Drug interactions between common illicit drugs and prescription therapies.

Science.gov (United States)

Lindsey, Wesley T; Stewart, David; Childress, Darrell

2012-07-01

The aim was to summarize the clinical literature on interactions between common illicit drugs and prescription therapies. Medline, Iowa Drug Information Service, International Pharmaceutical Abstracts, EBSCO Academic Search Premier, and Google Scholar were searched from date of origin of database to March 2011. Search terms were cocaine, marijuana, cannabis, methamphetamine, amphetamine, ecstasy, N-methyl-3,4-methylenedioxymethamphetamine, methylenedioxymethamphetamine, heroin, gamma-hydroxybutyrate, sodium oxybate, and combined with interactions, drug interactions, and drug-drug interactions. This review focuses on established clinical evidence. All applicable full-text English language articles and abstracts found were evaluated and included in the review as appropriate. The interactions of illicit drugs with prescription therapies have the ability to potentiate or attenuate the effects of both the illicit agent and/or the prescription therapeutic agent, which can lead to toxic effects or a reduction in the prescription agent's therapeutic activity. Most texts and databases focus on theoretical or probable interactions due to the kinetic properties of the drugs and do not fully explore the pharmacodynamic and clinical implications of these interactions. Clinical trials with coadministration of illicit drugs and prescription drugs are discussed along with case reports that demonstrate a potential interaction between agents. The illicit drugs discussed are cocaine, marijuana, amphetamines, methylenedioxymethamphetamine, heroin, and sodium oxybate. Although the use of illicit drugs is widespread, there are little experimental or clinical data regarding the effects of these agents on common prescription therapies. Potential drug interactions between illicit drugs and prescription drugs are described and evaluated on the Drug Interaction Probability Scale by Horn and Hansten.

The relationship between US heroin market dynamics and heroin-related overdose, 1992-2008.

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Unick, George; Rosenblum, Daniel; Mars, Sarah; Ciccarone, Daniel

2014-11-01

Heroin-related overdose is linked to polydrug use, changes in physiological tolerance and social factors. Individual risk can also be influenced by the structural risk environment including the illicit drug market. We hypothesized that components of the US illicit drug market, specifically heroin source/type, price and purity, will have independent effects on the number of heroin-related overdose hospital admissions. Yearly, from 1992 to 2008, Metropolitan Statistical Area (MSA) price and purity series were estimated from the US Drug Enforcement Administration data. Yearly heroin overdose hospitalizations were constructed from the Nationwide Inpatient Sample. Socio-demographic variables were constructed using several databases. Negative binomial models were used to estimate the effect of price, purity and source region of heroin on yearly hospital counts of heroin overdoses controlling for poverty, unemployment, crime, MSA socio-demographic characteristics and population size. Purity was not associated with heroin overdose, but each $100 decrease in the price per pure gram of heroin resulted in a 2.9% [95% confidence interval (CI) = 4.8%, 1.0%] increase in the number of heroin overdose hospitalizations (P = 0.003). Each 10% increase in the market share of Colombian-sourced heroin was associated with a 4.1% (95% CI = 1.7%, 6.6%) increase in number of overdoses reported in hospitals (P = 0.001) independent of heroin quality. Decreases in the price of pure heroin in the United States are associated with increased heroin-related overdose hospital admissions. Increases in market concentration of Colombian-source/type heroin is also associated with an increase in heroin-related overdose hospital admissions. Increases in US heroin-related overdose admissions appear to be related to structural changes in the US heroin market. © 2014 Society for the Study of Addiction.

Drug overdose resulting in quadriplegia.

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Wang, Teresa S; Grunch, Betsy H; Moreno, Jessica R; Bagley, Carlos A; Gottfried, Oren N

2012-06-01

To describe a case of cervical flexion myelopathy resulting from a drug overdose. A 56-year-old male presented to the emergency department unable to move his extremities following drug overdose. Neurological examination revealed him to be at C6 ASIA A spinal cord injury. The CT of his cervical spine revealed no fracture; however, an MRI revealed cord edema extending from C3 to C6 as well as posterior paraspinal signal abnormalities suggestive of ligamentous injury. The patient underwent a posterior cervical laminectomy and fusion from C3 to C7. Neurologically he regained 3/5 bilateral tricep function and 2/5 grip; otherwise, he remained at ASIA A spinal cord injury at 6 months. Our patient suffered a spinal cord injury likely due to existing cervical stenosis, and in addition to an overdose of sedating medications, he likely sat in flexed neck position for prolonged period of time with the inability to modify his position. This likely resulted in cervical spine vascular and/or neurological compromise producing an irreversible spinal cord injury. Spinal cord injury is a rare finding in patients presenting with drug overdose. The lack of physical exam findings suggestive of trauma may delay prompt diagnosis and treatment, and thus clinicians must have a high index of suspicion when evaluating patients in this setting.

Drug involvement in fatal overdoses

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Christopher J. Ruhm

2017-12-01

Full Text Available Death certificate data from the Multiple Cause of Death (MCOD files were analyzed to better understand the drug categories most responsible for the increase in fatal overdoses occurring between 1999 and 2014. Statistical adjustment methods were used to account for the understatement in reported drug involvement occurring because death certificates frequently do not specify which drugs were involved in the deaths. The frequency of combination drug use introduced additional uncertainty and so a distinction was made between any versus exclusive drug involvement. Many results were sensitive to the starting and ending years chosen for examination. Opioid analgesics played a major role in the increased drug deaths for analysis windows starting in 1999 but other drugs, particularly heroin, became more significant for recent time periods. Combination drug use was important for all time periods and needs to be accounted for when designing policies to slow or reverse the increase in overdose deaths.

The relationship between drug use settings, roles in the drug economy, and witnessing a drug overdose in Baltimore, Maryland.

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Latkin, Carl A; Edwards, Catie; Davey-Rothwell, Melissa A; Yang, Cui; Tobin, Karin E

2018-02-12

There has been a dramatic increase in drug overdose deaths in the United States. In the current study, the authors examined factors associated with witnessing a drug overdose. A sample of 450 substance users in Baltimore, Maryland, were recruited for a behavioral intervention and were administered a survey. Multinomial logistic regression models were used to compare participants who never witnessed a drug overdose with those who witnessed one in the prior 6 months and those who witnessed an overdose over 6 months ago. Most (58%) participants were male, 40% experienced homelessness in the prior 6 months, 63% reported a history of heroin injecting, 84% had snorted heroin, 75% reported witnessing a drug overdose, and 38% experienced an overdose. In multinomial logistic regression models, witnessing an overdose in the past 6 months was associated with number of different types of places where drugs were used (adjusted odds ratio [aOR] = 1.34), history of experiencing an overdose (aOR = 1.80), injecting heroin and/or speedball (aOR = 1.78), and snorting heroin (aOR = 1.54). Witnessing an overdose more than 6 months ago was associated with number of different places where drugs were used (aOR = 1.25), history of experiencing an overdose (aOR = 1.61), snorting heroin (aOR = 1.42), and injecting heroin or speedball (aOR = 1.47). These data suggest that people who engage in more public and frequent drug use, and hence are more likely to witness an overdose, should be targeted for interventions to prevent and treat drug overdose.

Emerging and Underrecognized Complications of Illicit Drug Use

OpenAIRE

Wurcel, Alysse G.; Merchant, Elisabeth A.; Clark, Roger P.; Stone, David R.

2015-01-01

This comprehensive review of infectious and noninfectious syndromes associated with illicit drug use focuses on underrecognized complications of common illicit drugs and constellations of syndromes associated with emerging illicit drugs.

High prevalence of non-fatal overdose among people who inject drugs in Malaysia: Correlates of overdose and implications for overdose prevention from a cross-sectional study.

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Bazazi, Alexander R; Zelenev, Alexei; Fu, Jeannia J; Yee, Ilias; Kamarulzaman, Adeeba; Altice, Frederick L

2015-07-01

Overdose is the leading cause of death among opioid users, but no data are available on overdose among people who inject drugs in Malaysia. We present the first estimates of the prevalence and correlates of recent non-fatal overdose among people who inject drugs in Malaysia. In 2010, 460 people who inject drugs were recruited using respondent-driven sampling (RDS) in Klang Valley to assess health outcomes associated with injection drug use. Self-reported history of non-fatal overdose in the previous 6 months was the primary outcome. Sociodemographic, behavioral and structural correlates of non-fatal overdose were assessed using multivariable logistic regression. All 460 participants used opioids and nearly all (99.1%) met criteria for opioid dependence. Most injected daily (91.3%) and were male (96.3%) and ethnically Malay (90.4%). Overall, 20% of participants had overdosed in the prior 6 months, and 43.3% had ever overdosed. The RDS-adjusted estimate of the 6-month period prevalence of overdose was 12.3% (95% confidence interval [CI] 7.9-16.6%). Having injected for more years was associated with lower odds of overdose (adjusted odds ratio [AOR] 0.6 per 5 years of injection, CI: 0.5-0.7). Rushing an injection from fear of the police nearly doubled the odds of overdose (AOR 1.9, CI: 1.9-3.6). Alcohol use was associated with recent non-fatal overdose (AOR 2.1, CI: 1.1-4.2), as was methamphetamine use (AOR 2.3, CI: 1.3-4.6). When adjusting for past-month drug use, intermittent but not daily methadone use was associated with overdose (AOR 2.8, CI: 1.5-5.9). This study reveals a large, previously undocumented burden of non-fatal overdose among people who inject drugs in Malaysia and highlights the need for interventions that might reduce the risk of overdose, such as continuous opioid substitution therapy, provision of naloxone to prevent fatal overdose, treatment of polysubstance use, and working with police to improve the risk environment. Copyright © 2014 Elsevier B

Concomitant overdosing of other drugs in patients with paracetamol poisoning

DEFF Research Database (Denmark)

Schmidt, Lars E; Dalhoff, Kim

2002-01-01

AIMS: Paracetamol is frequently involved in intended self-poisoning, and concomitant overdosing of other drugs is commonly reported. The purpose of the study was to investigate further concomitant drug overdose in patients with paracetamol poisoning and to evaluate its effects on the outcome...... of the paracetamol intoxication. METHODS: Six hundred and seventy-one consecutive patients admitted with paracetamol poisoning were studied and concomitant drug intake was recorded. The relative risk of hepatic encephalopathy, death or liver transplantation, hepatic dysfunction, liver cell damage, and renal...... favourable outcome was observed in patients with concomitant NSAID overdose. CONCLUSIONS: Concomitant overdosing of benzodiazepines or analgesics is frequent in patients admitted with paracetamol poisoning. Concomitant benzodiazepine or acetylsalicylic acid overdose was associated with more severe toxicity...

Arrhythmogenic effects of illicit drugs in athletes.

Science.gov (United States)

Furlanello, Francesco; Bentivegna, Stefano; Cappato, Riccardo; De Ambroggi, Luigi

2003-12-01

Cardiac arrhythmias are among the most important causes of non-eligibility to sports activities, and may be due to different causes (cardiomyopathies, myocarditis, coronary abnormalities, valvular diseases, primary electrical disorders, abuse of illicit drugs). The list of illicit drugs banned by the International Olympic Committee and yearly updated by the World Anti-Doping Agency includes the following classes: stimulants, narcotics, anabolic agents (androgenic steroids and others such as beta-2 stimulants), peptide hormones, mimetics and analogues, diuretics, agents with an antiestrogenic activity, masking agents. Almost all illicit drugs may cause, through a direct or indirect arrhythmogenic effect, in the short, medium or long term, a wide range of cardiac arrhythmias (focal or reentry type, supraventricular and/or ventricular), lethal or not, even in healthy subjects with no previous history of cardiac diseases. Therefore, given the widespread abuse of illicit drugs among athletes, in the management of arrhythmic athletes the cardiologist should always take into consideration the possibility that the arrhythmias be due to the assumption of illicit drugs (sometimes more than one type), especially if no signs of cardiac diseases are present. On the other hand, in the presence of latent underlying arrhythmogenic heart disease including some inherited cardiomyopathies at risk of sudden cardiac death, illicit drugs could induce severe cardiac arrhythmic effects.

Young people's attitudes towards illicit drugs: A population-based study.

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Friis, Karina; Østergaard, Jeanette; Reese, Sidsel; Lasgaard, Mathias

2017-12-01

Previous studies indicate that young people who have positive attitudes towards illicit drugs are more inclined to experiment with them. The first aim of our study was to identify the sociodemographic and risk behaviour characteristics of young people (16-24 years) with positive attitudes towards illicit drug use. The second aim was to identify the characteristics of young people with positive attitudes towards illicit drugs among those who had never tried drugs, those who had tried cannabis but no other illicit drugs, and those who regularly used cannabis and/or had tried other illicit drugs. The analysis was based on a population-based survey from 2013 ( N = 3812). Multiple logistic regression was used to analyse the association between sociodemographic and risk behaviour characteristics and positive attitudes towards illicit drugs. Young men had twice the odds of having positive attitudes towards illicit drug use compared with young women (AOR = 2.1). Also, young age, being single, being employed, smoking tobacco, practising unprotected sex, and experimental cannabis use were associated with positive attitudes towards illicit drug use. Finally, use of cannabis at least 10 times during the previous year and/or use of other illicit drugs had the strongest association with positive attitudes to illicit drug use (AOR = 6.0). Young people who have positive attitudes towards illicit drug use are characterized by a broad range of risky behaviours. These findings may help to identify young people at risk of initiating illicit drug use and thereby support the development and implementation of prevention programmes.

Missed paracetamol (acetaminophen) overdose due to confusion regarding drug names.

Science.gov (United States)

Hewett, David G; Shields, Jennifer; Waring, W Stephen

2013-07-01

Immediate management of drug overdose relies upon the patient account of what was ingested and how much. Paracetamol (acetaminophen) is involved in around 40% of intentional overdose episodes, and remains the leading cause of acute liver failure in many countries including the United Kingdom. In recent years, consumers have had increasing access to medications supplied by international retailers via the internet, which may have different proprietary or generic names than in the country of purchase. We describe a patient that presented to hospital after intentional overdose involving 'acetaminophen' purchased via the internet. The patient had difficulty recalling the drug name, which was inadvertently attributed to 'Advil', a proprietary non-steroidal anti-inflammatory drug. The error was later recognised when the drug packaging became available, but the diagnosis of paracetamol overdose and initiation of acetylcysteine antidote were delayed. This case illustrates the benefit of routinely measuring paracetamol concentrations in all patients with suspected poisoning, although this is not universally accepted in practice. Moreover, it highlights the importance of the internet as a source of medications for intentional overdose, and emphasises the need for harmonisation of international drug names to improve patient safety.

Drug decriminalization and the price of illicit drugs.

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Félix, Sónia; Portugal, Pedro

2017-01-01

This study is an empirical assessment of the impact of the drug decriminalization policy followed by Portugal in July 2001, on the price of illicit drugs. The analysis is performed using a difference-in-differences approach and the Synthetic Control Method in order to construct a synthetic control unit from a convex combination of countries. The results suggest that the prices of opiates and cocaine in the post-treatment period did not decrease in the sequence of the policy change. We conclude that the drug decriminalization policy seems to have caused no harm through lower illicit drugs prices, which would lead to higher drug usage and dependence. Copyright © 2016 Elsevier B.V. All rights reserved.

Denial of pain medication by health care providers predicts in-hospital illicit drug use among individuals who use illicit drugs.

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Ti, Lianping; Voon, Pauline; Dobrer, Sabina; Montaner, Julio; Wood, Evan; Kerr, Thomas

2015-01-01

Undertreated pain is common among people who use illicit drugs (PWUD), and can often reflect the reluctance of health care providers to provide pain medication to individuals with substance use disorders. To investigate the relationship between having ever been denied pain medication by a health care provider and having ever reported using illicit drugs in hospital. Data were derived from participants enrolled in two Canadian prospective cohort studies between December 2012 and May 2013. Using bivariable and multivariable logistic regression analyses, the relationship between having ever been denied pain medication by a health care provider and having ever reported using illicit drugs in hospital was examined. Among 1053 PWUD who had experienced ≥ 1 hospitalization, 452 (44%) reported having ever used illicit drugs while in hospital and 491(48%) reported having ever been denied pain medication. In a multivariable model adjusted for confounders, having been denied pain medication was positively associated with having used illicit drugs in hospital (adjusted OR 1.46 [95% CI 1.14 to 1.88]). The results of the present study suggest that the denial of pain medication is associated with the use of illicit drugs while hospitalized. These findings raise questions about how to appropriately manage addiction and pain among PWUD and indicate the potential role that harm reduction programs may play in hospital settings.

The lung effects of illicit drugs

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Crista Laslo

2018-04-01

Full Text Available Illicit drugs use is a real public health issue, especially among young people. The totality of the drugs harmful effects on the body is difficult to quantify, especially because of poor epidemiological data and ethical concerns about the inclusion of consumers in clinical trials. However, health professionals need to be alert to identify, report and fight drug-related pathology. This article aims to draw attention to the lung pathology induced by the consumption of some of the most commonly used illicit drugs: cocaine, heroin and cannabis.

The insults of illicit drug use on male fertility.

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Fronczak, Carolyn M; Kim, Edward D; Barqawi, Al B

2012-01-01

One-third of infertile couples may have a male factor present. Illicit drug use can be an important cause of male factor infertility and includes use of anabolic-androgenic steroids, marijuana, opioid narcotics, cocaine, and methamphetamines. The use of these illicit drugs is common in the United States, with a yearly prevalence rate for any drug consistently higher in males compared with females. We aim to provide a review of recent literature on the prevalence and effects of illicit drug use on male fertility and to aid health professionals when counseling infertile men whose social history suggests illicit drug use. Anabolic-androgenic steroids, marijuana, cocaine, methamphetamines, and opioid narcotics all negatively impact male fertility, and adverse effects have been reported on the hypothalamic-pituitary-testicular axis, sperm function, and testicular structure. The use of illicit drugs is prevalent in our society and likely adversely impacting the fertility of men who abuse drugs.

