snowball sampling, capture-recapture techniques, privileged access interviewer method and contact tracing. All these methods have been applied to the study of drug misuse. The various methods are described and examples of their use given, drawn from both the Brazilian and international drug misuse literature.
Full Text Available Beginning in the late 1990s, a movement began within the pain management field focused upon the underutilization of opioids, thought to be a potentially safe and effective class of pain medication. Concern for addiction and misuse were present at the start of this shift within pain medicine, and an emphasis was placed on developing reliable and valid methods and measures of identifying those at risk for opioid misuse. Since that time, the evidence for the safety and effectiveness of chronic opioid therapy (COT has not been established. Rather, the harmful, dose-dependent deleterious effects have become clearer, including addiction, increased risk of injuries, respiratory depression, opioid induced hyperalgesia, and death. Still, many individuals on low doses of opioids for long periods of time appear to have good pain control and retain social and occupational functioning. Therefore, we propose that the question, “Who is at risk of opioid misuse?” should evolve to, “Who may benefit from COT?” in light of the current evidence.
The benztropine analog JHW 007 displays high affinity for the dopamine transporter (DAT), but unlike typical DAT ligands, has relatively low abuse liability and blocks effects of cocaine,including its self-administration. To determine sites responsible for the cocaine-antagonist effects of JHW 007, ...
Systematic evaluation of "compliance" to prescribed treatment medications and "abstinence" from psychoactive drug abuse in chemical dependence programs: data from the comprehensive analysis of reported drugs.
Blum, Kenneth; Han, David; Femino, John; Smith, David E; Saunders, Scott; Simpatico, Thomas; Schoenthaler, Stephen J; Oscar-Berman, Marlene; Gold, Mark S
This is the first quantitative analysis of data from urine drug tests for compliance to treatment medications and abstinence from drug abuse across "levels of care" in six eastern states of America. Comprehensive Analysis of Reported Drugs (CARD) data was used in this post-hoc retrospective observational study from 10,570 patients, filtered to include a total of 2,919 patients prescribed at least one treatment medication during 2010 and 2011. The first and last urine samples (5,838 specimens) were analyzed; compliance to treatment medications and abstinence from drugs of abuse supported treatment effectiveness for many. Compared to non-compliant patients, compliant patients were marginally less likely to abuse opioids, cannabinoids, and ethanol during treatment although more likely to abuse benzodiazepines. Almost 17% of the non-abstinent patients used benzodiazepines, 15% used opiates, and 10% used cocaine during treatment. Compliance was significantly higher in residential than in the non-residential treatment facilities. Independent of level of care, 67.2% of the patients (n = 1963; Pabuse detected in either the first or last urine samples (abstinence). Moreover, in 2010, 16.9% of the patients (n = 57) were abstinent at first but not at last urine (deteriorating abstinence), the percentage dropped to 13.3% (n = 174) in 2011; this improvement over years was statistically significant. A longitudinal analysis for abstinence and compliance was studied in a randomized subset from 2011, (n = 511) representing 17.5% of the total cohort. A statistically significant upward trend (p = 2.353×10-8) of abstinence rates as well as a similar but stronger trend for compliance ((p = 2.200×10-16) was found. Being cognizant of the trend toward drug urine testing being linked to medical necessity eliminating abusive screening, the interpretation of these valuable results require further intensive investigation.
Massaly, Nicolas; Morón, Jose A; Al-Hasani, Ream
Pain and stress are protective mechanisms essential in avoiding harmful or threatening stimuli and ensuring survival. Despite these beneficial roles, chronic exposure to either pain or stress can lead to maladaptive hormonal and neuronal modulations that can result in chronic pain and a wide spectrum of stress-related disorders including anxiety and depression. By inducing allostatic changes in the mesolimbic dopaminergic pathway, both chronic pain and stress disorders affect the rewarding values of both natural reinforcers, such as food or social interaction, and drugs of abuse. Despite opioids representing the best therapeutic strategy in pain conditions, they are often misused as a result of these allostatic changes induced by chronic pain and stress. The kappa opioid receptor (KOR) system is critically involved in these neuronal adaptations in part through its control of dopamine release in the nucleus accumbens. Therefore, it is likely that changes in the kappa opioid system following chronic exposure to pain and stress play a key role in increasing the misuse liability observed in pain patients treated with opioids. In this review, we will discuss how chronic pain and stress-induced pathologies can affect mesolimbic dopaminergic transmission, leading to increased abuse liability. We will also assess how the kappa opioid system may underlie these pathological changes.
Full Text Available Pain and stress are protective mechanisms essential in avoiding harmful or threatening stimuli and ensuring survival. Despite these beneficial roles, chronic exposure to either pain or stress can lead to maladaptive hormonal and neuronal modulations that can result in chronic pain and a wide spectrum of stress-related disorders including anxiety and depression. By inducing allostatic changes in the mesolimbic dopaminergic pathway, both chronic pain and stress disorders affect the rewarding values of both natural reinforcers, such as food or social interaction, and drugs of abuse. Despite opioids representing the best therapeutic strategy in acute pain conditions, they are often misused as a result of these allostatic changes induced by chronic pain and stress. The kappa opioid receptor system is critically involved in these neuronal adaptations in part through its control of dopamine release in the nucleus accumbens. Therefore, it is likely that changes in the kappa opioid system following chronic exposure to pain and stress play a key role in increasing the misuse liability observed in pain patients treated with opioids. In this review, we will discuss how chronic pain and stress-induced pathologies can affect mesolimbic dopaminergic transmission, leading to increased abuse liability. We will also assess how the kappa opioid system may underlie these pathological changes.
... drug abuse. And it's illegal, just like taking street drugs. Why Do People Abuse Prescription Drugs? Some people abuse prescription drugs ... common risk of prescription drug abuse is addiction . People who abuse ... as if they were taking street drugs. That's one reason most doctors won't ...
Moussas, G I; Papadopoulou, A G
Substance abuse is a health problem with serious psychological and psychiatric dimensions and multiple social and economic consequences. Cancer is a disease that threatens not only life and physical integrity but mental health as well. Oncology patients suffer from mental disorders in high rates, especially from depression and anxiety. The role of substance abuse in the pathogenesis of cancer is studied systematically, since there are research data supporting the mutagenic effects of certain substances. It has been supported that a possible dysregulation of the immune system is linked to the oncogenic processes induced by substances of abuse. Specifically, opioids are the first addictive substances that have been identified as oncogenic factors. However, conflicting results have been offered by experimental animal studies, which showed that opioids, such as morphine, depending on the dosage administered, may not only enhance the process of tumor growth, but also inhibit it. Additionally, research data indicate that the use of cannabis may be associated with cancer, either as an independent factor or in relation to other mutagenics, although it is not yet clear to which extent these effects may be connected to the disease, especially once the consumption of tobacco and alcohol by these patients are taken into account. However, it has been argued that certain cannabinoids may have biological -anticancer- activities which could be used therapeutically without being accompanied by the corresponding 9-tetrahydrocannabinol psychoactive effects. It is well known that alcohol is a risk factor for developing head and neck cancer, and epidemiological studies indicate that the higher the consumption of alcohol, the more mortality due to cancer increases. In addition, it is suggested that there is no safety level for alcohol consumption regarding the risk of developing cancer; that is even a minimum daily consumption is associated with the occurrence of certain types of cancer
Nielsen, S D; Gluud, C
Information was gathered on recognition and treatment of alcohol problems in the primary and secondary health sectors, the latter represented by a department of hepatology. The general practitioner finds in most cases (18/26, 69%) that it is relevant to advise about a patient's alcohol misuse...... on admission forms when the patient previously has been discharged from another department with this diagnosis. However, if the patient has not previously been hospitalised due to alcohol misuse, information on the diagnosis is only rarely (30/114, 26%) available. This difference is highly significant (P = 0.......0001). The case-recording hospital physician at admission recognises 73% of alcohol misusers who are admitted with a non-alcohol-related diagnosis. When the patient had been evaluated by both the admitting physician and the case-recording hospital physician, information on the alcohol problem occurred...
The problem of antibiotic resistance is associated with the indiscriminate usage of antibiotics. Efforts have been directed at encouraging the rational use of these drugs to reduce the volume of antibiotic consumption and decrease resistance rates. There is evidence to suggest that the misuse of antibiotics by patients may also contribute to the problem. We describe a survey of a random selection of patients attending a General Practitioners\\' surgery over a six week period in an effort to estimate the level of non-compliance to antibiotic therapy in the community. The results suggest that there may be a significant level of antibiotic misuse prevalent in the local community. We discuss these results and present evidence in the literature suggesting how antibiotic misuse may affect resistance in the community. The factors affecting patient compliance to therapy are outlined along with suggested measures to improve compliance among patients.
This paper suggests that one response to growing scrutiny of authoritarian tactics is to turn to sub-constitutional public law, or private law. By using “ordinary” law in ways that seem consistent with formal and procedural aspects of rule of law, autocrats can nonetheless frustrate the rule of law and consolidate power, while also avoiding drawing unfavourable attention to that consolidation. I refer to this phenomenon as “abusive legalism.” This paper makes three main contributions to the s...
Results. OTC and prescription medicine misuse places a burden on health and social services in South Africa. This is ... benzodiazepine misuse is psychological and physiological ... one of two categories: opioid analgesics (e.g. morphine and.
...] Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services and..., the information collection associated with the Commission's Misuse of Internet Protocol (IP) Captioned...- 2235075, or email [email protected] . SUPPLEMENTARY INFORMATION: This document announces that, on...
Angelo Giovanni Icro Maremmani
Full Text Available Nowadays, the misuse of benzodiazepines (BZDs is a cause for a serious concern among pharmacologically inexperienced patients, whether treated or untreated, that could lead to significant complications, including tolerance, dependence, and addiction. We present a case report in which an Italian patient affected by anxiety disorder and treated with BZDs presented a severe case of dependence on BZDs. We treated him according to an agonist substitution approach, switching from the abused BZD to a slow-onset, long-acting, high potency agonist (clonazepam, and looking at the methadone treatment model as paradigm. We decided to use clonazepam for its pharmacokinetic properties. The advantage of choosing a slow-onset, long-lasting BZD for the treatment of our patient was that it led us to a remarkable improvement in the clinical situation, including the cessation of craving, absence of withdrawal symptoms, reduced anxiety, improvements in social functioning, and a better cognition level.
Kim, Sang-Yeon; Ahn, Seokhoon; Lim, Tae-Seop
This study examines contributing factors of alcohol misuse among college students in South Korea and the U.S. Exploratory factor analyses (EFA) on measurements of alcohol expectancy, alcohol efficacy, and accommodation resulted in social and personal causes for alcohol misuse. Social causes alone predicted alcohol misuse for both countries. Social factors constituted a much stronger predictor of alcohol misuse among South Korean students than among American students. Practical implications for effective deterrence of student binge drinking are discussed.
Obu Herbert A
Full Text Available Abstract Background Paracetamol (also known as acetaminophen is the commonest available analgesic and anti-pyretic. It is readily accessed from pharmacy, patent medicine and provision shops as over the counter drug making it a potential drug of abuse, especially in children. We sought to find its use and/or misuse in children seen at the paediatric outpatient clinic of the University of Nigeria Teaching Hospital (UNTH Ituku-Ozalla, Enugu. Objective To determine the dosage, formulation, and frequency of paracetamol administration to children by caregivers and factors associated with its use and/or misuse. Method An observational prospective study involving 231 children and their caregivers seen at the paediatric outpatient clinic of the University of Nigeria Teaching Hospital, Ituku - Ozalla, Enugu between June and November 2011 was undertaken. Data on paracetamol use before presentation to the clinic, in addition to demographic and other data were obtained from the caregivers using a structured questionnaire. Ethical consent for the study was obtained from the Hospital Ethics and Research Committee and informed consent was further obtained from the caregivers of the children. Results A total of 231 children aged six weeks to 16 years and their caregivers participated in this study. The mean ages of the children and their caregivers were 3.8 and 33.9 years, respectively. One hundred and thirty three of the children studied were males while 98 were females. Most of the children (75.6% received paracetamol at home before presenting. Paracetamol tablet alone or in combination with the syrup was mostly used (60% and this observation was made across all age groups. The commonest reason for using paracetamol tablet instead of the syrup was that it was more effective. Most caregivers relied on past experience (71.2% rather than on enclosed information leaflet to decide the appropriate dosage. Half of the children also received other medications
Engh Kraft, Lisbet; Rahm, GullBritt; Eriksson, Ulla-Britt
Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an…
Paulo J Cunha
Full Text Available A Neuropsicologia, aplicada ao abuso e dependência do álcool, busca a compreensão da relação entre danos cerebrais e seus efeitos na cognição e no comportamento do indivíduo. Estuda, ainda, os comprometimentos neurocognitivos dos pacientes, relacionando-os a achados estruturais e funcionais de neuroimagem (TC, RM, PET e SPECT. No uso agudo, o álcool tende a comprometer a atenção, memória, funções executivas e viso-espaciais, enquanto no uso crônico altera a memória, aprendizagem, análise e síntese viso-espacial, velocidade psicomotora, funções executivas e tomada de decisões, podendo chegar a transtornos persistentes de memória e demência alcoólica. Os déficits cognitivos encontrados nos dependentes de álcool, principalmente das funções executivas (frontais, têm implicação direta no tratamento, tanto para a escolha de estratégias a serem adotadas como para a análise do prognóstico. Ao final do artigo, é apresentado um instrumento útil e breve para rastreio de alterações cognitivas, a Bateria de Avaliação Frontal - FAB.15 Acredita-se que a Avaliação Neuropsicológica pode ser muito importante para a detecção e avaliação da progressão destas alterações e que a reabilitação cognitiva tem papel relevante na recuperação dos déficits e reinserção psicossocial destes pacientes.The aim of the Neuropsychology applied to the Alcohol Dependence field is the comprehension of the effects of brain dysfunction on cognition and human behavior. It investigates neurocognitive impairments and associates them to structural and functional neuroimaging findings (CT, MRI, PET and SPECT. Acute use of alcohol impairs attention, memory, executive functions and visuospatial skills, while chronic abuse causes neurocognitive deficits in memory, learning, visuospatial functions, psychomotor speed processing, executive functions and decision-making, and may lead to persistent amnesic disorder and alcoholic dementia
Angoorani, Hooman; Halabchi, Farzin
The high prevalence and potential side effects of anabolic-androgenic steroids (AAS) misuse by athletes has made it a major public health concern. Epidemiological studies on the abuse of such drugs are mandatory for developing effective preventive drug control programs in sports community. This study aimed to investigate the prevalence of AAS abuse and their association with some psycho-socio-demographic factors in Iranian male recreational body-builders. Between March and October 2011; 906 recreational male body-builders from 103 randomly selected bodybuilding clubs in Tehran, Iran were participated in this study. Some psycho-socio- demographic factors including age, job, average family income, family size, sport experience (months), weekly duration of the sporting activity (h), purpose of participation in sporting activity, mental health as well as body image (via General Health Questionnaire and Multidimensional Body-Self Relations Questionnaire, respectively), and history of AAS use were obtained by interviews using questionnaires. Participants were all recreational male body-builders [mean age (SD): 25.7 (7.1), ranging 14-56 yr]. Self-report of AAS abuse was registered in 150 body-builders (16.6%). Among different psycho-socio-demographic factors, only family income and sport experience were inversely associated with AAS abuse. Lifetime prevalence of AAS abuse is relatively high among recreational body-builders based on their self-report. Some psycho-socio-demographic factors including family income and sport experience may influence the prevalence of AAS abuse.
... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Drug and alcohol misuse education program... Ownership Operations Program Management § 91.1047 Drug and alcohol misuse education program. (a) Each... instructor, or aircraft maintenance duties with drug and alcohol misuse education. (b) No program manager may...
Prosek, Elizabeth A.; Giordano, Amanda L.; Turner, Kori D.; Bevly, Cynthia M.; Reader, Emily A.; LeBlanc, Yvette; Molina, Citlali E.; Vera, Ryan A.; Garber, Sage Ann
Misuse of stimulant medication is pervasive among college students. In this study, we surveyed undergraduate college students (N = 3,038) at a large-sized Southwestern university. We examined unique characteristics of students misusing stimulant medication with a prescription (n = 74) and those misusing without a prescription (n = 356). Both…
Dielman, T. E.; And Others
Questionnaires were administered to 4,157 junior high school students to determine levels of alcohol misuse, exposure to peer use and misuse of alcohol, susceptibility to peer pressure, internal health locus of control, and self-esteem. Conceptual model of antecendents of adolescent alcohol misuse and effectiveness of a prevention effort was…
... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Misuse of information. 1203.735-208 Section 1203.735-208 Foreign Relations UNITED STATES INTERNATIONAL DEVELOPMENT COOPERATION AGENCY EMPLOYEE... or in connection with Government employment which has not been made available to the general public. ...
All Medical Officers were asked to fill up a preformed questionnaire and the parents/guardians were interviewed on their ideas about antibiotics. Data were analyzed by the statistical software ... Both medical officers and parents felt that base line investigations were unnecessary. Antibiotic misuse is quite common in this part ...
Schoon, C.C. Huijskens, C.G. & Heijkamp, A.H.
The Dutch Ministry of Transport and Public Works commissioned the SWOV Institute for Road Safety Research and TNO Road-Vehicles Research Institute to carry out a research project. The aim is to establish the extent and type of misuse of both child seats and standard seat belts. This paper deals only
Background The misuse of topical steroids, i.e. the usage of these products for skin lightening, is a widespread phenomenon among African men and women. Studies have reported prevalence rates of 18.5% to 70% among participants. Though women constitute the majority of users, people of various age groups, ...
, A J Flisher, R Allin, J A Laubscher. Abstract. Objectives. To investigate the pattern of substance misuse in youth admitted to a psychiatric emergency unit of a 'major hospital, and to compare regular users of cannabis,methaqualone and ...
Fazel, Ismaeil; Kowkabi, Nasrin
In this article we first provide a brief discussion of what is generally referred to as "student plagiarism," which we prefer to call "source misuse" or "inappropriate textual borrowing," and then provide some of the factors that may contribute to this problem in language classes. Moreover, we provide our views and…
... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Prohibitions against misuse of seal. 2.3 Section 2.3 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION OFFICIAL... character, or with wrongful or fraudulent intent, using, buying, procuring, selling or transferring to...
The present study examined the effects of substance misuse on the personality traits of impulsivity and risky sexual decision-making. One hundred and one participants (101) were recruited via opportunist sampling, which comprise of 49 female, 52 male, 5 homosexual, 2 bisexual and 92 heterosexual with the mean age of ...
Vivek Kumar Dey
Full Text Available Background: Misuse of topical corticosteroids is a widespread phenomenon among young people in India, especially women. The practice is associated with significant adverse effects and poor awareness of these effects among the general public. Aim: This study was conducted to examine the misuse and adverse effects of topical corticosteroids among the people in Bastar region in Chhattisgarh state of India. Materials and Methods: Data collected from patients presenting with at least one of the adverse effects of topical corticosteroids as the chief complaint, from November 2010 to October 2011. Results: Out of the 6723 new patients, 379 (5.63% had presented with misuse and adverse effects of topical corticosteroids, of whom 78.89% were females. More than 65% of the patients were in the age group 10-29 years. The main reason for using the topical corticosteroids was to lighten skin colour and treat melasma and suntan. Acne (37.99% and telangiectasia (18.99% were the most common adverse effects noted. Conclusions: Misuse of topical corticosteroids has a huge impact on dermatological practice, leading to a significant proportion of visits to the dermatologist. This hydra-headed problem needs multi-dimensional interventions, involving educational, legal and managerial approaches with cooperation from different sectors of society.
King, Serena M; Keyes, Margaret; Malone, Stephen M; Elkins, Irene; Legrand, Lisa N; Iacono, William G; McGue, Matt
To examine the genetic and environmental influences of parental alcoholism on offspring disinhibited behavior. We compared the effect of parental alcoholism history on offspring in adoptive and non-adoptive families. In families with a history of parental alcohol dependence, we examined the effect of exposure to parental alcoholism symptoms during the life-time of the adolescent. Setting Assessments occurred at the University of Minnesota from 1998 to 2004. Adolescents adopted in infancy were ascertained systematically from records of three private Minnesota adoption agencies; non-adopted adolescents were ascertained from Minnesota birth records. Adolescents and their rearing parents participated in in-person assessments. For adolescents, measures included self- reports of delinquency, deviant peers, substance use, antisocial attitudes and personality. For parents, we conducted DSM-IV clinical assessments of alcohol abuse and dependence. A history of parental alcohol dependence was associated with higher levels of disinhibition only when adolescents were related biologically to their rearing parents. Within families with a history of parental alcoholism, exposure to parental alcohol misuse during the life-time of the adolescent was associated with increased odds of using alcohol in adopted adolescents only. These findings suggest that the association between a history of parental alcohol dependence and adolescent offspring behavioral disinhibition is attributable largely to genetic rather than environmental transmission. We also obtained some evidence for parental alcohol misuse as a shared environmental risk factor in adoptive families.
Full Text Available Ashley-Nicole Carmichael,1 Laura Morgan,1 Egidio Del Fabbro2 1School of Pharmacy, 2Division of Hematology, Oncology, and Palliative Care, Virginia Commonwealth University, Richmond, VA, USA Background: The misuse and abuse of opioid medications in many developed nations is a health crisis, leading to increased health-system utilization, emergency department visits, and overdose deaths. There are also increasing concerns about opioid abuse and diversion in patients with cancer, even at the end of life. Aims: To evaluate the current literature on opioid misuse and abuse, and more specifically the identification and assessment of opioid-abuse risk in patients with cancer. Our secondary aim is to offer the most current evidence of best clinical practice and suggest future directions for research. Materials and methods: Our integrative review included a literature search using the key terms “identification and assessment of opioid abuse in cancer”, “advanced cancer and opioid abuse”, “hospice and opioid abuse”, and “palliative care and opioid abuse”. PubMed, PsycInfo, and Embase were supplemented by a manual search. Results: We found 691 articles and eliminated 657, because they were predominantly noncancer populations or specifically excluded cancer patients. A total of 34 articles met our criteria, including case studies, case series, retrospective observational studies, and narrative reviews. The studies were categorized into screening questionnaires for opioid abuse or alcohol, urine drug screens to identify opioid misuse or abuse, prescription drug-monitoring programs, and the use of universal precautions. Conclusion: Screening questionnaires and urine drug screens indicated at least one in five patients with cancer may be at risk of opioid-use disorder. Several studies demonstrated associations between high-risk patients and clinical outcomes, such as aberrant behavior, prolonged opioid use, higher morphine-equivalent daily dose
... Handle Abuse KidsHealth / For Kids / How to Handle Abuse What's in this article? Tell Right Away How Do You Know Something Is Abuse? ... babysitter, teacher, coach, or a bigger kid. Child abuse can happen anywhere — at ... building. Tell Right Away A kid who is being seriously hurt ...
daily alcohol use, physical activity and stress • Weekly planners that can assist them in using tools to reduce their drinking and meet daily goals...1, 2015. A summary of his presentation is as follows: 1. Research Questions & Hypotheses a. AIM 1: Compare the Smartphone (SP)-BI and EUC conditions...changing mobile health field, with dramatic increases in the use of smartphone technologies, we are developing and testing an eHealth mobile phone app for
Investigator ix. Richard McCormick, PhD – Independent Consultant x. Carla Conroy, MPH, Case Western Reserve University – Research Manager xi. Brittany ...Serrano provided administrative support during this reporting period. Name: Brittany Brownrigg Project Role: Data Coordinator Researcher Identifier...the feasibility of gene (stress-related) by environment (CA) interactions on promoting changes in brain function (amygdala and mPFC response to
Gori, Alessio; Ponti, Lucia; Tani, Franca; Iraci Sareri, Giuseppe; Giannini, Marco; Meringolo, Patrizia; Craparo, Giuseppe; Bruschi, Angelo; Caretti, Vincenzo; Cacioppo, Marco; Paterniti, Rolando; Schuldberg, David
The relationship between substance use disorders and criminal activity is strong, and one that is not easily resolved in the criminal justice system. A better understanding of personality traits among substance misusers who commit offences could support better treatment efforts. The aim of this study is to explore associations between the psychopathology of people addicted to substances who have also committed crimes. We recruited 263 substance-dependent individuals (80% male, 20% female) from a cohort of people attending regional community services in Italy. They all completed an extensive evaluation of their current mental health and personality traits. Their official criminal records were obtained, and the psychopathology of those who had a criminal record compared with those who did not. The criminal group was more likely to perceive the external world as hostile and to consider others as responsible for their own problems and difficulties; in addition, substance-dependent individuals with criminal records showed more personality traits within the psychopathy range and fewer in the dependent personality range than the substance abusers who had never committed crimes. These findings allow us to hypothesise that substance abusers who also have criminal convictions may have a specific personality profile. If further research were to confirm this, then it could have important implications for identifying people for particular treatment pathways and developing more effective treatments. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
The increase in drug abuse in South Africa has had major social implications in the country. Problems associated with drug dependency are poverty, unemployment, a heavier burden on the health care system, the disintegration of family systems and drug-related crimes. Another area of concern is the link between drug abuse and child abuse. While…
Murphy, John P.
Examines the effect that a substance abuser may have on the family system and the maladaptive roles sometimes assumed by family members. Discusses dysfunctional family phases and therapeutic issues and presents 11 guidelines for counselors working with chemically dependent families. (JAC)
Full Text Available In recent years drug abuse has been recognised as a growing problem in Northern Ireland. The following article examines the family backgrounds of a group of young children (n=388 who were looked-after by social services and looks specifically at a group (n=162 whose family lives have involved adults who misuse drugs. Children from drug-abusing families did not show greater levels of recorded abuse or neglect than the other children in the "looked after" population nor were they more likely to stay within the care system. However, the prevalence of heroin and cocaine use in this population was extremely small. Drug abuse in this population was found to be significantly associated with alcohol abuse, mental health problems and offending behaviour within the family. There was evidence of a reduction in drug abuse within families over a two year period of social work involvement.
Andersen, ML; Sawyer, EK; Howell, LL
A consistent observation in drug abuse research is that males and females show differences in their response to drugs of abuse. In order to understand the neurobiology underlying cocaine abuse and effective treatments, it is important to consider the role of sex differences. Sex hormones have been investigated in both behavioral and molecular studies, but further evidence addressing drug abuse and dependence in both sexes would expand our knowledge of sex-differences in response to drugs of a...