VSRR Provisional Drug Overdose Death Counts

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U.S. Department of Health & Human Services — This data contains provisional counts for drug overdose deaths based on a current flow of mortality data in the National Vital Statistics System. National...

Characteristics of Suicides Caused by Drug Overdose in the State of Maryland

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Ling Li

2015-01-01

Full Text Available Suicidal drug overdose is a major public health issue. In the United States, every year more than 33,000 people commit suicides. Our study focused on the characteristics of suicide victims in the state of Maryland. Material and methods: This study was a retrospective review of autopsy cases of all suicide deaths caused by drug (s or drug (s with alcohol intoxication investigated by the OCME in Maryland over a 7-year period from January 2004 to December 2011. All deaths investigated by the OCME that require autopsy examination are subject to comprehensive toxicology testing for drugs and alcohol. The screen tests were performed using gas chromatography (GC and radioimmunoassay techniques. All detected drugs and/or metabolites were confirmed using GC-mass spectrometry (GC-MS. Results: From 2004 to 2011, 434 deaths were certified as suicide. Of the 434 suicidal overdose deaths, 84% were white, 11% were African-American, and about 5% were either Hispanic or Asian. The male and female ratio was almost equal. Their ages ranged 15-82 years. Of the 434 suicidal drug overdose deaths, 277 victims (63.8% consumed a single drug type and 157 (36.2% consumed more than one type of drug. Of the 277 single-drug overdose cases, 71.1% suicides were due to prescription drugs, 23.5% due to over-the-counter drugs, and 5.4% due to street/recreational drugs. Among single-type prescription drugs, analgesic (N = 76, antidepressant (N = 45, and neuroleptic (N = 35 classes were the three leading type of drugs used in suicidal deaths. Oxycodone, morphine, quetiapine, and amitriptyline were the most common prescription drugs in suicidal overdose. Diphenhydramine was the leading over-the-counter drug. Of the 157 victims who consumed more than one drug, combined prescription drugs were present in 54.1%, mixed prescription and over-the-counter drugs in 29.3%, and prescription drugs/over-the-counter drugs and street drugs in 16.6% of cases. Of the multiple-drug overdose suicides

12-step programs for reducing illicit drug use

DEFF Research Database (Denmark)

Bøg, Martin; Filges, Trine; Brännström, Lars

2017-01-01

12-step programs for reducing illicit drug use are neither better nor worse than other interventions Illicit drug abuse has serious and far-reaching implications for the abuser, their family members, friends, and society as a whole. Preferred intervention programs are those that effectively reduce...... illicit drug use and its negative consequences, and are cost-effective as well. Current evidence shows that overall, 12-step programs are just as effective as alternative, psychosocial interventions. The costs of programs are, therefore, an important consideration. However, the strength of the studies...

Increasing availability of illicit drugs among people who inject drugs in Bangkok, Thailand.

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Hayashi, Kanna; Nosyk, Bohdan; Ti, Lianping; Suwannawong, Paisan; Kaplan, Karyn; Wood, Evan; Kerr, Thomas

2013-09-01

In recent years, the Thai government has strengthened drug law enforcement as a strategy to address a continuing epidemic of illicit drug use. We sought to assess temporal trends in street-level availability of illicit drugs among injection drug users (IDUs) in Bangkok, Thailand. Using univariate statistics and multivariate logistic regression, we assessed changes in the availability of five substances (heroin, methamphetamine, crystal methamphetamine, midazolam, and illicit methadone) between 2009 and 2011 and examined social, structural and individual factors influencing availability among community-recruited samples of IDUs in Bangkok. Availability was measured in three levels: immediate (available in ≤10 min); moderate (available in 10-90 min); and delayed (available in >90 min; our reference category). The analyses included 718 IDUs, including 165 (23.0%) women. Controlling for changes in participant characteristics between assessments, and in a period of constant nominal illicit drug prices, moderate availability of all substances increased significantly between 2009 and 2011, with adjusted odds ratios ranging between 2.36 (illicit methadone) and 4.61 (crystal methamphetamine) (all pdrug suppression efforts, the availability of illicit drugs among IDUs in Bangkok increased significantly between 2009 and 2011. The findings raise concern about the overreliance on drug law enforcement-based approaches and point to the need for greater investment in evidence-based drug policies. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Predictors of illicit drug/s use among university students in Northern Ireland, Wales and England.

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El Ansari, Walid; Vallentin-Holbech, Lotte; Stock, Christiane

2014-12-16

The use of illicit drug/s among university students is a public health concern. Nevertheless, many UK studies investigated a narrow spectrum of variables to explore their association/s with illicit drug/s use. We assessed the associations between a wide range of socio-demographic, health and wellbeing variables (independent variables) and having used illicit drug/s regularly, occasionally or never in life (dependent variables). Data (3706 students) were collected from seven universities in England, Wales, and Northern Ireland, using a self-administered questionnaire. About 5% of the sample had regularly used illicit drug/s, 25% occasionally, and 70% never. Regular drug use (RDU) was significantly more likely among males aged 21-29 years, daily smokers, those with heavy episodic drinking or possible alcohol dependency (CAGE test), and those who perceived their academic performance better than their peers. RDU was less likely among students with high health awareness and those living with parents. The predictors of occasional drug use (ODU) were similar to those of RDU. However, in addition, students with higher perceived stress were less likely, and students who felt financial burden/s were more likely to report ODU, while no association with academic performance was found. Never use of illicit drug/s was inversely associated with most of the variables listed above, and was positively associated with religiosity. Illicit drug/s use goes along with other substance use (alcohol and smoking). The finding that illicit drug/s use was higher among students reporting good academic performance was surprising and raises the question of whether illicit drug/s may be used as performance enhancing drugs. The factors identified with illicit drug/s use in this study could be utilized to develop appropriate public health policies and preventive measures for the health of students. Multilevel, value based, comprehensive, and strategic long-term intervention plans are required. This

Differentiation of illicit drugs with THz time-domain spectroscopy

International Nuclear Information System (INIS)

Liu Guifeng; Ma Shihua; Ji Te; Zhao Hongwei; Wang Wenfeng

2010-01-01

The tera hertz time-domain spectroscopy (THz-TDS) was used for sensing and identifying illicit drugs. The absorption spectra of seven illicit drug samples(morphine and its hydrochloride, cocaine hydrochloride, codeine phosphate, papaverine hydrochloride, pethidine hydrochloride, and thebaine) were studied by THz-TDS at 0.3-2.0 THz at room temperature. The geometric structure and vibration frequencies of morphine were calculated by density functional theory. The four absorption features were dominated by intra-/inter-molecular collective or lattice vibration modes. Each illicit drug has a distinct signature in its THz spectra. The results indicate that the THz-TDS can be used to identify and discriminate illicit drugs by their characteristic fingerprints. (authors)

Illicit drugs policy through the lens of regulation.

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Ritter, Alison

2010-07-01

The application of regulatory theory to the problem of illicit drugs has generally been thought about only in terms of 'command and control'. The international treaties governing global illicit drug control and the use of law enforcement to dissuade and punish offenders have been primary strategies. In this paper I explore the application of other aspects of regulatory theory to illicit drugs-primarily self-regulation and market regulation. There has been an overreliance on strategies from the top of the regulatory pyramid. Two other regulatory strategies--self-regulation and market regulation--can be applied to illicit drugs. Self-regulation, driven by the proactive support of consumer groups may reduce drug-related harms. Market strategies such as pill-testing can change consumer preferences and encourage alternate seller behaviour. Regulatory theory is also concerned with partnerships between the state and third parties: strategies in these areas include partnerships between police and pharmacies regarding sale of potential precursor chemicals. Regulatory theory and practice is a rich and well-developed field in the social sciences. I argue that governments should consider the full array of regulatory strategies. Using regulatory theory provides a rationale and justification to strategies that are currently at the whim of politics, such as funding for user groups. The greater application of regulatory approaches may produce more flexible and structured illicit drug policies. Copyright (c) 2009 Elsevier B.V. All rights reserved.

Illicit drugs and cardiac arrhythmias in athletes.

Science.gov (United States)

Furlanello, Francesco; Serdoz, Laura Vitali; Cappato, Riccardo; De Ambroggi, Luigi

2007-08-01

The current management of athletes with cardiac arrhythmias has become complicated by the widespread use of illicit drugs, which can be arrhythmogenic. The World Anti-Doping Agency annually updates a list of prohibited substances and methods banned by the International Olympic Committee that includes different classes of substances namely, anabolic androgenic steroids, hormones and related substances, beta2-agonists, diuretics, stimulants, narcotics, cannabinoids, glucocorticosteroids, alcohol, beta-blockers and others. Almost all illicit drugs may cause, through a direct or indirect arrhythmogenic effect, a wide range of cardiac arrhythmias (focal or reentry type, supraventricular and/or ventricular) that can even be lethal and which are frequently sport activity related. A large use of illicit drugs has been documented in competitive athletes, but the arrhythmogenic effect of specific substances is not precisely known. Precipitation of cardiac arrhythmias, particularly in the presence of a latent electrophysiologic substrate including some inherited cardiomyopathies, at risk of sudden death or due to long-term consumption of the substances, should raise the suspicion that illicit drugs may be a possible cause and lead cardiologists to investigate carefully this relationship and appropriately prevent the clinical consequences.

Encouraging the Disuse of Illicit Drugs Among At-Risk Youth.

Science.gov (United States)

Cheung, Chau-kiu; Ngai, Steven Sek-yum

2016-05-01

Youth at risk of illicit drug abuse and other delinquent acts are the target of social work services. Preventing or discouraging the use of illicit drugs among at-risk youth is a long-standing practical and research concern. For this reason, the preventive function of courage is a research gap the present study seeks to fill. The study collected data from 169 at-risk youths and their social workers with two-wave panel surveys. Results show that courage in Wave 1 presented a strong negative effect on illicit drug use in Wave 2 in the youth, controlling for illicit drug use in Wave 1 and background characteristics. Moreover, the negative effect was stronger when Wave 1 drug use was more likely. These results imply the helpfulness of encouraging at-risk youth to gather courage to resist the temptation to use illicit drugs. © The Author(s) 2014.

Attitudes and knowledge about naloxone and overdose prevention among detained drug users in Ningbo, China

Directory of Open Access Journals (Sweden)

Liu Yu

2012-02-01

Full Text Available Abstract Background To date there has been limited research on both the prevalence of overdose and drug user knowledge about overdose prevention and response methods in China. In addition, there has been no effort to integrate naloxone information and distribution into pre-release services for drug users detained in isolated compulsory detoxification facilities in China. Methods The authors conducted a survey of 279 heroin users in isolated compulsory detoxification centers in Ningbo, China in an attempt to evaluate the possibility of conducting prelease peer naloxone programs in Ningbo isolated compulsory detoxification centers. Respondents' demographic background, history of heroin overdoses, and attitudes/knowledge about overdose prevention and response were collected. Results While drug users in Ningbo's compulsory detoxification centers have limited understandings of how to effectively respond to overdoses, they expressed concern about the possibility of overdose, interest in participating in overdose prevention and response programs, and a willingness to help their peers. In general, there was no significant difference in history and attitudes/knowledge of overdose between male and female participants. Conclusion Based on the findings of this research, our survey provides preliminary evidence that detained drug users have considerable interest in overdose prevention and response information and willingness to help peers. However, drug users in Ningbo isolated compulsory detoxification centers currently have limited understandings of effective ways of helping to prevent overdose deaths.

Increasing availability of illicit and prescription opioids among people who inject drugs in a Canadian setting, 2010-2014.

Science.gov (United States)

Ho, Joel; DeBeck, Kora; Milloy, M-J; Dong, Huiru; Wood, Evan; Kerr, Thomas; Hayashi, Kanna

2018-01-01

Nonmedical use of prescription opioid and illicit opioid has been increasing at an alarming rate in North America over the past decade. We sought to examine the temporal trends and correlates of the availability of illicit and prescription opioids among people who inject drugs (PWID) in Vancouver, Canada. Data were derived from three prospective cohort studies of PWID in Vancouver between 2010 and 2014. In semiannual interviews, participants reported the availability of five sets of illicit and prescription opioids: (1) heroin; (2) Percocet (oxycodone/acetaminophen), Vicodin (hydrocodone/acetaminophen), or Demerol (meperidine); (3) Dilaudid (hydromorphone); (4) Morphine; (5) oxycontin/OxyNEO (controlled-release oxycodone). We defined perceived availability as immediate (e.g., available within 10 minutes) versus no availability/available after 10 minutes. The trend and correlation of immediate availability were identified by multivariable generalized estimating equations logistic regression. Among 1584 participants, of which 564 (35.6%) were female, the immediate availability of all illicit and prescribed opioids (except for oxycontin/OxyNEO) increased over time, independent of potential confounders. The Adjusted Odds Ratios of immediate availability associated with every calendar year increase were between 1.09 (95% confidence interval 1.05-1.12) (morphine and Dilaudid) and 1.13 (95% confidence interval 1.09-1.17) (Percocet/Vicodin/Demerol) (all p-values illicit and prescription opioid use among PWID that could potentially increase the risk of overdose.

Increases in self-reported fentanyl use among a population entering drug treatment: The need for systematic surveillance of illicitly manufactured opioids.

Science.gov (United States)

Cicero, Theodore J; Ellis, Matthew S; Kasper, Zachary A

2017-08-01

Recent reports indicate a sharp increase in fentanyl-related overdose deaths across the United States, much of which is likely related to the introduction of cheap, illicitly manufactured fentanyl derivatives. In this study, we sought to estimate the magnitude of illicit fentanyl use from 2012 to 2016 using a national opioid abuse surveillance system. The study program surveyed 10,900 individuals entering substance abuse treatment for opioid use disorder, with participants asked to endorse past month 'use to get high' of fentanyl drugs, stratified by identifiable (i.e., branded) fentanyl formulations or a 'type unknown' drug alleged to contain fentanyl. Total past-month fentanyl-use rose modestly from 2012 to 2016. While use of known fentanyl products remained relatively stable (mean=10.9%; P=0.25), endorsements of 'unknown' fentanyl products nearly doubled from 9% in 2013 to 15.1% by 2016 (Pfentanyl use shows that recent increases in fentanyl use seem to be due almost entirely to 'unknown' fentanyl presumed to be illicitly manufactured. Given that it is difficult to assess the extent to which fentanyl may have been substituted for another drug (i.e., oxycodone, alprazolam, etc.) or was used as a heroin admixture, our data likely represent an underestimation of the full magnitude of illicit fentanyl abuse. As such, this growing public health problem requires immediate attention and more systematic efforts to identify and track its abuse. Copyright © 2017. Published by Elsevier B.V.

Trauma activation patients: evidence for routine alcohol and illicit drug screening.

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C Michael Dunham

Full Text Available BACKGROUND: Statistics from the National Trauma Data Bank imply that discretionary blood alcohol and urine drug testing is common. However, there is little evidence to determine which patients are appropriate for routine testing, based on information available at trauma center arrival. In 2002, Langdorf reported alcohol and illicit drug rates in Trauma Activation Patients. METHODOLOGY/PRINCIPAL FINDINGS: This is a retrospective investigation of alcohol and illicit drug rates in consecutive St. Elizabeth Health Center (SEHC trauma patients. SEHC Trauma Activation Patients are compared with the Langdorf Activation Patients and with the SEHC Trauma Nonactivation Patients. Minimum Rates are positive tests divided by total patients (tested and not tested. Activation patients: The minimum alcohol rates were: SEHC 23.1%, Langdorf 28.2%, combined 24.8%. The minimum illicit drug rates were: SEHC 15.7%, Langdorf 23.5, combined 18.3%. The minimum alcohol and/or illicit drug rates were: SEHC 33.4%, Langdorf 41.8%, combined 36.2%. Nonactivation patients: The SEHC minimum alcohol rate was 4.7% and the minimum illicit drug rate was 6.0%. CONCLUSIONS: Alcohol and illicit drug rates were significantly greater for Trauma Activation Patients, when compared to Nonactivation Patients. At minimum, Trauma Activation Patients are likely to have a 1-in-3 positive test for alcohol and/or an illicit drug. This substantial rate suggests that Trauma Activation Patients, a readily discernible group at trauma center arrival, are appropriate for routine alcohol and illicit drug testing. However, discretionary testing is more reasonable for Trauma Nonactivation Patients, because minimum rates are low.

Illicit drugs and the environment--a review.

Science.gov (United States)

Pal, Raktim; Megharaj, Mallavarapu; Kirkbride, K Paul; Naidu, Ravi

2013-10-01

Illicit drugs and their metabolites are the latest group of emerging pollutants. Determination of their concentration in environment (such as water bodies, soil, sediment, air) is an indirect tool to estimate the community level consumption of illicit drug and to evaluate potential ecotoxicological impacts from chronic low level exposure. They enter the wastewater network as unaltered drugs and/or their active metabolites by human excretion after illegal consumption or by accidental or deliberate disposal from clandestine drug laboratories. This article critically reviews the occurrence and concentration levels of illicit drugs and their metabolites in different environmental compartments (e.g., wastewater, surface waters, groundwater, drinking water, and ambient air) and their potential impact on the ecosystem. There is limited published information available on the presence of illicit drugs in the environment, reports are available mainly from European countries, UK, USA, and Canada but there is a lack of information from the remainder of the world. Although the environmental concentrations are not very high, they can potentially impact the human health and ecosystem functioning. Cocaine, morphine, amphetamine, and MDMA have potent pharmacological activities and their presence as complex mixtures in water may cause adverse effect on aquatic organisms and human health. However, there is no current regulation demanding the determination of occurrence of these emerging pollutants in treated wastewater, surface water, drinking water, or atmosphere. Thus, critical investigation on distribution pattern of this new group of emerging contaminant and their potential harmful impact on our environment needs immediate attention. Copyright © 2012. Published by Elsevier B.V.

Social and economic inequalities in fatal opioid and cocaine related overdoses in Luxembourg: a case-control study.

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Origer, Alain; Le Bihan, Etienne; Baumann, Michèle

2014-09-01

To investigate social and economic inequalities in fatal overdose cases related to opioid and cocaine use, recorded in Luxembourg between 1994 and 2011. Cross-examination of national data from law enforcement and drug use surveillance sources and of forensic evidence in a nested case-control study design. Overdose cases were individually matched with four controls, when available, according to sex, year of birth, drug administration route and duration of drug use. 272 cases vs 1056 controls were analysed. Conditional logistic regression analysis was performed to assess the respective impact of a series of socioeconomic variables. Being professionally active [OR=0.66 (95% CI 0.45-0.99)], reporting salary as main legal income source [OR=0.42 (95% CI 0.26-0.67)] and education attainment higher than primary school [OR=0.50 (95% CI 0.34-0.73)] revealed to be protective factors, whereas the professional status of the father or legal guardian of victims was not significantly associated to fatal overdoses. Socioeconomic inequalities in drug users impact on the occurrence of fatal overdoses. Compared to their peers, users of illicit drugs with lower socioeconomic profiles show increased odds of dying from overdose. However, actual and self-referred socioeconomic characteristics of drug users, such as educational attainment and employment, may have a greater predictive value of overdose mortality than the parental socioeconomic status. Education, vocational training and socio-professional reintegration should be part of drug-related mortality prevention policies. Copyright © 2014 Elsevier B.V. All rights reserved.

Illicit drugs in Canadian municipal wastewater and estimates of community drug use

Energy Technology Data Exchange (ETDEWEB)

Metcalfe, Chris, E-mail: cmetcalfe@trentu.c [Worsfold Water Quality Centre, Trent University, 1600 West Bank Drive Peterborough, ON, K9J 7B8 (Canada); Tindale, Kathryn [Worsfold Water Quality Centre, Trent University, 1600 West Bank Drive Peterborough, ON, K9J 7B8 (Canada); Li, Hongxia, E-mail: lihongxia@trentu.c [Worsfold Water Quality Centre, Trent University, 1600 West Bank Drive Peterborough, ON, K9J 7B8 (Canada); Rodayan, Angela [Department of Chemical Engineering, McGill University, 3610 University St., Montreal, QC, H3A 2B2 (Canada); Yargeau, Viviane, E-mail: viviane.yargeau@mcgill.c [Department of Chemical Engineering, McGill University, 3610 University St., Montreal, QC, H3A 2B2 (Canada)

2010-10-15

In this study of wastewater treatment plants in three Canadian cities, selected illicit drugs, including cocaine and its major metabolite, benzoylecgonine (BE), amphetamine, methamphetamine and ecstasy (i.e. MDMA) were detected in untreated wastewater. Cocaine was the most widely used illicit drug at a median level for the 3 cities of 15.7 doses per day per 1000 people. For the other drugs, the median doses per day per 1000 people were 1.8 for amphetamine, 4.5 for methamphetamine and 0.4 for ecstasy. Methamphetamine use was highest in the largest city and cocaine use was lowest in the smallest city. Removal of the illicit drugs by wastewater treatment was generally >50%, except in a WWTP that uses primary treatment. The community consumption estimate for ecstasy in the present study is far below published estimates of the prevalence of ecstasy use among the Canadian population, which may be due to only occasional use of ecstasy. - Cocaine and amphetamines were detected in untreated and treated sewage in the wastewater treatment plants of three Canadian cities, and community consumption patterns estimated from the concentrations of the drugs in untreated wastewater were consistent with estimates of the use of illicit drugs in Canada.

Illicit drugs in Canadian municipal wastewater and estimates of community drug use

International Nuclear Information System (INIS)

Metcalfe, Chris; Tindale, Kathryn; Li, Hongxia; Rodayan, Angela; Yargeau, Viviane

2010-01-01

In this study of wastewater treatment plants in three Canadian cities, selected illicit drugs, including cocaine and its major metabolite, benzoylecgonine (BE), amphetamine, methamphetamine and ecstasy (i.e. MDMA) were detected in untreated wastewater. Cocaine was the most widely used illicit drug at a median level for the 3 cities of 15.7 doses per day per 1000 people. For the other drugs, the median doses per day per 1000 people were 1.8 for amphetamine, 4.5 for methamphetamine and 0.4 for ecstasy. Methamphetamine use was highest in the largest city and cocaine use was lowest in the smallest city. Removal of the illicit drugs by wastewater treatment was generally >50%, except in a WWTP that uses primary treatment. The community consumption estimate for ecstasy in the present study is far below published estimates of the prevalence of ecstasy use among the Canadian population, which may be due to only occasional use of ecstasy. - Cocaine and amphetamines were detected in untreated and treated sewage in the wastewater treatment plants of three Canadian cities, and community consumption patterns estimated from the concentrations of the drugs in untreated wastewater were consistent with estimates of the use of illicit drugs in Canada.

Nonnatural deaths among users of illicit drugs: pathological findings and illicit drug abuse stigmata.

Science.gov (United States)

Delaveris, Gerd Jorunn Møller; Hoff-Olsen, Per; Rogde, Sidsel

2015-03-01

The aim of the study was to provide information on illicit drug abuse stigmata and general pathological findings among an adult narcotic drug-using population aged 20 to 59 years whose death was nonnatural. A total of 1603 medicolegal autopsy reports from 2000 to 2009 concerning cases positive for morphine, heroin, amphetamines, ecstasy, cannabis, LSD (lysergic acid diethylamide), PCP (phencyclidine), and high levels of GHB (γ-hydroxybutyric acid) in addition to methadone and buprenorphine were investigated. Reported findings of hepatitis, portal lymphadenopathy, recent injection marks, drug user's equipment, and numbers of significant pathological conditions were registered and analyzed according to cases positive for opiates, opioids (OPs), and central nervous system (CNS)-stimulating illicit drugs, respectively. Of the selected cases, 1305 were positive for one or more opiate or OP. Cases positive for OPs had significantly more findings of noninfectious pathological conditions. Hepatitis, portal lymphadenopathy, recent injections marks findings of drug user's equipment were all findings found more frequently among the opiate OP-positive individuals. Portal lymphadenopathy was significantly more often found in cases with hepatitis than in cases with other or no infection. In the population positive for CNS stimulants, hepatitis recent injection marks were more frequent findings than in the CNS stimulant-negative group, irrespective of whether they were opiate OP positive or negative.

Multi-level governance: The way forward for European illicit drug policy?

Science.gov (United States)

Chatwin, Caroline

2007-12-01

Illicit drug policy has long been an area that has attracted international policy intervention, however, the European Union has declared it an area of subsidiarity, leaving ultimate control to national governments. Nevertheless, European Union preoccupation with the illicit drug issue and international drug trafficking and organised crime concerns have ensured that continued and increased cooperation in illicit drug policy is never off the agenda. This article examines the history of European integration in contrasting areas of policy and considers both the desirability and the viability of an increasingly harmonised drug policy for Europe. Finally, it proposes a model of integrated illicit drug policy that is strongly connected to developing patterns of European social policy, calling on multi-level governance and close involvement at the level of the citizen.

Non-medical use of prescription drugs among illicit drug users: A case study on an online drug forum.

Science.gov (United States)

Rönkä, Sanna; Katainen, Anu

2017-01-01

The non-medical use of prescription drugs is a growing phenomenon associated with increasing health-related harms. However, little is known about the drivers of this process among illicit drug users. Our aim is to show how the qualities of pharmaceutical drugs, pharmaceutical related knowledge, online communities sharing this knowledge and medical professionals mediate and transform the consumption behaviour related to pharmaceutical drugs. The data consist of discussion threads from an online drug use forum. Using actor network theory (ANT), we analysed translations that mediate the online user community's relationship with pharmaceutical drugs. Differences in experienced drug effects are explained both as a process of 'learning' and as differences in brain chemistry at the receptor level. Both science- and experience-based information are shared on best practices to optimise use, avoid adverse health effects and maximise the experience of intoxication. The expanded context of doctors' practices places stress on the medical framework for drug use. Our analysis shows how the non-medical use of psychoactive pharmaceuticals relates to joint, medicalised ideas of bodies as sites of medical experimentation, as well as to the collective process of constructing 'pharmaceutical competences' in user networks. Understandings of intoxication have increasingly been permeated with the pharmacological and scientific logic of knowledge. The forum works as a platform for harm reduction inspired exchange of knowledge. However, the user community's knowledge sharing practices can generate a shared perception of a sufficient or even superior drug use experience and knowledge. This may lead to overdoses and other risky behaviour, and thereby contribute to increased harms related to non-medical use of prescription drugs. Copyright © 2016 Elsevier B.V. All rights reserved.

Temporal differences in gamma-hydroxybutyrate overdoses involving injecting drug users versus recreational drug users in Helsinki: a retrospective study

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Boyd James J

2012-02-01

Full Text Available Abstract Background Gamma-hydroxybutyrate (GHB and gamma-butyrolactone (GBL have been profiled as 'party drugs' used mainly at dance parties and in nightclubs on weekend nights. The purpose of this study was to examine the frequency of injecting drug use among GHB/GBL overdose patients and whether there are temporal differences in the occurrence of GHB/GBL overdoses of injecting drug and recreational drug users. Methods In this retrospective study, the ambulance and hospital records of suspected GHB- and GBL overdose patients treated by the Helsinki Emergency Medical Service from January 1st 2006 to December 31st 2007 were reviewed. According to the temporal occurrence of the overdose, patients were divided in two groups. In group A, the overdose occurred on a Friday-Saturday or Saturday-Sunday night between 11 pm-6 am. Group B consisted of overdoses occurring on outside this time frame. Results Group A consisted of 39 patient contacts and the remaining 61 patient contacts were in group B. There were statistically significant differences between the two groups in (group A vs. B, respectively: history of injecting drug abuse (33% vs. 59%, p = 0.012, reported polydrug and ethanol use (80% vs. 62%, p = 0.028, the location where the patients were encountered (private or public indoors or outdoors, 10%, 41%, 41% vs. 25%, 18%, 53%, p = 0.019 and how the knowledge of GHB/GBL use was obtained (reported by patient/bystanders or clinical suspicion, 72%, 28% vs. 85%, 10%, p = 0.023. Practically all (99% patients were transported to emergency department after prehospital care. Conclusion There appears to be at least two distinct groups of GHB/GBL users. Injecting drug users represent the majority of GHB/GBL overdose patients outside weekend nights.

[Illicit drug use by pregnant women infected with HIV].

Science.gov (United States)

Melo, Victor Hugo; Botelho, Ana Paula Machado; Maia, Marcelle Marie Martins; Correa, Mário Dias; Pinto, Jorge Andrade

2014-12-01

To determine if illicit drug use increases the vertical transmission of HIV, to identify the risk factors involved in mother and child health and the prevalence of illicit drug use among these pregnant women. Sixty-four (7.6%) of 845 pregnant women from the metropolitan region of Belo Horizonte, Minas Gerais, Brazil, attended in the service between October 1997 and February 2012 reported the use of illicit drugs. Cases were HIV-positive drug users (n=64) and controls were women who did not use drugs (n=192). Three controls were selected for each case. Several conditions of exposure were considered in the control group such as tobacco use, alcohol use, alcohol and tobacco use, maternal age, educational level, ethnicity, and marital status. Problems during the prenatal period, delivery and postpartum, vertical HIV transmission and neonatal outcomes were also investigated. Univariate analysis showed as significant variables: maternal age, tobacco use, number of prenatal care visits, antiretroviral therapy, mode of infection, and viral load at delivery. Logistic regression revealed as significant variables: maternal age (less than 25 years); tobacco use, and number of prenatal care visits (less than 6). The vertical transmission of HIV was 4,8% (95%CI 1.7-13.3) among drug users and 2,1% (95%CI 0.8-5.2) in the control group, with no statistically significant difference between groups. Neonatal complications were more frequent among drug users, but also with no statistically significant difference between groups. The use of illicit drug is frequent during pregnancy among HIV-infected women. The approach to illicit drug use should be routine during prenatal care visits. These women are more discriminated against and tend to deny their habits or do not seek prenatal care. There was no difference in vertical virus transmission between groups, probably indicating adherence to antiretroviral use for antiretroviral therapies during pregnancy.

A strategy to reduce illicit drug use is effective in elite Australian football.

Science.gov (United States)

Harcourt, Peter R; Unglik, Harry; Cook, Jill L

2012-10-01

The World Anti-Doping Agency (WADA) prescribes that drug testing is conducted in sports competitions to detect drug use in athletes. This testing includes performance-enhancing drugs as well as illicit substances such as marijuana, amphetamines and cocaine. Illicit drugs are tested for on match days but not on non-match days. Some athletes are known to use illicit substances for recreational purposes, away from competition times and this poses a serious health and welfare issue not addressed by the usual sport drug testing regimes. This paper reports the results of the first 7 years of an illicit drug-testing programme that included non-match day testing in the elite Australian Football competition, the Australian Football League (AFL). Players in the AFL were tested for illicit drugs both in-competition and out-of-competition. Players were selected for illicit substance tests either randomly or targeted based on previous test history or time since previous test. The number of tests conducted was increased each year from 2005 to 2011 and testing was focused on high-risk times during non-competition periods. There were no positive match day tests. There was a significant reduction in positive tests (19-6) for illicit drugs during non-competition periods over the 7 years (p<0.0001). The reduction in positive tests may be related to player education, the greater number of tests conducted and the harm minimisation approach of the illicit drug policy. An illicit drugs programme using a harm minimisation strategy can work effectively alongside a sport's WADA compliant Anti-Doping Code.

Exploring drug-target interaction networks of illicit drugs

OpenAIRE

Atreya, Ravi V; Sun, Jingchun; Zhao, Zhongming

2013-01-01

Background Drug addiction is a complex and chronic mental disease, which places a large burden on the American healthcare system due to its negative effects on patients and their families. Recently, network pharmacology is emerging as a promising approach to drug discovery by integrating network biology and polypharmacology, allowing for a deeper understanding of molecular mechanisms of drug actions at the systems level. This study seeks to apply this approach for investigation of illicit dru...

Rapid identification of drugs in the overdosed patient.

Science.gov (United States)

Hackett, L P; Dusci, L J

1977-01-01

A rapid analytical procedure is described for a variety of drugs that could be present in the overdosed patient. The technique used gives quantitative results for most of the drugs analyzed in serum using gas chromatography and incorporates thin-layer chromatography and spot tests for drug confirmation. The procedure is novel for it relies on the initial extraction of acidics, basics, and neutrals from serum acidified with hydroxhloric acid.

Illicit drug use and harms, and related interventions and policy in Canada: A narrative review of select key indicators and developments since 2000.

Science.gov (United States)

Fischer, Benedikt; Murphy, Yoko; Rudzinski, Katherine; MacPherson, Donald

2016-01-01

By the year 2000, Canada faced high levels of illicit drug use and related harms. Simultaneously, a fundamental tension had raisen between continuing a mainly repression-based versus shifting to a more health-oriented drug policy approach. Despite a wealth of new data and numerous individual studies that have emerged since then, no comprehensive review of key indicators and developments of illicit drug use/harm epidemiology, interventions and law/policy exist; this paper seeks to fill this gap. We searched and reviewed journal publications, as well as key reports, government publications, surveys, etc. reporting on data and information since 2000. Relevant data were selected and extracted for review inclusion, and subsequently grouped and narratively summarized in major topical sub-theme categories. Cannabis use has remained the principal form of illicit drug use; prescription opioid misuse has arisen as a new and extensive phenomenon. While new drug-related blood-borne-virus transmissions declined, overdose deaths increased in recent years. Acceptance and proliferation of - mainly local/community-based - health measures (e.g., needle exchange, crack paraphernalia or naloxone distribution) aiming at high-risk drug users has evolved, though reach and access limitations have persisted; Vancouver's 'supervised injection site' has attracted continued attention yet remains un-replicated elsewhere in Canada. While opioid maintenance treatment utilization increased, access to treatment for key (e.g., infectious disease, psychiatric) co-morbidities among drug users remained limited. Law enforcement continued to principally focus on cannabis and specifically cannabis users. 'Drug treatment courts' were introduced but have shown limited effectiveness; several attempts cannabis control law reform have failed, except for the recent establishment of 'medical cannabis' access provisions. While recent federal governments introduced several law and policy measures reinforcing a

Fatalities involving illicit drug use in Pretoria, South Africa, for the ...

African Journals Online (AJOL)

The most frequently detected drug was heroin, the presence of which was confirmed in 35.2% of cases, followed by cocaine in 19.9%. Alcohol in combination with an illicit drug or drugs was detected in 56 cases (36.4%). Conclusions. Results from this study indicate that illicit drugs were implicated in a considerable number ...