The causes of drug abuse and criminal behavior are closely linked. Not surprisingly, there is a high percentage of prisoners who during sentence execution abuse or are dependent on drugs. Antisocial personality disorder can be considered a common predictor of committing criminal offenses and drug abuse. A review of studies has revealed a high prevalence of inmates who use drugs while serving a sentence. Also, prison environment represents only a new context of the continuum of drug abuse by i...
Comorbidade entre transtorno de estresse pós-traumático e abuso e dependência de álcool e drogas: uma revisão da literatura Comorbidity of post traumatic stress disorder (PTSD with alcohol and drug abuse and dependency: a literature review
Heloisa de Souza Dantas
Full Text Available CONTEXTO: Pesquisas revelam uma alta comorbidade entre o transtorno de estresse pós-traumático (TEPT e o abuso e dependência de álcool e drogas (ADAD. OBJETIVOS: Descrever a natureza da associação entre TEPT e ADAD, as diferenças entre os gêneros feminino e masculino, bem como os principais tratamentos utilizados. MÉTODOS: Pesquisa bibliográfica entre os anos de 1995 e 2007 no PubMed, utilizando os termos "trauma" AND "alcohol", "trauma" AND "substance abuse", "trauma" AND "dependence", "trauma" AND "drugs", "posttraumatic stress" AND "alcohol", posttraumatic stress" AND "substance abuse", "posttraumatic stress" AND "dependence", "posttraumatic stress" AND "drugs". RESULTADOS: As seguintes hipóteses foram identificadas: 1 o abuso de substâncias aumenta os riscos para a ocorrência de TEPT em virtude de estilos de vida que expõem mais o sujeito à ocorrência de traumas e pelo fato de as drogas potencializarem as seqüelas do trauma; 2 o TEPT levaria ao aumento do uso de álcool e drogas acompanhado de possível abuso com o objetivo de aliviar sintomas decorrentes do transtorno. Conclusões: A identificação precoce da comorbidade entre o TEPT e o ADAD é fundamental para o bom prognóstico do paciente, bem como o atendimento adequado às vítimas de situações traumáticas para que sejam minimizadas as chances da ocorrência do TEPT.BACKGROUND: The literature reveals high comorbidity rates between post traumatic stress disorder (PTSD and substance abuse and dependence (SAD. OBJECTIVES: This paper seeks to describe the relationship between the two disorders; the gender differences; and the primary treatments used to reduce PTSD as well as SAD symptoms. METHODS: A review of the literature between 1995 and 2007. A PubMed search was used to find articles with the key words: "trauma" AND "alcohol", "trauma" AND "substance abuse", "trauma" AND "dependence", "trauma" AND "drugs", "post traumatic stress" AND "alcohol", post traumatic
Marilisa Berti de Azevedo Barros
Full Text Available OBJECTIVE: To estimate the prevalence of alcohol abuse/dependence and identify associated factors among demographic, family, socioeconomic and mental health variables. METHODS: A household survey was carried out in the urban area of Campinas, southeastern Brazil, in 2003. A total of 515 subjects, aged 14 years or more were randomly selected using a stratified cluster sample. The Self-Report Questionnaire and the Alcohol Use Disorder Identification Test were used in the interview. Prevalences were calculated, and univariate and multivariate logistic analyses performed by estimating odds ratios and 95% confidence intervals. RESULTS: The estimated prevalence of alcohol abuse/dependence was 13.1% (95% CI: 8.4;19.9 in men and 4.1% (95% CI: 1.9;8.6 in women. In the final multiple logistic regression model, alcohol abuse/dependence was significantly associated with age, income, schooling, religion and illicit drug use. The adjusted odds ratios were significantly higher in following variables: income between 2,501 and 10,000 dollars (OR=10.29; income above 10,000 dollars (OR=10.20; less than 12 years of schooling (OR=13.42; no religion (OR=9.16 or religion other than Evangelical (OR=4.77; and illicit drug use during lifetime (OR=4.47. Alcohol abuse and dependence patterns were different according to age group. CONCLUSIONS: There is a significantly high prevalence of alcohol abuse/dependence in this population. The knowledge of factors associated with alcohol abuse, and differences in consumption patterns should be taken into account in the development of harm reduction strategies.OBJETIVO: Estimar a prevalência do abuso/dependência de álcool e identificar fatores associados entre variáveis demográficas, familiares, socioeconômicas e relativas à saúde mental. MÉTODOS: Inquérito domiciliar na área urbana de Campinas, Estado de São Paulo, realizado em 2003. Indivíduos de 14 anos ou mais de idade (N=515 foram selecionados aleatoriamente
Full Text Available Introduction: Topical corticosteroids (TCS are widely misused. Uncontrolled use of steroids can cause undesirable adverse effects especially on face. Aim: The aim of this study was to assess the skin manifestations of TCS misuse over the face in the patients attending dermatology outpatient and to analyze various factors contributing to such misuse. Material and Methods: A total of 200 patients with facial dermatoses using topical steroids over face for minimum period of 1 month, reported between June 2010 and May 2011 were enrolled in the study. Details about the usage of topical corticosteroids and their side effects were recorded. The patients were educated about the misuse. Results: Majority of the patients were females (71%. The most common reason for misuse was acne (61% followed by use as a fairness cream (23%. The average duration of usage was 6 months to 1 year, longest being 8 years. The drug most commonly misused was Betamethaone Valerate (71%. The commonest side effect noted was acne form eruptions (52% followed by steroid dependent face (SDF (36%. There were no cases of allergic contact dermatitis or perioral dermatitis. The exacerbation of the lesions on stoppage of steroid cream (90% fairness effect (10% were the reasons for continued use. (100% were unaware of side effects of topical steroids. Conclusions: Steroids have been misused by patients on their own or by doctors for various reasons. Hence the awareness about their correct usage is essential.
Robert N. Jamison
Full Text Available Opioid analgesics provide effective treatment for noncancer pain, but many physicians have concerns about adverse effects, tolerance, and addiction. Misuse of opioids is prominent in patients with chronic back pain and early recognition of misuse risk could help physicians offer adequate patient care while implementing appropriate levels of monitoring to reduce aberrant drug-related behaviors. In this review, we discuss opioid abuse and misuse issues that often arise in the treatment of patients with chronic back pain and present an overview of assessment and treatment strategies that can be effective in improving compliance with the use of prescription opioids for pain. Many persons with chronic back pain have significant medical, psychiatric and substance use comorbidities that affect treatment decisions and a comprehensive evaluation that includes a detailed history, physical, and mental health evaluation is essential. Although there is no “gold standard” for opioid misuse risk assessment, several validated measures have been shown to be useful. Controlled substance agreements, regular urine drug screens, and interventions such as motivational counseling have been shown to help improve patient compliance with opioids and to minimize aberrant drug-related behavior. Finally, we discuss the future of abuse-deterrent opioids and other potential strategies for back pain management.
Rosen, Daniel; Engel, Rafael J; Hunsaker, Amanda E; Engel, Yael; Detlefsen, Ellen Gay; Reynolds, Charles F
This article examines the extent to which studies of alcohol abuse, illicit drug use, and prescription drug abuse among older adults appear in the leading gerontological and substance abuse journals. The authors reviewed articles published in the 10 social science gerontological journals and the 10 social science substance abuse journals with the highest 5-year impact factors in PubMed from 2000 to 2010. Articles were selected that presented original research on alcohol, substance, or prescription abuse with older adults aged 50 and older; and were identified through aging and substance abuse-related Medical Subject Headings and word searches of titles and abstracts (N = 634). Full text of each article was reviewed by the authors, and consensus determined inclusion in the final sample. Of the 19,953 articles published respectively in the top 10 gerontological and substance abuse journals, 181 articles met the inclusion criteria of reporting findings related to substance use disorders among older adults. Specifically, 0.9% (102 of 11,700) of articles from the top 10 gerontology journals and 1.0% (79 of 8,253) of articles from the top 10 substance abuse journals met the criteria. Most published articles addressed alcohol misuse/abuse or polysubstance abuse with few articles addressing illicit drug use or the misuse of prescription medications. Less than 1% of articles published in the 10 gerontology journals and the 10 substance abuse journals with the highest 5-year impact scores addressed substance abuse in older adults. Practitioners treating health and/or mental health problems are at a disadvantage in accurately identifying and treating these conditions in older adult populations without a proper understanding of the role of comorbid substance use disorders.
Nisha, Catherin; Manjaly, Steve; Kiran, Pretesh; Mathew, Betsy; Kasturi, Arvind
Elder abuse and neglect is a problem that occurs across all settings and all populations. Elder abuse has many forms, such as abandonment, emotional or psychological abuse, financial or material exploitation, neglect, physical abuse, and sexual abuse. We conducted this research to determine the prevalence of various types of abuse and neglect and their associated factors among elderly patients attending the urban and rural geriatric clinics at a medical college hospital in Bangalore, India. A total of 200 elderly patients participated in the study. The overall prevalence of elder abuse or neglect was 32 (16%), comprised of: verbal abuse in 25 (12.5%); neglect in 22 (11%); financial abuse in 17 (8.5%); and physical abuse in 3 (1.5%). Hence, many elderly patients had experienced multiple forms of abuse. There was statistically significant association between elder abuse and total financial dependence, lack of social support, and depression among the elderly patients.
Rousounidis, Andreas; Papaevangelou, Vassiliki; Hadjipanayis, Adamos; Panagakou, Sotiria; Theodoridou, Maria; Syrogiannopoulos, George; Hadjichristodoulou, Christos
Upper respiratory tract infections (URTIs) are common in children and represent a significant cause of antibiotic abuse which contributes to the development of antibiotic resistance. A survey was conducted in Cyprus in 2006 to assess parents’ and pediatricians’ Knowledge, Attitude and Practices (KAP) concerning the role of antibiotics in children with URTIs. A school-based stratified geographic clustering sampling was used and a pre-tested KAP questionnaire was distributed. A different questionnaire was distributed to paediatricians. Demographic factors associated with antibiotic misuse were identified by backward logistic regression analysis. The parental overall response rate was 69.3%. Parents (N = 1,462) follow pediatricians advice and rarely administer antibiotics acquired over the counter. Although a third expects an antibiotic prescription for URTI symptoms, most deny pressuring their doctors. Low parental education was the most important independent risk factor positively related to antibiotic misuse (OR = 2.88, 95%CI 2.02 to 4.12, p parental pressure but admit that parents ask for antibiotics and believe they expect antibiotic prescriptions even when not needed. In conclusion, Cypriotic parents trust their primary care providers. Although it appears that antibiotic misuse is not driven by parental pressure, the pediatricians’ view differs. PMID:21909304
Rousounidis, Andreas; Papaevangelou, Vassiliki; Hadjipanayis, Adamos; Panagakou, Sotiria; Theodoridou, Maria; Syrogiannopoulos, George; Hadjichristodoulou, Christos
Upper respiratory tract infections (URTIs) are common in children and represent a significant cause of antibiotic abuse which contributes to the development of antibiotic resistance. A survey was conducted in Cyprus in 2006 to assess parents' and pediatricians' Knowledge, Attitude and Practices (KAP) concerning the role of antibiotics in children with URTIs. A school-based stratified geographic clustering sampling was used and a pre-tested KAP questionnaire was distributed. A different questionnaire was distributed to paediatricians. Demographic factors associated with antibiotic misuse were identified by backward logistic regression analysis. The parental overall response rate was 69.3%. Parents (N = 1,462) follow pediatricians advice and rarely administer antibiotics acquired over the counter. Although a third expects an antibiotic prescription for URTI symptoms, most deny pressuring their doctors. Low parental education was the most important independent risk factor positively related to antibiotic misuse (OR = 2.88, 95%CI 2.02 to 4.12, p parental pressure but admit that parents ask for antibiotics and believe they expect antibiotic prescriptions even when not needed. In conclusion, Cypriotic parents trust their primary care providers. Although it appears that antibiotic misuse is not driven by parental pressure, the pediatricians' view differs.
Full Text Available Upper respiratory tract infections (URTIs are common in children and represent a significant cause of antibiotic abuse which contributes to the development of antibiotic resistance. A survey was conducted in Cyprus in 2006 to assess parents’ and pediatricians’ Knowledge, Attitude and Practices (KAP concerning the role of antibiotics in children with URTIs. A school-based stratified geographic clustering sampling was used and a pre-tested KAP questionnaire was distributed. A different questionnaire was distributed to paediatricians. Demographic factors associated with antibiotic misuse were identified by backward logistic regression analysis. The parental overall response rate was 69.3%. Parents (N = 1,462 follow pediatricians advice and rarely administer antibiotics acquired over the counter. Although a third expects an antibiotic prescription for URTI symptoms, most deny pressuring their doctors. Low parental education was the most important independent risk factor positively related to antibiotic misuse (OR = 2.88, 95%CI 2.02 to 4.12, p < 0.001. Pediatricians (N = 33 denied prescribing antibiotics after parental pressure but admit that parents ask for antibiotics and believe they expect antibiotic prescriptions even when not needed. In conclusion, Cypriotic parents trust their primary care providers. Although it appears that antibiotic misuse is not driven by parental pressure, the pediatricians’ view differs.
Jackson, K.A.; Neuman, M.C.; Simmonds, D.D.; Stallings, C.A.; Thompson, J.L.; Christoph, G.G.
An effective method for detecting computer misuse is the automatic monitoring and analysis of on-line user activity. This activity is reflected in the system audit record, in the system vulnerability posture, and in other evidence found through active testing of the system. During the last several years we have implemented an automatic misuse detection system at Los Alamos. This is the Network Anomaly Detection and Intrusion Reporter (NADIR). We are currently expanding NADIR to include processing of the Cray UNICOS operating system. This new component is called the UNICOS Realtime NADIR, or UNICORN. UNICORN summarizes user activity and system configuration in statistical profiles. It compares these profiles to expert rules that define security policy and improper or suspicious behavior. It reports suspicious behavior to security auditors and provides tools to aid in follow-up investigations. The first phase of UNICORN development is nearing completion, and will be operational in late 1994.
Jackson, K.A.; Neuman, M.C.; Simmonds, D.D.; Stallings, C.A.; Thompson, J.L.; Christoph, G.G.
An effective method for detecting computer misuse is the automatic auditing and analysis of on-line user activity. This activity is reflected in system audit records, in system vulnerability postures, and in other evidence found through active system testing. Since 1989 we have implemented a misuse and intrusion detection system at Los Alamos. This is the Network Anomaly Detection and Intrusion Reporter, or NADIR. NADIR currently audits a Kerberos distributed authentication system, file activity on a mass, storage system, and four Cray supercomputers that run the UNICOS operating system. NADIR summarizes user activity and system configuration in statistical profiles. It compares these profiles to expert rules that define security policy and improper or suspicious behavior. It reports suspicious behavior to security auditors and provides tools to aid in follow-up investigations, As NADIR is constantly evolving, this paper reports its development to date.
Turk, Dennis C.; O’Connor, Alec B.; Dworkin, Robert H.; Chaudhry, Amina; Katz, Nathaniel P.; Adams, Edgar H.; Brownstein, John S.; Comer, Sandra D.; Dart, Richard; Dasgupta, Nabarun; Denisco, Richard A.; Klein, Michael; Leiderman, Deborah B.; Lubran, Robert; Rappaport, Bob A.; Zacny, James P.; Ahdieh, Harry; Burke, Laurie B.; Cowan, Penney; Jacobs, Petra; Malamut, Richard; Markman, John; Michna, Edward; Palmer, Pamela; Peirce-Sandner, Sarah; Potter, Jennifer S.; Raja, Srinivasa N.; Rauschkolb, Christine; Roland, Carl L.; Webster, Lynn R.; Weiss, Roger D.; Wolf, Kerry
Opioids are essential to the management of pain in many patients, but they also are associated with potential risks for abuse, overdose, and diversion. A number of efforts have been devoted to the development of abuse-deterrent formulations of opioids to reduce these risks. This article summarizes a consensus meeting that was organized to propose recommendations for the types of clinical studies that can be used to assess the abuse deterrence of different opioid formulations. Due to the many types of individuals who may be exposed to opioids, an opioid formulation will need to be studied in several populations using various study designs in order to determine its abuse-deterrent capabilities. It is recommended that the research conducted to evaluate abuse deterrence should include studies assessing: (1) abuse liability; (2) the likelihood that opioid abusers will find methods to circumvent the deterrent properties of the formulation; (3) measures of misuse and abuse in randomized clinical trials involving pain patients with both low risk and high risk of abuse; and (4) post-marketing epidemiological studies. PMID:22770841
Hyman, Scott M; Sinha, Rajita
We examined the role of stress as a risk factor and motivation for cannabis use/misuse. A systematic review of studies gathered from PsychINFO and MEDLINE databases was conducted. Findings suggest that cannabis is commonly used as a stress-coping strategy. Negative life events, trauma, and maladaptive coping were all related to consumption. Cannabis use for stress-coping purposes was most evident when examining chronic as compared with experimental use. Although many individuals may be able to use cannabis without consequences, there appears to be a subset of individuals who experience greater life stress and who may be more likely to use for stress-coping purposes. These individuals may be at greatest risk for addiction. Chronic use may potentiate stress-related motivation to use/abuse cannabis and is associated with decision-making deficits and alterations in brain-stress pathways that may exacerbate compulsive drug seeking and sensitize individuals to stress-related drug use. Overall, stress-coping interventions and harm reduction focused on reducing the amount ingested may facilitate prevention and recovery efforts.
Diagnosis, while central to scientific medicine, is nevertheless secondary to treatment, the real purpose of medical care. A brief summary of the extensive literature about the use and misuse of radiological tests is presented. Among the factors involved in the recent increases in diagnostic tests, briefly presented in this article, are the presence of the new modalities themselves, advances in understanding and treatment of diseases, an ageing population, medico-legal concerns, self referral and medical consumerism. 32 refs
Caykoylu, Ali; Ibiloglu, Aslihan O; Taner, Yasemen; Potas, Nihan; Taner, Ender
Domestic violence is passed from one generation to the next, and it affects not only the victim but also the psychological states of the witnesses, and especially the psychosocial development of children. Studies have reported that those who have been the victim of or witnessing violence during their childhood will use violence to a greater extent as adults in their own families. This research examines the relationships between a history of childhood physical abuse, likelihood of psychiatric diagnoses, and potential for being a perpetrator of childhood physical abuse in adulthood among women who received psychiatric treatment and in the healthy population from Turkey. Estimates of the prevalence of childhood physical abuse vary depending on definition and setting. The frequency of witnessing and undergoing physical abuse within the family during childhood is much higher in the psychiatrically disordered group than the healthy controls. Childhood physical abuse history is one of the major risk factors for being an abuser in adulthood. The best indicator of physically abusing one's own children was found to be as physical abuse during the childhood period rather than psychiatric diagnosis. There is a large body of research indicating that adults who have been abused as children are more likely to abuse their own children than adults without this history. This is an important study from the point of view that consequences of violence can span generations. Further studies with different risk factor and populations will help to identify different dimensions of the problem.
Schepis, Ty S.; Krishnan-Sarin, Suchitra
A study found that adolescents who recently acquired medication by buying it had the worst risk profile among all medications classes in terms of concurrent substance use and the severity of prescription misuse. It is hoped that the findings could help identify subgroups of adolescents prescription misusers who are most vulnerable to consequences…
Leung, Chi-Ching; Tong, Eddie M W
Positive emotions, such as gratitude has been found to be beneficial to both physical and mental well-being but so far, drug misuse research has yet to identify important emotive predictors related to drug use. This study aimed to examine the relationship between gratitude and drug use among a group of drug misusers. It was hypothesized that greater dispositional gratitude was associated with lesser drug use through greater use of adaptive coping methods and lesser use of maladaptive coping methods. This study utilized a cross-sectional design to examine the relationship between gratitude, coping, and drug use among a sample of drug misusers (N = 105) at a drug rehabilitation center. Participants completed the gratitude questionnaire (GQ-6), the joy subscale of the Dispositional Positive Emotion Scale (DPES), the Brief COPE, and a questionnaire on their drug use. Data were collected in 2015. Mediation analysis supported the hypothesis and found that adaptive coping mediated the relationship between gratitude and drug use. However, mediation was not found for maladaptive coping. Additional analysis found that adaptive coping as a mediator was not found for joy. Results suggested that gratitude has utility in reducing drug use through the use of more adaptive coping strategies and this relationship was not simply due to positive affect. Interventions targeting drug use behavior could consider introducing gratitude to increase adaptive coping abilities to reduce drug use.
The aim of this study was to estimate the social costs of alcohol misuse in Estonia in 2006. Using a prevalence-based cost-of-illness approach, both direct and indirect costs were considered, including tangible costs associated with health care, criminal justice, rescue services, damage to property, premature mortality, incarceration, incapability of working due to illnesses, and lower labor productivity. The results show that alcohol misuse cost Estonia more than EUR 200 million in 2006. The costs involved are estimated to represent 1.6% of the gross domestic product (GDP), which is relatively high in comparison with many other countries. In addition, the state receives less receipts from the alcohol excise tax than the costs that it incurs as a consequence of alcohol misuse, which points to the existence of economic inefficiency with respect to the alcohol market. The results of this study suggest that there is definitely a need for further cost-benefit analysis to reach a conclusion regarding the possible utility of government intervention. Copyright 2008 S. Karger AG, Basel.
Barrense-Dias, Yara; Berchtold, André; Akre, Christina; Surís, Joan-Carles
Adolescence is a transitory and exploratory stage during which risky behaviors such as substance use take place. This study aims to assess the characteristics and predictive risk factors of alcohol misuse among adolescents. A sample of 621 youths was followed from ages 14 to 16 years in Switzerland between spring 2012 (T0) and spring 2014 (T1). Participants were divided into two groups according to their alcohol misuse evolution: those who increased it (Misusers) and those who decreased or never experimented it (Non-misusers). The final sample consisted of 574 adolescents. At T0, participants reported demographic data, substance use data and emotional well-being. A multivariate regression was performed to assess the explanatory variables of alcohol misuse at T1 using Non-misusers as the reference category. Alcohol misuse in the previous month increased dramatically from 2.4% (T0) to 29.2% (T1). At the bivariate level, alcohol misuse was associated with residence, use of alcohol, tobacco and cannabis. Compared to Non-misusers, Misusers were significantly more likely to live in a rural area (aOR: 1.75 [1.1:2.8]), use cannabis (aOR: 3.2 [1.0:9.8]) and have consumed alcohol (aOR: 2.65 [1.6:4.3]) at T0. Alcohol misuse increases dramatically with age. However, the only demographic difference between groups was that young adolescents living in rural areas were more likely to misuse alcohol. Moreover, having consumed alcohol without drunkenness and using cannabis at age 14 years predicted alcohol misuse at age 16 years. This finding is in line with the reverse gateway theory, where cannabis use precedes the use of legal substances.
Full Text Available This paper examines the complexities of the help-seeking process of minoritized women (primarily asylum-seekers and immigrants experiencing domestic violence in Northern Ireland. The term ‘minoritized’ is used here to emphasize that “minority” status is not a static or innate trait of certain groups but instead is the outcome of a process of being positioned as a minority. The paper addresses the intersections of ethnicity, nationality, class and gender and shows how state policies in relation to immigration and social security reinforce inequalities in gendered power relations. Despite attempts to improve the social security and immigration systems, the findings from a Northern Ireland study show how recent policy changes have not addressed the systemic institutional racism and institutionalised patriarchy in these agencies. Where avenues for action are undermined by such practices, the policies raise concerns about the safety and protection of minoritized women living in abusive relationships. We argue that the UK is failing to meet its human rights responsibilities to provide adequate support and assistance to minoritized women in abusive relationships and conclude that delivering state accountability alongside a human rights framework based on security, autonomy, liberty and equality is what is needed. Este artículo analiza las complejidades del proceso de búsqueda de ayuda en Irlanda del Norte para mujeres pertenecientes a minorías (principalmente solicitantes de asilo e inmigrantes que sufren violencia doméstica. El término 'minoritarizadas' se utiliza aquí para hacer hincapié en que la situación de "minoría" no es un rasgo estático o innato de ciertos grupos, sino que es el resultado de un proceso de ser posicionado como una minoría. El artículo aborda las intersecciones de origen étnico, nacionalidad, clase y género y muestra cómo las políticas estatales en relación a la inmigración y la seguridad social
Kylie A. Bailey
Full Text Available This study explores the relationship between reported parental emotional neglect when a child, assault type experienced, posttraumatic stress symptoms (PTSS, depression, and alcohol consumption in treatment seekers for comorbid depressive symptoms and alcohol misuse. Participants (n = 220 with concurrent depression and alcohol misuse were recruited from the DAISI (Depression and Alcohol Integrated and Single-focussed Interventions project. Assault type and PTSS were retrospectively assessed by the Posttraumatic Stress Diagnostic Scale. The Measure of Parenting Style is a self-report measure that retrospectively assessed emotional neglect experienced as a child. An exploratory factor analysis using the tetrachoric correlation matrix (applying principal factor extraction with a varimax rotation identified the two assault factors of sexual assault (SA and physical assault (PA. A path analysis revealed that Maternal Emotional Neglect increased the impact of PTSS and depression. Paternal Emotional Neglect increased the impact of PA on PTSS and alcohol dependence symptoms. There appears to be differential effects of assault type and Maternal/Paternal emotional neglect on depression and alcohol misuse, suggesting that parenting roles serve distinct protective functions.
Arias, Francisco; Szerman, Nestor; Vega, Pablo; Mesias, Beatriz; Basurte, Ignacio; Morant, Consuelo; Ochoa, Enriqueta; Poyo, Félix; Babín, Francisco
The objective was to quantify the prevalence of dual diagnosis and to evaluate the characteristics of these patients from community mental health and substance misuse services in Madrid. The sample consisted of 837 outpatients from Madrid, 208 from mental health services and 629 from substance misuse services. We used the Mini International Neuropsychiatric Interview (MINI) and Personality Disorder Questionnaire (PDQ4+) to evaluate disorders from axis I and II. It was considered that 517 (61.8%) patients had dual pathology (current diagnoses of axis I or II disorders and an addictive disorder): 36,1% in mental health services and 70,3% in substance misuse services. There were fewer males amongst the dual patients and it was also found that they had a worse employment situation, along with higher figures of alcohol and cannabis dependence than addicts without dual diagnoses (n=194). When comparing them with patients with mental disorder diagnoses only, excluding substance use disorder (n=126), there were differences in all socio-demographic characteristics analyzed, and dual patients were associated with diagnoses of bipolar disorder, agoraphobia, generalized anxiety disorder, post-traumatic stress disorder, and had more suicide risk and different personality disorders. Thus, dual pathology is higher in patients who are in treatment and have differential characteristics (higher suicide risk, worse employment situation) that suggest greater severity that could be of help in the planning of care resource policies for these patients.
... Videos for Educators Search English Español Cough & Cold Medicine Abuse KidsHealth / For Teens / Cough & Cold Medicine Abuse ... resfriado Why Do People Use Cough and Cold Medicines to Get High? There's an ingredient in many ...
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... use of these drugs is a form of drug abuse. Medicines that are for treating a health problem ... about local resources. Alternative Names Overdose from drugs; Drug abuse first aid References Myck MB. Hallucinogens and drugs ...
... what the doctor prescribed, it is called prescription drug abuse. It could be Taking a medicine that ... purpose, such as getting high Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, ...
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comorbidity and head injury could have been an artifact of clinical protocols (e.g., toxicology screening when neurological damage is evident or...Drug dependence-cocaine dependence 304.3 - Drug dependence- cannabis dependence 304.4 - Drug dependence-amphetamine and other psychostimulant...unspecified drug dependence 305.2 – Nondependent abuse of drugs- cannabis abuse 305.3 – Nondependent abuse of drugs-hallucinogen abuse 305.4
Newman, Robert G; Gevertz, Susan G
In a recent article, Lund et al sought to compare maternal and neonatal outcomes of various treatment regimens for opioid dependence during pregnancy.1 In their background, discussion the authors state that "In the United States buprenorphine plus naloxone [Suboxone(®)] … has been the preferred form of prescribed buprenorphine due to its reduced abuse liability relative to buprenorphine alone [Subutex(®)]." This claim is certainly consistent with the view of the firm that has manufactured and sold both products, Reckitt Benckiser. In September of 2011, the company announced that it was "… discontinuing distribution and sale of Subutex(®) tablets as we believe that mono product (product containing buprenorphine alone with no naloxone) creates a greater risk of misuse, abuse and diversion …".2 Supporting evidence for the alleged "reduced abuse liability" appears to be lacking, however, and evidence cannot be located in the two references cited by Dr. Lund and his co-authors, which in fact are silent on the subject of abuse potential.3,4 In contrast, it has been reported that the transition to buprenorphine/naloxone from the mono formulation has been associated with "… no reduction in injection risk behaviors among IDUs."5.
Robert G. Newman M.D., M.P.H.
Full Text Available In a recent article, Lund et al sought to compare maternal and neonatal outcomes of various treatment regimens for opioid dependence during pregnancy. 1 In their background, discussion the authors state that “In the United States buprenorphine plus naloxone [Suboxone®] … has been the preferred form of prescribed buprenorphine due to its reduced abuse liability relative to buprenorphine alone [Subutex®].” This claim is certainly consistent with the view of the firm that has manufactured and sold both products, Reckitt Benckiser. In September of 2011, the company announced that it was “… discontinuing distribution and sale of Subutex® tablets as we believe that mono product (product containing buprenorphine alone with no naloxone creates a greater risk of misuse, abuse and diversion …”. 2 Supporting evidence for the alleged “reduced abuse liability” appears to be lacking, however, and evidence cannot be located in the two references cited by Dr. Lund and his co-authors, which in fact are silent on the subject of abuse potential. 3 , 4 In contrast, it has been reported that the transition to buprenorphine/naloxone from the mono formulation has been associated with “… no reduction in injection risk behaviors among IDUs.” 5
Tauriac, Jesse J.; Scruggs, Natoschia
Perceptions of extreme, moderate, and mild forms of elder abuse among African-American women (n=25) and men (n=10) were examined. African-American respondents emphasized physical abuse when giving examples of extremely abusive behavior. Along with physical abuse, verbal abuse was the most frequently identified form of abuse, and was significantly…
Perceptions of elder abuse were examined in Japanese women (n =100) and men (n =46). Japanese women and men both emphasized physical aggression, followed by neglect and blaming, when giving examples of extremely abusive behavior. Physical aggression was also the most frequently mentioned type of moderate elder abuse, followed by neglect, economic…
Doyle, Kathleen; Morrow, Marilyn J.
The Elder Abuse Awareness Project was undertaken: (1) to determine the incidence of abuse and neglect in seven Illinois counties; and (2) to develop, produce, and distribute educational materials on elder abuse for the service provider and for senior citizens. Results are presented and discussed. (MT)
AIMS: To examine (1) the prevalence of alcohol use disorders in adult general hospital inpatients; (2) the accuracy of documentation in relation to alcohol use. METHODS: A total of 210 random patients were interviewed out of 1,448 consecutive new admissions to CUH over 7 days. Case notes were reviewed for 206 (98%). Alcohol consumption was assessed using the Fast Alcohol Screening Test (FAST) and weekly drinking diary. FAST-positive (and a random sample of FAST-negative) patients then had a standardized interview. RESULTS: A total of 82% admitted for drinking alcohol. Among them 22% were drinking in excess of guidelines, 9% had DSM-IV Alcohol Abuse and 7% dependence. The sensitivity and specificity of the FAST for detecting those drinking above guidelines were 89 and 94% and for detecting a DSM-IV diagnosis was 100 and 73%. The majority of case notes contained inadequate information about alcohol intake. CONCLUSION: Alcohol use disorders are common and often undetected in the general hospital setting.
Sasha A. Fleary
Full Text Available This study explored the extent to which nonprescription and prescription drugs misuse among adolescents/young adults are related to their perception that it is safer than illicit drugs, ease of access, and lower societal stigma. Adolescents/young adults (; , completed an online survey about their nonprescription and prescription drug misuse, other substance use, and correlates of use. Perceived risk, societal stigma, and access to nonprescription and prescription drugs were predictive of misuse. Results support program planners working towards targeting perceived risk and societal stigma in reducing misuse and the need to restrict and monitor access to nonprescription and prescription drugs for adolescents/young adults.
De Alwis, Duneesha; Agrawal, Arpana; Reiersen, Angela M; Constantino, John N; Henders, Anjali; Martin, Nicholas G; Lynskey, Michael T
Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder frequently co-occur. Several studies show increased risk of substance use disorders in ADHD, yet there is limited information related to how ADHD symptoms, autistic traits, and their combined effects are associated with nicotine, alcohol, and cannabis use and use disorders in the general population. Cross-sectional interview and self-report questionnaire data from 3,080 young adult Australian twins (mean age 31.9 years) were used to assess ADHD symptoms, autistic traits, substance use, and substance use disorders. Substance use disorders-based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria-were assessed in the full sample as well as in those who reported substance use. Logistic regression analyses were used for comparing the associations between ADHD symptoms, autistic traits, substance use, and substance misuse after conduct disorder, sex, age, and zygosity were controlled for. Greater ADHD symptoms and autistic traits scores were associated with elevated levels of regular smoking; cannabis use; and nicotine, alcohol, and cannabis use disorders, even after conduct disorder was adjusted for. In contrast, for alcohol use, those with high autistic traits scores were less likely to report drinking to intoxication. However, upon initiation, and similar to the findings for nicotine and cannabis, they were at elevated risk for developing alcohol dependence. Increased liability to ADHD and elevated autistic traits scores were associated with substance use and misuse, with the exception of alcohol use. Given the social underpinnings of drinking, persons with autistic traits may be less likely to engage in it; however, upon engagement in drinking, their vulnerability to alcohol dependence is elevated.
Full Text Available The aim of the current study is to examine the quality of sibling relationship in families with a sibling with substance misuse (SSU and compare the relationship to families with a sibling with no use (SNU. Thirty-six (36 families participated in the study (17 with SSU and 19 with SNU; N = 144. Semi-structured interviews were conducted with 40 siblings (20 SNU and 20 SSU; 18-31 years old in order to qualitatively investigate the characteristics of the sibling relationship. The siblings were not identified with any psychopathology, according to SCL-90R. Moreover, we considered the family cohesion and adaptability, as identified by the FACES III (administered to the whole sample and the family constellation (including number of children, birth order, gender, family size, family structure, years of substance misuse and socioeconomic level. The results of the thematic analysis seem to support Furman and Buhrmester’s (1985 framework, in the context of SNU families. Nevertheless, when considering families with SSU the framework is enriched with a new axis: Loss/mourning. The substance misuse seems to provoke an overturn of the representation of the sibling relationship: the behavioral changes (i.e. disengagement of the sibling with drug use are experienced as a loss by the sibling non user, thus triggering the psychological process of ‘mourning’. Moreover, in these families, the sibling with no drug use seem to experience differential parenting, they feel neglected, angry and they take up a parental role towards the SSU, whom they experience as “sensitive” and “vulnerable”.
Anastasia Tsamparli; Elvisa Frrokaj
The aim of the current study is to examine the quality of sibling relationship in families with a sibling with substance misuse (SSU) and compare the relationship to families with a sibling with no use (SNU). Thirty-six (36) families participated in the study (17 with SSU and 19 with SNU; N = 144). Semi-structured interviews were conducted with 40 siblings (20 SNU and 20 SSU; 18-31 years old) in order to qualitatively investigate the characteristics of the sibling relationship. The siblings w...
and behaviour associated with cannabis abuse among you'ng people. .... or other psychotropic drugs, but these cases will not be dealt with in this study. .... secondary diagnosis in 31 patients with these features. Of this .... The consequences of.
ANGOORANI, Hooman; HALABCHI, Farzin
Background: The high prevalence and potential side effects of anabolic-androgenic steroids (AAS) misuse by athletes has made it a major public health concern. Epidemiological studies on the abuse of such drugs are mandatory for developing effective preventive drug control programs in sports community. This study aimed to investigate the prevalence of AAS abuse and their association with some psycho-socio-demographic factors in Iranian male recreational body-builders. Methods: Between March and October 2011; 906 recreational male body-builders from 103 randomly selected bodybuilding clubs in Tehran, Iran were participated in this study. Some psycho-socio- demographic factors including age, job, average family income, family size, sport experience (months), weekly duration of the sporting activity (h), purpose of participation in sporting activity, mental health as well as body image (via General Health Questionnaire and Multidimensional Body-Self Relations Questionnaire, respectively), and history of AAS use were obtained by interviews using questionnaires. Results: Participants were all recreational male body-builders [mean age (SD): 25.7 (7.1), ranging 14–56 yr]. Self-report of AAS abuse was registered in 150 body-builders (16.6%). Among different psycho-socio-demographic factors, only family income and sport experience were inversely associated with AAS abuse. Conclusion: Lifetime prevalence of AAS abuse is relatively high among recreational body-builders based on their self-report. Some psycho-socio-demographic factors including family income and sport experience may influence the prevalence of AAS abuse. PMID:26811817
de Melo Nunes, Adriana; Baltieri, Danilo Antonio
The proportion of women incarcerated is growing at a faster pace than that for men. The reasons for this important increase have been mainly attributed to drug-using lifestyle and drug-related offenses. About half of female inmates have history of substance misuse and one third demonstrate high impulsiveness levels. The objectives of this study were to (a) identify subtypes of alcohol and drug problems and impulsiveness among women convicted of homicide, and (b) examine the association between psychosocial and criminological features and the resulting clusters. Data come from 158 female inmates serving a sentence for homicide in the Penitentiary of Sant'Ana in São Paulo State, Brazil. Latent class analysis was used to group participants into substance misuse and impulsiveness classes. Two classes were identified: nonproblematic (cluster 1: 54.53%, n = 86) and problematic (cluster 2: 45.57%, n = 72) ones. After controlling for several psychosocial and criminological variables, cluster 2 inmates showed an earlier beginning of criminal activities and a lower educational level than their counterparts. To recognize the necessities of specific groups of female offenders is crucial for the development of an adequate system of health politics and for the decrease of criminal recidivism among those offenders who have shown higher risk.
Full Text Available Alcohol may be used and misused for different reasons, i.e. to enhance positive affect and to cope with negative affect. These to pathways are thought to depend on two distinct and relatively stable neurobiological systems: the behavioral activation (BAS; i.e. fun seeking, drive, reward responsiveness and behavioral inhibition (BIS systems. This study investigates the associations of BAS and BIS sensitivity with risky single-occasion drinking and alcohol use disorder in a representative sample of 5,362 young Swiss men. In order to better understand the contribution of more proximal motivational factors in the associations of BIS and BAS with alcohol outcomes, mediations via drinking motives (i.e. enhancement, social, coping, conformity was also tested.Risky single-occasion drinking and alcohol use disorder were positively associated with fun seeking and negatively with reward responsiveness. Drive was negatively associated with risky single-occasion drinking. BIS was positively associated with alcohol use disorder and negatively with risky single-occasion drinking. Positive associations of fun seeking with risky single-occasion drinking and alcohol use disorder were partially mediated mainly by enhancement motives. Negative association of drive with risky single-occasion drinking was partially mediated by conformity motives. The negative reward responsiveness –alcohol use disorder association was partially mediated, whereas the negative reward responsiveness –risky single-occasion drinking association was fully mediated, mainly by coping and enhancement motives. The positive BIS–alcohol use disorder association was fully mediated mainly by coping motives. Fun seeking constitutes a risk factor, whereas drive and reward responsiveness constitute protective factors against alcohol misuse and disorder. BIS constitutes a protective factor against risky single-occasion drinking and a risk factor for alcohol use disorder. The results of the
Diel, P; Friedel, A; Geyer, H; Kamber, M; Laudenbach-Leschowsky, U; Schänzer, W; Thevis, M; Vollmer, G; Zierau, O
Desoxymethyltestosterone (DMT), also known as Madol, is a steroid recently identified to be misused as a doping agent. Since, the knowledge of functions of this substance is rather limited, it was our aim to characterise the pharmacological profile of DMT and to identify potential adverse side effects. DMT was synthesised, its purity was confirmed and its biological activity was tested. The potency of Madol (DMT) to transactivate androgen receptor (AR) dependent reporter gene expression was two times lower as compared to dihydrotestosterone (DHT). Receptor binding tests demonstrate that DMT binds with high selectivity to the AR, binding to the progesterone receptor (PR) was low. In vivo experiments in orchiectomised rats demonstrated that treatment with DMT resulted only in a stimulation of the weight of the levator ani muscle; the prostate and seminal vesicle weights remained unaffected. Like testosterone, administration of DMT resulted in a stimulation of IGF-1 and myostatin mRNA expression in the gastrocnemius muscle. In the prostate proliferation was stimulated by TP (testosteronepropionate), but remained unaffected by DMT. Remarkably, treatment with DMT, in contrast to TP, resulted in a significant increase of the heart weight. In the liver, DMT slightly stimulates the expression of the tyrosine aminotransferase gene (TAT). Our results demonstrate that DMT is a potent AR agonist with an anabolic activity. Besides the levator ani weight, DMT also modulates the gene expression in the musculus gastrocnemius. The observed stimulation of TAT expression in the liver and the significant increase of the heart weight after DMT treatment can be taken as an indication for side effects. Summarizing these data it is obvious that DMT is a powerful anabolic steroid with selective androgen receptor modulators (SARM) like properties and some indications for toxic side effects. Therefore, there is a need for a strict control of a possible misuse.
Wilens, Timothy E.; Gignac, Martin; Swezey, Allison; Monuteaux, Michael C.; Biederman, Joseph
Objective: Little is known about the risks and characteristics of attention-deficit/hyperactivity disorder (ADHD) patients who misuse or divert their stimulant medications. As part of a 10-year longitudinal study of youths with ADHD, the authors evaluated medication diversion or misuse at the last follow-up period. Method: Structured psychiatric…
... 32 National Defense 1 2010-07-01 2010-07-01 false Guideline M-Misuse of Information technology... CLASSIFIED INFORMATION Adjudication § 147.15 Guideline M—Misuse of Information technology systems. (a) The... ability to properly protect classified systems, networks, and information. Information Technology Systems...
Garland, Eric L; Froeliger, Brett; Howard, Matthew O
Chronic pain patients who misuse prescription opioids may suffer from allostatic dysregulation of natural reward processing. Hence, this study examined whether prescription opioid misusers with chronic pain (n=72) evidenced decreased natural reward responsiveness relative to non-misusers with chronic pain (n=26). Subjects completed a dot probe task containing pain-related, opioid-related, and natural reward stimuli while attentional bias (AB) scores and heart rate variability (HRV) responses were assessed. Compared to non-misusers, misusers evidenced significantly more attenuated HRV responses to opioid, pain, and natural reward cues presented during the dot probe task. These significant between-groups differences in HRV were largest during attention to natural reward cues, but became non-significant in a sensitivity analysis controlling for opioid dosing. In addition, non-misusers evidenced an AB toward natural reward cues, whereas misusers did not. Findings suggest that opioid misusers exhibit attentional and autonomic deficits during reward processing. Copyright © 2015 Elsevier B.V. All rights reserved.
Rassool, G H; Villar-Luis, M
To provide an overview of the extent of drug and alcohol misuse in Brazil and the policies and approaches in tackling substance misuse. An examination of the challenges facing the nursing profession in working with substance misusers is presented. Alcohol, cocaine, and cannabis are the most commonly misused psychoactive substances in Brazil. One of the biggest public health problems is the interface between the misuse of psychoactive substances and HIV prevalence and other sexually transmitted diseases. Findings from a recent study suggest that undergraduate nurses in Brazil are not adequately prepared in the care and management of substance misuse problems. The nursing profession in Brazil faces numerous challenges in the development of professional competence of nurses in this field. A strategy proposed is the creation of regional centres in Brazil to study the integration of substance use and misuse in the nursing undergraduate curriculum and the giving of specific support in teaching and research to nurse teachers. Nurses have a key role to play in the early recognition, assessment, prevention, and treatment of substance misuse.
Full Text Available Abstract Objective To investigate psychological well-being and substance abuse among medical students in Pakistan. Methods A cross-sectional questionnaire-based survey was conducted in six medical colleges across Pakistan. Final-year medical students were interviewed by either a postgraduate trainee in psychiatry or a consultant psychiatrist. Results A total of 540 medical students were approached; 342 participated and the response rate was 64.5%. Mean age was 23.73 years (SD 2.45 years; 52.5% were male and 90% single. Two out of every five respondents reported that work/study at medical school affected their personal health and well-being. A considerable proportion of students were aware of alcohol and smoking as coping strategies for stress in medical students. The main factors causing stress were heavy workload (47.4%, relationship with colleagues (13.5% and staff (11.9%. A total of 30% reported a history of depression and 15% among them had used an antidepressant. More than half were aware of depression in colleagues. The majority of respondents said that teaching provided on substance misuse in the areas of alcohol and illegal drugs, management/treatment of addiction, and models of addiction was poor. There was significant association (p = 0.044 between stress and awareness about alcohol as a coping strategy for stress among medical students. A significant negative association was also found between medical colleges in public sector (p = 0.052, female gender (p = 0.003 and well-being. Conclusion The majority of the medical students reported a negative impact of heavy workload on their psychological well-being. Significant numbers of medical students think that substance misuse is a coping strategy for stress. Teaching on addiction/addictive substances is poor at undergraduate level in Pakistani medical colleges.
Blashill, Aaron J; Calzo, Jerel P; Griffiths, Scott; Murray, Stuart B
To examine the prevalence of anabolic steroid misuse among US adolescent boys as a function of sexual orientation and race/ethnicity. We analyzed boys from the 2015 Youth Risk Behavior Survey (n = 6248; mean age = 16), a representative sample of US high school students. Lifetime prevalence of anabolic steroid misuse was dichotomized as never versus 1 or more times. Sexual minority boys reported elevated misuse compared with heterosexual boys, within each level of race/ethnicity. Black, Hispanic, and White sexual minority boys reported misuse at approximately 25%, 20%, and 9%, respectively. Sexual orientation health disparities in anabolic steroid misuse disproportionally affect Black and Hispanic sexual minority adolescent boys, but more research is needed to understand the mechanisms driving these disparities.
Higgins, P G; Clough, D H; Wallerstedt, C
To explore patterns and levels of self-esteem of pregnant substance abusers. A descriptive prospective study to describe the self-esteem of pregnant substance abusers. Subjects (N = 31) were abusing and dependent on three or more legal and/or illegal substances. Subjects were asked one open-ended question regarding their self-esteem, then the Rosenberg Self-Esteem Inventory (RSI) was administered. Subjects gave 46 responses to the open-ended question. Overall, they used a single word to describe self-esteem. The most frequent response on the RSI was "low" for self-esteem, 23 subjects used positive terms, 20 used negative terms, and 3 reported a neutral term. The RSI confirmed the aspects of low self-esteem. Problems with low self-esteem were evident. Intervention strategies need to be developed to increase self-esteem in pregnant substance abusers.
Weyandt, Lisa L.; Oster, Danielle R.; Marraccini, Marisa Ellen; Gudmundsdottir, Bergljot Gyda; Munro, Bailey A.; Rathkey, Emma S.; Mccallum, Alison
Prescription stimulants, including methylphenidate (e.g., Ritalin) and amphetamine compounds (e.g., dextroamphetamine; Adderall), have been approved by the U.S. Food and Drug Administration for the treatment of attention deficit hyperactivity disorder (ADHD) and are classified by the United States Drug Enforcement Administration (DEA) as Schedule II medications due to their high potential for abuse and dependence (DEA, U.S. Department of Justice, 2015). Despite the potential health and judici...
Sutter, M E; Chenoweth, J; Albertson, T E
The incidence of drug abuse with alternative agents is increasing. The term "alternative drugs of abuse" is a catch-all term for abused chemicals that do not fit into one of the classic categories of drugs of abuse. The most common age group abusing these agents range from 17 to 25 years old and are often associated with group settings. Due to their diverse pharmacological nature, legislative efforts to classify these chemicals as a schedule I drug have lagged behind the development of new alternative agents. The potential reason for abuse of these agents is their hallucinogenic, dissociative, stimulant, anti-muscarinic, or sedative properties. Some of these drugs are easily obtainable such as Datura stramonium (Jimson Weed) or Lophophora williamsii (Peyote) because they are natural plants indigenous to certain regions. The diverse pharmacology and clinical effects of these agents are so broad that they do not produce a universal constellation of signs and symptoms. Detailed physical exams are essential for identifying clues leading one to suspect an alternative drug of abuse. Testing for the presence of these agents is often limited, and even when available, the results do not return in a timely fashion. Intoxications from these agents pose unique challenges for health care providers. Physician knowledge of the physiological effects of these alternative agents and the local patterns of drug of abuse are important for the accurate diagnosis and optimal care of poisoned patients. This review summarizes the current knowledge of alternative drugs of abuse and highlights their clinical presentations.
Full Text Available Abuse and neglect are preventable societal problems that influence elderly individuals physically, spiritually and socially. Elder abuse is neglected for many years and is a growing problem all over the world. The aim of this article is to review the evaluation of elderly individuals who are exposed to abuse and neglect with systematic detailed history and physical examination and to describe individual, familial, and social measures that should be taken to prevent these abuses. [Archives Medical Review Journal 2013; 22(3.000: 393-407
Young, Lisa M
Physical abuse of the elderly is a significant public health concern. The true prevalence of all types is unknown, and under-reporting is known to be significant. The geriatric population is projected to increase dramatically over the next 10 years, and the number of abused individuals is projected to increase also. It is critical that health care providers feel competent in addressing physical elder abuse. This article presents cases illustrating the variety of presenting symptoms that may be attributed to physical elder abuse. Copyright © 2014 Elsevier Inc. All rights reserved.
Xu, Xiaoming; Gupta, Abhay; Al-Ghabeish, Manar; Calderon, Silvia N.; Khan, Mansoor A.
High strength extended release opioid products, which are indispensable tools in the management of pain, are associated with serious risks of unintentional and potentially fatal overdose, as well as of misuse and abuse that might lead to addiction. The issue of drug abuse becomes increasingly prominent when the dosage forms can be readily manipulated to release a high amount of opioid or to extract the drug in certain products or solvents. One approach to deter opioid drug abuse is by providing novel abuse deterrent formulations (ADF), with properties that may be viewed as barriers to abuse of the product. However, unlike regular extended release formulations, assessment of ADF technologies are challenging, in part due to the great variety of formulation designs available to achieve deterrence of abuse by oral, parenteral, nasal and respiratory routes. With limited prior history or literature information, and lack of compendial standards, evaluation and regulatory approval of these novel drug products become increasingly difficult. The present article describes a risk-based standardized in-vitro approach that can be utilized in general evaluation of abuse deterrent features for all ADF products. PMID:26784976
Das, Jai K; Salam, Rehana A; Arshad, Ahmed; Finkelstein, Yaron; Bhutta, Zulfiqar A
Many unhealthy behaviors often begin during adolescence and represent major public health challenges. Substance abuse has a major impact on individuals, families, and communities, as its effects are cumulative, contributing to costly social, physical, and mental health problems. We conducted an overview of systematic reviews to evaluate the effectiveness of interventions to prevent substance abuse among adolescents. We report findings from a total of 46 systematic reviews focusing on interventions for smoking/tobacco use, alcohol use, drug use, and combined substance abuse. Our overview findings suggest that among smoking/tobacco interventions, school-based prevention programs and family-based intensive interventions typically addressing family functioning are effective in reducing smoking. Mass media campaigns are also effective given that these were of reasonable intensity over extensive periods of time. Among interventions for alcohol use, school-based alcohol prevention interventions have been associated with reduced frequency of drinking, while family-based interventions have a small but persistent effect on alcohol misuse among adolescents. For drug abuse, school-based interventions based on a combination of social competence and social influence approaches have shown protective effects against drugs and cannabis use. Among the interventions targeting combined substance abuse, school-based primary prevention programs are effective. Evidence from Internet-based interventions, policy initiatives, and incentives appears to be mixed and needs further research. Future research should focus on evaluating the effectiveness of specific interventions components with standardized intervention and outcome measures. Various delivery platforms, including digital platforms and policy initiative, have the potential to improve substance abuse outcomes among adolescents; however, these require further research. Copyright © 2016 Society for Adolescent Health and Medicine
... use and alcohol misuse program. Each employer shall establish an anti-drug use and alcohol misuse... 49 Transportation 7 2010-10-01 2010-10-01 false Requirement to establish an anti-drug use and alcohol misuse program. 655.11 Section 655.11 Transportation Other Regulations Relating to Transportation...