Concomitant overdosing of other drugs in patients with paracetamol poisoning

DEFF Research Database (Denmark)

Schmidt, Lars E; Dalhoff, Kim

2002-01-01

of the paracetamol intoxication. METHODS: Six hundred and seventy-one consecutive patients admitted with paracetamol poisoning were studied and concomitant drug intake was recorded. The relative risk of hepatic encephalopathy, death or liver transplantation, hepatic dysfunction, liver cell damage, and renal...... was a protective factor in the development of hepatic encephalopathy (OR 0.26; CI 0.07, 0.96). Concomitant acetylsalicylic acid overdose was a risk factor in the development of hepatic encephalopathy (OR 4.87; CI 1.52, 15.7) and death or liver transplantation (OR 6.04; CI 1.69, 21.6). A tendency towards a more...... favourable outcome was observed in patients with concomitant NSAID overdose. CONCLUSIONS: Concomitant overdosing of benzodiazepines or analgesics is frequent in patients admitted with paracetamol poisoning. Concomitant benzodiazepine or acetylsalicylic acid overdose was associated with more severe toxicity...

Drug use patterns among Thai illicit drug injectors amidst increased police presence

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Suwannawong Paisan

2009-07-01

Full Text Available Abstract Thailand has traditionally pursued an aggressive enforcement-based anti-illicit drug policy in an effort to make the country "drug-free." In light of this ongoing approach, we sought to assess impacts of enforcement on drug use behaviors among a cohort of injection drug users (IDU in Thailand. We examined drug use patterns among IDU participating in a cross-sectional study conducted in Bangkok (n = 252. Participants were asked to provide data regarding patterns of drug use in the previous six months, including types of drugs consumed, method of consumption, frequency of use, and weekly income spent on drugs. We also conducted bivariate analyses to identify a possible effect of a reported increase in police presence on measures of drug use and related risk behaviors among study participants. One hundred fifty-five (61.5% individuals reported injection heroin use and 132 (52.4% individuals reported injection midazolam use at least daily in the past six months. Additionally, 86 (34.1% individuals reported at least daily injection Yaba and Ice (i.e., methamphetamine use. Participants in our study reported high levels of illicit drug use, including the injection of both illicit and licit drugs. In bivariate analyses, no association between increased police presence and drug use behaviors was observed. These findings demonstrate high ongoing rates of drug injecting in Thailand despite reports of increased levels of strict enforcement and enforcement-related violence, and raise questions regarding the merits of this approach.

A further component analysis for illicit drugs mixtures with THz-TDS

Science.gov (United States)

Xiong, Wei; Shen, Jingling; He, Ting; Pan, Rui

2009-07-01

A new method for quantitative analysis of mixtures of illicit drugs with THz time domain spectroscopy was proposed and verified experimentally. In traditional method we need fingerprints of all the pure chemical components. In practical as only the objective components in a mixture and their absorption features are known, it is necessary and important to present a more practical technique for the detection and identification. Our new method of quantitatively inspect of the mixtures of illicit drugs is developed by using derivative spectrum. In this method, the ratio of objective components in a mixture can be obtained on the assumption that all objective components in the mixture and their absorption features are known but the unknown components are not needed. Then methamphetamine and flour, a illicit drug and a common adulterant, were selected for our experiment. The experimental result verified the effectiveness of the method, which suggested that it could be an effective method for quantitative identification of illicit drugs. This THz spectroscopy technique is great significant in the real-world applications of illicit drugs quantitative analysis. It could be an effective method in the field of security and pharmaceuticals inspection.

A strategy to reduce illicit drug use is effective in elite Australian football

Science.gov (United States)

Harcourt, Peter R; Unglik, Harry; Cook, Jill L

2012-01-01

Background The World Anti-Doping Agency (WADA) prescribes that drug testing is conducted in sports competitions to detect drug use in athletes. This testing includes performance-enhancing drugs as well as illicit substances such as marijuana, amphetamines and cocaine. Illicit drugs are tested for on match days but not on non-match days. Some athletes are known to use illicit substances for recreational purposes, away from competition times and this poses a serious health and welfare issue not addressed by the usual sport drug testing regimes. This paper reports the results of the first 7 years of an illicit drug-testing programme that included non-match day testing in the elite Australian Football competition, the Australian Football League (AFL). Methods Players in the AFL were tested for illicit drugs both in-competition and out-of-competition. Players were selected for illicit substance tests either randomly or targeted based on previous test history or time since previous test. The number of tests conducted was increased each year from 2005 to 2011 and testing was focused on high-risk times during non-competition periods. Results There were no positive match day tests. There was a significant reduction in positive tests (19–6) for illicit drugs during non-competition periods over the 7 years (psport's WADA compliant Anti-Doping Code. PMID:22893512

Drug affordability-potential tool for comparing illicit drug markets.

Science.gov (United States)

Groshkova, Teodora; Cunningham, Andrew; Royuela, Luis; Singleton, Nicola; Saggers, Tony; Sedefov, Roumen

2018-06-01

The importance of illicit drug price data and making appropriate adjustments for purity has been repeatedly highlighted for understanding illicit drug markets. The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has been collecting retail price data for a number of drug types alongside drug-specific purity information for over 15 years. While these data are useful for a number of monitoring and analytical purposes, they are not without their limitations and there are circumstances where additional adjustment needs to be considered. This paper reviews some conceptual issues and measurement challenges relevant to the interpretation of price data. It also highlights the issues with between-country comparisons of drug prices and introduces the concept of affordability of drugs, going beyond purity-adjustment to account for varying national economies. Based on a 2015 European data set of price and purity data across the heroin and cocaine retail markets, the paper demonstrates a new model for drug market comparative analysis; calculation of drug affordability is achieved by applying to purity-adjusted prices 2015 Price Level Indices (PLI, Eurostat). Available data allowed retail heroin and cocaine market comparison for 27 European countries. The lowest and highest unadjusted prices per gram were observed for heroin: in Estonia, Belgium, Greece and Bulgaria (lowest) and Finland, Ireland, Sweden and Latvia (highest); for cocaine: the Netherlands, Belgium and the United Kingdom (lowest) and Turkey, Finland, Estonia and Romania (highest). The affordability per gram of heroin and cocaine when taking into account adjustment for both purity and economy demonstrates different patterns. It is argued that purity-adjusted price alone provides an incomplete comparison of retail price across countries. The proposed new method takes account of the differing economic conditions within European countries, thus providing a more sophisticated tool for cross

Social causation and neighborhood selection underlie associations of neighborhood factors with illicit drug-using social networks and illicit drug use among adults relocated from public housing.

Science.gov (United States)

Linton, Sabriya L; Haley, Danielle F; Hunter-Jones, Josalin; Ross, Zev; Cooper, Hannah L F

2017-07-01

Theories of social causation and social influence, which posit that neighborhood and social network characteristics are distal causes of substance use, are frequently used to interpret associations among neighborhood characteristics, social network characteristics and substance use. These associations are also hypothesized to result from selection processes, in which substance use determines where people live and who they interact with. The potential for these competing selection mechanisms to co-occur has been underexplored among adults. This study utilizes path analysis to determine the paths that relate census tract characteristics (e.g., economic deprivation), social network characteristics (i.e., having ≥ 1 illicit drug-using network member) and illicit drug use, among 172 African American adults relocated from public housing in Atlanta, Georgia and followed from 2009 to 2014 (7 waves). Individual and network-level characteristics were captured using surveys. Census tract characteristics were created using administrative data. Waves 1 (pre-relocation), 2 (1st wave post-relocation), and 7 were analyzed. When controlling for individual-level sociodemographic factors, residing in census tracts with prior economic disadvantage was significantly associated with illicit drug use at wave 1; illicit drug use at wave 1 was significantly associated with living in economically-disadvantaged census tracts at wave 2; and violent crime at wave 2 was associated with illicit drug-using social network members at wave 7. Findings from this study support theories that describe social causation and neighborhood selection processes as explaining relationships of neighborhood characteristics with illicit drug use and illicit drug-using social networks. Policies that improve local economic and social conditions of neighborhoods may discourage substance use. Future studies should further identify the barriers that prevent substance users from obtaining housing in less

Economic-Social Analysis of Global Illicit Drug Trade

Directory of Open Access Journals (Sweden)

Salahedin Ghaderi

2003-11-01

Full Text Available Political unstability, less respect to the role of law, low life standards and suitable conditions for poppy/coca cultivation, have all affected on growing illicit drug international trafficking. Colombia is the center for global cocaine industry. Colombians had to use ship in the Carribean but now they pass Mexico where the costs are half of using ship. Mexican traffickers permit that the domestic poppy plants turned into herion, Colombian cocaine transited to USA and methamephtamine manufactured and distributed. Golden triangle in southeast Asia is one of the major regions for opium poppy cultivation. This region has seen many guerrilla warfare for selling illicit drugs especially in Myanmar. Manufactured hroin is usually dealt in Thailand. Golden Crescent region in southwest Asia has a suitable climate for opium poppy cultivation which provides necessay money for purchasing needed weapons by rival groups in northwestern border provinces of Afghanistan and Pakistan. Nigeria is one of the main centers for transporting heroin from Golden Crescent and cocaine from Brazil. Dominics run cocaine trade in New York and New England and Afro-American criminal organizations conduct heroin trading in big cities such as New york, Detroit, Chicago, Phila Delphia and Washington. Street trading of illicit drugs is mainly done by cultural or commanding gangs. Illicit drug traffickers apply many methods to laundering their profits including money exchange, smurfs, electronic transferring, and faced firms (the firms that are only registered.

Suicide risk among Thai illicit drug users with and without mental/alcohol use disorders

Science.gov (United States)

Kittirattanapaiboon, Phunnapa; Suttajit, Sirijit; Junsirimongkol, Boonsiri; Likhitsathian, Surinporn; Srisurapanont, Manit

2014-01-01

Background It is not yet known if the increased risk of suicide in substance abusers is caused by the causal and/or coexisting relationship between substance use and psychiatric disorders. This study was designed to estimate the suicide risk among individuals with illicit drug use alone, illicit drug users with mental disorders, and illicit drug users with alcohol use disorders. Methods Subjects were participants of the 2008 Thai National Mental Health Survey. They were asked for their illicit drug use in the past year. The Mini International Neuropsychiatric Interview (MINI), current suicidality (1 month prior to assessment), mood episodes, anxiety disorders, psychotic disorders, and alcohol use disorders were used for assessing mental/alcohol use disorders. A score of 1 or more for the MINI–Suicidality module was defined as the presence of suicide risk. Results Of the total 17,140 respondents, 537 currently used illicit drugs, while 1,194 respondents had a suicide risk. Common illicit drugs were kratom (59%) and (meth)amphetamine (24%). Compared with 16,603 Thais without illicit drug use, the illicit drug users with or without mental/alcohol use disorders (n=537) had an increased risk of suicide (adjusted odds ratio [OR], 95% confidence interval [CI] =2.09, 1.55–2.81). While those who used illicit drugs alone (no mental/alcohol use disorder) (n=348) had no increased risk of suicide (adjusted OR, 95% CI =1.04, 0.66–1.65), the illicit drug users with mental or alcohol use disorders (n=27 and n=162, respectively) had significantly increased risk of suicide (adjusted ORs, 95% CIs =14.06, 6.50–30.3 and 3.14, 1.98–4.99, respectively). Conclusion A key limitation of this study was the combined suicidal behaviors as a suicidality risk. Mental or alcohol use disorders found in this population actually increased the suicide risk. These findings support the coexisting relationship that mental and alcohol use disorders play a vital role in increasing the suicide

Illicit drug use is increasing among non-medical users of prescription drugs-Results from population-based surveys 2002-2014.

Science.gov (United States)

Karjalainen, Karoliina; Lintonen, Tomi; Hakkarainen, Pekka

2017-09-01

Non-medical use of prescription drugs (NMUPD) is known to be associated with illicit drug use, but less is known about how illicit drug use has changed in NMUPD. We examined (1) the changes in illicit drug use among Finnish non-medical users of prescription drugs during the 2000s and (2) whether the trends of illicit drug use differ by non-medical use of prescription drugs in the general population. Data were derived from population-based (aged 15-69) Drug Surveys conducted in Finland in 2002, 2006, 2010 and 2014. The response rates varied between 63% and 48%. NMUPD during the last year was measured (n=252). Past-year illicit drug use among non-medical users of prescription drugs and the reference population not reporting NMUPD (n=10,967) was compared. Logistic regression was used to estimate the p-values for trends. Illicit drug use has increased notably among Finnish non-medical users of prescription drugs (from 21% to 70%, p for trendillicit drug use also increased statistically significantly, but much more moderately (from 2.5% to 5.4%). The difference between the trends was confirmed by an interaction test (p=0.022). NMUPD seems to be increasingly merging with illicit drug use. This indicates an increasing prevalence of polydrug use among non-medical users of prescription drugs, which may bring about more severe harms and worse health outcomes for users and more challenges in regard to treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

Systematic review of surveillance by social media platforms for illicit drug use.

Science.gov (United States)

Kazemi, Donna M; Borsari, Brian; Levine, Maureen J; Dooley, Beau

2017-12-01

The use of social media (SM) as a surveillance tool of global illicit drug use is limited. To address this limitation, a systematic review of literature focused on the ability of SM to better recognize illicit drug use trends was addressed. A search was conducted in databases: PubMed, CINAHL via Ebsco, PsychINFO via Ebsco, Medline via Ebsco, ERIC, Cochrane Library, Science Direct, ABI/INFORM Complete and Communication and Mass Media Complete. Included studies were original research published in peer-reviewed journals between January 2005 and June 2015 that primarily focused on collecting data from SM platforms to track trends in illicit drug use. Excluded were studies focused on purchasing prescription drugs from illicit online pharmacies. Selected studies used a range of SM tools/applications, including message boards, Twitter and blog/forums/platform discussions. Limitations included relevance, a lack of standardized surveillance systems and a lack of efficient algorithms to isolate relevant items. Illicit drug use is a worldwide problem, and the rise of global social networking sites has led to the evolution of a readily accessible surveillance tool. Systematic approaches need to be developed to efficiently extract and analyze illicit drug content from social networks to supplement effective prevention programs. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

[International cooperation in combatting illicit drugs in Mozambique].

Science.gov (United States)

Buvana, Flávia; Ventura, Carla Aparecida Arena

2011-06-01

Countries from Southern Africa have formed a Development Community (SADC) to stimulate common actions in several areas, among them illicit drugs combat. In this context, the goal of this qualitative study was to identify information and perception about the cooperation set up between Mozambique and other SADC members in combatting illicit drugs. Data were collected through semi-structured interviews with public employees developing actions directed at the implementation of the Protocol to Combat Drugs in SADC. After transcriptions, the interviews were analyzed by content analysis and resulted in the categories: "Mozambique as a drugs corridor", "Cooperation Initiatives on Drugs among African countries", "Cooperation Difficulties in Africa", "Problems in Protocol Implementation" and "Difficulties to implement a control policy". As a consequence, there is a need to review and update the policies and strategies in the drugs area, as they are not contextualized in the country's current reality.

Recent illicit drug use among psychiatric patients in Brazil: a national representative study

Science.gov (United States)

Nahas, Miriam Almeida; Melo, Ana Paula Souto; Cournos, Francine; Mckinnon, Karen; Wainberg, Milton; Guimarães, Mark Drew Crosland

2017-01-01

ABSTRACT OBJECTIVE To estimate factors associated to illicit drug use among patients with mental illness in Brazil according to gender. METHODS A cross-sectional representative sample of psychiatric patients (2,475 individuals) was randomly selected from 11 hospitals and 15 public mental health outpatient clinics. Data on self-reported illicit drug use and sociodemographic, clinical and behavioral characteristics were obtained from face-to-face interviews. Logistic regression was used to estimate associations with recent illicit drug use. RESULTS The prevalence of any recent illicit drug use was 11.4%. Men had higher prevalence than women for all substances (17.5% and 5.6%, respectively). Lower education, history of physical violence, and history of homelessness were associated with drug use among men only; not professing a religion was associated with drug use in women only. For both men and women, younger age, current hospitalization, alcohol and tobacco use, history of incarceration, younger age at sexual debut, and more than one sexual partner were statistically associated with illicit drug use. CONCLUSIONS Recent illicit drug use among psychiatric patients is higher than among the general Brazilian population and it is associated with multiple factors including markers of psychiatric severity. Our data indicate the need for the development of gender-based drug-use interventions among psychiatric patients in Brazil. Integration of substance use treatment strategies with mental health treatment should be a priority. PMID:28832753

The lung effects of illicit drugs

OpenAIRE

Crista Laslo; Beatrice G. Ioan; Ovidiu G. Bratu; Bogdan Socea; Camelia Diaconu

2018-01-01

Illicit drugs use is a real public health issue, especially among young people. The totality of the drugs harmful effects on the body is difficult to quantify, especially because of poor epidemiological data and ethical concerns about the inclusion of consumers in clinical trials. However, health professionals need to be alert to identify, report and fight drug-related pathology. This article aims to draw attention to the lung pathology induced by the consumption of some of the most commonly ...

Relationships between Illicit Drug Use and Body Mass Index among Adolescents

Science.gov (United States)

Blackstone, Sarah R.; Herrmann, Lynn K.

2016-01-01

Prior research has established associations between body mass index (BMI) and use of alcohol, tobacco, and marijuana. However, little research has been done investigating the relationship between other common illicit drugs and BMI trends. The present study investigated whether adolescents who reported using illicit drugs showed differences in BMI…

Overdose Deaths Related to Fentanyl and Its Analogs - Ohio, January-February 2017.

Science.gov (United States)

Daniulaityte, Raminta; Juhascik, Matthew P; Strayer, Kraig E; Sizemore, Ioana E; Harshbarger, Kent E; Antonides, Heather M; Carlson, Robert R

2017-09-01

Ohio is experiencing unprecedented loss of life caused by unintentional drug overdoses (1), with illicitly manufactured fentanyl (IMF) emerging as a significant threat to public health (2,3). IMF is structurally similar to pharmaceutical fentanyl, but is produced in clandestine laboratories and includes fentanyl analogs that display wide variability in potency (2); variations in chemical composition of these drugs make detection more difficult. During 2010-2015, unintentional drug overdose deaths in Ohio increased 98%, from 1,544 to 3,050.* In Montgomery County (county seat: Dayton), one of the epicenters of the opioid epidemic in the state, unintentional drug overdose deaths increased 40% in 1 year, from 249 in 2015 to 349 in 2016 (estimated unadjusted mortality rate = 57.7 per 100,000) (4). IMFs have not been part of routine toxicology testing at the coroner's offices and other types of medical and criminal justice settings across the country (2,3). Thus, data on IMF test results in the current outbreak have been limited. The Wright State University and the Montgomery County Coroner's Office/Miami Valley Regional Crime Laboratory (MCCO/MVRCL) collaborated on a National Institutes of Health study of fentanyl analogs and metabolites and other drugs identified in 281 unintentional overdose fatalities in 24 Ohio counties during January-February 2017. Approximately 90% of all decedents tested positive for fentanyl, 48% for acryl fentanyl, 31% for furanyl fentanyl, and 8% for carfentanil. Pharmaceutical opioids were identified in 23% of cases, and heroin in 6%, with higher proportions of heroin-related deaths in Appalachian counties. The majority of decedents tested positive for more than one type of fentanyl. Evidence suggests the growing role of IMFs, and the declining presence of heroin and pharmaceutical opioids in unintentional overdose fatalities, compared with 2014-2016 data from Ohio and other states (3-5). There is a need to include testing for IMFs as part

Prescription drug overdose: between patients and their doctors

Directory of Open Access Journals (Sweden)

Ling W

2013-01-01

Full Text Available Walter Ling,1 Li-Tzy Wu21Department of Psychiatry and Biobehavioral Science, Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA; 2Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USAPrescription drug overdoses, mainly involving prescription opioids, have reached epidemic proportions in the United States over the past 20 years.1,2 Since 2003, prescription opioids have been involved in more drug-related overdose deaths than heroin and cocaine combined. Among patients who were prescribed opioids, an estimated 20% were prescribed high doses of opioids by either single or multiple physicians, and these patients appeared to account for the majority of prescription opioid-related overdoses.1,3,4 The increase in prescription overdose deaths has coincided with a major increase in prescription opioid sales.2 The prescribing practices of some physicians are often believed to have contributed in part to the increase in these overdose deaths. In a recently published perspective, Anna Lembke speculated on why doctors prescribe opioids to known prescription opioid abusers.5 Her article raises a timely and troubling issue for all of us interested in this area of medicine. Lembke identifies the root of the problem to lie in the changing societal attitude towards pain and suffering, the ever-growing availability of opioid medications, the regulatory requirements promulgated, and the perceived shift in the role of the medical professional in this context. Central to her argument is that physicians must now practice according to a set of externally imposed expectations of patients, payers, and regulators, putting the prescriber in the position of being "damned if you do and damned if you don’t". If Lembke is right, the physician now prescribes not according to what he or she wants to do, but according to what he or she must do. The result, at one extreme, is the patient acting as their

Recent illicit drug use among psychiatric patients in Brazil: a national representative study

Directory of Open Access Journals (Sweden)

Miriam Almeida Nahas

2017-08-01

Full Text Available ABSTRACT OBJECTIVE To estimate factors associated to illicit drug use among patients with mental illness in Brazil according to gender. METHODS A cross-sectional representative sample of psychiatric patients (2,475 individuals was randomly selected from 11 hospitals and 15 public mental health outpatient clinics. Data on self-reported illicit drug use and sociodemographic, clinical and behavioral characteristics were obtained from face-to-face interviews. Logistic regression was used to estimate associations with recent illicit drug use. RESULTS The prevalence of any recent illicit drug use was 11.4%. Men had higher prevalence than women for all substances (17.5% and 5.6%, respectively. Lower education, history of physical violence, and history of homelessness were associated with drug use among men only; not professing a religion was associated with drug use in women only. For both men and women, younger age, current hospitalization, alcohol and tobacco use, history of incarceration, younger age at sexual debut, and more than one sexual partner were statistically associated with illicit drug use. CONCLUSIONS Recent illicit drug use among psychiatric patients is higher than among the general Brazilian population and it is associated with multiple factors including markers of psychiatric severity. Our data indicate the need for the development of gender-based drug-use interventions among psychiatric patients in Brazil. Integration of substance use treatment strategies with mental health treatment should be a priority.

Recovery and identification of bacterial DNA from illicit drugs.

Science.gov (United States)

Cho, Kaymann T; Richardson, Michelle M; Kirkbride, K Paul; McNevin, Dennis; Nelson, Michelle; Pianca, Dennis; Roffey, Paul; Gahan, Michelle E

2014-02-01

Bacterial infections, including Bacillus anthracis (anthrax), are a common risk associated with illicit drug use, particularly among injecting drug users. There is, therefore, an urgent need to survey illicit drugs used for injection for the presence of bacteria and provide valuable information to health and forensic authorities. The objectives of this study were to develop a method for the extraction of bacterial DNA from illicit drugs and conduct a metagenomic survey of heroin and methamphetamine seized in the Australian Capital Territory during 2002-2011 for the presence of pathogens. Trends or patterns in drug contamination and their health implications for injecting drug users were also investigated. Methods based on the ChargeSwitch(®)gDNA mini kit (Invitrogen), QIAamp DNA extraction mini kit (QIAGEN) with and without bead-beating, and an organic phenol/chloroform extraction with ethanol precipitation were assessed for the recovery efficiency of both free and cellular bacterial DNA. Bacteria were identified using polymerase chain reaction and electrospray ionization-mass spectrometry (PCR/ESI-MS). An isopropanol pre-wash to remove traces of the drug and diluents, followed by a modified ChargeSwitch(®) method, was found to efficiently lyse cells and extract free and cellular DNA from Gram-positive and Gram-negative bacteria in heroin and methamphetamine which could then be identified by PCR/ESI-MS. Analysis of 12 heroin samples revealed the presence of DNA from species of Comamonas, Weissella, Bacillus, Streptococcus and Arthrobacter. No organisms were detected in the nine methamphetamine samples analysed. This study develops a method to extract and identify Gram-positive and Gram-negative bacteria from illicit drugs and demonstrates the presence of a range of bacterial pathogens in seized drug samples. These results will prove valuable for future work investigating trends or patterns in drug contamination and their health implications for injecting drug

Suicide risk among Thai illicit drug users with and without mental/alcohol use disorders

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Kittirattanapaiboon P

2014-03-01

Full Text Available Phunnapa Kittirattanapaiboon,1 Sirijit Suttajit,2 Boonsiri Junsirimongkol,1 Surinporn Likhitsathian,2 Manit Srisurapanont2 1Department of Mental Health, Ministry of Public Health, Nonthaburi, Thailand; 2Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Background: It is not yet known if the increased risk of suicide in substance abusers is caused by the causal and/or coexisting relationship between substance use and psychiatric disorders. This study was designed to estimate the suicide risk among individuals with illicit drug use alone, illicit drug users with mental disorders, and illicit drug users with alcohol use disorders. Methods: Subjects were participants of the 2008 Thai National Mental Health Survey. They were asked for their illicit drug use in the past year. The Mini International Neuropsychiatric Interview (MINI, current suicidality (1 month prior to assessment, mood episodes, anxiety disorders, psychotic disorders, and alcohol use disorders were used for assessing mental/alcohol use disorders. A score of 1 or more for the MINI–Suicidality module was defined as the presence of suicide risk. Results: Of the total 17,140 respondents, 537 currently used illicit drugs, while 1,194 respondents had a suicide risk. Common illicit drugs were kratom (59% and (methamphetamine (24%. Compared with 16,603 Thais without illicit drug use, the illicit drug users with or without mental/alcohol use disorders (n=537 had an increased risk of suicide (adjusted odds ratio [OR], 95% confidence interval [CI] =2.09, 1.55–2.81. While those who used illicit drugs alone (no mental/alcohol use disorder (n=348 had no increased risk of suicide (adjusted OR, 95% CI =1.04, 0.66–1.65, the illicit drug users with mental or alcohol use disorders (n=27 and n=162, respectively had significantly increased risk of suicide (adjusted ORs, 95% CIs =14.06, 6.50–30.3 and 3.14, 1.98–4.99, respectively. Conclusion: A key

12-step programs to reduce illicit drug use

DEFF Research Database (Denmark)

Filges, Trine; Nielsen, Sine Kirkegaard; Jørgensen, Anne-Marie Klint

2014-01-01

Many treatments are not rigorously evaluated as to their effectiveness, and it is uncertain which types of interventions are more effective than others in reducing illicit drug use. The aim of this paper is to provide a systematic mapping of the research literature of the effectiveness of 12-step...... programs in reducing illicit drug use. A systematic literature search was conducted based on 17 international and Nordic Bibliographic databases. A total of 15993 references were screened, and eleven unique studies were finally included in this mapping. The included studies demonstrated conflicting results...... regarding the effectiveness of the 12-step treatment and TSF in reducing individuals’ drug use. Two studies reported a positive effect of the TSF treatment compared to the comparison conditions in reducing drug use. Six studies reported no differences between 12-step program and the comparison condition...

Licit and illicit drugs: a group approach with teenagers

OpenAIRE

Deborah Amaral Donnini; Darilene Rocha Cordeiro; Bruna Camargos de Lima; Selma Maria da Fonseca Viegas

2017-01-01

This work is an extension intervention arising from the results of an epidemiological cross-sectional study with 605 teenagers from 13 to 16 years old. The extension actions had as a method the group educational practice on licit and illicit drugs, with 2.012 teenagers from 22 municipal and state public schools of the urban region of Divinópolis, State of Minas Gerais, Brazil, from March 2015 to February 2016. It aimed to work with group educational practices on licit and illicit drugs in the...

Radiographic abnormalities in tricyclic acid overdose

International Nuclear Information System (INIS)

Varnell, R.M.; Richardson, M.L.; Vincent, J.M.; Godwin, J.D.

1987-01-01

Several case reports have described adult respiratory distress syndrome (ARDS) secondary to tricyclic acid (TCA) overdose. During a 1-year period 83 patients requiring intubation secondary to drug overdose were evaluated. Abnormalities on chest radiographs occurred in 26 (50%) of the 54 patients with TCA overdose, compared to six (21%) of the 29 patients overdosed with other drugs. In addition, five (9%) of the patients with TCA overdose subsequently had radiographic and clinical abnormalities meeting the criteria for ARDS. Only one (3%) of the patients with non-TCA overdose subsequently had change suggesting ARDS. TCAs should be added to the list of drugs associated with ARDS, and TCA overdose should be considered a major risk factor in the development of radiographically evident abnormalities

A review of illicit psychoactive drug use in elective surgery patients: Detection, effects, and policy.

Science.gov (United States)

Selvaggi, Gennaro; Spagnolo, Antonio G; Elander, Anna

2017-12-01

Limited information is present in literature regarding detection of illicit drug users visiting physicians when planning elective surgery; also, there is no update manuscript that is illustrating the effects of illicit drugs use that require reconstructive surgery interventions. Aims of this manuscript are: 1) to summarize existing knowledge, and give surgeons information how to detect patients who might possible use illicit drugs; 2) to review the effects of illicit drug use that specifically require reconstructive surgery interventions; 3) to assess on existing policies on asymptomatic illicit drug users when planning elective surgery. Studies were identified by searching systematically in the electronic databases PubMed, Medline, The Cochrane Library and SveMed+. Because of the nature of research questions to be investigated (drug policy and surgery), a "systematic review" was not possible. In spite of some existing policies to detect illicit drug use in specific situations such as workplaces or acute trauma patients, there is a lack of data and lack of information, and subsequently no policy has ever been made, for detection and management of illicit drug use asymptomatic patients requesting or referred for plastic surgery interventions. This manuscript poses questions for further ethical evaluations and future policy. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Trends in Deaths Involving Heroin and Synthetic Opioids Excluding Methadone, and Law Enforcement Drug Product Reports, by Census Region - United States, 2006-2015.

Science.gov (United States)

O'Donnell, Julie K; Gladden, R Matthew; Seth, Puja

2017-09-01

Opioid overdose deaths quadrupled from 8,050 in 1999 to 33,091 in 2015 and accounted for 63% of drug overdose deaths in the United States in 2015. During 2010-2015, heroin overdose deaths quadrupled from 3,036 to 12,989 (1). Sharp increases in the supply of heroin and illicitly manufactured fentanyl (IMF) are likely contributing to increased deaths (2-6). CDC examined trends in unintentional and undetermined deaths involving heroin or synthetic opioids excluding methadone (i.e., synthetic opioids)* by the four U.S. Census regions during 2006-2015. Drug exhibits (i.e., drug products) obtained by law enforcement and reported to the Drug Enforcement Administration's (DEA's) National Forensic Laboratory Information System (NFLIS) that tested positive for heroin or fentanyl (i.e., drug reports) also were examined. All U.S. Census regions experienced substantial increases in deaths involving heroin from 2006 to 2015. Since 2010, the South and West experienced increases in heroin drug reports, whereas the Northeast and Midwest experienced steady increases during 2006-2015. † In the Northeast, Midwest, and South, deaths involving synthetic opioids and fentanyl drug reports increased considerably after 2013. These broad changes in the U.S. illicit drug market highlight the urgent need to track illicit drugs and enhance public health interventions targeting persons using or at high risk for using heroin or IMF.

Migration and illicit drug use among two types of male migrants in Shanghai, China.

Science.gov (United States)

Wong, Frank Y; He, N; Huang, Z J; Young, D; O'Conor, C; Ding, Y Y; Fu, C; Arayasirikul, S

2010-03-01

Large-scale internal migrations within China have led to speculation of increased drug use, but with little empirical evidence. This cross-sectional study examines the association between migration characteristics and illicit drug use in 100 general male migrants and 239 "money boys" (i.e., male migrants engaging in same-sex transactional sex) in Shanghai, China. Only three general male migrants reported any drug use. Among money boys, lifetime illicit drug use was 12%; Ecstasy and methamphetamine appeared to be the most popular drugs. In addition, depression prevalence was very high among both types of male migrants. Depression was associated with lifetime soft- and hard-drug use, while earning a higher income was associated with lifetime soft-drug use. These findings provide the first set of quantitative evidence of illicit drug use among Chinese male migrants. Although illicit drug use among male migrants is low compared to Western countries, its resurgence after 30 years of drug control gives cause for concern.

Pill-poppers and dopers: a comparison of non-medical prescription drug use and illicit/street drug use among college students.

Science.gov (United States)

Ford, Jason A; Arrastia, Meagan C

2008-07-01

Data from the 2001 College Alcohol Study, a national sample of U.S. college students, were used to conduct multinomial logistic regression analysis examining correlates of substance use. Students were divided into three groups based on their lifetime substance use: non-users, non-medical prescription drug use only, and illicit/street drug use only. The purpose of this analytic strategy was to examine the similarities/differences in the correlates of non-medical prescription drug use and illicit/street drug use. Findings indicate that race, age, G.P.A., sexual activity, health, binge drinking, marijuana use, social bonding and social learning measures are correlates of non-medical prescription drug use. Correlates of illicit/street drug use include gender, Hispanic ethnicity, sexual activity, binge drinking, marijuana use, social bonding and social learning measures. Finally, the focus of the paper is a comparison of students who report only non-medical prescription drug use to students who report only illicit/street drug use. Findings indicate that gender, race, marital status, sexual activity, marijuana use, and social bonding measures significantly distinguish illicit/street drug use from non-medical prescription drug use. Important implications, limitations, and future research needs were discussed.

Licit and illicit drugs: a group approach with teenagers

Directory of Open Access Journals (Sweden)

Deborah Amaral Donnini

2017-06-01

Full Text Available This work is an extension intervention arising from the results of an epidemiological cross-sectional study with 605 teenagers from 13 to 16 years old. The extension actions had as a method the group educational practice on licit and illicit drugs, with 2.012 teenagers from 22 municipal and state public schools of the urban region of Divinópolis, State of Minas Gerais, Brazil, from March 2015 to February 2016. It aimed to work with group educational practices on licit and illicit drugs in the school environment with teenagers. The extension and research allowed us to understand the context in which adolescents were inserted through the communication kept with them and among them; to know the level of information the teenagers had about licit and illicit drugs; to provide new knowledges, attitudes and opportunities in the recreation of an own way of selfcare. It was stressed that education is an important tool for health promotion and prevention of risks and hazards, as well as plays a key role in the formation of the proactive subject.

Illicit drug use among adolescent students. A peer phenomenon?

OpenAIRE

Cousineau, D.; Savard, M.; Allard, D.

1993-01-01

Illicit drug use was studied in 2071 students 11 to 18 years of age. Almost all drug users had friends who consumed drugs, compared with only one third of those who did not use drugs. This suggests a bond between adolescent drug users, who form a distinct group of which most students are unaware.

A review of ecological effects and environmental fate of illicit drugs in aquatic ecosystems.