... 49 Transportation 7 2010-10-01 2010-10-01 false Required elements of an anti-drug use and alcohol... and alcohol misuse program. An anti-drug use and alcohol misuse program shall include the following: (a) A statement describing the employer's policy on prohibited drug use and alcohol misuse in the...
Alcohol misuse and harm are more prevalent amongst sports people than non-sports people. Few studies have trialled interventions to address alcohol misuse for this group. The study aimed to test the effectiveness of an intervention to reduce alcohol misuse and related harms amongst amateur sports people in Ireland.
Oates, R K; Tebbutt, J; Swanston, H; Lynch, D L; O'Toole, B I
To see if mothers who were sexually abused in their own childhood are at increased risk of their children being sexually abused and to see if prior sexual abuse in mothers affects their parenting abilities. Sixty-seven mothers whose children had been sexually abused by others and 65 control mothers were asked about sexual abuse in their own childhood. The sexually abused children of mothers who had been sexually abused in their own childhood were compared with the sexually abused children of mothers who had not suffered child sexual abuse as children. Comparisons were made on self-esteem, depression and behavior in the children. Thirty-four percent of mothers of sexually abused children gave a history of sexual abuse in their own childhoods, compared with 12% of control mothers. Assessment of the sexually abused children for self-esteem, depression and behavior at the time of diagnosis, after 18 months and after 5 years showed no difference in any of these measures at any of the three time intervals between those whose mothers had suffered child sexual abuse and those whose mothers had not been abused. In this study, sexual abuse in a mother's own childhood was related to an increased risk of sexual abuse occurring in the next generation, although prior maternal sexual abuse did not effect outcome in children who were sexually abused.
... Wellness Courts Cultural Competence Diverse Populations and Communities Domestic Violence Human Trafficking Laws & Policies Service Array Statistics ... Home Topics Preventing Child Abuse & Neglect Preventing Child Abuse & Neglect Resources on child abuse prevention, protecting children ...
and categories emerged in the domains childhood physical abuse (CPA), childhood emotional abuse (CEA), and neglect. Participants articulated wide personal impacts of child abuse in emotional, relational, and behavioral domains in their adult lives. These narratives contribute valuable clinical information...
Ogbu, Uzor C
Full Text Available The Centers for Disease Control and Prevention (CDC has published significant data trends related to substance abuse involving opioid pain relievers (OPR, benzodiazepines and alcohol in the United States. The CDC describes opioid misuse and abuse as an epidemic, with the use of OPR surpassing that of illicit drugs. Alcohol has also been a persistent problem and is associated with a number of emergency department visits and deaths independent of other substances. The use of these drugs in combination creates an additive effect with increased central nervous system suppression and a heightened risk of an overdose. We present a summary of the findings from the Morbidity and Mortality Weekly Report (MMWR with commentary on strategies to combat prescription drug and alcohol abuse. [West J Emerg Med. 2015;16(1:76–79.
Cusack, Karen J; Herring, Amy H; Steadman, Henry J
Many of the individuals with serious mental illness involved in the criminal justice system have experienced interpersonal victimization, such as sexual abuse, and have high rates of alcohol and drug use disorders. Little attention has been paid to the prevalence of posttraumatic stress disorder (PTSD) and its potential role in the substance misuse of offenders with mental illness. The study used a path analytic framework to test the hypothesis that PTSD mediates the relationship between sexual abuse and level of alcohol and drug use among individuals (N=386) with mental illness enrolled in a multisite (N=7) jail diversion project. Sexual abuse was strongly associated with PTSD, which was in turn associated with both heavy drug use and heavy drinking. These findings suggest that PTSD may be an important target for jail diversion programs.
Full Text Available Amie Shei,1 Matthew Hirst,2 Noam Y Kirson,1 Caroline J Enloe,1 Howard G Birnbaum,1 William C N Dunlop21Analysis Group, Inc., Boston, MA, USA; 2Mundipharma International Limited, Cambridge, UK Background: Opioid abuse, including abuse of prescription opioids (“RxOs” and illicit substances like heroin, is a serious public health issue in Europe. Currently, there is limited data on the magnitude of RxO abuse in Europe, despite increasing public and scientific interest in the issue. The purpose of this study was to use the best-available data to derive comparable estimates of the health care burden of RxO abuse in France, Germany, Italy, Spain, and the United Kingdom (EU5. Methods: Published data on the prevalence of problem opioid use and the share of opioid abuse patients reporting misuse of non-heroin opioids were used to estimate the prevalence of RxO abuse in the EU5 countries. The costs of RxO abuse were calculated by applying published estimates of the incremental health care costs of opioid abuse to country-specific estimates of the costs of chronic pain conditions. These estimates were input into an economic model that quantified the health care burden of RxO abuse in each of the EU5 countries. Sensitivity analyses examined key assumptions. Results: Based on best-available current data, prevalence estimates of RxO abuse ranged from 0.7 to 13.7 per 10,000 individuals across the EU5 countries. Estimates of the incremental health care costs of RxO abuse ranged from €900 to €2,551 per patient per year. The annual health care cost burden of RxO abuse ranged from €6,264 to €279,927 per 100,000 individuals across the EU5 countries. Conclusion: This study suggests that RxO abuse imposes a cost burden on health systems in the five largest European countries. The extent of RxO abuse in Europe should be monitored given the potential for change over time. Continued efforts should be made to collect reliable data on the prevalence and costs
Ciriello, Raffaele; Richter, Alexander; Schwabe, Gerhard
insights into PowerPoint use and misuse through an ethnographically informed field study of employee-driven innovation inside a multinational European banking software provider. Drawing on primary data consisting of 62 interviews, 41 slide decks, and longitudinal series of observations and workshops......PowerPoint continues to permeate the presentation genre in general and business communication in particular. Whereas PowerPoint’s role in organizational practices has caught increasing research interest, research on PowerPoint in digital innovation is still scarce. This study provides comprehensive......, the paper illustrates how deeply entangled PowerPoint is in digital innovation. Our in-depth analysis of PowerPoint use at different innovation process stages suggests that the tool cannot be simply regarded as beneficial or detrimental for innovation. Instead, we provide a revised dialectical examination...
... can help abused children regain a sense of self-esteem, cope with feelings of guilt about the abuse, and begin the process of overcoming ... find Facts for Families © helpful and would like to make good mental health a reality, consider donating to the Campaign for ...
Essential facts The government's definition of domestic violence and abuse, published in 2016 by the Home Office, is: 'Any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those 16 years or over who are, or have been, intimate partners or family members, regardless of gender or sexuality.'
Orendorff, Christopher [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Lamb, Joshua [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Steele, Leigh Anna Marie [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)
This report describes recommended abuse testing procedures for rechargeable energy storage systems (RESSs) for electric vehicles. This report serves as a revision to the FreedomCAR Electrical Energy Storage System Abuse Test Manual for Electric and Hybrid Electric Vehicle Applications (SAND2005-3123).
The Elder Abuse Prevention Project sponsored by the Seniors' Education Centre, University Extension, University of Regina (Saskatchewan, Canada) emerged from a provincial workshop held by the Centre in 1989. The workshop was designed to examine possible avenues for addressing elder abuse issues in Saskatchewan. The purposes of the project were to…
Thorne, Craig R.; DeBlassie, Richard R.
Cummings (1979), citing evidence from the National Institute of Drug Abuse, reports that one of every eleven adult Americans suffers from a severe addictive problem. Drug addiction is epidemic among teenagers; one of every six teenagers suffers from a severe addictive problem. This paper focuses on adolescent drug/substance abuse. (Author)
Prentice, Trisha M; Gillam, Lynn; Davis, Peter G; Janvier, Annie
The neonatal intensive care unit is recognized as a stressful environment; the nature of caring for sick babies with uncertain outcomes and the need to make difficult decisions results in a work place where moral distress is prevalent. According to the prevailing definition, moral distress occurs when the provider believes that what is "done" is not the right course of action, with an element of constraint: the provider has no choice but to act this way. This can lead to adverse outcomes, including burnout and a change of career. Traditionally, moral distress was considered to represent a misuse of power that forced nurses (typically) to provide burdensome treatments they believed not in the patient's best interests. Today, with shared decision-making, it is rare for physicians to act in a purely paternalistic fashion and impose management strategies on a team and parents. However, in the grey zones, it is not unusual for individuals with different values to disagree on a course of treatment. Healthcare professionals across all disciplines may feel constrained despite there being no identified misuse of power. We argue for a broader understanding of moral distress and an awareness that maladaptive responses to moral distress may result in "transference" of moral distress on to other healthcare professionals and even on to the families of babies for whom we have a duty of care. Strategies for dealing with moral distress exist. An appreciation of these dynamics will enable providers to reduce the negative impacts of moral distress while also using it as a vehicle for constructive discussion and progressive thought that will better serve our patients and our colleagues. Copyright © 2017 Elsevier Ltd. All rights reserved.
This article investigates the relationship between sexual abuse, power and the body from a Catholic ... Some researchers recognize that power also plays a role in sexual abuse, but this abuse of ..... Gender, power, and organizational culture.
Schjerning, Ole; Rosenzweig, Mary; Pottegård, Anton
BACKGROUND: Several case reports and epidemiological studies have raised concern about the abuse potential of pregabalin, the use of which has increased substantially over the last decade. Pregabalin is, in some cases, used for recreational purposes and it has incurred attention among drug abusers...... for causing euphoric and dissociative effects when taken in doses exceeding normal therapeutic dosages or used by alternative routes of administration, such as nasal insufflation or venous injection. The magnitude of the abuse potential and the mechanism behind it are not fully known. OBJECTIVE: The aim...... of this study was to present a systematic review of the data concerning the abuse potential of pregabalin. METHODS: We performed a systematic literature search and reviewed the preclinical, clinical and epidemiological data on the abuse potential of pregabalin. RESULTS: We included preclinical (n = 17...
Fogel, Joshua; Shlivko, Alexander
Reality television watching and social media use are popular activities. Reality television can include mention of illegal drug use and prescription drug misuse. To determine if reality television and social media use of Twitter are associated with either illegal drug use or prescription drug misuse. Survey of 576 college students in 2011. Independent variables included watching reality television (social cognitive theory), parasocial interaction (parasocial interaction theory), television hours watched (cultivation theory), following a reality television character on Twitter, and demographics. Outcome variables were illegal drug use and prescription drug misuse. Watching reality television and also identifying with reality TV program characters were each associated with greater odds for illegal drug use. Also, following a reality TV character on Twitter had greater odds for illegal drug use and also in one analytical model for prescription drug misuse. No support was seen for cultivation theory. Those born in the United States had greater odds for illegal drug use and prescription drug misuse. Women and Asians had lower odds for illegal drug use. African Americans and Asians had lower odds for prescription drug misuse. Physicians, psychologists, and other healthcare practitioners may find it useful to include questions in their clinical interview about reality television watching and Twitter use. Physician and psychology groups, public health practitioners, and government health agencies should consider discussing with television broadcasting companies the potential negative impact of including content with illegal drugs and prescription drug misuse on reality television programs.
Bryner, Jodi K.; Wang, Uerica K.; Hui, Jenny W.; Bedodo, Merilin; MacDougall, Conan; Anderson, Ilene B.
Objectives To analyze the trend of dextromethorphan abuse in California and to compare these findings with national trends. Design A 6-year retrospective review. Setting California Poison Control System (CPCS), American Association of Poison Control Centers (AAPCC), and Drug Abuse Warning Network (DAWN) databases from January 1, 1999, to December 31, 2004. Participants All dextromethorphan abuse cases reported to the CPCS, AAPCC, and DAWN. The main exposures of dextromethorphan abuse cases included date of exposure, age, acute vs long-term use, coingestants, product formulation, and clinical outcome. Main Outcome Measure The annual proportion of dextromethorphan abuse cases among all exposures reported to the CPCS, AAPCC, and DAWN databases. Results A total of 1382 CPCS cases were included in the study. A 10-fold increase in CPCS dextromethorphan abuse cases from 1999 (0.23 cases per 1000 calls) to 2004 (2.15 cases per 1000 calls) (odds ratio, 1.48; 95% confidence interval, 1.43–1.54) was identified. Of all CPCS dextromethorphan abuse cases, 74.5% were aged 9 to 17 years; the frequency of cases among this age group increased more than 15-fold during the study (from 0.11 to 1.68 cases per 1000 calls). Similar trends were seen in the AAPCC and DAWN databases. The highest frequency of dextromethorphan abuse occurred among adolescents aged 15 and 16 years. The most commonly abused product was Coricidin HBP Cough & Cold Tablets. Conclusions Our study revealed an increasing trend of dextromethorphan abuse cases reported to the CPCS that is paralleled nationally as reported to the AAPCC and DAWN. This increase was most evident in the adolescent population. PMID:17146018
Cooper, Claudia; Livingston, Gill
Elder abuse may be defined as a violation of a vulnerable older person's human and civil rights. Psychiatric illness is an important cause of vulnerability to abuse, especially when it is comorbid with other risk factors, such as physical frailty, sensory impairment, social isolation, and physical dependency. Health care providers are likely to encounter elder abuse regularly, and therefore have an important role in its detection and management, and in the treatment of subsequent psychiatric illness. This article reviews the relationships between psychiatric illnesses and elder abuse and neglect, examines the psychiatric consequences, and discusses how these may be treated. Copyright © 2014 Elsevier Inc. All rights reserved.
Full Text Available Objectives: There are researches to point epidemiology of addiction to drugs, chemical and solvent abuse in elderlies. Drug and Solvent abuse is considered as one of these addictions. This study was point to chemical abuse among elderly population of Ahwaz an Iranian city during year of 2007. Methods & Materials: Research method is description-exploration with use to questionnaire, clinical interview and survey of medical and clinical reports among volunteer clients. Statistical community is all elderly population at one of citizen region in Ahwaz city (Iran. Seventy four dossiers were considered via random sampling; with 30 Elder volunteer clients been interviewed and replied to Elderly Drug Abuse Questionnaire (EDAQ. Results: Signification of hypothesis with X2 test was considered significant relation between age and addiction record variables to solvent abuse; this relation is very significant to second value of drug's derivations such as Morphine, Codeine, Tebaine and Heroine. Interview showed psychological dependent due to appeal them to solvent abuse. Kind of abuse among elderly was snuffing and abuse of medicine drugs which were been recommended to them by their physician. Conclusion: Although study of solvent and chemical abuse's epidemiology pointed less average of this addiction in samples, should be considered important and notice in studies. Finally, researchers were suggested to avoid of this new drug abuse and so to control behavior and interaction of these addicted and their behavior development; it's better to control on distribution of solvent and glue materials and recommending of medicine drug via physicians visiting exderlies.
Guillem, Eric; Notides, Christine; Vorspan, Florence; Debray, Marcel; Nieto, Isabel; Leroux, Mayliss; Lépine, Jean-Pierre
The aim of this study was to evaluate the psychometric properties of the French version of the Marijuana Effect Expectancy Questionnaire (48 items) and study the cannabis expectancies according to the patterns of substance use and psychiatric disorders (DSM-IV). A sample of 263 subjects (average age 33.1 years [SD = 8.7], 56% men) consisting of cannabis users (n = 64), psychiatric inpatients (n = 175, most of whom were hospitalized for withdrawal), and a control group (n = 24) completed the questionnaire. Internal reliability was good (α= .87) and temporal reliability was satisfactory, with 24 of 48 items having a significant κ ≥ .41. Factor analysis showed four main factors that explained 42.1% of the total variance. The women feared Cognitive Impairment and Negative Effects, and Negative Behavioral Effects more than the men. The onset age of cannabis use, onset age of abuse, abuse and dependence were associated with fewer negative expectancies. Cannabis dependents differed from abusers by more Relaxation and Social Facilitation expectancies. Patients with major depressive episodes, panic disorder, social anxiety disorder, or posttraumatic stress disorder feared negative effects the most. Schizophrenic patients expected more Perceptual Enhancement and Craving. The French version of the Marijuana Effect Expectancy Questionnaire has good psychometric properties and is valid to assess cannabis expectancies in adolescents and adults with substance use disorders. Copyright © American Academy of Addiction Psychiatry.
Baumevieille, M; Haramburu, F; Bégaud, B
Few quantitative data are available concerning abuse of medicine in the general population, although dependence on prescription medicines involves a significant proportion of the population. Falsified prescription forms can be used as an indicator of abuse. Community pharmacists in a representative network were asked to report any falsified prescription form presented over a 1-year period. Sales data were used to express results as abuse rate and abuse rate ratio. Two-thirds of the 130 pharmacies in the network reported at least 1 falsified prescription. The reported incidence of falsified prescriptions was 2.3 per 10 000 inhabitants. A total of 392 falsified prescription forms was collected. The abuse rate ratios were 171 (95% CI 140 to 210) for dextroamphetamine-phenobarbital in combination, 168 (95% CI 131 to 216) for fenozolone, 67 (95% CI 53 to 84) for buprenorphine, and 40.5 (95% CI 33 to 50) for clobenzorex. These results show the efficiency of a method for detecting falsified prescriptions forms using community pharmacists. The abuse of medicines already known for their addictive potential can be estimated and alerts can also be detected.
Joel Rey U. Acob
Full Text Available Aim: The study determined individual lived experiences of the abused elderly in the provinces of Leyte and Biliran. Methods: The study utilized qualitative phenomenology. Interviews are made and recorded, then later transcribed verbatim. Collaizi’s method is used as method of analysis to obtain themes of the lived experiences of the ten abused key informants. Results: Based from results, most of the abused entities are female, widowed aging 6o to 65 years old, earning less than 2000 pesos per month and are dependently living in a nuclear family structure for 40 years. Based on their responses to the open-ended guide questions, key informants revealed emotional mistreatment being the most extensive type of abuse. Physical and sexual maltreatment are also evident amidst their old age. Family members and employers are the main identified perpetrators of the elderly. Bruises on most covered areas in their body, rope burns, torn undergarments, being touched without consent are some of the objective indicators of abuse. Themes such as family violence and workplace mistreatment are the most common form of abuse experienced. Conclusion: Based from the findings, it is recommended that the local government and concerned stakeholders to timely review existing rules protecting vulnerable adults especially its implementation.
van Amsterdam, Jan; van den Brink, Wim
In the the past two decades the medical use of prescription opioids (POs), in particular oxycodone, increased up to 14-fold in the U.S. and Canada. The high consumption of these pain relievers also led to non-medical use and abuse of these substances which in turn resulted in a dramatic increase in
interventions designed to target antibiotic abuse are established and successfully ... as the proposed “Schedule H1” in India should not only focus ...  Unfortunately, and due to the lack of educational ... also include students at medical schools and practicing ... We have conducted a research on attitudes towards antibiotic.
Marcelle M. Lobo Dinis Castro
Full Text Available OBJETIVO: Identificar e rever os instrumentos que explorem a motivação como fator capaz de predizer o resultado de tratamento da dependência de substâncias psicoativas e que vêm sendo utilizados na última década. MÉTODO: Revisão bibliográfica abrangente de literatura científica indexada sobre escalas que aferem o grau motivação. RESULTADO: Identificaram-se quatro instrumentos e suas propriedades psicométricas, os dois primeiros com versões validadas em português: Rhode Island Change Assessment Questionnaire (URICA, Stages of Change Readiness and Treatment Eargness Scale (SOCRATES, Treatment Motivation Questionnaire (TMQ, Readiness to Change Questionnaire (RCQ. CONCLUSÃO: A teoria motivacional vem sendo regularmente estudada na última década, permitindo avaliação pragmática de seus parâmetros por meio de escalas com validade e confiabilidades que variam de boa a excelente.OBJECTIVE: To identify and review tools used in specialized services to explore aspectos of motivation as a predictive factor of treatment outcome in drug-abusing patients. METHOD: Comprehensive literature review of scales used to assess the degree of motivation. RESULT: Four scales to evaluate stages of behavioural change related to motivation were identified and described, together with their associated psychometric properties - Rhode Island Change Assessment Questionnaire (URICA, Stages of Change Readiness and Treatment Eargness Scale (SOCRATES, Treatment Motivation Questionnaire (TMQ, Readiness to Change Questionnaire (RCQ; The first two have Portuguese validated versions. CONCLUSION: Motivacional theory has been regularly studied in the last decade, allowing the definition of pragmatic evaluation parameters in scales with validity and reliabilities that vary from good to excellent.
Jang, K L; Vernon, P A; Livesley, W J
This study seeks to estimate the extent to which a common genetic and environmental basis is shared between (i) traits delineating specific aspects of antisocial personality and alcohol misuse, and (ii) childhood family environments, traits delineating broad domains of personality pathology and alcohol misuse. Postal survey data were collected from monozygotic and dizygotic twin pairs. Twin pairs were recruited from Vancouver, British Columbia and London, Ontario, Canada using newspaper advertisements, media stories and twin clubs. Data obtained from 324 monozygotic and 335 dizygotic twin pairs were used to estimate the extent to which traits delineating specific antisocial personality traits and alcohol misuse shared a common genetic and environmental aetiology. Data from 81 monozygotic and 74 dizygotic twin pairs were used to estimate the degree to which traits delineating personality pathology, childhood family environment and alcohol misuse shared a common aetiology. Current alcohol misuse and personality pathology were measured using scales contained in the self-report Dimensional Assessment of Personality Pathology. Perceptions of childhood family environment were measured using the self-report Family Environment Scale. Multivariate genetic analyses showed that a subset of traits delineating components of antisocial personality (i.e. grandiosity, attention-seeking, failure to adopt social norms, interpersonal violence and juvenile antisocial behaviours) are influenced by genetic factors in common to alcohol misuse. Genetically based perceptions of childhood family environment had little relationship with alcohol misuse. Heritable personality factors that influence the perception of childhood family environment play only a small role in the liability to alcohol misuse. Instead, liability to alcohol misuse is related to genetic factors common a specific subset of antisocial personality traits describing conduct problems, narcissistic and stimulus
Davies-Kershaw, Hilary; Petersen, Irene; Nazareth, Irwin; Stevenson, Fiona
Drug misuse is a serious public health problem. Evidence from previous epidemiological studies show that GPs are recording drug misuse in electronic patient records (EPR). However, although the recording trends are similar to national surveys, recording rates are much lower. To explore the factors that influence GPs to record drug misuse in the EPR, and to gain a clearer understanding of the gap between the amount of drug misuse recorded in primary care and that in national surveys and other studies. A semi-structured qualitative interview study of GPs working in general practices across England. Purposive sampling was employed to recruit 12 GPs, both with and without a special interest in drug misuse, from across England. Semi-structured face-to-face interviews were conducted to consider whether and why GPs record drug misuse, which methods GPs use for recording, GPs' actions if a patient asks for the information not to be recorded, and GPs' actions if they think a patient misuses drugs but does not disclose the information. Resulting data were analysed using a combination of inductive and deductive thematic analysis. The complexity of asking about drug misuse preceded GPs' decision to record. They described how the context of the general practice protocols, interaction between GP and patient, and the questioning process affected whether, how, and in which circumstances they asked about drug use. This led to GPs making a clinical decision on whether, who, and how to record in the EPR. When making decisions about whether or not to record drug misuse, GPs face complex choices. Aside from their own views, they reported feelings of pressure from the general practice environment in which they worked and their clinical commissioning group, as well as government policies. © British Journal of General Practice 2018.
Finfgeld-Connett, Deborah L
Alcohol and benzodiazepine misuse is a significant problem in older women for a number of reasons such as physiological changes, outdated prescribing practices, and failure to identify hazardous use. In addition, treatment barriers involving the health-care system, conflicting information, and ageism also exist. Substance misuse among older women is predicted to become a bigger problem as the baby boom generation ages. Brief interventions that consist of assessment, feedback, responsibility, advice, menu, empathy, and self-efficacy, or A-FRAMES, have the potential to reduce alcohol and benzodiazepine misuse among older women in a cost-effective manner.
Hassija, Christina M; Jakupcak, Matthew; Maguen, Shira; Shipherd, Jillian C
The present study evaluated the impact of combat and interpersonal trauma exposure in a sample of 115 U.S. women veterans from Gulf War I and the Iraq and Afghanistan wars on 3 postdeployment trauma-related mental health outcomes: posttraumatic stress disorder symptoms (PSS), depressive symptom severity (DSS), and alcohol misuse. Patients presenting for healthcare services at a Veterans Affairs postdeployment health specialty clinic completed screening questionnaires that assessed combat exposure, lifetime interpersonal trauma history of childhood neglect, physical, or sexual abuse, and adult sexual and physical assault. In a regression model, combat exposure was the only significant independent variable associated with PSS, DSS, and alcohol misuse (β = .42, .27 and B = 1.58, respectively) even after adding lifetime interpersonal assault exposure to the model. Results highlight the negative effects of combat exposure on treatment-seeking women veterans' postdeployment mental health. Incorporating combat exposure into routine screening procedures for Gulf War and Iraq and Afghanistan war women veterans can aid in mental health treatment planning. Copyright © 2012 International Society for Traumatic Stress Studies.
Mattoo, Khurshid A; Garg, Rishabh; Kumar, Shalabh
This study is a continuation of the earlier studies and has been extended to investigate the potential forensic markers of elder abuse. To determine the prevalence of elder abuse in various outpatient departments (OPDs). To study the associated parameters related to the abuser and the abused. To determine the existence of potential forensic markers of elder abuse. The subjects were randomly selected from the medical and the dental OPDs of the university. Eight hundred and thirty two elderly subjects in the age range 40-60 years were interviewed using a questionnaire to determine the existence of elder abuse. The subjects were investigated and examined for weight, nutrition and hydration, vital signs, habits, existing visual and auditory capabilities, medications, disclosure of wills/deeds, signs of depression, and documented cleanliness. The mini-mental state examination, the Geriatric Depression Scale, the Clock drawing test, and the Brief Psychiatric Rating Scale were used to determine the potential forensic markers. Mean values in percentage were determined by dividing the number of determined subjects by the total number of subjects for that parameter. About 37% in medical and 41% in dental OPDs were found to have suffered from abuse, mostly in the age group 60-70 years. Females received more abuse and a combination of son and daughter-in-law constituted most abusers. Various potential markers of elder abuse and neglect investigated among the elder abuse victims included depression (89%), signs of improper feeding (83%), changes in personal hygiene (69%), need for medical/dental treatment (78%), medication misuse (67%), changes in wills/deeds (26%), decubiti (10%), bruises (17%), skin tears (27%), and confusion (23%). Elder abuse exists in one or more forms in both medical and dental OPDs among both males and females in all age groups.
Ana Teresa Araujo Reyes
Full Text Available Infantile abuse is a frequent problem, that must be suspected to bediagnosed, the children victims of infantile abuse can present anytype of injury, nevertheless there are associated injuries common toan inferred trauma that constitute radiological patterns highly specific for abuse, among them are the metafisial injuries, posterior costal fractures and first costal arc fractures, fractures of the toracolumbar region, fractures without apparent explanation, fractures in different stage of evolution, subdural hematoma, subarachnoid hemorrhage, intraparenquimatose contusion and diffuse axonal injury, which combined with the history of the trauma, the age, the development of mental abilities, as well as the mechanism guides the injury diagnose.
The atmosphere within the work setting speaks volumes about your culture, and is often a primary factor in recruitment and retention (or turnover) of staff. Workplace tension and abuse are significant contributing factors as to why nurses are exiting workplaces--and even leaving the profession. Abuse can take many forms from inappropriate interpersonal communication to sexual harassment and even violence. Administrators should adopt a zero tolerance policy towards abusive communication. Addressing peer behavior is essential, but positive behavior must also be authentically modeled from the CNO and other nursing leaders. Raising awareness and holding individuals accountable for their behavior can lead to a safer and more harmonious work environment.
Bassiony, Medhat M; Salah El-Deen, Ghada M; Yousef, Usama; Raya, Yasser; Abdel-Ghani, Mohamed M; El-Gohari, Hayam; Atwa, Samar A
Tramadol abuse liability is underestimated and the evidence of abuse and dependence is emerging. It has many health and social consequences especially in adolescents. Tramadol abuse has not been well studied in Egypt. The aim of this study was to estimate the prevalence and associated correlates of tramadol use and abuse among school students in Egypt. A total of 204 students, aged 13-18 years, from six schools in Zagazig, Egypt, were screened for tramadol use using The Drug Use Disorders Identification Test and a urine screen for tramadol. The prevalence of tramadol use was 8.8% among school students and the average age at onset of tramadol use was 16.5 ± 1.1. Some 83% of the users were using tramadol alone while the rest (17%) were using a combination of tramadol, alcohol, and cannabis. Two-thirds of these students started with tramadol as the first drug after the onset of tobacco smoking. Over one third of tramadol users had drug-related problems and 6% had dependence. There was a significant association between tramadol use and older age, male gender, and smoking. Drug-related problems were negatively correlated with age at onset of tramadol use. Tramadol use was common among adolescents and over one third of tramadol users had drug-related problems. Population-based longitudinal studies are needed to investigate tramadol use and the possible role of tramadol as a gateway drug in the development of substance abuse in Egypt.
Manchikanti, Laxmaiah; Brown, Keith R; Singh, Vijay
The National All Schedules Prescription Electronic Reporting Act, or NASPER, is a bill proposed by the American Society of Interventional Pain Physicians to provide and improve patient access with quality care, and protect patients and physicians from deleterious effects of controlled substance misuse, abuse and trafficking. Controlled prescription drugs, including narcotic analgesics, anxiolytics, anti-depressants, stimulants, and sedative-hypnotics play a significant and legitimate role in interventional pain management practices in managing chronic pain and related disorders. Based on the 1997 household survey on drug abuse it is estimated that 76.9 million Americans had used an illicit drug at least once in their life. In 1997, 4.2 million people used analgesics, 2.1 million used tranquillizers, and an additional 2.3 million people used various other drugs, including sedatives, tranquillizers, etc. The non-medical use of prescription drugs exceeds that of all illicit substances except for marijuana and hashish. The report on epidemiology trends in drug abuse, based on community epidemiology work group analysis showed continued increase of abuse of prescription drugs in urban, suburban, and rural areas. The most commonly abused drugs include oxycodone, hydrocodone, hydromorphone, morphine, codeine, clonazepam, alprazolam, lorazepam, diazepam and carisoprodol. The diversion of prescription controlled substances to illicit channels is a public health and safety issue. This review describes the role of controlled substances in chronic pain management, prevalence and economic impact of controlled substance abuse, prescription accountability, effectiveness of prescription monitoring programs, and rationale for national controlled substance electronic reporting system.
Woika, Shirley; Bowersox, Carissa
Teachers and teachers-in-training are mandated reporters; they are legally required to report any suspected child abuse or neglect. This article describes: (1) How to file a report; (2) How prevalent child abuse is; (3) What abuse is; (4) What it means to be a mandated reporter; (5) When the report should be made; and (6) What to do if abuse is…
Full Text Available Joseph V Pergolizzi, Jr,1 Robert Taylor Jr,1 Jo Ann LeQuang,1 Robert B Raffa2,3 On behalf of the NEMA Research Group 1NEMA Research Inc., Naples, FL, USA; 2University of Arizona College of Pharmacy, Tucson, AZ, USA; 3Temple University School of Pharmacy, Philadelphia, PA, USA Abstract: Proper management of severe pain represents one of the most challenging clinical dilemmas. Two equally important goals must be attained: the humanitarian/medical goal to relieve suffering and the societal/legal goal to not contribute to the drug abuse problem. This is an age-old problem, and the prevailing emphasis placed on one or the other goal has resulted in pendulum swings that have resulted in either undertreatment of pain or the current epidemic of misuse and abuse. In an effort to provide efficacious strong pain relievers (opioids that are more difficult to abuse by the most dangerous routes of administration, pharmaceutical companies are developing products in which the opioid is manufactured in a formulation that is designed to be tamper resistant. Such a product is known as an abuse-deterrent formulation (ADF. ADF opioid products are designed to deter or resist abuse by making it difficult to tamper with the product and extracting the opioid for inhalation or injection. To date, less than a dozen opioid formulations have been approved by the US Food and Drug Administration to carry specific ADF labeling, but this number will likely increase in the coming years. Most of these products are extended-release formulations. Keywords: oxycodone/naltrexone, abuse-deterrent formulation, abuse-deterrent opioid, oxycodone, abuse liability
Negus, S. Stevens; Banks, Matthew L.
Here we describe methods for preclinical evaluation of candidate medications to treat opioid abuse and dependence. Our perspective is founded on the propositions that (1) drug self-administration procedures provide the most direct method for assessment of medication effects, (2) procedures that assess choice between opioid and nondrug reinforcers are especially useful, and (3) the states of opioid dependence and withdrawal profoundly influence both opioid reinforcement and the effects of candidate medications. Effects of opioid medications on opioid choice in nondependent and opioid-dependent subjects are reviewed. Various nonopioid medications have also been examined, but none yet have been identified that safely and reliably reduce opioid choice. Future research will focus on (1) strategies for increasing safety and/or effectiveness of opioid medications, and (2) continued development of nonopioids such as inhibitors of endocannabinoid catabolic enzymes or inhibitors of opioid-induced glial activation. PMID:23125072
Cho, Dai Ok; Kim, Jae Phil; Kim, Deog Yoon; Yang, Hyung In; Koh, Eun Mi; Kim, Kwang Won; Choi, Young Kil [Kyung Hee University College of Medicine, Seoul (Korea, Republic of)
Drug abuse is widespread in worldwide and has been associated with neurologic complication. Zipeprol is one of drugs which been abused for psychological satisfaction in some adolescents. This agent is non-opioid antitussive agent, which is not legally considered as being capable of creating dependence or abuse liability at therapeutic serum levels. But it has been reported that acute or chronic overdose create neurologic complication such as convulsion as well as dependence. Recently we experienced six zipeprol abusers who admitted due to convulsion and variable neurologic symptoms. The aim of our study was to determine the role of Tc-99m- HMPAO brain SPECT in those patients. EEG and brain CT showed no abnormal finding, but brain SPECT showed focal or multiple perfusion abnormalities in frontal, parietal, occipital cortex, basal ganglia, thalamus and especially at temporal cortex. These results suggest that brain SPECT may be a useful diagnostic tool to evaluate the cerebral dysfunction induced by zipeprol abuse.
Cho, Dai Ok; Kim, Jae Phil; Kim, Deog Yoon; Yang, Hyung In; Koh, Eun Mi; Kim, Kwang Won; Choi, Young Kil
Drug abuse is widespread in worldwide and has been associated with neurologic complication. Zipeprol is one of drugs which been abused for psychological satisfaction in some adolescents. This agent is non-opioid antitussive agent, which is not legally considered as being capable of creating dependence or abuse liability at therapeutic serum levels. But it has been reported that acute or chronic overdose create neurologic complication such as convulsion as well as dependence. Recently we experienced six zipeprol abusers who admitted due to convulsion and variable neurologic symptoms. The aim of our study was to determine the role of Tc-99m- HMPAO brain SPECT in those patients. EEG and brain CT showed no abnormal finding, but brain SPECT showed focal or multiple perfusion abnormalities in frontal, parietal, occipital cortex, basal ganglia, thalamus and especially at temporal cortex. These results suggest that brain SPECT may be a useful diagnostic tool to evaluate the cerebral dysfunction induced by zipeprol abuse.
Wainwright, Verity; Lennox, Charlotte; McDonnell, Sharon; Shaw, Jenny; Senior, Jane
Ex-armed forces personnel constitute the largest known occupational group in prison but there is little evidence regarding their mental health, or substance misuse, needs. A total of 105 participants were interviewed and measures assessing symptoms of common mental health (CMH) problems and substance misuse were completed along with a review of their health care records. Forty (38%) participants screened for current CMH problems (CCMH) and high levels of dual symptomology and alcohol misuse were assessed. Thirty-nine (37%) had a mental health diagnosis recorded, most commonly for post-traumatic stress disorder (PTSD), depression and personality disorder. Those who screened for a CCMH problem were more likely to have pre-service vulnerability to negative health outcomes and those with dual symptomology were more likely to have experienced deployment during their service. Findings suggest the mental health needs of this group are similar to the general prison population. Potentially higher prevalences of PTSD and alcohol misuse may direct service provision.
Yue, M.; Cheng, L.-Y.; Bari, R.
Misuse of declared nuclear facilities is one of the important proliferation threats. The robustness of a facility against these threats is characterized by a number of proliferation resistance (PR) measures. This paper evaluates and compares PR measures for several misuse scenarios using a Markov model approach to implement the pathway analysis methodology being developed by the PR and PP (Proliferation Resistance and Physical Protection) Expert Group. Different misue strategies can be adopted by a proliferator and each strategy is expected to have different impacts on the proliferator's success. Selected as the probabilistic measure to represent proliferation resistance, the probabilities of the proliferator's success of misusing a hypothetical ESFR (Example Sodium Fast Reactor) facility system are calculated using the Markov model based on the pathways constructed for individual misuse scenarios. Insights from a comparison of strategies that are likely to be adopted by the proliferator are discussed in this paper.
Reinhart, Michael A.
Reports of male victims (N=189) of child sexual abuse were retrospectively reviewed. Comparison to an age- and race-matched group of female victims revealed similarities in patterns of disclosure and perpetrator characteristics. (Author/DB)
... Showing private parts ("flashing"), forcing children to watch pornography, verbal pressure for sex, and exploiting children as prostitutes or for pornography can be sexual abuse as well. Researchers estimate ...
García Ampudia, Lupe; Orellana M., Oswaldo; Pomalaya V., Ricardo; Yanac Reynoso, Elisa; Malaver S., Carmela; Herrera F., Edgar; Sotelo L., Noemi; Campos C., Lilia; Sotelo L., Lidia; Orellana García, Daphne; Velasquez M., Katherine
The objective of this research is the study of the abuse rising in two generations, of parents and children and establishing the relationship between background child’s abuse with the potential abuse. The sample is comprised of 441 students and 303 parents who agreed to answer the Memories of Abuse Questionnaire. The used instruments were the Child History Questionnaire adapted for the purpose of this research, the Inventory of Potential Child Abuse (Milner, J. 1977), adapted by De Paul, Arru...
McCabe, Brian E; Schaefer Solle, Natasha; Peragallo Montano, Nilda; Mitrani, Victoria B
Alcohol misuse and depressive symptoms have been linked to HIV/STI risk, but studies have rarely included Hispanic women, who have over four times greater HIV incidence than white, non-Hispanic women. Understanding the connections among alcohol misuse, depressive symptoms, and HIV/STI risks may suggest ways to meet specific needs of Hispanic women. This study's objective is to examine the relationships among alcohol misuse, depressive symptoms, and seven HIV/STI risk factors. Five hundred forty-eight US Hispanic women with intake data from a randomized trial were assessed for alcohol misuse (CAGE) and depressive symptoms (CES-D). GZLM and path analyses tested relationships between alcohol misuse or depressive symptoms and HIV/STI risk factors. Self-efficacy and condom use were not related to alcohol misuse or depressive symptoms, but only 15% of women reported consistent condom use. After controlling for demographics, women with alcohol misuse had significantly more perceived HIV/STI risk (OR = 2.15) and better HIV/STI knowledge (β = -.54); and women with depressive symptoms had significantly more perceived HIV/STI risk (OR = 1.76) and worse HIV/STI knowledge (β = .37). Interventions to increase condom use for Hispanic women are needed, regardless of mental disorders. Working with Hispanic women with alcohol misuse or depressive symptoms presents a need (and opportunity) to address issues directly related to HIV/STI risk. Women's health practitioners have an excellent opportunity to reach women by implementing regular screening programs in clinics that serve Hispanic women. For women with high depressive symptoms, poor HIV/STI knowledge should also be addressed. Future studies should test whether integrated and tailored risk reduction interventions affect these factors and lower HIV/STI risk for Hispanic women.
Lehavot, Keren; Williams, Emily C; Millard, Steven P; Bradley, Katharine A; Simpson, Tracy L
Sexual minority women report greater alcohol misuse than heterosexual women in the general population, with more pronounced differences found among younger age groups. It is unknown whether these differences exist among women veterans. We evaluated differences in alcohol misuse across two dimensions of sexual orientation (identity and behavior) among women veterans, and examined whether these differences were modified by age. Women veterans were recruited via the internet to participate in an online survey. Participants provided information on their self-reported sexual identity and behavior and responded to the validated 3-item Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C). Regression models were used to compare the prevalence of alcohol misuse (AUDIT-C ≥ 3) and severity (AUDIT-C scores) across sexual identity and behavior and to test effect modification by age. Among the 702 participants (36% lesbian/bisexual), prevalence and severity of alcohol misuse varied by both sexual identity and behavior, but there were significant interactions with age. Prevalence and severity of alcohol misuse were higher among relatively younger self-identified lesbians compared to heterosexual women. Similarly, both prevalence and severity of alcohol misuse were generally higher among younger women who had any sex with women compared to those who had sex only with men. In this online study of women veterans, younger sexual minority women were more likely to screen positive for alcohol misuse, and they had more severe alcohol misuse, than their heterosexual counterparts. Prevention and treatment efforts focused specifically on sexual minority women veterans may be needed.
Ali, Kamal; Rosser, Thomas; Bhat, Ravindra; Wolff, Kim; Hannam, Simon; Rafferty, Gerrard F.; Greenough, Anne
Objectives: To determine at the peak age for sudden infant death syndrome (SIDS) the ventilatory response to hypoxia of infants whose mothers substance misused in pregnancy (SM infants), or smoked during pregnancy (S mothers) and controls whose mothers neither substance misused or smoked. In addition, we compared the ventilatory response to hypoxia during the neonatal period and peak age of SIDS. Working hypothesis: Infants of S or SM mothers compared to control infants would have a poorer ve...
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Misuse of the word âpearl.â 23.19 Section 23... JEWELRY, PRECIOUS METALS, AND PEWTER INDUSTRIES § 23.19 Misuse of the word “pearl.” (a) It is unfair or deceptive to use the unqualified word “pearl” or any other word or phrase of like meaning to describe...
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Misuse of the word âgem.â 23.25 Section 23... JEWELRY, PRECIOUS METALS, AND PEWTER INDUSTRIES § 23.25 Misuse of the word “gem.” (a) It is unfair or deceptive to use the word “gem” to describe, identify, or refer to a ruby, sapphire, emerald, topaz, or...
MCLELLAN, A. THOMAS
This paper first introduces important conceptual and practical distinctions among three key terms: substance “use,” “misuse,” and “disorders” (including addiction), and goes on to describe and quantify the important health and social problems associated with these terms. National survey data are presented to summarize the prevalence and varied costs associated with misuse of alcohol, illegal drugs, and prescribed medications in the United States.
Full Text Available Jarrett M Burns, Edward W Boyer Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA Abstract: Abuse of antitussive preparations is a continuing problem in the United States and throughout the world. Illicit, exploratory, or recreational use of dextromethorphan and codeine/promethazine cough syrups is widely described. This review describes the pharmacology, clinical effects, and management of toxicity from commonly abused antitussive formulations. Keywords: dextromethorphan, purple drank, sizzurp, codeine/promethazine
This article investigates the relationship between sexual abuse, power and the body from a Catholic theological viewpoint. The article starts with the relationship between sexual abuse and power. It is argued that sexual abuse is always a form of power abuse. A second step examines the relation between sexual abuse and the body. We may not ignore the theme of the body when we speak about sexual abuse as a form of power abuse. The article also explores whether the body is a theme in recent (th...
Hernandez, Lynn; Rodriguez, Ana Maria; Spirito, Anthony
Synopsis Research has consistently shown that a lack of parental involvement in the activities of their children predicts initiation and escalation of substance use. Parental monitoring, as well as youth disclosure about their whereabouts, parent child communication, positive parenting and family management strategies, e.g., consistent limit setting, and parental communication about and disapproval of substance use, have all been shown to protect against adolescent substance abuse and substance problems. Given the empirical evidence, family and parenting approaches to preventing and intervening on adolescent substance misuse have received support in the literature. This article discusses the theoretical foundations as well as the application of the Family Check-up, a brief family-based intervention for adolescent substance use. PMID:26092741
LeClair, Amy; Kelly, Brian C; Pawson, Mark; Wells, Brooke E; Parsons, Jeffrey T
As part of a larger study on prescription drug misuse among young adults active in urban nightlife scenes, we examined participants' motivations for misuse. Prescription painkillers, stimulants and sedatives were the primary substances of interest. Participants were recruited from nightlife venues in New York using time-space sampling. Subjects completed a mixed-methods assessment at project research offices. The data presented here are from a subsample of 70 qualitative interviews conducted during the baseline assessment. We identified experimentation and a "work hard, play hard" ethos as key motivations for misusing prescription drugs and argue that these motivations are specific, though not necessarily unique, to the participants' social location as young adults. These findings highlight the role of life stage and social context in the misuse of prescription drugs. Future studies of prescription drug misuse should pay attention to the larger social contexts in which users are embedded and, therefore, make decisions about how and why to misuse. Moving beyond the very broad concepts of "recreation" and "self-medication" presently established in the research, policies targeting young adults may want to tailor intervention efforts based on motivations.
Walton, Jessica L; Raines, Amanda M; Cuccurullo, Lisa-Ann J; Vidaurri, Desirae N; Villarosa-Hurlocker, Margo C; Franklin, C L
Prior research has revealed a strong relationship between Posttraumatic Stress Disorder (PTSD) and alcohol misuse. However, previous attempts to understand nuanced associations between PTSD symptom clusters and alcohol misuse within military veteran samples have produced mixed results. In an attempt to better understand the associations between PTSD and alcohol misuse, the current study examined the unique relationships between the newly classified Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) PTSD symptom clusters and alcohol misuse in an outpatient sample of military veterans seeking treatment for PTSD and Substance Use Disorders. Veterans (N = 100) were administered a brief battery of self-report questionnaires prior to receiving psychological services to aid in diagnostic assessment and treatment planning. Hierarchical regression analyses revealed that PTSD intrusions (cluster B), negative alterations in cognition and mood (cluster D), and arousal/reactivity (cluster E) symptoms were associated with alcohol misuse. The positive association between alcohol misuse and PTSD symptom severity is consistent with a broader body of literature demonstrating the co-occurrence of these disorders, particularly in military samples. Increased alcohol consumption may interfere with current front-line treatments for PTSD, which encourages patients to experience a full range of emotions. As such, future research should explore the impact of substance use on the effectiveness of trauma focused treatments in the alleviation of DSM-5 PTSD symptoms. (Am J Addict 2018;27:23-28). © 2017 American Academy of Addiction Psychiatry.
Giordano, Amanda L; Prosek, Elizabeth A; Reader, Emily A; Bevly, Cynthia M; Turner, Kori D; LeBlanc, Yvette N; Vera, Ryan A; Molina, Citlali E; Garber, Sage Ann
Prescription stimulant medication is commonly used to treat attention-deficit hyperactivity disorder (ADHD). However, stimulant medication misuse is a prevalent problem among the college population. There is limited research on psychological factors associated with collegiate nonmedical stimulant misuse. To examine the association between college students' self-worth and stimulant medication misuse. A quantitative study implemented during the 2013-2014 academic year in which we utilized a convenience sample of undergraduate students at a public university. College students (N = 3,038) completed an electronic survey packet including a stimulant use index and the Contingencies of Self-Worth Scale. We conducted descriptive discriminant analysis (DDA) to measure the associations between four groups: Nonusers, Appropriate Users, Nonprescribed Misusuers, and Prescribed Users. Significant differences in contingencies of self-worth existed between the four groups of students. Specifically, external contingencies of self-worth, such as appearance and approval, were associated with stimulant medication misuse, whereas, internal contingencies of self-worth, such as God's love and virtue, were associated with nonuse and appropriate prescribed use. Conclusions/Importance: The findings of the current study suggested contingencies of self-worth partially explain prescription stimulant misuse among the collegiate population. Addressing self-worth may be helpful in the treatment of stimulant misuse with college students.
The natural Rn isotopes were discovered within the period 1899-1902 and at that time referred to as emanations because they came out (emanated) of sources/materials containing actinium, thorium and radium, respectively. The (somewhat mysterious) emanations appeared to disintegrate into radioactive decay products which by depositing at solid surfaces gave rise to 'induced' radioactivity i.e. radioactive substances with various half-lives. Following the discovery of the emanations the volume of the research involving them and their disintegration products grew steeply. The identity of a number of these radioactive products was soon established. Radium emanation was soon used as a source of RaD ( 210 Pb) to be applied as an 'indicator' (radiotracer) for lead in a study on the solubility of lead sulphide and lead chromate. Moreover, radium and its emanation were introduced into the medical practice. Inhaling radon and drinking radon-containing water became an accepted medicinal use (or misuse?) of that gas. Shortly after the turn of the century, the healing (?) action of natural springs (spas) was attributed to their radium emanation, i.e. radon. Bathing in radioactive spring water and drinking it became very popular. Even today, bathing in radon-containing water is still a common medical treatment in Jachymov, Czech Republic. (author)
Marino, Michael J
Descriptive, exploratory, and inferential statistics are necessary components of hypothesis-driven biomedical research. Despite the ubiquitous need for these tools, the emphasis on statistical methods in pharmacology has become dominated by inferential methods often chosen more by the availability of user-friendly software than by any understanding of the data set or the critical assumptions of the statistical tests. Such frank misuse of statistical methodology and the quest to reach the mystical αstatistical training. Perhaps more critically, a poor understanding of statistical tools limits the conclusions that may be drawn from a study by divorcing the investigator from their own data. The net result is a decrease in quality and confidence in research findings, fueling recent controversies over the reproducibility of high profile findings and effects that appear to diminish over time. The recent development of "omics" approaches leading to the production of massive higher dimensional data sets has amplified these issues making it clear that new approaches are needed to appropriately and effectively mine this type of data. Unfortunately, statistical education in the field has not kept pace. This commentary provides a foundation for an intuitive understanding of statistics that fosters an exploratory approach and an appreciation for the assumptions of various statistical tests that hopefully will increase the correct use of statistics, the application of exploratory data analysis, and the use of statistical study design, with the goal of increasing reproducibility and confidence in the literature. Copyright © 2013. Published by Elsevier Inc.
Ossiander, Eric M
Volatile substance misuse (VSM - also known as huffing or sniffing) causes some deaths, but because there are no specific cause-of-death codes for VSM, these deaths are rarely tabulated. Count and describe VSM deaths occurring in Washington State during 2003-2012. We used the textual cause-of-death information on death certificates to count VSM-associated deaths that occurred in Washington State during 2003-2012. We extracted records that contained words suggesting either a method of inhalation or a substance commonly used for VSM, and reviewed those records to identify deaths on which the inhalation of a volatile substance was mentioned. We conducted a descriptive analysis of those deaths. Fifty-six deaths involving VSM occurred in Washington State during 2003-2012. VSM deaths occurred primarily among adults age 20 and over (91%), males (88%), and whites (93%). Twelve different chemicals were associated with deaths, but 1 of them, difluoroethane, was named on 30 death certificates (54%), and its involvement increased during the study period. Gas duster products were named as the source of difluoroethane for 12 deaths; no source was named for the other 18 difluoroethane deaths. Most VSM deaths occurred among white male adults, and gas duster products containing difluoroethane were the primary source of inhalants. Approaches to deter VSM, such as the addition of bitterants to gas dusters, should be explored.