Science.gov (United States)

Rosi-Marshall, E J; Snow, D; Bartelt-Hunt, S L; Paspalof, A; Tank, J L

2015-01-23

Although illicit drugs are detected in surface waters throughout the world, their environmental fate and ecological effects are not well understood. Many illicit drugs and their breakdown products have been detected in surface waters and temporal and spatial variability in use translates into "hot spots and hot moments" of occurrence. Illicit drug occurrence in regions of production and use and areas with insufficient wastewater treatment are not well studied and should be targeted for further study. Evidence suggests that illicit drugs may not be persistent, as their half-lives are relatively short, but may exhibit "pseudo-persistence" wherein continual use results in persistent occurrence. We reviewed the literature on the ecological effects of these compounds on aquatic organisms and although research is limited, a wide array of aquatic organisms, including bacteria, algae, invertebrates, and fishes, have receptors that make them potentially sensitive to these compounds. In summary, illicit drugs occur in surface waters and aquatic organisms may be affected by these compounds; research is needed that focuses on concentrations of illicit drugs in areas of production and high use, environmental fate of these compounds, and effects of these compounds on aquatic ecosystems at the concentrations that typically occur in the environment. Copyright © 2014 Elsevier B.V. All rights reserved.

Tobacco, illicit drugs use and risk of cardiovascular disease in patients living with HIV.

Science.gov (United States)

Raposeiras-Roubín, Sergio; Abu-Assi, Emad; Iñiguez-Romo, Andrés

2017-11-01

There is a strong link between HIV, smoking and illicit drugs. This association could be clinically relevant as it may potentiate the risk of cardiovascular diseases (CVD). The purpose of this review is to bring readers up to date on issues concerning the cardiovascular risk associated with tobacco and illicit drugs in patients living with HIV (PLHIV), examining the studies related to this topic published in the last year. There is a strong association between smoking and atherosclerotic disease in PLHIV, reducing life expectancy secondary to CVD by up to 6 years. Illicit drugs were associated with increased risk of atherosclerotic problems but to a lesser extent than smoking. A significant association of drugs such as cocaine with subclinical coronary atherosclerosis been demonstrated. The relation of marijuana, heroin and amphetamines with atherosclerosis generates more controversy. However, those drugs are associated with cardiovascular morbidity, independently of smoking and other traditional risk factors. Tobacco and illicit drugs are linked to CVD in HIV patients. This leads to the need to create special programs to address the addiction to smoking and illicit drugs, in order to mitigate their consequences and reduce cardiovascular risk.

How do Australian news media depict illicit drug issues? An analysis of print media reporting across and between illicit drugs, 2003-2008.

Science.gov (United States)

Hughes, Caitlin Elizabeth; Lancaster, Kari; Spicer, Bridget

2011-07-01

Media reporting on illicit issues has been frequently criticised for being sensationalised, biased and narrow. Yet, there have been few broad and systematic analyses of the nature of reporting. Using a large sample and methods commonly adopted in media communications analysis this paper sought to identify the dominant media portrayals used to denote illicit drugs in Australian newspapers and to compare and contrast portrayals across drug types. A retrospective content analysis of Australian print media was carried out over the period 2003-2008 from a sample comprised of 11 newspapers. Articles that contained one or more mention of five different drugs (or derivatives) were identified: cannabis, amphetamines, ecstasy, cocaine and heroin. A sub-sample of 4397 articles was selected for media content analysis (with 2045 selected for full content analysis) and a large number of text elements coded for each. Key elements included topic, explicit or implicit messages about the consequences of drugs/use and three value dimensions: overall tone, whether drugs were portrayed as a crisis issue and moral evaluations of drugs/use. The dominant media portrayals depicted law enforcement or criminal justice action (55%), but most articles were reported in a neutral manner, in the absence of crisis framings. Portrayals differed between drugs, with some containing more narrow frames and more explicit moral evaluations than others. For example, heroin was disproportionately framed as a drug that will lead to legal problems. In contrast, ecstasy and cocaine were much more likely to emphasise health and social problems. Media reporting on illicit drugs is heavily distorted towards crime and deviance framings, but may be less overtly sensationalised, biased and narrowly framed than previously suggested. This is not to suggest there is no sensationalism or imbalance, but this appears more associated with particular drug types and episodes of heightened public concern. Copyright © 2011

Risk behaviours of illicit drug users while travelling

Directory of Open Access Journals (Sweden)

Tatja Kostnapfel Rihtar

2013-07-01

Full Text Available Introduction: Despite various formal limitations, an increasing number of opioid users, especially those stabilised in substitution therapy, travel abroad, away from their permanent residence to neighbouring and remote countries on other continents. Drug users are particularly at risk to get infected with hepatitis A, B, C and HIV during travelling.The main objectives of the study were to identify and determine the frequency of potential travel-related risk behaviour, such as illicit drug use, sharing of injecting equipment, unprotected sex, involvement in criminal activities and the extent of risk in illicit drug users, included in the programmes of the Centers for Prevention and Treatment of Drug Addiction in Slovenia.Methods: The study was carried out in two phases. The first phase included semi-structured interviews conducted in a group of drug users willing to participate in the study. Based on the analysis of transcripts and additional data, the original questionnaire Risky behaviour of illicit drug users during travels was developed and filled in anonymously and on a voluntary basis at the network of Centres for Prevention and Treatment of Drug Addiction. Univariate analysis between independent and dependent factors was conducted based on chi-square test and t-test for independent factors. Multivariate analysis of the impact of independent factors on the dependent factor was conducted based on binary logistic regression.Results: The questionnaire was filled out anonymously and voluntarily by 776 individuals in 14 Slovene centres for prevention and treatment of drug addiction. The results confirmed the first hypothesis that drug users travelling away from their permanent residence are more likely to share their injecting equipment, and engage in unprotected sex and in drug-related crime, and the second hypothesis stating that illegal drug users included in the substitution treatment programmes, who regularly use drugs at home, more often

Mexicans' use of illicit drugs in an era of drug reform: national comparative analysis by migrant status.

Science.gov (United States)

Guerrero, Erick G; Villatoro, Jorge Ameth; Kong, Yinfei; Gamiño, Marycarmen Bustos; Vega, William A; Mora, Maria Elena Medina

2014-05-01

Although rates of illicit drug use are considerably lower in Mexico than in the United States, rates in Mexico have risen significantly. This increase has particular implications for Mexican women and US migrants, who are considered at increased risk of drug use. Due to drug reforms enacted in Mexico in 2008, it is critical to evaluate patterns of drug use among migrants who reside in both regions. We analysed a sample of Mexicans (N=16,249) surveyed during a national household survey in 2011, the Encuesta Nacional de Adicciones (National Survey of Addictions). Comparative analyses based on Mexicans' migrant status - (1) never in the United States, (2) visited the United States, or (3) lived in the United States (transnationals) - featured analysis of variance and Chi-square global tests. Two multilevel regressions were conducted to determine the relationships among migrant status, women, and illicit drug use. Comparative findings showed significant differences in type and number of drugs used among Mexicans by migrant status. The regression models showed that compared with Mexicans who had never visited the United States, Mexican transnationals were more likely to report having used drugs (OR=2.453, 95% CI=1.933, 3.113) and using more illicit drugs (IRR=2.061, 95% CI=1.626, 2.613). Women were less likely than men to report having used drugs (OR=0.187, 95% CI=0.146, 0.239) and using more illicit drugs (IRR=0.153, 95% CI=0.116, 0.202). Overall, the findings support further exploration of risk factors for illicit drug use among Mexican transnationals, who exhibit greater drug use behaviours than Mexicans never in the United States. Because drug reform mandates referrals to treatment for those with recurrent issues of drug use, it is critical for the Mexican government and civic society to develop the capacity to offer evidence-based substance abuse treatment for returning migrants with high-risk drug behaviours. Copyright © 2014 Elsevier B.V. All rights reserved.

Mexicans’ Use of Illicit Drugs in an Era of Drug Reform: National Comparative Analysis by Migrant Status

Science.gov (United States)

Villatoro, Jorge Ameth; Kong, Yinfei; Gamiño, Marycarmen Bustos; Vega, William A.; Mora, Maria Elena Medina

2014-01-01

Although rates of illicit drug use are considerably lower in Mexico than in the United States, rates in Mexico have risen significantly. This increase has particular implications for Mexican women and U.S. migrants, who are considered at increased risk of drug use. Due to drug reforms enacted in Mexico in 2008, it is critical to evaluate patterns of drug use among migrants who reside in both regions. We analysed a sample of Mexicans (N = 16,249) surveyed during a national household survey in 2011, the Encuesta Nacional de Adicciones (National Survey of Addictions). Comparative analyses based on Mexicans’ migrant status—(1) never in the United States, (2) visited the United States, or (3) lived in the United States (transnationals)—featured analysis of variance and chi-square global tests. Two multilevel regressions were conducted to determine the relationships among migrant status, women, and illicit drug use. Comparative findings showed significant differences in type and number of drugs used among Mexicans by migrant status. The regression models showed that compared with Mexicans who had never visited the United States, Mexican transnationals were more likely to report having used drugs (OR = 2.453, 95% CI = 1.933, 3.113) and using more illicit drugs (IRR = 2.061, 95% CI = 1.626, 2.613). Women were less likely than men to report having used drugs (OR = 0.187, 95% CI = 0.146, 0.239) and using more illicit drugs (IRR = 0.153, 95% CI = 0.116, 0.202). Overall, the findings support further exploration of risk factors for illicit drug use among Mexican transnationals, who exhibit greater drug use behaviours than Mexicans never in the United States. Because drug reform mandates referrals to treatment for those with recurrent issues of drug use, it is critical for the Mexican government and civic society to develop the capacity to offer evidence-based substance abuse treatment for returning migrants with high-risk drug behaviours. PMID:24816376

Disneyization: A framework for understanding illicit drug use in bounded play spaces.

Science.gov (United States)

Turner, Tim

2018-05-17

This paper combines evidence from an ethnographic study of illicit drug use amongst tourists in Ibiza with Bryman's (2004) theoretical model of Disneyization. The principal aim was to construct a new conceptual framework that may help scholars, practitioners and policy makers make sense of dynamic patterns of illegal drug use across bounded play spaces such as tourist resorts, music festivals and nightclubs. Ethnographic fieldwork employing a grounded theory design was undertaken over three summers in tourist locations on the Balearic island of Ibiza, including nightclubs, bars, cafes, beaches, airports and hotels. Field notes from participant observation were supplemented with data from semi-structured interviews (n = 56) and secondary sources gathered from tourist marketing. The framework of Disneyization has been discussed in terms of 5 constructs: theming, hybrid consumption, branding, performative labour and atmospheres; each having a specific role in relation to understanding illicit drug use in bounded play spaces. Thus: Theming sets the stage, by physically and symbolically demarcating space with indelible themes of hedonism that open up the possibility of illicit drug use. Hybrid-consumption blurs the distinction between legal and illegal forms of intoxication, making the trading and consumption of illegal drugs appear like a natural feature of the consumer space. Branding demonstrates how participants construct intricate hierarchies of taste and credibility related to drug of choice. Performative labour re-enforces hybrid consumption, with participants working in the bounded play spaces of Ibiza immersed within the illicit drug market. Atmospheres represents the alchemic synergy of bounded play space and is important to understanding illicit drug use as a sensorial, deeply immersive but transitory experience. This research offers Disneyization as a new conceptual framework for making sense of deeply complex spatial, socio-cultural, psychological and

EXPERIMENTATION AND REGULAR USE OF ILLICIT DRUGS BY STUDENTS IN THE CITY OF BRAGANÇA, NORTHEASTERN PARÁ.

Directory of Open Access Journals (Sweden)

Clemenes Prata Araújo

2013-03-01

Full Text Available This study determined the prevalence and factors associated with illicit drug useamongstudents inhighschools in the municipality of Bragança, Pará, northern Brazil. School-based cross-sectional study, a total of five public schools and 1632 students in the municipality ofBragança. The self-administered questionnaire was adapted from other epidemiological studies tothe appropriate population group, with rigorous procedure, guaranteeing anonymity andconfidentiality. The prevalence of illicit drug use among students was 4.37%. Several risk factors tothe use of licit and illicit drugs were detected, of which include: the lack of parental involvement inschool life of students, family income above 3 minimum wages, parents, friends and family whouse illicit drugs and lack of incentive to not use illegal drugs. In summary, this study found thatregular use of illicit drugs is associated with social and economic factors, which should beconsidered in the development of measures to control and prevent the use of illicit drugs in the cityof Bragança.

Heroin and fentanyl overdoses in Kentucky: Epidemiology and surveillance.

Science.gov (United States)

Slavova, Svetla; Costich, Julia F; Bunn, Terry L; Luu, Huong; Singleton, Michael; Hargrove, Sarah L; Triplett, Jeremy S; Quesinberry, Dana; Ralston, William; Ingram, Van

2017-08-01

The study aims to describe recent changes in Kentucky's drug overdose trends related to increased heroin and fentanyl involvement, and to discuss future directions for improved drug overdose surveillance. The study used multiple data sources (death certificates, postmortem toxicology results, emergency department [ED] records, law enforcement drug submissions, and prescription drug monitoring records) to describe temporal, geographic, and demographic changes in drug overdoses in Kentucky. Fentanyl- and heroin-related overdose death rates increased across all age groups from years 2011 to 2015 with the highest rates consistently among 25-34-year-olds. The majority of the heroin and fentanyl overdose decedents had histories of substantial exposures to legally acquired prescription opioids. Law enforcement drug submission data were strongly correlated with drug overdose ED and mortality data. The 2016 crude rate of heroin-related overdose ED visits was 104/100,000, a 68% increase from 2015 (62/100,000). More fentanyl-related overdose deaths were reported between October, 2015, and September, 2016, than ED visits, in striking contrast with the observed ratio of >10 to 1 heroin-related overdose ED visits to deaths. Many fatal fentanyl overdoses were associated with heroin adulterated with fentanyl; fentanyl and other synthetic drugs. In order to inform coordinated public health and safety responses, drug overdose surveillance must move from a reactive to a proactive mode, utilizing the infrastructure for electronic health records. Copyright © 2017 Elsevier B.V. All rights reserved.

Influence of depression and early adverse experiences on illicit drug dependence: a case-control study.

Science.gov (United States)

Ferigolo, Maristela; Stein, Airton T; Fuchs, Flavio D; Barros, Helena M T

2009-06-01

The purpose of this study was to investigate the association between depression and illicit drug dependence among a Latin-American population. illicit drug dependent patients (n = 137) and controls (n = 274) were interviewed using the Diagnostic Interview for Genetic Studies, in order to detect lifetime and current depressive disorder and illicit (cocaine, cannabis or inhalants) substance dependence. A regression analysis was used to estimate the odds ratio for drug dependence according to the diagnosis of depression. The lifetime diagnosis of depression (p = 0.001; OR = 4.9; 95% CI, 1.9-12.7) predicts illegal drugs dependence. Sociodemographic variables such as male gender (p drug dependence. Additional influent factors detected were having parents (p = 0.006; OR = 18.9; 95% CI, 2.3-158) or friends (p illicit drugs dependents. although a causal relationship between dependence on illicit drugs and depression cannot be determined, comparison of the sequence of events point to the occurrence of depression later in life than dependence. It remains to be determined whether depression is a comorbidity of dependence, sharing etiological factors, or a consequence of drug abuse and/or abstinence.

Relationship between marijuana and other illicit drug use and depression/suicidal thoughts among late middle-aged and older adults.

Science.gov (United States)

Choi, Namkee G; DiNitto, Diana M; Marti, C Nathan; Choi, Bryan Y

2016-04-01

Despite growing numbers of older-adult illicit drug users, research on this topic is rare. This study examined the relationship between marijuana and/or other illicit drug use and major depressive episode (MDE) and serious suicidal thoughts among those aged 50+ years in the USA. The public use files of the 2008 to 2012 US National Survey on Drug Use and Health (NSDUH) provided data on 29,634 individuals aged 50+ years. Logistic regression analysis was used to test hypothesized associations between past-year marijuana and/or other illicit drug use and MDE and serious suicidal thoughts. Nearly 6% of the 50+ years age group reported past-year marijuana and/or other illicit drug use. Compared to non-users of any illicit drug, the odds of past-year MDE among those who used marijuana only, other illicit drugs only, and marijuana and other illicit drugs were 1.54 (95% CI = 1.17-2.03), 2.75 (95% CI = 1.75-4.33), and 2.12 (95% CI = 1.45-3.09), respectively. Those who used marijuana and other drugs also had higher odds (2.44, 95% CI = 1.58-3.77) of suicidal thoughts than non-users of any illicit drug. However, among users of any illicit drug, no difference was found among users of marijuana only, marijuana and other illicit drugs, and other illicit drugs only. Among marijuana users, marijuana use frequency was a significant correlate of suicidal thoughts only among those with MDE. Health and mental health (MH) service providers should pay close attention to the potential reciprocal effects of marijuana and other illicit drug use and MDE and suicidal thoughts among late middle-aged and older adults.

Illicit drug exposure in patients evaluated for alleged child abuse and neglect.