Ali, Kamal; Rossor, Thomas; Bhat, Ravindra; Wolff, Kim; Hannam, Simon; Rafferty, Gerrard F; Peacock, Janet L; Greenough, Anne
Infants of smoking (S) and substance misusing (SM) mothers have an increased risk of sudden infant death syndrome. The aim of this study was to test the hypothesis that infants of SM or S mothers compared with infants of non-SM, non-smoking mothers (controls) would have a poorer ventilatory response to hypoxia, which was particularly marked in the SM infants. Physiological study. Tertiary perinatal centre. 21 SM; 21 S and 19 control infants. Infants were assessed before maternity/neonatal unit discharge. Maternal and infant urine samples were tested for cotinine, cannabinoids, opiates, amphetamines, methadone, cocaine and benzodiazepines. During quiet sleep, the infants were switched from breathing room air to 15% oxygen and changes in minute volume were assessed. The SM infants had a greater mean increase (p=0.028, p=0.034, respectively) and a greater magnitude of decline (pventilatory response to a hypoxic challenge. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Zakirhusain A Shaikh
Full Text Available Background and Aims: Epidemiological transition in the form of noncommunicable diseases (NCDs now becoming the main cause of mortality and morbidity is very much evident even in developing countries like India. Alcohol is an important risk factor for NCD. The use of alcohol is increasing especially in young people and women. This increased use can be attributed to aggressive and innovative marketing by alcohol, in spite of and due to restrictions on its marketing. Social media, in recent times, has been misused by alcohol companies for marketing their products legally, due to legal loophole. The present study examined the reach of alcohol companies on social media and the marketing strategies used by them. Design, Settings, Participants: Facebook, Twitter and YouTube were explored for accounts and content by alcohol companies for marketing their product. Policies of social media sites pertaining to alcohol marketing were also studied. Measurements: Alcohol marketing was measured in terms of content posted by alcohol companies, use of direct or surrogate advertisement and engagement with users. Findings: Alcohol companies have been conveniently using social media to target young urban population with direct and surrogate advertisements of their products. Current social media policies and laws are ineffective in controlling it. Conclusions: Amendment of laws pertaining to alcohol marketing to include social media also in its ambit is necessary. Social media sites should revise their policies to prevent alcohol marketing and promotion especially to underaged users.
Meltzer, Howard; Ford, Tamsin; Bebbington, Paul; Vostanis, Panos
The primary aim of this study is to examine the extent to which running away from home as a child is associated with behavioral problems and victimization during childhood and with suicidal behavior and substance abuse during early adulthood. A random probability sample comprising 7,461 respondents was interviewed for the 2007 survey of psychiatric morbidity of adults in England. A subsample of 16- to 34-year-old individuals was selected for secondary analysis (N = 2,247). All survey respondents were asked whether they had run away from home and asked specific questions on being physically, emotionally and sexually abused as children. They were also asked about suicidal behavior and alcohol and drug dependence in early adulthood. Approximately 7% of 16- to 34-year-old individuals reported running away from home before the age of 16 years, with higher rates in women than in men (9.8% compared with 5.3%). Overall, 45.3% reported being bullied, 25.3% experienced violence at home, and 8.8% reported unwanted sexual intercourse. Runaways were far more likely than other children to have suffered victimization and family difficulties and to exhibit behavioral problems. Adults who reported running away from home were three times more likely than other adults to have thought about or attempted suicide, but the relationship with substance abuse was far less pronounced. Sexual, physical, and emotional abuse, along with family difficulties, can all impact children who run away from home. Running away from home was strongly associated with suicidal behavior in adulthood, regardless of other childhood adversities. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Mysyuk, Yuliya; Westendorp, Rudi Gerardus Johannes; Lindenberg, Jolanda
independently, in residential care facilities and nursing homes. SUBJECTS: six males and 11 females aged 63-90 years. RESULTS: the main causes of abuse identified by older victims themselves were mutual dependency between victim and perpetrator, power and control imbalances, loneliness and a marginalised social...... with the perpetrator. Coping strategies mentioned by victims were seeking informal or professional help and using self-help strategies. CONCLUSION: older victims perceive abuse differently depending on the expected acceptability of the type(s) of abuse experienced and the anticipated stigma associated...
Lokuge, Kamalini; Wallace, Polly; Subasinghe, Kalini; Thurber, Katherine; De Silva, Tissa; Clarke, Naomi; Waas, Dulshika; Liyanage, Nisansala; Attygalle, Udena; Carron-Arthur, Bradley; Rodrigo, Kalyana; Banks, Emily; D'Este, Cate; Rajapakse, Thilini
Past research has identified links between intimate partner violence (IPV) and alcohol misuse and poverty in Sri Lanka. Services that address substance misuse are amongst the few interventions shown to reduce IPV in settings similar to Sri Lanka. This paper describes the protocol for a study examining the impact of a preschool-based capacity building intervention on the prevalence of IPV and substance misuse in parents with children attending preschools, including uptake of available government services. The study is a cluster randomised controlled trial. Government-managed preschools (n = 34) in Galle and Colombo municipalities will be randomly assigned to an intervention (n = 17) or control group (n = 17). Parents with children attending these preschools will be recruited to participate. The study intervention will build the capacity of selected community volunteers (parents) and preschool teachers in the provision of information and support to families affected by IPV and substance misuse. This intervention is directed at improving uptake, access and coordination of existing services. Data will be collected from all parents, and teachers in the intervention group, pre-intervention and 10 months post-intervention. The primary outcome for this study is experience of IPV amongst mothers of preschool-attending children. Secondary outcomes are substance misuse amongst fathers, measured via the locally adapted Alcohol Use Disorders Identification Test and Drug Abuse Screening Test; and awareness and uptake of services for these issues measured through locally-relevant tools. Demographic information and satisfaction with the intervention will also be assessed. By intervening through preschools we aim to support high-risk families early enough to arrest the cycle of violence that results in children themselves becoming victims and perpetrators of such violence. The innovative project design will reach the most vulnerable sections of the community and will
Rafiu Ibrahim Adebayo
Full Text Available The proliferation of places of worship and the increase in the number of devotees of religions are considered by many to be a welcome development, but their adverse effects on environmental degradation have hardly been considered. This paper attempts to study the role or the abuse of religion on environmental pollution and its implications for sustainable development in Nigeria. Based upon primary and secondary information, this study found that religion has largely been misused by its practitioners resulting in environmental pollution, with a serious negative influence on sustainable development. The paper further suggests possible solutions to this problem on the basis of Islamic injunctions for sustainable environmental development.
Easton, Scott D; Renner, Lynette M; O'Leary, Patrick
Men who were sexually abused during childhood are at risk for a variety of long-term mental health problems, including suicidality. However, little is known about which factors are related to recent suicide attempts for this vulnerable, under-researched population. The purpose of this study was to examine the relationship between abuse severity, mental health, masculine norms and recent suicide attempts among men with histories of child sexual abuse (CSA). We analyzed survey data gathered from a purposive sample of 487 men who were sexually abused during childhood. The age of the sample ranged from 19 to 84 years (μ = 50.4 years). Recent suicide attempts served as the dependent variable in the study. Self-reported measures of sexual abuse severity, child physical abuse, mental health, masculine norms, and demographic information (age, race) represented the independent variables. The results from logistic regression modeling found that five variables - duration of the sexual abuse, use of force during the sexual abuse, high conformity to masculine norms, level of depressive symptoms, and suicidal ideation - increased the odds of a suicide attempt in the past 12 months. To improve mental health services for men with histories of CSA, mental health practitioners should incorporate sexual abuse severity, current mental health, and adherence to masculine norms into assessment and treatment planning. Copyright © 2013 Elsevier Ltd. All rights reserved.
Grosshans, Martin; Lemenager, Tagrid; Vollmert, Christian; Kaemmerer, Nina; Schreiner, Rupert; Mutschler, Jochen; Wagner, Xenija; Kiefer, Falk; Hermann, Derik
Pregabalin is a novel GABA-analogue approved for the treatment of partial onset seizures, neuropathic pain, and general anxiety disorder. Pregabalin has been classified as a Schedule V drug with a low risk of inflicting abuse or addiction. However, some publications have indicated that pregabalin may have a potential for abuse among patients with past or current opiate addiction. Thus, we hypothesized that pregabalin might be abused by patients who were undergoing an opiate replacement therapy and never had an indication for taking pregabalin on medical grounds. Urine specimens from 124 patients with opiate dependency syndrome and from 111 patients with other addiction disorders (alcohol, benzodiazepines, cannabis, amphetamines) were screened for pregabalin by means of a mass spectrometer analysis. We found 12.1 % of all urine specimens from patients with opiate addiction to be positive for pregabalin. None of the patients concerned had a medical indication for using pregabalin. In the control group, 2.7 % of the patients were tested positively for pregabalin, due to their taking it regularly for chronic pain or general anxiety. Our data suggest that pregabalin is liable to be abused among individuals with opiate dependency syndrome Thus, vigilance and caution are called for when patients with a past or current opiate dependency are exposed to treatment with pregabalin.
Full Text Available Introduction and Aim. Further gains in the prevention of drug abuse disorders require in-depth and holistic understanding of the risk factors of addiction from different perspectives. Lay persons and experts have different concepts of risk which could complement each other. The purpose of this study was to elaborate drug abuse risk factors through the story of individuals who had become drug dependent. Design and Methods. In this qualitative research, 33 individuals attending treatment centres for drug abuse were interviewed about the story of their addiction in Kerman, Iran. Interview questions were around the story of the participants. Results. All participants were male and in the age range of 18–40 years. Narrative analysis identified five themes as the main risk factors: family factors, peer pressure, the effect of gateway drugs (especially waterpipe, individual characteristics, and the community factors. More emphasis was placed upon the role of family factors, peer influence, and gateway effect. Discussion and Conclusion. This study elicited information from drug dependent subjects regarding the risk factors of drug abuse. According to drug dependent individuals’ views, more attention should be devoted to family and peer influences by policy makers, in developing culture-based preventive strategies.
Kraanen, F.L.; Emmelkamp, P.M.G.
Substance abuse has often been associated with committing sex offenses. In this article, the following will be reviewed: 1) studies that assessed substance abuse in sex offenders; 2) differences in substance abuse among different types of sex offenders; 3) differences in substance abuse between sex
Rogers, Steven C; Gallo, Karen; Saleheen, Hassan; Lapidus, Garry
Despite national, state, and hospital policies that require newborns to be transported in correctly used child safety seats (CSSs), significant CSS misuse frequently occurs among newborn infants. The objective of this study was to evaluate a comprehensive educational CSS training program for nurses and parents in a maternal/newborn unit. In the preintervention phase, we conducted a survey among maternal/newborn unit nurses in a large urban teaching hospital to measure CSS knowledge, attitude, and practice. We then enrolled 60 maternal-newborn dyads at discharge to survey maternal CSS knowledge and observe the CSS misuse rate. Our intervention phase included a 1-hour "mandatory" nurse CSS education classroom session, a nurse hands-on CSS demonstration and practice in a mother's room. During the postintervention phase, we enrolled 70 maternal-newborn dyads at discharge to survey maternal CSS knowledge and observe change in CSS misuse rate. In the preintervention phase, 43 (73%) of 59 eligible nurses completed the survey, and 47 (80%) of 59 completed the CSS education and training program. In the preintervention CSS survey, 23% of the nurses reported that education is part of their routine, 44% have CSS educational materials, 32% feel comfortable providing CSS education to parents, 12% feel CSS trained, 25% have time, 84% identify that CSS misuse is a problem, and 16% received CSS training.Enrolled mothers reflect maternal/newborn unit demographics as follows: maternal mean age of 29 years (range, 16-48 years), white (54%), black (11%), Hispanic origin (28%), English as primary language (83%), high school degree (31%), college degree (30%), Medicaid (23%), and private insurance (65%).Of 70 postintervention mothers, 44% reported receiving no nurse education, 21% reported receiving a brochure only, and 31% reported receiving nurse education. CSS misuse among mothers who received registered nurse education was not reduced compared with mother's who received a brochure
Jogerst, Gerald J; Daly, Jeanette M; Galloway, Lara J; Zheng, Shimin; Xu, Yinghui
Substance abuse by either victim or perpetrator has long been associated with violence and abuse. Sparse research is available regarding elder abuse and its association with substance abuse. The objective of this study was to evaluate the association of state-reported domestic elder abuse with regional levels of substance abuse. Census demographic and elder abuse data were sorted into substate regions to align with the substance use treatment-planning regions for 2269 US counties. From the 2269 US counties there were 229 substate regions in which there were 213,444 investigations of abuse. For the other Ns (reports and substantiations) there were fewer counties and regions. See first sentence of data analyses and first sentence of results. Elder abuse report rates ranged from .03 to .41% (80 regions), investigation rates .001 to .34% (229 regions), and substantiation rates 0 to .22% (184 regions). Elder abuse investigations and substantiations were associated with various forms of substance abuse. Higher investigation rates were significantly associated with a higher rate of any illicit drug use in the past month, a lower median household income, lower proportion of the population graduated high school, and higher population of Hispanics. Higher substantiation rates were significantly associated with higher rate of illicit drug use in the past month and higher population of Hispanics. It may be worthwhile for administrators of violence programs to pay particular attention to substance abuse among their clients and in their community's environment, especially if older persons are involved. Measures of documented elder abuse at the county level are minimal. To be able to associate substance abuse with elder abuse is a significant finding, realizing that the substance abuse can be by the victim or the perpetrator of elder abuse.
Rojas, Patria; Dillon, Frank R.; Duan, Rui; De La Rosa, Mario
This paper focuses on the importance of family member closeness as a protective factor against domestic abuse. We explore the link between long-lasting relations within the family and intra-familial violence perpetrated against women in Latino households in South Florida. We use data from an Inter-generational Transmission of Drug Use between Latina Mothers and Daughters (ITDMD) study. The study includes data on family relations and domestic abuse. We estimate a series of multivariate regressions to obtain the probability of abuse against women, the types of abuse inflicted and the relationship with the abusers. Our results indicate that among abused women, the effects of long-lasting relations within the family differ depending on the type of relationship between the abuser and the victim and the degree of closeness the victim feels towards other family members. Given these findings, there is a need to further study family relations and abuse in Latino households. PMID:29033494
Nelson, Michael E; Bryant, Sean M; Aks, Steven E
Many new emerging drugs of abuse are marketed as legal highs despite being labeled "not for human consumption" to avoid regulation. The availability of these substances over the Internet and in "head shops" has lead to a multitude of emergency department visits with severe complications including deaths worldwide. Despite recent media attention, many of the newer drugs of abuse are still largely unknown by health care providers. Slight alterations of the basic chemical structure of substances create an entirely new drug no longer regulated by current laws and an ever-changing landscape of clinical effects. The purity of each substance with exact pharmacokinetic and toxicity profiles is largely unknown. Many of these substances can be grouped by the class of drug and includes synthetic cannabinoids, synthetic cathinones, phenethylamines, as well as piperazine derivatives. Resultant effects generally include psychoactive and sympathomimetic-like symptoms. Additionally, prescription medications, performance enhancing medications, and herbal supplements are also becoming more commonly abused. Most new drugs of abuse have no specific antidote and management largely involves symptom based goal directed supportive care with benzodiazepines as a useful adjunct. This paper will focus on the history, epidemiology, clinical effects, laboratory analysis, and management strategy for many of these emerging drugs of abuse. Copyright © 2014 Elsevier Inc. All rights reserved.
Osvalder, Anna-Lisa; Bohman, Katarina
Booster cushions are effective tools to protect children from injuries in car crashes, but there remains a large amount of misuse. The aim of this study was to assess potential misuse of booster cushions in an observational laboratory study, and to identify whether booster cushion design, age or clothing had any effect. 130 Swedish children from the ages of 4-12 years participated. Each child buckled up on an integrated and on an aftermarket booster cushion in the rear seat. The older children also buckled up with seat belt only. Interviews, observations and body measurements were performed. Time to buckle up and amount of belt slack were registered. Photographs were taken to document misuse. Results showed that 77% failed to perform correct belt routing on the aftermarket cushion, independent of age, although they were familiar with this system. The misuse rate for the integrated cushion was only 4%. No misuse was found for seat belt only. Few children tightened the belt. The belt slack increased when wearing winter jackets. This indicates the importance of adding pretensioners to the rear seat. Sled tests with HIII&TNO 6y dummies were also performed for the most frequent misuse situations found. The main conclusion is that an integrated booster cushion has many advantages compared to an aftermarket cushion regarding both safety and comfort. It is easy and quick to handle, has few possibilities for misuse, has an intuitive design, the buckling up sequence is equal to buckling up with an ordinary seat belt, and younger children can buckle up correctly.
Barth, Kelly S; Balliet, Wendy; Pelic, Christine M; Madan, Alok; Malcolm, Robert; Adams, David; Morgan, Katherine; Owczarski, Stefanie; Borckardt, Jeffrey J
The objective of this study is to assess clinical variables that may be associated with risk for opioid misuse in individuals with chronic pancreatitis. This study utilized a descriptive, quasi-experimental, cross sectional design. Three hundred seven individuals with nonalcoholic chronic pancreatitis engaged in chronic opioid therapy for pain presented to an outpatient specialty clinic at an academic medical center. Participants completed the Current Opioid Misuse Measure (COMM), Brief Pain Inventory (BPI), Short Form (SF)-12 Quality of Life Measure, Center for Epidemiological Studies 10-item Depression Scale (CESD), and a single item asking about current alcohol use. Mean scores on the CESD, COMM, BPI, SF-12, and factors associated with opioid misuse measures from regression analyses were the outcome measures. Mean scores on the CESD, COMM, BPI pain-on-average item, and the SF-12 physical and psychological quality of life factors (t scores) were 11.2 (standard deviation [SD] = 6.7), 8.5 (SD = 7.3), 4.8 (SD = 2.8), 39.7 (SD = 7.0), and 45 (SD = 9.0), respectively. Descriptive analyses revealed that 55% of participants scored above the clinical cutoff for depression on the CESD, and 39% scored above the cutoff for opioid misuse concerns on the COMM. Regression analyses identified several factors associated with higher opioid misuse measure scores, including increased depressive symptoms from the CESD (β = 0.38, P factors accounted for 37% of the variance in current opioid misuse scores. Depression, quality of life, pain intensity and alcohol use may be good candidate variables for prospective studies to determine clinical risk factors for opioid misuse among patients with pancreatitis. Wiley Periodicals, Inc.
Kirk, David Anthony; Park, Allysia C; Smith, Adam C; Howes, Briar J; Prouse, Brigid K; Kyssa, Naschelly G; Fairhurst, Elizabeth N; Prior, Kent A
The foundational concept of habitat lies at the very root of the entire science of ecology, but inaccurate use of the term compromises scientific rigor and communication among scientists and nonscientists. In 1997, Hall, Krausman & Morrison showed that 'habitat' was used correctly in only 55% of articles. We ask whether use of the term has been more accurate since their plea for standardization and whether use varies across the broader range of journals and taxa in the contemporary literature (1998-2012). We searched contemporary literature for 'habitat' and habitat-related terms, ranking usage as either correct or incorrect, following a simplified version of Hall et al.'s definitions. We used generalized linear models to compare use of the term in contemporary literature with the papers reviewed by Hall et al. and to test the effects of taxa, journal impact in the contemporary articles and effects due to authors that cited Hall et al. Use of the term 'habitat' has not improved; it was still only used correctly about 55% of the time in the contemporary data. Proportionately more correct uses occurred in articles that focused on animals compared to ones that included plants, and papers that cited Hall et al. did use the term correctly more often. However, journal impact had no effect. Some habitat terms are more likely to be misused than others, notably 'habitat type', usually used to refer to vegetation type, and 'suitable habitat' or 'unsuitable habitat', which are either redundant or nonsensical by definition. Inaccurate and inconsistent use of the term can lead to (1) misinterpretation of scientific findings; (2) inefficient use of conservation resources; (3) ineffective identification and prioritization of protected areas; (4) limited comparability among studies; and (5) miscommunication of science-based findings. Correct usage would improve communication with scientists and nonscientists, thereby benefiting conservation efforts, and ecology as a science.
Roberto, Karen A
Elder abuse is a growing societal concern, affecting at least 1 in 10 older Americans. Researchers and practitioners alike consistently assert that a dramatic discrepancy exists between the prevalence rates of elder abuse and the number of elder abuse cases reported. As a field of study, recognition and understanding of elder abuse is still emerging. Comparing findings of a small, but growing, body of literature on perceived and substantiated cases of elder abuse is challenging because there is no uniform term or agreed-upon definition used among state governments, researchers, health care and service providers, and advocates. This article summarizes current understanding of elder abuse, including what constitutes elder abuse, risk factors for elder abuse, perpetrators of elder abuse, and outcomes of elder abuse. Issues associated with the detection of elder abuse and intervention strategies for victims of abuse are addressed. In the final section, potential roles and contributions of psychologists for advancing elder abuse research, professional practice, and policy development are highlighted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Full Text Available The causes of drug abuse and criminal behavior are closely linked. Not surprisingly, there is a high percentage of prisoners who during sentence execution abuse or are dependent on drugs. Antisocial personality disorder can be considered a common predictor of committing criminal offenses and drug abuse. A review of studies has revealed a high prevalence of inmates who use drugs while serving a sentence. Also, prison environment represents only a new context of the continuum of drug abuse by inmates. There are different theoretical approaches in explaining this phenomenon. Treatment programs based on empirically validated principles that guarantee the effectiveness, may be one strategy for solving the problem of drug abuse in prisons, with multiple positive effects.
Hayakawa, Momoko; Giovanelli, Alison; Englund, Michelle M; Reynolds, Arthur J
By the 12th grade, half of American adolescents have abused an illicit drug at least once (Johnston et al., 2015). Although many substance misuse prevention programs exist, we propose an alternative mechanism for reducing substance use. There is evidence that parent involvement is related to reductions in children's behavior problems which then predict later substance abuse. We examine the Child-Parent Center (CPC) program, an early childhood intervention, as a strategy to impact substance abuse. We conducted a path analysis from CPC to parent involvement through early adolescent problem behaviors and competencies to young adult substance abuse. Participants (N = 1,203; 51.5% female; 93.8% African-American) were assessed from age 3 to 26 years. CPC participation initiates a pathway to increased parent involvement and expectations, which positively impact adolescents' competencies and problem behaviors, lowering rates of substance abuse. Through early childhood education, increasing early parental involvement and expectations can alter life-course outcomes by providing children with a foundation for positive behaviors and encouraging adaptive functioning in adolescence. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
This study explored the manner in which abused women cope with loneliness. Eighty women, victims of domestic abuse, were compared to 84 women from the general population who have had no history of abusive relationships. A 34-item yes/no loneliness questionnaire was utilized in order to compare the "beneficial" ways of coping with loneliness in the…
... Research Synthesize and disseminate high quality research on elder abuse to encourage the translation of research into practice. ... to further the field for those interested in elder abuse identification and prevention. What’s Happening National Center on ...
... poor weight gain Emotional issues such as low self-esteem, depression, and anxiety Extreme behavior such as acting ... child was abused The success of therapy and parenting classes Alternative Names Neglect - child; Emotional abuse - child ...
Pediatricians and other medical providers caring for children need to be aware of the dynamics in the significant relationship between substance abuse and child maltreatment. A caregiver's use and abuse of alcohol, marijuana, heroin, cocaine, methamphetamine, and other drugs place the child at risk in multiple ways. Members of the medical community need to understand these risks because the medical community plays a unique and important role in identifying and caring for these children. Substance abuse includes the abuse of legal drugs as well as the use of illegal drugs. The abuse of legal substances may be just as detrimental to parental functioning as abuse of illicit substances. Many substance abusers are also polysubstance users and the compounded effect of the abuse of multiple substances may be difficult to measure. Often other interrelated social features, such as untreated mental illness, trauma history, and domestic violence, affect these families.
... for Families - Vietnamese Spanish Facts for Families Guide Child Abuse - The Hidden Bruises No. 5; Updated November 2014 The statistics on physical child abuse are alarming. It is estimated hundreds of thousands ...
Becker, Jill B.; Hu, Ming
Sex differences are present for all of the phases of drug abuse (initiation, escalation of use, addiction, and relapse following abstinence). While there are some differences among specific classes of abused drugs, the general pattern of sex differences is the same for all drugs of abuse. Females begin regularly self-administering licit and illicit drugs of abuse at lower doses than do males, use escalates more rapidly to addiction, and females are at greater risk for relapse following abstin...
Kennedy, Alison J; Mellor, David; McCabe, Marita P; Ricciardelli, Lina A; Brumby, Susan A; Head, Alexandra; Mercer-Grant, Catherine
Alcohol misuse by farmers continues to challenge rural nurses. This article reports on the experiences of Australian nurses participating in the Alcohol Intervention Training Program (AITP). Qualitative interviews of 15 rural and remote nurses. Semi-structured phone interviews were utilized to assess the response to and implementation of the AITP-an intervention designed to build nurses' knowledge, confidence and skills when responding to alcohol misuse. It comprises practical and theoretical components and was designed for rural and remote settings where nurses encounter alcohol misuse. Nurses found the training provided new-or built on existing-knowledge of alcohol misuse and offered practical hands-on "real life" skills. A range of workplace and personal situations where the content of the training was now being utilized were identified, and future use anticipated. Barriers to using the new knowledge and skills included both rural and generic issues. Constructive feedback to increasingly target the training to rural settings was recommended. The AITP is an effective training program. It can be further tailored to meet common needs of rural and remote nurses working with farmers who misuse alcohol, while recognizing diversity in rural practice. © 2013 Wiley Periodicals, Inc.
Victor, Bryan G; Grogan-Kaylor, Andrew; Ryan, Joseph P; Perron, Brian E; Gilbert, Terri Ticknor
Families that experience domestic violence and parental substance misuse are disproportionately involved with the child welfare system. Prior research suggests that child protective services (CPS) caseworkers are more likely to substantiate maltreatment allegations when domestic violence and parental substance misuse are identified during the investigation, pointing to one possible mechanism for this disproportionate involvement. While previous studies have relied on nationally representative data sets, the current study used administrative records from a large Midwestern child welfare agency that accounts for state-level variation in child welfare policy and practice. A total of 501,060 substantiation decisions made between 2009 and 2013 were examined to assess the influence of caseworker-perceived domestic violence and parental substance misuse on the decision to substantiate reported maltreatment. Results from multilevel modeling suggest that the identification of domestic violence and parental substance misuse during an investigation significantly increased the probability that an allegation would be substantiated. The implication of these findings for child welfare practice are considered in light of the fact that many child welfare agencies do not consider exposure to domestic violence and parental substance misuse in and of themselves to constitute child maltreatment. Copyright © 2018 Elsevier Ltd. All rights reserved.