Science.gov (United States)

Oral, Resmiye; Bayman, Levent; Assad, Abraham; Wibbenmeyer, Lucy; Buhrow, Jakob; Austin, Andrea; Bayman, Emine O

2011-06-01

Substantiation of drug exposure in cases with alleged maltreatment is important to provide proper treatment and services to these children and their families. A study performed at University of Iowa Hospitals and Clinics showed that 30% of pediatric patients with burn injuries, which were due to child maltreatment, were also exposed to illicit drugs. The children presenting to the University of Iowa Hospitals and Clinics with alleged maltreatment have been tested for illicit substances since 2004. The objective of this study was to analyze the presence of illicit drug exposure in the pediatric subpopulation admitted to pediatric inpatient and outpatient units for an evaluation for abuse/neglect. The study design is a retrospective chart review. Using hospital databases, every pediatric chart with a child abuse/neglect allegation was retrieved. The association between risk factors and clinical presentation and illicit drug test result was assessed. Excel and SAS were used for statistical analysis. Institutional review board approval was obtained to conduct this study. Six hundred sixty-five charts met study inclusion criteria for child abuse/neglect allegation. Of those, 232 cases were tested for illicit drugs between 2004 and 2008 per the testing protocol. Thirty-four cases (14.7%) tested positive on a drug test. Positive test rates based on clinical presentation were 28.6% (18/63) in neglect cases, 16.1% (5/31) in cases with soft tissue injuries, 14.3% (4/28) in burn injuries, 10.0% (2/20) in cases with sexual abuse, 7.1% (2/28) in cases with fractures, and 4.8% (3/62) in abusive head trauma cases. There were long-term abuse findings in 129 children (55.6%). Logistic regression analysis revealed that positive drug testing was most significantly associated with clinical symptoms suggesting physical abuse or neglect versus sexual abuse (odds ratio [OR] = 6.70; 95% confidence interval [CI], 1.26-35.49; P = 0.026), no or public health insurance versus those with

Pharmaceuticals and illicit drugs in wastewater samples in north-eastern Tunisia.

Science.gov (United States)

Moslah, Bilel; Hapeshi, Evroula; Jrad, Amel; Fatta-Kassinos, Despo; Hedhili, Abderrazek

2017-04-07

Pharmaceutically active substances (PhACs) and drugs of abuse (DAs) are two classes of contaminants of emerging concern that have attracted great concern and interest by the scientific community during the last two decades. Numerous studies have revealed their presence in treated urban wastewaters. This is mainly due to the fact that some compounds are not efficiently removed during wastewater treatment processes, and are thus able to reach the aquatic environment through wastewater discharge and reuse practices. The application of an optimized multi-residue method for the simultaneous confirmation and quantification of licit and illicit drugs has been investigated in influent and effluent wastewater samples from seven wastewater treatment plants (WWTPs) located in north-eastern Tunisia. Analysis was performed through ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). Out of 12 pharmaceutical compounds analyzed, 11 of them were detected mainly in effluent wastewaters. In both matrices, antibiotics and β-blockers were the most detected groups. This suggests that these compounds show noticeable resistance against biological treatment in WWTPs. The estimated concentrations of antibiotics in effluents ranged from ca. 35 ng/L to 1.2 μg/L. However, all five studied illicit drugs were detected, mainly in influent wastewaters. Forensic investigation performed on people suspected to be drug abusers covering all Tunisian cities was conducted by monitoring an epidemiological study of human urine samples surveying rate of consumption for illicit drugs. Hence, these preliminary results confirmed the presence of illicit drugs in the influent wastewater samples. For example, quantification ranges for cocaine were found to be 25-450 ng/L in influent wastewater samples. Significant differences for cocaine consumption across the two sampling methods were observed. Consequently, we conclude that the analyses in wastewater are more reflective of the

Latent classes of polydrug and polyroute use and associations with human immunodeficiency virus risk behaviours and overdose among people who inject drugs in Tijuana, Baja California, Mexico.

Science.gov (United States)

Meacham, Meredith C; Roesch, Scott C; Strathdee, Steffanie A; Lindsay, Suzanne; Gonzalez-Zuniga, Patricia; Gaines, Tommi L

2018-01-01

Patterns of polydrug use among people who inject drugs (PWID) may be differentially associated with overdose and unique human immunodeficiency virus (HIV) risk factors. Subgroups of PWID in Tijuana, Mexico, were identified based on substances used, route of administration, frequency of use and co-injection indicators. Participants were PWID residing in Tijuana age ≥18 years sampled from 2011 to 2012 who reported injecting an illicit substance in the past month (n = 735). Latent class analysis identified discrete classes of polydrug use characterised by 11 indicators of past 6 months substance use. Multinomial logistic regression examined class membership association with HIV risk behaviours, overdose and other covariates using an automated three-step procedure in mplus to account for classification error. Participants were classified into five subgroups. Two polydrug and polyroute classes were defined by use of multiple substances through several routes of administration and were primarily distinguished from each other by cocaine use (class 1: 5%) or no cocaine use (class 2: 29%). The other classes consisted primarily of injectors: cocaine, methamphetamine and heroin injection (class 3: 4%); methamphetamine and heroin injection (class 4: 10%); and heroin injection (class 5: 52%). Compared with the heroin-only injection class, memberships in the two polydrug and polyroute use classes were independently associated with both HIV injection and sexual risk behaviours. Substance use patterns among PWID in Tijuana are highly heterogeneous, and polydrug and polyroute users are a high-risk subgroup who may require more tailored prevention and treatment interventions. [Meacham MC, Roesch SC, Strathdee SA, Lindsay S, Gonzalez-Zuniga P, Gaines TL. Latent classes of polydrug and polyroute use and associations with human immunodeficiency virus risk behaviours and overdose among people who inject drugs in Tijuana, Baja California, Mexico. Drug Alcohol Rev 2018;37:128-136]. �

Illicit drug use and violence in acute psychosis among acute adult ...

African Journals Online (AJOL)

Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch ... Background and objective: The prevalence of mental illness and illicit .... risk to the patients or adverse implications on their rights ... (age, gender, and drainage area), illicit drug use, violent ... whom (62.6%) were older than 35 years.

Vital Signs-Preventing Prescription Drug Overdose

Centers for Disease Control (CDC) Podcasts

This podcast is based on the July 2014 CDC Vital Signs report. Every day, 46 people in the U.S. die from an overdose of prescription opioid painkillers. Learn what can be done to make painkiller prescribing safer and help prevent overdoses.

Evaluation of the health effects of occupational exposure of analytic laboratory workers processing illicit drug investigation files.

Science.gov (United States)

Bentur, Y; Bentur, L; Rotenberg, M; Tepperberg, M; Leiba, R; Wolf, E Udi

2013-05-01

The Analytic Laboratory of Israel Police processes illicit drug files. In recent years, workers of this laboratory have complained of health problems. Limited information exists on the effect of occupational exposure to illicit drugs; biomonitoring was never done. To assess health effects and systemic absorption of illicit drugs in workers of the Analytic Laboratory occupationally exposed to illicit drugs. A prospective cohort study using health and occupational questionnaires, clinical assessments, and monitoring of urinary excretion of illicit drugs was conducted. The study included three blocks of one week each. At each week workers were assessed at the beginning (baseline), and the assessments were repeated at the end of the three working days. Urine specimens were analyzed for illicit drugs in an independent laboratory. Demographic, clinical, occupational, and laboratory data were subjected to descriptive analysis, and paired Student's t-test, chi-square analysis, and repeated measures model. Twenty-seven workers (age, 39.2 ± 8.3 years; 77.8% females) were included, yielding 122 paired samples. The following parameters were reduced at the end of shift compared with baseline: diastolic blood pressure (71.2 ± 11.2 and 77.2 ± 13.6 mmHg, respectively, p health complaints included headache, fatigue, and dry eyes. No illicit drug was detected in the urine specimens. It is suggested that the health concerns of the laboratory workers were not related to the absorption of illicit drugs; environmental conditions (e.g. inadequate ventilation and respirable dust) can contribute to these concerns.

Preventing Prescription Drug Overdose PSA (:60)

Centers for Disease Control (CDC) Podcasts

This 60 second public service announcement is based on the July 2014 CDC Vital Signs report. Every day, 46 people in the U.S. die from an overdose of prescription opioid painkillers. Learn what can be done to make painkiller prescribing safer and help prevent overdoses.

[Peer group influence and illicit drug use among adolescent students in Brazil: a cross-sectional study].

Science.gov (United States)

Jorge, Kelly Oliva; Ferreira, Raquel Conceição; Ferreira, Efigênia Ferreira E; Kawachi, Ichiro; Zarzar, Patrícia Maria; Pordeus, Isabela Almeida

2018-03-08

The aim of the present cross-sectional study was to examine illicit drug use and associations with socioeconomic factors as well as peer group influence among Brazilian adolescents aged 15 to 19 years. Two-stage cluster sampling was adopted, involving the random selection of public and private schools from the nine administrative districts of a Brazilian state capital and the random selection of classrooms at each school. Illicit drug use was the outcome and was measured through the question: "Have you ever used any illicit drugs (marijuana, inhalants, hypnotics, cocaine/crack, hallucinogens, amphetamines and opioids) in your life?". The most important group of friends was ranked as school, family, religious activities and sports/culture. The area-based Health Vulnerability Index (HVI) was used to assess socioeconomic status. Data from 891 adolescents were analyzed using the chi-squared test and logistic regression. The overall rate of illicit drug use was 15.2%. Gender heterogeneity within groups (OR = 3.14; 95%CI: 1.63-6.06), religion-based friendships (OR = 0.36; 95%CI: 0.17-0.75) and sports/culture-based friendships (OR = 0.44; 95%CI: 0.22-0.87) remained significantly associated with illicit drug use. Adolescents who lived in less vulnerable areas had higher chance of drug use in comparison with those living in more vulnerable areas. Religion-based and sports/culture-based friendships seem to demonstrate a protective effect against lifetime illicit drug use. Gender heterogeneity within groups and residing in a less vulnerable area increased the chances of adolescents reporting illicit drug use.

Illicit drug use in seven Latin American countries: critical perspectives of families and familiars.

Science.gov (United States)

Silva, Jaqueline da; Ventura, Carla Aparecida Arena; Vargens, Octavio Muniz da Costa; Loyola, Cristina Maria Douat; Albarracín, Daniel Gonzalo Eslava; Diaz, Jorge; Funes, Gladys Magdalena Rodríguez; Hernández, Mabell Granados; Torres, Ruth Magdalena Gallegos; Rodriguez, Ruth Jakeline Oviedo

2009-01-01

This cross-sectional multi-centre study explored how family members and friends of illicit drug users perceived protective and risk factors, treatment facilities and policies and laws regarding illicit drug use. Family members and friends of illicit drug users were recruited in 10 urban health care outpatient units in 7 Latin American countries (Brazil, Colombia, Costa Rica, Ecuador, Guatemala, Honduras and Mexico) to complete a questionnaire. The majority of the respondents chose psycho-social factors over genetic or biological explanations as causes of drug problems. Respondents felt that families and governments were responsible for preventing drug problems. Church/religious institutions were most often mentioned in the context of accessible treatment. When asked about access to treatment facilities, the majority said that there were not enough. Shame about drug use, cost, and limited treatment options were most often cited as barriers to treatment.

Young Women's Experiences of Resisting Invitations to Use Illicit Drugs

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Koehn, Corinne V.; O'Neill, Linda K.

2011-01-01

Ten young women were interviewed regarding their experiences of resisting invitations to use illicit drugs. Hermeneutic phenomenology was used to gather and analyze information. One key theme was the motivations that inspired women to refuse drug offers. Young women resisted drug invitations because of their desires to be authentic, protect their…

Hepatitis C, illicit drug use and public health: does Canada really have a viable plan?

Science.gov (United States)

Fischer, Benedikt; Kalousek, Kate; Rehm, Jürgen; Powis, Jeff; Krajden, Mel; Reimer, Jens

2006-01-01

Some 300,000 individuals are infected with the hepatitis C virus (HCV) in Canada. HCV infection is associated with major morbidity, mortality and health care costs; these indicators are projected to rise over the next decade. The vast majority of prevalent and incident HCV infections in Canada are illicit drug use-related; thus, the HCV disease burden can only be addressed through interventions targeting this primary risk factor. Both preventive (e.g., needle exchange, methadone treatment) and therapeutic (e.g., the accessibility of HCV treatment for illicit drug users) interventions aimed at HCV in illicit drug users have been broadly expanded in Canada in recent years. However, evidence suggests that existing preventive measures only offer limited effectiveness in reducing HCV risk exposure. Also, due to restricted resources, treatment for HCV currently only reaches an extremely small proportion (i.e., Canada is not achieving a net reduction in the prevalence of HCV-related to illicit drug use. In order to reduce the HCV disease burden, Canada needs to reconsider the scope, delivery and resourcing of both preventive and treatment interventions targeting the primary risk population of illicit drug users.

Use of illicit drugs by adolescents and young adults of an urban settlement in Brazil.

Science.gov (United States)

Guimarães, Rafael Alves; Souza, Márcia Maria de; Caetano, Karlla Antonieta Amorim; Teles, Sheila Araujo; Matos, Marcos André de

2018-02-01

To estimate the prevalence and factors associated with illicit drug use by adolescents and young adults of a formal urban settlement. Cross-sectional study including adolescents and young adults 12-24 years of an urban settlement in the Midwest Region of Brazil. Data were collected using a structured questionnaire and analyzed using Stata, version 12.0. We used Poisson regression model to estimate the factors associated with illicit drug use. Of the total participants (n=105), 27.6% (95CI 20.0-36.9%) had used illicit drugs such as marijuana, cocaine, crack, LSD and inhalants. The consumption of these substances was associated with male gender, use of body piercing and/or tattoos, licit drug use and self-report of signs and/or symptoms of sexually transmitted infections. High prevalence of illicit drug use was found in the individuals investigated, ratifying the presence of risk factors to the vulnerability of the settlers to use these substances in the urban settlement population.

Prepovedane droge v slovenskih množičnih medijih: Illicit drugs in Slovene mass media:

OpenAIRE

Drev, Andreja; Kamin, Tanja; Sever, Maja

2006-01-01

Aim: The purpose of the article was to establish the frequency of Slovene media reports on illicit drugs, as well as to identify the main initiators of media coverage of illicit drugs and to determine the influence of health institutions on the information provided. Method: During the period studied, we collected 360 articles on illicit drugs published in twelve selected Slovene mass media. Basic techniques of descriptive statistical analysis and statistical significance tests were used. The ...

The use of crack and other illicit drugs impacts oral health-related quality of life in Brazilians.

Science.gov (United States)

Antoniazzi, R P; Zanatta, F B; Ardenghi, T M; Feldens, C A

2018-04-01

The aim of this study was to investigate the impact of the use of crack and other illicit drugs on oral health-related quality of life (OHRQoL) in young adults. This cross-sectional study evaluated 106 crack users at a public treatment center for drug addiction and 106 controls matched for gender, age, and use of tobacco. Clinical examinations were performed for dental caries and periodontal disease. The outcome was OHRQoL, which was determined using the Oral Health Impact Profile (OHIP-14). The association between OHRQoL and illicit drugs was modeled using conditional Poisson regression. Users of crack and other illicit drugs had a poorer OHRQoL than the controls (p illicit drugs. Users of crack and other illicit drugs exerted a negative impact on OHRQoL independently of socio-demographic characteristics and tobacco use, suggesting the need for special attention regarding the specific oral health needs of this population as well as drug prevention and treatment strategies. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.

The social exigencies of the gateway progression to the use of illicit drugs from adolescence into adulthood.

Science.gov (United States)

Otten, Roy; Mun, Chung Jung; Dishion, Thomas J

2017-10-01

There is limited empirical integration between peer clustering theory and the Gateway framework. The goal of the present study was to test the hypothesis that friendship associations partly predict gateway escalations in the use of drugs from adolescence to adulthood. This longitudinal study analyzed 3 waves of data from a community sample of 711 male and female participants without a history of illicit drug use reporting drug use at age 17, 22, and 27. Substance use assessments including tobacco, alcohol, cannabis, onset and abuse/dependence tendency of illicit drugs other than cannabis (i.e., cocaine, methamphetamine, and opiates), and friends' reported use of illicit drugs. Structural equation modeling was used to test the hypothesized model. Participants' cannabis use level at age 17 was positively associated with perceived friends' drug use at age 22, which in turn predicted participants' onset of illicit drug use between ages 22 and 27. Moreover, progression of tobacco use throughout age 17 to 22 was associated with an increased onset of illicit drug use between ages 22 and 27. Apart for an effect of cannabis use at age 22 on abuse and dependence tendency to various drugs at age 28, results were similar. During this period of development, the availability and selection of drug-using friends contributes to the progression to potentially more rewarding and damaging illicit drugs. These findings suggest the need to attend to the peer ecology in prevention and support the common practice of using abstaining peers in treatment for drug dependence. Copyright © 2017. Published by Elsevier Ltd.

Frequency Of Illicit Drug Consumption In The First Trimester Of Pregnancy (Tehran - 2001

Directory of Open Access Journals (Sweden)

Ramezanzadeh f

2003-11-01

Full Text Available Illicit drug abuse is a major area of interest for clinicians, as well as for public health and social authorities, but one of the major concerns is the illicit drug abuse during the periconceptional period and throughout pregnancy, because of its potential effects on the embryo and fetus. In this study we investigated the prevalence of illicit drug abuse in the first trimester of pregnancy in women who referred to Iran, Tehran and Shahid Beheshti universities of medical sciences, for prenatal care."nMaterials and Methods: In this descriptive cross sectional study, a non-randomized sample of 2000 pregnant women that were in their second and third trimester of their pregnancy, were interviewed about drug abuse in their first trimester. Collected data were analyzed by SPSS software."nResults: The prevalence of illicit drug abuse in the first trimester was 2.5% which the majority of these drugs were in group B. The prevalence of drug abuse was 0.9% and alcohol usage and alcohol abuse was 0.2%, cigarette smoking was the most common drug abusing phenomena. Variables such as husband education, infertility and satisfaction with pregnancy have significant relation with drug abuse."nConclusion: The results of this study support the need for continued education and this education must end in by itself to make dramatic changes in behavior. So results of this study showed that, improving education and knowledge of mothers and consultation with them in regard to risks and complications of drug abuse during pregnancy, would make dramatic changes in their behavior."n"n"n"n"n"n"n"n 

General Beliefs and Stigma Regarding Illicit Drug Use: Perspectives of Family Members and Significant Others of Drug Users in an Inner City in Brazil.