Kylie A. Bailey
Full Text Available Although assault exposure is common in mental health and substance misusing populations, screening for assaults in treatment settings is frequently overlooked. This secondary analysis explored the effects of past sexual (SA and physical (PA assault on depression, alcohol misuse, global functioning and attrition in the Depression and Alcohol Integrated and Single focussed Intervention (DAISI project, whose participants (N = 278 received cognitive behaviour therapy (CBT for their depression and/or alcohol misuse. Of the 278 DAISI participants, 220 consented to screening for past assault (either by a stranger or non-stranger at baseline. Depression, alcohol, and global functioning assessments were administered at baseline and 3, 12, 24, and 36 months post baseline. A between-group analysis was used to assess differences between SA and No SA, and PA and No PA groupings, on adjusted mean treatment outcomes across all assessment periods. SA and PA participants had similar mean symptom reductions compared to No SA and No PA participants except for lower depression and global functioning change scores at the 12-month follow-up. People with coexisting depression and alcohol misuse reporting SA or PA can respond well to CBT for depression and alcohol misuse. However, follow-up is recommended in order to monitor fluctuations in outcomes.
How can you protect young people from the dangers of the internet, now that they are living increasingly hidden lives online? Cyber bullying, sexual harassment, cyber stalking--these are all risks that young people may face every day, and effective e-safety is more important than ever. This practical, hands-on resource will help you understand…
Murphy, Kieran; Waa, Sheila; Jaffer, Hussein; Sauter, Agnes; Chan, Amanda
To review the medical literature for reports on the types of physical injuries in elder abuse with the aim of eliciting patterns that will aid its detection. The databases of PubMed, CINAHL, EMBASE, and TRIP were searched from 1975 to March 2012 for articles that contained the following phrases: "physical elder abuse," "older adult abuse," "elder mistreatment," "geriatric abuse," "geriatric trauma," and "nonaccidental geriatric injury." Distribution and description of injuries in physical elder abuse from case-control studies, cross-sectional studies, case series, and case reports as seen at autopsy, in hospital emergency departments, or in medicolegal reports were tabulated and summarized. A review of 9 articles from a total of 574 articles screened yielded 839 injuries. The anatomic distribution in these was as follows: upper extremity, 43.98%; maxillofacial, dental, and neck, 22.88%; skull and brain, 12.28%; lower extremity, 10.61%; and torso, 10.25%. Two-thirds of injuries that occur in elder abuse are to the upper extremity and maxillofacial region. The social context in which the injuries takes place remains crucial to accurate identification of abuse. This includes a culture of violence in the family; a demented, debilitated, or depressed and socially isolated victim; and a perpetrator profile of mental illness, alcohol or drug abuse, or emotional and/or financial dependence on the victim. Copyright © 2013 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.
... maternal prescription drug abuse and dependence and resulting increases in opioid exposed babies with NAS and possibly other consequences. Misuse and abuse of, and dependence upon, prescription opioid drugs... access treatment through family medicine and gynecological practitioners, and specialty treatment...
Jirik, Stacey; Sanders, Sara
The purpose of this article is to describe the state elder abuse statutes in the United States and Washington DC during 2011-2012. The last review of elder abuse statutes occurred in 2001; thus, a reexamination is warranted given the increased awareness of elder abuse at the state and national level and the growing number of older adults in the United States. This descriptive study analyzed the following components of elder or dependent abuse statutes: definitions, reporting requirements, training, and consequences for failure to report. It was determined that differences remain in how states respond to elder abuse at the community-based level.
Putnam, Frank W.
The issues raised by Jonker and Jonker-Bakker and Young et al (EC 601 187-188) illustrate a major controversy dividing the child abuse community, the alleged existence of a conspiracy of satanic, ritual, sexual abuse of children. No evidence is found to support claims that large numbers of babies and children are being sacrificed or abused in…
Despite the prevailing agreement among researchers that the increasing rate of elder abuse in Israel is relatively understudied, not sufficiently identified, and not appropriately addressed, literature on elderly abuse in the Israeli society remains limited. The common discourse on aging, eldercare, and elder abuse and neglect, mainly revolves…
Scorzelli, James F.
This report examines the incidence of drug abuse and the methods of treatment and prevention of drug abuse used in Southeast Asia. Countries studied include Malaysia, Singapore, Thailand, Indonesia, and the Philippines. Because of Malaysia's intensive effort to eliminate its drug abuse problem, emphasis is placed on this country's treatment and…
Brunt, T.M.; Noorden, M.S. van; Kamal, R.M.; Dijkstra, B.A.G.; Jong, C.A.J. de; Preedy, V.
Gamma-hydroxybutyrate (GHB) has been used as a recreational drug in the nightlife setting since the 1990s in many Western countries. Problematic GHB use and addiction has been observed in certain countries recently. In this chapter, the epidemiology of GHB addiction is described as well as
Busto, U; Bendayan, R; Sellers, E M
The present review discusses the available data on the kinetic properties of non-opiate abused drugs including psychomotor stimulants, hallucinogens and CNS-depressants. Some of the drugs of abuse reviewed here are illicit drugs (e.g. cannabis, cocaine), while others are effective pharmacological agents but have the potential to be abused (e.g. benzodiazepines). Although some of the drugs mentioned in this review have been in use for centuries (e.g. caffeine, nicotine, cocaine, cannabis), knowledge of their kinetics and metabolism is very recent and in some cases still incomplete. This is partially due to the difficulties inherent in studying drugs of abuse in humans, and to the complex metabolism of some of these drugs (e.g. cannabis, caffeine) which has made it difficult to develop sensitive assays to determine biological pathways. Although drugs of abuse may have entirely different intrinsic pharmacological effects, the kinetic properties of such drugs are factors contributing to abuse and dependence. The pharmacokinetic properties that presumably contribute to self-administration and drug abuse include rapid delivery of the drug into the central nervous system and high free drug clearance. Kinetic characteristics also play an important role in the development of physical dependence and on the appearance of a withdrawal syndrome: the longer the half-life, the greater the likelihood of the development of physical dependence; the shorter the half-life, the earlier and more severe the withdrawal. The balance between these 2 factors, which has not yet been carefully studied, will also influence abuse patterns. The clinical significance of kinetic characteristics with respect to abuse is discussed where possible.
Tatiana dos Reis Nunes
Full Text Available The authors report the case of a pregnant woman admitted to cocaine overdose and discuss maternal and fetal complications of cocaine abuse in pregnancy. Considering the increased frequency of users in the female population, the obstetric team should be able to make the patient's care and your baby.
Rech, Megan A; Donahey, Elisabeth; Cappiello Dziedzic, Jacqueline M; Oh, Laura; Greenhalgh, Elizabeth
Drug abuse is a common problem and growing concern in the United States, and over the past decade, novel or atypical drugs have emerged and have become increasingly popular. Recognition and treatment of new drugs of abuse pose many challenges for health care providers due to lack of quantitative reporting and routine surveillance, and the difficulty of detection in routine blood and urine analyses. Furthermore, street manufacturers are able to rapidly adapt and develop new synthetic isolates of older drugs as soon as law enforcement agencies render them illegal. In this article, we describe the clinical and adverse effects and purported pharmacology of several new classes of drugs of abuse including synthetic cannabinoids, synthetic cathinones, salvia, desomorphine, and kratom. Because many of these substances can have severe or life-threatening adverse effects, knowledge of general toxicology is key in recognizing acute intoxication and overdose; however, typical toxidromes (e.g., cholinergic, sympathomimetic, opioid, etc.) are not precipitated by many of these agents. Medical management of patients who abuse or overdose on these drugs largely consists of supportive care, although naloxone may be used as an antidote for desomorphine overdose. Symptoms of aggression and psychosis may be treated with sedation (benzodiazepines, propofol) and antipsychotics (haloperidol or atypical agents such as quetiapine or ziprasidone). Other facets of management to consider include treatment for withdrawal or addiction, nutrition support, and potential for transmission of infectious diseases. © 2014 Pharmacotherapy Publications, Inc.
Full Text Available Claudia L Reardon, Shane Creado Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA Abstract: Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the history of doping in athletes, the effects of different classes of substances used for doping, side effects of doping, the role of anti-doping organizations, and treatment of affected athletes. Doping goes back to ancient times, prior to the development of organized sports. Performance-enhancing drugs have continued to evolve, with “advances” in doping strategies driven by improved drug testing detection methods and advances in scientific research that can lead to the discovery and use of substances that may later be banned. Many sports organizations have come to ban the use of performance-enhancing drugs and have very strict consequences for people caught using them. There is variable evidence for the performance-enhancing effects and side effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions. Keywords: doping, athletes, steroids, drug abuse, mental illness
Franchitto, Nicolas; Jullian, Benedicte; Salles, Juliette; Pelissier, Fanny; Rolland, Benjamin
Nalmefene, a long-acting µ-opioid antagonist approved to treat alcohol use disorder, is occasionally mistakenly prescribed to opiate-dependent or opioid-treated patients. We review recent literature on drug-drug interactions between nalmefene and opioids that lead to precipitated opioid withdrawal, and focus on its management and planning for care at discharge. Areas covered: This article provides a brief and comprehensive review of management of precipitated opioid withdrawal syndrome when nalmefene is associated with an opioid, whether misused or legally prescribed. Expert opinion: When treating an opiate-dependent patient with co-occurring alcohol use disorder, both conditions need to be a focus of clinical attention. New drugs for alcohol use disorder have been approved, but must be given cautiously and with a full understanding of their potential drug-drug interactions with opioid medications. Opiate-dependent patients should be intensively monitored for risk factors of alcohol use disorder and should be continuously motivated for treatment maintenance. When nalmefene is administered to opiate-dependent patients, acute opioid withdrawal syndrome may occur. Management of precipitated acute opioid withdrawal may include short or long-acting µ-opioid agonists during hospitalization, in addition to supportive treatment. The best management of polydrug abusers is based on a multidisciplinary approach, which should be pursued and improved through continuing medical education.
Francis, Karen J.; Wolfe, David A.
Objective: Abusive fathers perpetrate a substantial portion of child physical abuse. Despite this, little is known about how they differ from non-abusive fathers. This study compared a broad range of cognitive and affective factors between physically abusive and non-abusive fathers. Methods: Abusive (n = 24) and non-abusive (n = 25) fathers…
Broman, Clifford L; Miller, Paula K; Jackson, Emmanuel
The research here investigates race-ethnicity and self-esteem in the misuse of prescription drugs. While there has been much research into the demographic factors that predict prescription drug misuse (PDM), we lack a full accounting of psychosocial factors of possible importance in influencing patterns of race-ethnicity and PDM. One possible influence is self-esteem. We use data from the National Longitudinal Survey on Adolescent Health to investigate race-ethnicity, PDM and self-esteem. Findings indicate first that race-ethnicity is significant is PDM. Secondly, results indicate that self-esteem is important in understanding patterns of prescription drug misuse among young adults, but only among whites.
McLellan, A Thomas
This paper first introduces important conceptual and practical distinctions among three key terms: substance "use," "misuse," and "disorders" (including addiction), and goes on to describe and quantify the important health and social problems associated with these terms. National survey data are presented to summarize the prevalence and varied costs associated with misuse of alcohol, illegal drugs, and prescribed medications in the United States. With this as background, the paper then describes historical views, perspectives, and efforts to deal with substance misuse problems in the United States and discusses how basic, clinical, and health service research, combined with recent changes in healthcare legislation and financing, have set the stage for a more effective, comprehensive public health approach.
Background: Child sexual abuse with significant impact on victim's physical, mental and social health has now been recognized as existing on an appreciable scale worldwide. Diversity of opinions exist about the concept, types, prevalence and repercussions along with a paucity of systematic and scientific work in the developing world including Pakistan. Objective: This paper aims at reviewing the literature for clarification of concept, update of estimates and correlates, and to identify lines for future research. Data sources: The literature was search through BMJ-Medline for international data, supplemented by local data through CPSP-MEDLIP service. The search term child sexual abuse with associated sub-heads were used. No constraint of time period, publication type or source applied except english Language version Comparative findings: Wide variations identified in conceptual boundaries with consequent impact on prevalence estimates. Agreement found for its existence as an international problem with rates ranging from 7% - 36% for women and 3% - 29% for men. Female abused 1.5-3 times more than male with exponential high rates in age group 3-6 years and 8-11 years. In 2/3 cases the perpetrator identified belonged to nuclear or extended family. Significant association exists with early onset of psychiatric ailments like substance abuse, eating disorders, personality disorders, dissociative disorders and depression. Conclusion and Suggestion: The need for extensive research studies in immense in developing countries like Pakistan where environmental circumstances suggest its presence at rates higher than the identified elsewhere. In addition to facilitate awareness and perhaps to clarify the concept as well as the prevalence of child sexual abuse researchers need to select methodologies and instruments with international comparison in mind. (author)
Becker, Jill B; Hu, Ming
Sex differences are present for all of the phases of drug abuse (initiation, escalation of use, addiction, and relapse following abstinence). While there are some differences among specific classes of abused drugs, the general pattern of sex differences is the same for all drugs of abuse. Females begin regularly self-administering licit and illicit drugs of abuse at lower doses than do males, use escalates more rapidly to addiction, and females are at greater risk for relapse following abstinence. In this review, sex differences in drug abuse are discussed for humans and in animal models. The possible neuroendocrine mechanisms mediating these sex differences are discussed.
Full Text Available Animal abuse is important social issue, which includes a wide range of behaviors of humans that are harmful to animals, starting from unintentional neglect to intentional cruelty. Types of animal abuse are different and they can include physical, sexual, emotional abuse or neglect. Training dogs for fights and dog fighting are considered to be neglection of animals. Forensic veterinarians are called for testifining more often now for presenting the evidence that can lead to making a case regarding animal abuse. This study will include an explanation of forensic vet's role and different types of animal abuse.
Barroso, Osquel; Schamasch, Patrick; Rabin, Olivier
Due to its considered performance enhancing effects, human growth hormone (hGH) is abused as a doping agent in sport. Its misuse also carries potentially serious side effects to a person's health. Consequently, hGH and its releasing factors are prohibited in sport, as established in the Prohibited List which is updated and published yearly by the World Anti-Doping Agency (WADA). In order to fight the menace that hGH doping poses to the spirit of sport and to the health of athletes, the sport movement and the anti-doping authorities, initially led by the International Olympic Committee (IOC) and later by WADA, have put substantial efforts into developing tests for its detection. Currently, a primary analytical approach, the isoform differential immunoassay, has been implemented in WADA-accredited laboratories. In parallel, a second, indirect approach for the detection of hGH abuse, based on the quantification of hGH-associated biological markers, has been developed. The final aim is to combine both methodologies to improve the sensitivity and expand the time window to detect doping with hGH. In addition, novel analytical procedures, based on proteomic and genomic technologies as well as the use of mass spectrometry-based methods of detection, are being investigated for future application in hGH anti-doping tests.
Diamanti-Kandarakis, Evanthia; Konstantinopoulos, Panagiotis A; Papailiou, Joanna; Kandarakis, Stylianos A; Andreopoulos, Anastasios; Sykiotis, Gerasimos P
The administration of recombinant human erythropoietin (rhEPO) increases the maximum oxygen consumption capacity, and is therefore abused as a doping method in endurance sports. The detection of erythropoietin (EPO) abuse is based on direct pharmacological and indirect haematological approaches, both of which have several limitations. In addition, current detection methods cannot cope with the emerging doping strategies of EPO mimicry, analogues and gene doping, and thus novel detection strategies are urgently needed. Direct detection methods for EPO misuse can be either pharmacological approaches that identify exogenous substances based on their physicochemical properties, or molecular methods that recognise EPO transgenes or gene transfer vectors. Since direct detection with molecular methods requires invasive procedures, it is not appropriate for routine screening of large numbers of athletes. In contrast, novel indirect methods based on haematological and/or molecular profiling could be better suited as screening tools, and athletes who are suspect of doping would then be submitted to direct pharmacological and molecular tests. This article reviews the current state of the EPO doping field, discusses available detection methods and their shortcomings, outlines emerging pharmaceutical and genetic technologies in EPO misuse, and proposes potential directions for the development of novel detection strategies.
Guyll, Max; Spoth, Richard; Cornish, Marilyn A
Economic analyses of substance misuse prevention assess the intervention cost necessary to achieve a particular outcome, and thereby provide an additional dimension for evaluating prevention programming. This article reviews several types of economic analysis, considers how they can be applied to substance misuse prevention, and discusses challenges to enhancing their international relevance, particularly their usefulness for informing policy decisions. Important first steps taken to address these challenges are presented, including the disease burden concept and the development of generalized cost-effectiveness, advances that facilitate international policy discussions by providing a common framework for evaluating health care needs and program effects.
Sussman, Steve; Arriaza, Bridget; Grigsby, Timothy J.
Background: Relative to youth in regular high schools, alternative high school (AHS) youth are at high risk for alcohol, tobacco, and other drug (ATOD) misuse. Prevention and cessation efforts are needed for this population. Methods: A systematic, exhaustive literature search was completed to identify ATOD misuse prevention and cessation research…
This study examined attitudinal and behavioral differences between internal and external locus of control (LOC) consumers on credit card misuse, the importance of money, and compulsive buying. Using multiple analysis of variance and separate analyses of variance, internal LOC consumers were found to have lower scores on credit card misuse and…
Bradley, Katharine A; Rubinsky, Anna D; Sun, Haili
Patients who screen positive for alcohol misuse on the Alcohol Use Disorder Identification Test Consumption Questionnaire (AUDIT-C ≥5 points) have significantly increased postoperative complications. Severe alcohol misuse (AUDIT-C ≥9 points) is associated with increased postoperative health care...
... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false False or fraudulent reporting on or misuse of the Automated Export System. 30.71 Section 30.71 Commerce and Foreign Trade Regulations... REGULATIONS Penalties § 30.71 False or fraudulent reporting on or misuse of the Automated Export System. (a...
Novik, Melinda G.; Boekeloo, Bradley O.
Intercession into collegiate alcohol misuse by the Department of Resident Life (DRL) in freshmen dormitories at one large Mid-Atlantic, diverse, public university was examined. Freshmen dormitory resident drinkers (n = 357), 71% of whom reported alcohol misuse, were surveyed. Student self-report and DRL documentation, respectively, revealed that…
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Misuse of the words âbrilliantâ and âfull cut.â 23.16 Section 23.16 Commercial Practices FEDERAL TRADE COMMISSION GUIDES AND TRADE PRACTICE RULES GUIDES FOR THE JEWELRY, PRECIOUS METALS, AND PEWTER INDUSTRIES § 23.16 Misuse of the words...
Full Text Available Background: The HTA-report (Health Technology Assessment deals with over- and undertreatment of pain therapy. Especially in Germany chronic pain is a common reason for the loss of working hours and early retirement. In addition to a reduction in quality of life for the affected persons, chronic pain is therefore also an enormous economic burden for society. Objectives: Which diseases are in particular relevant regarding pain therapy? What is the social-medical care situation regarding pain facilities in Germany? What is the social-medical care situation in pain therapy when comparing on international level? Which effects, costs or cost-effects can be seen on the micro-, meso- and macro level with regard to pain therapy? Among which social-medical services in pain therapy is there is an over- or undertreatment with regard to the micro-, meso- and macro level? Which medical and organisational aspects that have an effect on the costs and/or cost-effectiveness have to be particularly taken into account with regard to pain treatment/chronic pain? What is the influence of the individual patient's needs (micro level in different situations of pain (e. g. palliative situation on the meso- and macro level? Which social-medical and ethical aspects for an adequate treatment of chronic pain on each level have to be specially taken into account? Is the consideration of these aspects appropriate to avoid over- or undertreatment? Are juridical questions included in every day care of chronic pain patients, mainly in palliative care? On which level can appropriate interventions prevent over- or undertreatment? Methods: A systematic literature research is done in 35 databases. In the HTA, reviews, epidemiological and clinical studies and economic evaluations are included which report about pain therapy and in particular palliative care in the years 2005 till 2010. Results: 47 studies meet the inclusion criteria. An undertreatment of acupuncture, over- and misuse
Dietl, Markus; Korczak, Dieter
The HTA-report (Health Technology Assessment) deals with over- and undertreatment of pain therapy. Especially in Germany chronic pain is a common reason for the loss of working hours and early retirement. In addition to a reduction in quality of life for the affected persons, chronic pain is therefore also an enormous economic burden for society. Which diseases are in particular relevant regarding pain therapy?What is the social-medical care situation regarding pain facilities in Germany?What is the social-medical care situation in pain therapy when comparing on international level?Which effects, costs or cost-effects can be seen on the micro-, meso- and macro level with regard to pain therapy?Among which social-medical services in pain therapy is there is an over- or undertreatment with regard to the micro-, meso- and macro level?Which medical and organisational aspects that have an effect on the costs and/or cost-effectiveness have to be particularly taken into account with regard to pain treatment/chronic pain?What is the influence of the individual patient's needs (micro level) in different situations of pain (e. g. palliative situation) on the meso- and macro level?Which social-medical and ethical aspects for an adequate treatment of chronic pain on each level have to be specially taken into account?Is the consideration of these aspects appropriate to avoid over- or undertreatment?Are juridical questions included in every day care of chronic pain patients, mainly in palliative care?On which level can appropriate interventions prevent over- or undertreatment? A systematic literature research is done in 35 databases. In the HTA, reviews, epidemiological and clinical studies and economic evaluations are included which report about pain therapy and in particular palliative care in the years 2005 till 2010. 47 studies meet the inclusion criteria. An undertreatment of acupuncture, over- and misuse with regard to opiate prescription and an overuse regarding
Introduction: stroke in recreational substance users can be an indirect complication, like endocarditis and cardio embolism in parenteral drug users. With some drug like cocaine, stroke appear to be the result of a direct effect. In young subjects without other risk factors provide persuasive evidence for causality . OPIATES: Heroine is the most abused opiate drug, which is administered by injection, by snorting or by smoking. Stroke affects heroin users by diverse mechanisms,. Injec...
McCarthy, J B
Family research studies confirm that abusive parents tend to be undifferentiated partners who compete with each other and with their children for attention and nurturance. More or less healthy parents make demands on children to counteract their own injured narcissism, but they do so largely without devaluation and the sadistic use of projective identification. Under sufficient stress abusive parents attack the child who fails to gratify their needs, thereby giving vent to longstanding frustrations and feelings of being threatened by the child's individuation and competency. The emotional atmosphere in such families facilitates ego deficits like those of the borderline personality as it molds the child's efforts to avoid anxiety. Devaluation, loss, and defenses against mourning partially account for depression and paranoid traits in abused youngsters. Early neglect and abuse exposes them to influential models who act out rage and primitive defenses. Some abused individuals project their rage and later become paranoid or antisocial, whereas others fragment or retain infantile defenses. The destructiveness of severe psychological abuse lies in the constriction of the experiencing self and healthy character development, together with the conditioning to repeat abusive relationships and to avoid intimacy. Achieving individuation under these circumstances entails overcoming the internalized abusive relationships and relinquishing the unconscious wish to be transformed from the abused into the abuser.
Westwood, Greta; Meredith, Paul; Atkins, Susan; Greengross, Peter; Schmidt, Paul E; Aspinall, Richard J
targeted with interventions to reduce the burden of alcohol related harm. Lay summary: Many people who die from alcohol related liver disease (ARLD) have a recent history of recurrent admissions to hospital. These admissions may represent missed opportunities to intervene earlier and offer effective therapies for alcohol misuse. Unfortunately, we know that patients are often missed because medical staff may not routinely ask about alcohol consumption. In our study of over 50,000 admissions, we have demonstrated the feasibility of offering screening for alcohol misuse to all medical admissions to hospital and delivered this 24hours a day, 7days a week, with automatic referral to treatment services. We have shown that it is possible to identify those people who are at the highest risk of dependency, those who have attended the emergency department the most and those who are at an increased risk of ARLD. We hope this study will lead to improved detection and management of alcohol problems in acute hospitals. Copyright © 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Full Text Available Background: A lot of cosmetic and Ayurvedic products containing unlabeled depigmenting agent and steroids are available readily over the counter sale. The side effects of these products are not documented and can lead to adverse effects of continuous usage. Objective: By this study, we aimed to find out the true nature of the above problem and it′s implication in the Indian rural scenario. Methodology: All patients attending dermatology department during the period of 3 months from May to June 2013 for skin diseases were enquired about unsupervised use of any cosmetic product on their facial skin, duration of use, any side effect experienced through the prescribed questionnaire. Results: Total 50 patients were recruited for the study. Out of which, 48% were males and 52% were females. Seventy-four percent of people had applied topical products/steroids in an attempt of attainment of fair complexion, 14% for melasma, 8% for acne induced hyperpigmentation, and 4% for dark circles. About 80% people had obtained one or the other products over the counter sale, 8% had followed the attractive advertisements, 8% had started the application on the recommendation of friends/family while only 4% people had correctly gone through the proper channel to consult a dermatologist. Conclusion: The problem of topical products or steroids abuse is rampant and significant, and unless and until immediate steps are taken to root out this problem from our setup, the condition will become worse all the more.
Hill, J [UKAEA
This paper reproduces an address by Sir John Hill, Chairman of the United Kingdom Atomic Energy Authority, at a conference in London organised by the Financial Times in July 1976. Actions that, in the author's view, could be regarded as constituting abuse of nuclear power are first summarised, and the various aspects of the use and abuse of nuclear power are discussed. The author considers that achieving the maximum degree of acceptance of the Non-Proliferation Treaty is the most important political objective in nuclear power, but considers that nuclear terrorism would be abortive and that, so far as the UK is concerned, the present precautions are adequate and will remain so. It is considered that much abuse of nuclear power arises from the prevalence of its critics, particularly with reference to Pu hazards, the health of nuclear employees, and possible damage to the health of the public. The Pu problem is considered to be far more emotive than rational. The possibility of lung cancer and leukaemia is discussed. It is concluded that atomic energy is one of the best of industries in which to work, both from the health and interest points of view.
Full Text Available In Bangladesh, a large number of children are deprived of their basic human rights due to unacceptable health, nutrition, education as well as social conditions. In addition, children are exposed to severe forms of sexual, physical and mental abuses at home, in the work place, in institutions and other public places. The nature and extent of violence against children irrespective of age, sex and class has been increasing day by day. These include physical torture, rape, homicide and sometimes heinous attacks with acid. Children are also victims of child labor and trafficking, both of which are treated as the most severe form of child exploitation and child abuse in the world today. This review article is aimed to focus on the present situation of various forms of child abuses in our country. Data collection is based on secondary sources of information from Dhaka Medical College Hospital, One Stop Crisis Center (OCC,UNICEF, Ministry of Home Affairs, Ministry of Women and Children Affairs, several Dhaka based organizations and news paper clipping. Ibrahim Med. Coll. J. 2015; 9(1: 18-21
Simone, Lacher; Wettstein, Albert; Senn, Oliver; Rosemann, Thomas; Hasler, Susann
Detecting elder abuse is challenging because it is a taboo, and many cases remain unreported. This study aimed to identify types of elder abuse and to investigate its associated risk factors. Retrospective analyses of 903 dossiers created at an Independent Complaints Authority for Old Age in the Canton of Zurich, Switzerland, from January 1, 2008 to October 31, 2012. Characteristics of victims and perpetrators, types of abuse, and associated risk factors related to the victim or the perpetrator were assessed. Bi- and multivariate analysis were used to identify abuse and neglect determinants. A total of 150 cases reflected at least one form of elder abuse or neglect; 104 cases were categorised as abuse with at least one type of abuse (overall 135 mentions), 46 cases were categorised as neglect (active or passive). Psychological abuse was the most reported form (47%), followed by financial (35%), physical (30%) and anticonstitutional abuse (18%). In 81% of the 150 cases at least two risk factors existed. In 13% no associated risk factor could be identified. Compared with neglect, elders with abuse were less likely to be a nursing home resident than living at home (odds ratio [OR] 0.02, 95% confidence interval [CI] 0.00-0.19). In addition, they were more likely to be cohabiting with their perpetrators (OR 18.01, 95% CI 4.43-73.19). For the majority of the reported elder abuse cases at least two associated risk factors could be identified. Knowledge about these red flags and a multifaceted strategy are needed to identify and prevent elder abuse.
Johanson, C E
In order to place appropriate restrictions upon the availability of certain therapeutic agents to limit their abuse, it is important to assess abuse liability, an important aspect of drug safety evaluation. However, the negative consequences of restriction must also be considered. Drugs most likely to be tested are psychoactive compounds with therapeutic indications similar to known drugs of abuse. Methods include assays of pharmacological profile, drug discrimination procedures, self-administration procedures, and measures of drug-induced toxicity including evaluations of tolerance and physical dependence. Furthermore, the evaluation of toxicity using behavioural end-points is an important component of the assessment, and it is generally believed that the most valid procedure in this evaluation is the measurement of drug self-administration. However, even this method rarely predicts the extent of abuse of a specific drug. Although methods are available which appear to measure relative abuse liability, these procedures are not validated for all drug classes. Thus, additional strategies, including abuse liability studies in humans, modelled after those used with animals, must be used in order to make a more informed prediction. Although there is pressure to place restrictions on new drugs at the time of marketing, in light of the difficulty of predicting relative abuse potential, a better strategy might be to market a drug without restrictions, but require postmarketing surveillance in order to obtain more accurate information on which to base a final decision.
Tedgård, Eva; Råstam, Maria; Wirtberg, Ingegerd
To add to our knowledge concerning the key elements involved in the individual's experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children's ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents.
Tedgård, Eva; Råstam, Maria; Wirtberg, Ingegerd
ABSTRACT Aim: To add to our knowledge concerning the key elements involved in the individual’s experience of growing up with substance abusing parents and the resulting challenges this involved for their own parenthood. Methods: In-depth interviews were conducted with 19 parents who had participated in a mental health intervention programme. All had experienced substance abusing parents in their family of origin. Qualitative content analysis was used to analyse the data. They also completed a self-report questionnaire assessing their attachment style. Result: Participants reported a high incidence of emotional abuse and neglect coupled with inadequate support from the community. Their own parental role was influenced by high parental stress and a majority had an insecure attachment style. Conclusions: All participants had experienced a very difficult childhood which was reinforced by the fact that they received little support from society. Their childhood experience and the resulting challenges that this created in their own parenting role could negatively influence their own children’s ability to form a secure psychosocial development. It is therefore important to develop instruments that can help to identify children who were raised in misuse families in order to accommodate the transgenerational effects of growing up with substance abusing parents. PMID:29482480
The music education profession is faced with two serious problems regarding the (mis)use of data in music teacher evaluation. The first has to do with the quality and kinds of data that music teachers have been forced to use; the second is concerned with how these data are being used in the music teacher evaluation process. The evidence I will use…
Pinkerton, Ross; Hardy, Janet R
In the context of a therapeutic opioid epidemic, particularly in the USA, where increasingly stringent screening for 'at risk' individuals and close monitoring of opioid prescription and use is strongly recommended, the issue of misuse within the cancer population must be addressed. Most patients with advanced cancer will have pain requiring opioid therapy at some stage during their disease course. In the majority, this will provide good pain relief with no short- or longer-term adverse sequelae. A subset will present with substance misuse issues that will influence management and prescribing practice. The potential ethical issues of limiting effective analgesia on the basis of addiction risk or history must be acknowledged. Both a judgemental or 'relaxed' approach to such patients is problematic. Ignoring the situation will not be in the patient's best interest, but an undue focus on this aspect may damage therapeutic relationships with clinicians and adversely affect a holistic approach to care. Clinical practitioners must be aware of the risk factors for opioid misuse and in patients who are not under palliative care consider screening prior to commencing opioids. Clinicians must be able to manage and monitor those identified as having an opioid misuse problem. © 2017 Royal Australasian College of Physicians.
Gallucci, Andrew R.; Wynveen, Chris; Hackman, Christine; Meyer, Andrew; Usdan, Stuart
The current study examined the effect that students' educational environment has on the prevalence and motivations associated with the misuse of prescription analgesics (MPA). A sample of 893 undergraduate students was recruited from one religiously affiliated private university and one public university in the Southern United States. Participants…
Botvin, Gilbert J.; Griffin, Kenneth W.
Research concerning the etiology and prevention of substance misuse has led to the development of preventive interventions that are theory-based and effective. One such approach, Life Skills Training (LST), targets key etiologic factors using a conceptual framework derived from social learning theory and problem behavior theory. LST has been…
This article offers a reflective perspective of the uses and misuses of data and statistics in public communication and development as a construct of democracy. It begins by situating data use in light of the “big data” revolution characterised by devolution and globalisation of information. Drawing on illustrations from advocacy ...
A pharmaco-epidemiological survey was carried out to determine the most used and misused antibiotics in selected veterinary clinics and farms in three urban cities in the southwest and south-south geopolitical zones of Nigeria. In all, 55 respondents comprising 40 veterinary doctors, 9 animal health workers and 6 farmers ...
Wong, Ho Ting; Lin, Teng-Kang; Lin, Jen-Jia
This study aims to assess rural-urban differences in the predictors of emergency ambulance service (EAS) demand and misuse in New Taipei City. Identifying the predictors of EAS demand will help the EAS service managing authority in formulating focused policies to maintain service quality. Over 160,000 electronic EAS usage records were used with a negative binomial regression model to assess rural-urban differences in the predictors of EAS demand and misuse. The factors of 1) ln-transformed population density, 2) percentage of residents who completed up to junior high school education, 3) accessibility of hospitals without an emergency room, and 4) accessibility of EAS were found to be predictors of EAS demand in rural areas, whereas only the factor of percentage of people aged above 65 was found to predict EAS demand in urban areas. For EAS misuse, only the factor of percentage of low-income households was found to be a predictor in rural areas, whereas no predictor was found in the urban areas. Results showed that the factors predicting EAS demand and misuse in rural areas were more complicated compared to urban areas and, therefore, formulating EAS policies for rural areas based on the results of urban studies may not be appropriate. Copyright © 2018. Published by Elsevier B.V.
Bilal, Naser Eldin; Gedebou, Messele; Al-Ghamdi, Saleh
Patients admitted during a 6-month period to a maternity hospital in Saudi Arabia were studied for nosocomial infections and misuse of antibiotics. Patient history and diagnosis on admission and subsequent clinical and laboratory data were analysed. Infection developing from 72 h after admission was considered nosocomial. Therapeutic and prophylactic data as recorded on the patients' charts were assessed for possible misuse of antibiotics. Of 3439 patients, 136 (4.0%) developed nosocomial infection: 2.0%, 8.9% and 37.7% in obstetric, gynaecologic and nursery patients, respectively. Infections among adults were mostly found in the urinary (44.4%) and lower genital (33.3%) tracts. Among newborns, over 70% of cases were eye and ear (29.8%), skin (26.2%) and blood (19.0%) infections. Gram-negative bacteria caused 65.7% of the infections. Over 90% of the bacterial isolates were multidrug-resistant. About 24% of patients received single or multiple antibiotics; 57.2% were misused. The minimal hospital cost estimate for both nosocomial infections and misused antibiotics was US $318,705. The findings of this study, the first of its type in this region, should prompt improved infection control measures as well as educational and antibiotic restriction interventions.
My medicines management article (reflections February 8) highlighted legal muddles over the prescription of controlled drugs. The Medicines Act was amended four years ago to allow independent nurse prescribers to prescribe almost all controlled drugs. But the Misuse of Drugs Act needs to amended to make this legally possible.
van Hoof, Joris Jasper; Moll, Marit
In order to address the issues of adolescent alcohol (mis)use in Romanian cities and to develop local alcohol prevention policies comprised of interventions aimed at reducing alcohol consumption and alcohol related problems, information on the prevalence of alcohol use and relevant related topics is
Many studies have found EFL/ESL learners over/under/misuse linking adverbials. Because their use is specific to genre and register (Biber et al., 1999), and news writing is a compulsory course for EFL journalism majors at many Chinese universities, this study investigates their usage patterns in news and suggests teaching material design for the…
...) MISCELLANEOUS EXCISE TAXES MANUFACTURERS AND RETAILERS EXCISE TAXES Refunds and Other Administrative Provisions of Special Application to Retailers and Manufacturers Taxes § 48.6715-1 Penalty for misuse of dyed... other liquid (other than diesel fuel or kerosene ) that contains the type and amount of dye and marker...
Westlund, Erik; Stuart, Elizabeth A.
This article discusses the nonuse, misuse, and proper use of pilot studies in experimental evaluation research. The authors first show that there is little theoretical, practical, or empirical guidance available to researchers who seek to incorporate pilot studies into experimental evaluation research designs. The authors then discuss how pilot…
Alkhamis, Ahmed; Matheson, Catriona; Bond, Christine
Aims: To provide baseline data regarding GPs' knowledge, experience, and attitudes toward the management of PsychoStimulant Drug Misuse (PSDM) patients to inform future education and training initiatives. Methods: A structured cross-sectional postal questionnaire was developed following initial content setting interviews, piloted then sent to a…
Koder, Deborah-Anne; Klahr, Amanda
The Mini-Mental State Examination (MMSE) is one of the most commonly used instruments to screen for cognitive deficits within the hospital setting. However training in how to administer this widely used tool is scarce with little, if any, formal training for nursing staff. Scores are also often misused with over reliance on results and cut-offs to…
... equipment and software used in conjunction with their service have captions turned off as the default... equipment and software used in conjunction with their service have a default setting of captions off, so...] Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services and...
... providers to ensure that equipment and software used in conjunction with their service have a default...] Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services and Speech-to-Speech Services for Individuals With Hearing and Speech Disabilities AGENCY: Federal...
Foster, Durwin B.; Kelly, Mary Theresa
Men experience higher lifetime trauma rates than women, and they use and misuse substances at rates far exceeding women. Men are also reported to experience significantly higher lifetime rates of comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD) than women. Although there is agreement in the clinical field of trauma…
Davies, Emma; Martin, Jilly; Foxcroft, David
Purpose: The purpose of this paper is to report on the use of the Delphi method to gain expert feedback on the identification of behaviour change techniques (BCTs) and development of a novel intervention to reduce adolescent alcohol misuse, based on the Prototype Willingness Model (PWM) of health risk behaviour. Design/methodology/approach: Four…
Young, Susan; González, Rafael A; Wolff, Kim; Mutch, Laura; Malet-Lambert, Isabella; Gudjonsson, Gisli H
There is a reasonable theoretical base for understanding the possible causes and motivations behind substance misuse and its dependency. There is a need for a reliable and valid measure that delineates the markers of substance use from its initiation and identifies different motivations for drug use transitioning, maintenance, and dependency. We addressed this gap in the United Kingdom by examining and validating the Substance Transitions in Addiction Rating Scale (STARS). For this review, 390 male prisoners were screened for conduct disorder and assessed with a clinical diagnostic interview for attention deficit/hyperactivity disorder (ADHD). They completed the four STARS subscales regarding their substance use. Exploratory structural equation modeling was performed to assess the STARS structure and to derive factors to assess validity against ADHD and conduct disorder diagnostic categories. Each of the subscales produced meaningful and reliable factors that supported the self-medication and behavioral disinhibition hypotheses of substance use motivation. The findings robustly show that ADHD is significantly associated with the need for coping as a way of managing primary and comorbid symptoms, but not conduct disorder. The findings were strongest for the combined ADHD type. STARS has a great potential to further the understanding of the motivation behind substance use and its dependency in different populations.
Kessler, Asia Sikora; Maclean, Johanna Catherine
Recent economic work suggests a role for personality traits in determining socioeconomic outcomes. Much of this work has considered labor market outcomes, human capital accumulation, and, to some extent, health outcomes. No economic studies have explored the role of the Big Five taxonomy in alcohol use and misuse. Given defining characteristics of the Big Five, they are plausibly linked with these outcomes. Alcohol misuse is associated with large social costs through healthcare costs, traffic fatalities, violence, and reduced labor market productivity. Thus, understanding risk factors for such use is warranted. To investigate the associations between the Big Five, and measures of alcohol use and alcohol misuse. We obtain data on older adults 50 years and older from the Health and Retirement Study (HRS). Our outcomes include one measure of use (any use) and two measures of misuse (heavy drinking and binge drinking). Comparing across different measures of alcohol consumption can shed light on whether the Big Five are related to moderate alcohol use that need not impose social costs or alcohol misuse that may indeed impose such costs. A randomly selected sub-set of respondents completed a self-administered questionnaire developed for the Midlife Development Inventory in either the 2006 or 2008 round of the HRS. We use information collected in this instrument to generate our independent variables of primary interest: agreeableness, openness, extraversion, neuroticism, and conscientiousness traits. We find that the Big Five personality traits are linked with measures of both alcohol use and alcohol misuse. We observe substantial heterogeneity in the associations by personality traits. Specifically, agreeableness is associated with increased risk for alcohol use/misuse while extraversion and openness are negatively associated with risk for these patterns of alcohol consumption. We find no evidence that neuroticism or contentiousness predict alcohol use and misuse. We
Giordano, Nan Hervig; Giordano, Jeffrey A.
Reviews the literature on elder abuse and examines categories of abuse, the incidence of abuse, and characteristics of the typical abused person. Concluded that the abused person is characteristically a severely impaired woman, aged 75 and over, White, widowed, and living with relatives. (LLL)
Results also showed that old abused women scored significantly lower on depression than young abused women, F(1,337)=P<.01. Likewise, high education abused women self-reported significantly higher on depression than low education abused women, t(2,337)= 5.44. On self-esteem, old abused women were ...
Palmer, H; Weston, J T
All childhood deaths which occurred in New Mexico during 1974 and 1975 were reviewed. Nine fatal instances of abuse were identified representing the entire spectrum of physical abuse: neglect, abuse in a single episode of injury, repetitive abuse, or sexual abuse. Several cases are summarized. These are unusual either in the distribution of pathologic findings or in the problems encountered in court presentation.
Aleksić Jelena; Jović Slavoljub
Animal abuse is important social issue, which includes a wide range of behaviors of humans that are harmful to animals, starting from unintentional neglect to intentional cruelty. Types of animal abuse are different and they can include physical, sexual, emotional abuse or neglect. Training dogs for fights and dog fighting are considered to be neglection of animals. Forensic veterinarians are called for testifining more often now for presenting the evidence that can lead to making a case rega...
Manhica, Hélio; Gauffin, Karl; Almqvist, Ylva B; Rostila, Mikael; Hjern, Anders
High rates of mental health problems have been described in young refugees, but few studies have been conducted on substance misuse. This study aimed to investigate the patterns of hospital care and criminality associated with substance misuse in refugees who settled in Sweden as teenagers. Gender stratified Cox regression models were used to estimate the risks of criminal convictions and hospital care associated with substance misuse from national Swedish data for 2005-2012. We focused on 22,992 accompanied and 5,686 unaccompanied refugees who were aged 13-19 years when they settled in Sweden and compared them with 1 million native Swedish youths from the same birth cohort. The risks of criminal conviction associated with substance misuse increased with the length of residency in male refugees, after adjustment for age and domicile. The hazard ratios (HRs) were 5.21 (4.39-6.19) for unaccompanied and 3.85 (3.42-4.18) for accompanied refugees after more than 10 years of residency, compared with the native population. The risks were slightly lower for hospital care, at 2.88 (2.18-3.79) and 2.52(2.01-3.01) respectively. Risks were particularly pronounced for male refugees from the Horn of Africa and Iran. The risks for all male refugees decreased substantially when income was adjusted for. Young female refugees had similar risks to the general population. The risks of criminality and hospital care associated with substance misuse in young male refugees increased with time of residency in Sweden and were associated with a low level of income compared with the native Swedish population. Risks were similar in accompanied and unaccompanied refugees.
Al-Abri, S A; Kearney, T
Baking soda is a common household product promoted by the manufacturer as an antacid. It contains sodium bicarbonate and has the potential for significant toxicity when ingested in excessive amounts. Characterizing the patterns and outcomes from the misuse of baking soda as a home remedy can guide the clinical assessment and preventative counselling of patients at risk for use of this product. We conducted a retrospective review of all symptomatic cases involving ingestion and misuse of a baking soda powder product that were reported to the California Poison Control System between the years 2000 and 2012. Of the 192 cases we identified, 55·8% were female, ages ranged 2 months to 79 years, and the most common reasons for misuse included antacid (60·4%), 'beat a urine drug test' (11·5%) and treat a UTI (4·7%). Most cases (55·2%) had significant symptoms warranting a medical evaluation, whereas 12 patients required hospital admission developed either electrolyte imbalances, metabolic alkalosis or respiratory depression. Misuse of baking soda can result in serious electrolyte and acid/base imbalances. Patients at highest risk of toxicity may include those who chronically use an antacid, those who use the method to 'beat' urine drug screens, pregnant women and young children. Self-treatment with baking soda as a home remedy may also mask or delay medical care thereby complicating or exacerbating an existing medical problem. We suggest that healthcare providers counsel high-risk patients about the potential complications of misuse of baking soda as a home remedy. © 2013 John Wiley & Sons Ltd.
Foxcroft, David R; Tsertsvadze, Alexander
Alcohol misuse by young people causes significant health and social harm, including death and disability. Therefore, prevention of youth alcohol misuse is a policy aim in many countries. Our aim was to examine the effectiveness of (1) school-based, (2) family-based and (3) multi-component universal alcohol misuse prevention programmes in children and adolescents. Three Cochrane systematic reviews were performed: searches in MEDLINE, EMBASE, PsycINFO, Project CORK and the Cochrane Register of Controlled Trials up to July 2010, including randomised trials evaluating universal alcohol misuse prevention programmes in school, family or multiple settings in youths aged 18 years or younger. Two independent reviewers identified eligible studies and any discrepancies were resolved via discussion. A total of 85 trials were included in the reviews of school (n = 53), family (n = 12) and multi-component (n = 20) programmes. Meta-analysis was not performed due to study heterogeneity. Most studies were conducted in North America. Risk of bias assessment revealed problems related to inappropriate unit of analysis, moderate to high attrition, selective outcome reporting and potential confounding. Certain generic psychosocial and life skills school-based programmes were effective in reducing alcohol use in youth. Most family-based programmes were effective. There was insufficient evidence to conclude that multiple interventions provided additional benefit over single interventions. In these Cochrane reviews, some school, family or multi-component prevention programmes were shown to be effective in reducing alcohol misuse in youths. However, these results warrant a cautious interpretation, since bias and/or contextual factors may have affected the trial results. Further research should replicate the most promising studies identified in these reviews and pay particular attention to content and context factors through rigorous evaluation.
Kenne, Deric R; Hamilton, Kelsey; Birmingham, Lauren; Oglesby, Willie H; Fischbein, Rebecca L; Delahanty, Douglas L
Since the early 1990s, the United States has seen a significant increase in the prevalence of prescription opioid misuse. Despite benefits prescription opioids provide, misuse can be fatal. The current study was designed to investigate the prevalence of prescription opioid misuse, perceived harm of misuse, and reasons for misuse for physical or emotional pain instead of seeking professional medical or mental health treatment. Survey data were collected in the fall of 2013 via an online survey to a random sample of 668 students from a public Midwestern university. Lifetime prevalence of prescription opioid misuse was 9.5%. Misusers of prescription opioid drugs generally reported lower ratings of perceived harm as compared to individuals not reporting misuse of prescription opioid drugs. Primary reasons for misuse of prescription opioid drugs was to relieve pain (33.9%), "to feel good/get high" (23.2%) and experimentation (21.4%). Lifetime misuse of a prescription opioid drug for physical or emotional pain was reported by 8.1% and 2.2% of respondents, respectively. Primary reasons for misuse for physical pain included because pain was temporary, immediate relief was needed, and no health insurance/financial resources. Primary reasons for misuse for emotional pain included not wanting others to find out, embarrassment and fear. Conclusions/Importance: Reasons for misuse of prescription opioid drugs vary by type of prescription opioid drug. Reasons for not seeking treatment that ultimately lead to misuse, vary by type of pain being treated and may be important considerations in the effort to stem the misuse of prescription opioid drugs among college students.
Anne Marie Ciobanu
Full Text Available Consumption of drugs of abuse is a scourge of modern world. Abuse, drug addiction and their consequences are one of the major current problems of European society because of the significant repercussions in individual, family, social and economic level. In this context, toxicological analysis of the drugs of abuse in biological samples is a useful tool for: diagnosis of drug addiction, checking an auto-response, mandatory screening in some treatment programs, identification of a substance in the case of an overdose, determining compliance of the treatment. The present paper aims to address the needs of healthcare professionals involved in drugs addiction treatment through systematic presentation of information regarding their toxicological analysis. Basically, it is a tool that help you to select the suitable biological sample and the right collecting time, as well as the proper analysis technique, depending on the purpose of analysis, pharmacokinetic characteristics of the drugs of abuse, available equipment and staff expertise.
Mahmoudi, Morteza; Pakpour, Sepideh; Perry, George
Opioid drug abuse and dependence/addiction are complex disorders regulated by a wide range of interacting networks of genes and pathways that control a variety of phenotypes. Although the field has been extensively progressed since the birth of the National Institute on Drug Abuse in 1974, the fundamental knowledge and involved mechanisms that lead to drug dependence/addiction are poorly understood, and thus, there has been limited success in the prevention of drug addiction and development of therapeutics for definitive treatment and cure of addiction disease. The lack of success in both identification of addiction in at-risk populations and the development of efficient drugs has resulted in a serious social and economic burden from opioid drug abuse with global increasing rate of mortality from drug overdoses. This perspective aims to draw the attention of scientists to the potential role of nanotechnologies, which might pave the way for the development of more practical platforms for either drug development or identification and screening of patients who may be vulnerable to addiction after using opioid drugs.
Full Text Available A major goal of drug abuse research is to identify and understand drug-induced changes in brain function that are common to many or all drugs of abuse. As these may underlie drug dependence and addiction, the purpose of the present study was to examine if different drugs of abuse effect changes in gene expression that converge in common molecular pathways. Microarray analysis was employed to assay brain gene expression in postmortem anterior prefrontal cortex (aPFC from 42 human cocaine, cannabis and/or phencyclidine abuse cases and 30 control cases, which were characterized by toxicology and drug abuse history. Common transcriptional changes were demonstrated for a majority of drug abuse cases (N = 34, representing a number of consistently changed functional classes: Calmodulin-related transcripts (CALM1, CALM2, CAMK2B were decreased, while transcripts related to cholesterol biosynthesis and trafficking (FDFT1, APOL2, SCARB1, and Golgi/endoplasmic reticulum (ER functions (SEMA3B, GCC1 were all increased. Quantitative PCR validated decreases in calmodulin 2 (CALM2 mRNA and increases in apolipoprotein L, 2 (APOL2 and semaphorin 3B (SEMA3B mRNA for individual cases. A comparison between control cases with and without cardiovascular disease and elevated body mass index indicated that these changes were not due to general cellular and metabolic stress, but appeared specific to the use of drugs. Therefore, humans who abused cocaine, cannabis and/or phencyclidine share a decrease in transcription of calmodulin-related genes and increased transcription related to lipid/cholesterol and Golgi/ER function. These changes represent common molecular features of drug abuse, which may underlie changes in synaptic function and plasticity that could have important ramifications for decision-making capabilities in drug abusers.
This book provides a description for all the known radiological alterations occurring in child abuse. This allows for precise interpretation of findings by radiologists. It also helps eliminate the confusion among both clinicians and non-medical personnel involved in the diagnosis, management, and legal issues related to child abuse. CONTENTS: Introduction; Skeletal trauma: general considerations; Extremity trauma; Bony thoracic trauma; Spinal trauma; Dating fractures; Visceral trauma; Head trauma; Miscellaneous forms of abuse and neglect; The postmortem examination; Differential diagnosis of child abuse; Legal considerations; Psychosocial considerations; Technical considerations and dosimetry
Oguma, Eiji; Aihara, Toshinori [Saitama Children' s Medical Center, Iwatsuki (Japan)
The major role of imaging in cases of suspected child abuse is to identify the physical injuries and to confirm the occurrence of abuse. In severely abused infants, the imaging findings may be the only evidence for a diagnosis of inflicted injury. Imaging may be the first clue to abuse in children seen with apparent other conditions and lead to appropriate measures to protect them from the risk of more serious injury. The radiologist must be familiar with imaging findings of inflicted injuries to fulfill these roles. (author)
Oguma, Eiji; Aihara, Toshinori
The major role of imaging in cases of suspected child abuse is to identify the physical injuries and to confirm the occurrence of abuse. In severely abused infants, the imaging findings may be the only evidence for a diagnosis of inflicted injury. Imaging may be the first clue to abuse in children seen with apparent other conditions and lead to appropriate measures to protect them from the risk of more serious injury. The radiologist must be familiar with imaging findings of inflicted injuries to fulfill these roles. (author)
Gibbs, Deborah A
...: spouse abuse child abuse and substance abuse. By supporting the development of improved responses to troubled families findings from this study can potentially reduce mortality and morbidity among military personal and their family members...