Science.gov (United States)

Ventura, Carla Aparecida Arena; Carrara, Bruna Sordi; Bobbili, Sireesha; Vedana, Kelly Graziani Giacchero; Khenti, Akwatu; Hayashida, Miyeko; Ferreira, Paulo Sergio

2017-09-01

People who use drugs are continuously subjected to harsh stigmatization through a process of relational and social degradation, which limits their possibility for recovery. This quantitative study explores the perspectives of family members or significant others of illicit drug users, regarding general beliefs about illicit drug use and their stigma. Respondents agree that most people do not trust people who use drugs, disregard individuals who have been hospitalized due to drug problems and do not think people who use drugs are as intelligent as the general population. These findings reveal a high level of public stigma regarding illicit drug use.

Suicidal behaviours in male and female users of illicit drugs recruited in drug treatment facilities

Directory of Open Access Journals (Sweden)

Elisabet Arribas-Ibar

2017-07-01

Conclusions: Prevalence of suicidal ideation/plans was high among illicit drug users recruited from healthcare facilities. Besides psychological variables, participation in illegal market activities and crime ought to be considered in drug users’ suicidal prevention. Suicide risk needs to be evaluated in drug treatment facilities and psychological status and context contemplated.

The role of illicit, licit, and designer drugs in the traffic in Hungary.

Science.gov (United States)

Institóris, László; Hidvégi, Előd; Dobos, Adrienn; Sija, Éva; Kereszty, Éva M; Tajti, László Balázs; Somogyi, Gábor Pál; Varga, Tibor

2017-06-01

The aim of this study was to investigate the prevalence and pattern of psychoactive substances among suspected DUID (Driving Under the Influence of Drugs) drivers in Hungary in 2014 and 2015. Blood and/or urine samples of 1252 suspected drivers (600 in 2014 and 652 in 2015) were analyzed for classical illicit and licit drugs, stimulant designer drugs (SDDs), and for synthetic cannabinoids, with 78.3% and 79.6% positive cases for at least one substance in 2014, and 2015, respectively. Impairment was proven in 39.2% (2014) and 35.7% (2015) of all drivers tested, based on the legal criteria of Hungary. Classical illicit drugs were found to be present in blood or urine of 89-61%, drivers tested. Drivers also tested positive for legal medications in 20-22%, SDDs in 21-28%, and synthetic cannabinoids in 15-19% of all cases. This indicates a drop in prevalence for classical illicit drugs and a slight but statistically non-significant increase for the other three substance groups. The distribution of drug types in each category were: [1] classical illicit drugs: cannabis (432), amphetamine (321), and cocaine (79); [2] medicines: alprazolam (94) and clonazepam (36); [3] SDDs: pentedrone (137) and α-PVP (33); [4] synthetic cannabinoids: AB-CHMINACA (46) and MDMB-CHMICA (30). The average age of illicit drug and SDD users was 30 years, while legal medications users were 36 years old on average, and the mean age of synthetic cannabinoid users was 26.5 years. The presence of both alcohol and at least one drug in samples was found in about 10% of the cases, both years. The ratio of multi-drug use was 33.0% in 2014 and 41.3% in 2015. Compared to former years the number of drivers who tested positive for drugs doubled in Hungary, but it is still low compared to alcohol positive cases. The relatively low detected rate of DUID can be explained by (1) combined alcohol consumption masking drug symptoms, (2) the absence of road-side tests for illicit and designer drugs and, (3) police

Vital Signs-Preventing Prescription Drug Overdose

Centers for Disease Control (CDC) Podcasts

2014-07-01

This podcast is based on the July 2014 CDC Vital Signs report. Every day, 46 people in the U.S. die from an overdose of prescription opioid painkillers. Learn what can be done to make painkiller prescribing safer and help prevent overdoses.  Created: 7/1/2014 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 7/1/2014.

Studying illicit drug trafficking on Darknet markets: Structure and organisation from a Canadian perspective.

Science.gov (United States)

Broséus, J; Rhumorbarbe, D; Mireault, C; Ouellette, V; Crispino, F; Décary-Hétu, D

2016-07-01

Cryptomarkets are online marketplaces that are part of the Dark Web and mainly devoted to the sale of illicit drugs. They combine tools to ensure anonymity of participants with the delivery of products by mail to enable the development of illicit drug trafficking. Using data collected on eight cryptomarkets, this study provides an overview of the Canadian illicit drug market. It seeks to inform about the most prevalent illicit drugs vendors offer for sale and preferred destination countries. Moreover, the research gives an insight into the structure and organisation of distribution networks existing online. In particular, we provide information about how vendors are diversifying and replicating across marketplaces. We inform on the number of listings each vendor manages, the number of cryptomarkets they are active on and the products they offer. This research demonstrates the importance of online marketplaces in the context of illicit drug trafficking. It shows how the analysis of data available online may elicit knowledge on criminal activities. Such knowledge is mandatory to design efficient policy for monitoring or repressive purposes against anonymous marketplaces. Nevertheless, trafficking on Dark Net markets is difficult to analyse based only on digital data. A more holistic approach for investigating this crime problem should be developed. This should rely on a combined use and interpretation of digital and physical data within a single collaborative intelligence model. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Use of illicit drugs by adolescents and young adults of an urban settlement in Brazil

Directory of Open Access Journals (Sweden)

Rafael Alves Guimarães

Full Text Available Summary Objective: To estimate the prevalence and factors associated with illicit drug use by adolescents and young adults of a formal urban settlement. Method: Cross-sectional study including adolescents and young adults 12-24 years of an urban settlement in the Midwest Region of Brazil. Data were collected using a structured questionnaire and analyzed using Stata, version 12.0. We used Poisson regression model to estimate the factors associated with illicit drug use. Results: Of the total participants (n=105, 27.6% (95CI 20.0-36.9% had used illicit drugs such as marijuana, cocaine, crack, LSD and inhalants. The consumption of these substances was associated with male gender, use of body piercing and/or tattoos, licit drug use and self-report of signs and/or symptoms of sexually transmitted infections. Conclusion: High prevalence of illicit drug use was found in the individuals investigated, ratifying the presence of risk factors to the vulnerability of the settlers to use these substances in the urban settlement population.

Tobacco, alcohol and illicit drugs during pregnancy and risk of neuroblastoma: systematic review.

Science.gov (United States)

Müller-Schulte, Eloise; Kurlemann, Gerhard; Harder, Anja

2017-11-21

To determine whether prenatal and perinatal maternal consumption of alcohol, tobacco and/or illicit drugs is associated with risk of neuroblastoma. Medline and Embase (both from inception to February 2017), and reference lists of included studies. To be eligible, a study had to be an original report including data on intake of alcohol, tobacco smoking and/or consumption of illicit drugs during pregnancy and risk of neuroblastoma in the child. From eligible studies, data study characteristics as well as effect measures and confounders were extracted. We assessed unadjusted and confounder-adjusted estimates, performed risk of bias analysis, constructed random-effects models and assessed heterogeneity. We identified 14 case-control studies (1987-2016) involving a total of 3114 children with neuroblastoma. Meta-analysis of unadjusted estimates showed an association between alcohol (OR 1.26; 95% CI 1.07 to 1.49), tobacco (OR 1.22; 95% CI 1.04 to 1.44) and illicit drug consumption during pregnancy and risk of neuroblastoma during childhood, with illicit drug consumption showing the strongest association (OR 3.26; 95% CI 1.36 to 7.86). However, adjusted estimates were highly heterogeneous. All studies were at high risk of bias. Smoking, alcohol or illicit drugs during pregnancy might play a role in the development of neuroblastoma. However, well-designed studies are needed to assess whether these exposures are causal and whether time period during pregnancy, dose or co-consumption of substances is critical. Registration number CRD42016036165. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Microbial and chemical analysis of illicit drugs samples confiscated from different areas of PakistanMicrobial and chemical analysis of illicit drugs samples confiscated from different areas of Pakistan.

Science.gov (United States)

Hussain, Shahzad; Khattak, Zainab; Mahmood, Sidra; Malik, Farnaz; Riaz, Humayun; Raza, Syed Atif; Khan, Samiullah

2016-09-01

The microbial and chemical analysis of illicit drug samples from different areas of Pakistan i.e. Quetta, Karachi, Lahore and Islamabad was conducted in a cross-sectional study at National Institute of Health, Islamabad. The drug samples were confiscated by Anti Narcotics Force (ANF), Pakistan. Microbial analysis was done by estimating bioburden which revealed the presence of gram negative and positive bacteria's, fungus, Streptococcus, Staphylococcus species. Trypton soya agar was used for total aerobic count, MacConkey agar for gram-negative bacteria, Sabouraud dextrose agar for fungus and Vogel-Johnson agar for Streptococcus and Staphylococcus species. Colour tests were applied to identify the drug samples. Qualitative and quantitative analysis of suspected samples of Heroin, morphine, cocaine and acetic anhydride was made by employing different chromatographic techniques i.e. Thin-layer chromatography (TLC) and High-performance liquid chromatography (HPLC). The samples were found to be adulterated with paracetamol, diazepam and Dextromethorphen. Acetic anhydride was adulterated with hydrochloric acid (HCl). There is lack of information providing structured advice on responses to the consequences of illicit drug adulteration. Robust and rehearsed interventions and communication strategies would provide a basis for response for a wide variety of organisations. Research into the usefulness of media warnings about adulteration of illicit drugs is required.

Feelings and codependent behavior in the family of illicit drugs users

Directory of Open Access Journals (Sweden)

Bruna da Costa

2017-08-01

Full Text Available Current descriptive and qualitative study described feelings and codependent behavior in relatives of illicit drug users. Data were collected between March and April 2012 by an open interview with eight family members of illicit drugs-dependent individuals and subjected to theme-mode content analysis. Results were classified into two categories which showed intense suffering coupled to feelings of guilt, fear, shame, sadness, shame and manifestation of codependent behaviors such as denial and control of the one´s situation and that of others. Professionals should know the situation in which the families of drug addicts live to assist them in a different way. They should also identify codependent relatives, since they also need care so that their behavior does not worsen the symptoms and behavior of the drug user and prevents a possible medical or psychiatric diagnosis.

Cognitive impairment in patients clinically recovered from central nervous system depressant drug overdose.

Science.gov (United States)

Dassanayake, Tharaka L; Michie, Patricia T; Jones, Alison; Carter, Gregory; Mallard, Trevor; Whyte, Ian

2012-08-01

Central nervous system depressant drugs (CNS-Ds) are known to impair cognitive functions. Overdose of these drugs is common, and most of the hospital-treated patients are discharged within 24 to 48 hours. No previous studies have examined whether they have residual impairment at the time of discharge. Our aim was to evaluate whether patients with CNS-D overdose are impaired in cognitive domains important in daily activities at that time. We compared visuomotor skills (Trail-Making Test A and Choice Reaction Time), executive functions (viz attentional set-shifting: Trail-Making Test B; and planning: Stockings of Cambridge Task from the Cambridge Neuropsychological Test Automated Battery), working memory (Letter-Number Sequencing), and impulsivity and decision making (Cambridge Neuropsychological Test Automated Battery Information Sampling) in 107 patients with CNS-D overdose (benzodiazepines, opioids, or antipsychotics) with a control group of 68 with non-CNS-D overdose (acetaminophen, selective serotonin reuptake inhibitors, and serotonin noradrenaline reuptake inhibitors) on discharge from hospital. Outcome measures were adjusted for demographic and clinical covariates in multivariate regression models. Compared with the controls, patients in the CNS-D group were significantly impaired in all domains: they had prolonged Trail-Making completion times and reaction times, poorer working memory and planning and were more impulsive in decision making. Their Stockings of Cambridge Task performance was comparable to that of the control group for simple problems but worsened with increasing task complexity. The results show that patients with CNS-D overdose could be impaired in multiple cognitive domains underlying everyday functioning even at the time they are deemed medically fit to be discharged. Such impairments could adversely affect social and professional lives of this relatively young population during the immediate postdischarge period.

Preventing Prescription Drug Overdose PSA (:60)

Centers for Disease Control (CDC) Podcasts

2014-07-01

This 60 second public service announcement is based on the July 2014 CDC Vital Signs report. Every day, 46 people in the U.S. die from an overdose of prescription opioid painkillers. Learn what can be done to make painkiller prescribing safer and help prevent overdoses.  Created: 7/1/2014 by National Center for Immunization and Respiratory Diseases (NCIRD).   Date Released: 7/1/2014.

Prevalence of illicit drug use in pregnant women in a Wisconsin private practice setting.

Science.gov (United States)

Schauberger, Charles W; Newbury, Emily J; Colburn, Jean M; Al-Hamadani, Mohammed

2014-09-01

We sought to measure the prevalence of illicit drug use in our obstetric population, to identify the drugs being used, and to determine whether a modified version of the 4Ps Plus screening tool could serve as an initial screen. In this prospective study, urine samples of 200 unselected patients presenting for initiation of prenatal care in a Wisconsin private practice were analyzed for evidence of the use of illicit drugs. Of 200 patients, 26 (13%) had evidence of drugs of abuse in their urine samples. Marijuana (7%) and opioids (6.5%) were the most commonly identified drugs. Adding 5 questions about drug or alcohol use to the obstetric intake questionnaire proved sensitive in identifying patients with high risks of having a positive drug screen. The rate of drug use in our low-risk population was higher than expected and may reflect increasing rates of drug use across the United States. Enhanced screening should be performed to identify patients using illicit drugs in pregnancy to improve their care. Medical centers and communities may benefit from periodic testing of their community prevalence rates to aid in appropriate care planning. Copyright © 2014 Mosby, Inc. All rights reserved.

Association of elevated ambient temperature with death from cocaine overdose.

Science.gov (United States)

Auger, Nathalie; Bilodeau-Bertrand, Marianne; Labesse, Maud Emmanuelle; Kosatsky, Tom

2017-09-01

Ecologic data suggest that elevated outdoor temperature is correlated with mortality rates from cocaine overdose. Using non-aggregated death records, we studied the association of hot temperatures with risk of death from cocaine overdose. We carried out a case-crossover study of all deaths from cocaine or other drug overdose between the months of May and September, from 2000 through 2013 in Quebec, Canada. We used conditional logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between maximum outdoor temperature and death from cocaine or other drug overdose. The main outcome measure was death from cocaine overdose as a function of maximum temperature the day of death and the days immediately preceding death. There were 316 deaths from cocaine overdose and 446 from other drug overdoses during the study. Elevated temperature the preceding week was associated with the likelihood of death from cocaine but not other drug overdose. Compared with 20°C, a maximum weekly temperature of 30°C was associated with an OR of 2.07 for death from cocaine overdose (95% CI 1.15-3.73), but an OR of 1.03 for other drug overdoses (95% CI 0.60-1.75). Associations for cocaine overdose were present with maximum daily temperature the day of and each of the three days preceding death. Elevated ambient temperature is associated with the risk of death from cocaine overdose. Public health practitioners and drug users should be aware of the added risk of mortality when cocaine is used during hot days. Copyright © 2017 Elsevier B.V. All rights reserved.

Illicit drug use and treatment in South Africa: a review.

Science.gov (United States)

Peltzer, Karl; Ramlagan, Shandir; Johnson, Bruce D; Phaswana-Mafuya, Nancy

2010-11-01

This review synthesizes available epidemiological data on current drug use and substance user treatment admissions in South Africa since 1994, and how changes in the political, economic, and social structures within South Africa, both before and after Apartheid, has made the country more vulnerable to drug use. Based on national surveys, current use of cannabis ranged among adolescents from 2% to 9% and among adults it was 2%, cocaine/crack (0.3%), mandrax/sedatives (0.3%), club drugs/amphetamine-type stimulants (0.2%), opiates (0.1%), and hallucinogens (0.1%). The use of primary illicit substance at admission to South African drug user treatment centers was cannabis 16.9%, methamphetamine (tik) 12.8%, crack/cocaine 9.6%, cannabis and mandrax 3.4%, heroin/opiates 9.2%, and prescription and OTC drugs 2.6%. An increase in substance user treatment admissions has increased. While the prevalence of illicit drug use in South Africa is relatively low compared to the United States and Australia, prevention and intervention policies need to be designed to reduce these levels by targeting the more risky subpopulations identified from this review.

Use of illicit drugs by truck drivers arriving at Paranaguá port terminal, Brazil.

Science.gov (United States)

Peixe, Tiago Severo; de Almeida, Rafael Menck; Girotto, Edmarlon; de Andrade, Selma Maffei; Mesas, Arthur Eumann

2014-01-01

The purpose of this study was to estimate the prevalence of recent use of illicit drugs among truck drivers who had parked their vehicles at the terminal port in Paranaguá City at Paraná State, southern Brazil. This cross-sectional study was part of a larger research project conducted among drivers at a regional Brazilian port. Data on professional characteristics, involvement in road traffic injuries, sleep, and use of alcohol and illicit drugs were collected using a questionnaire. Urine samples were collected and analyzed for amphetamines, cocaine, and cannabis using gas chromatography with mass spectrometric detection. Sixty-two drivers were included in the study. Toxicological analyses showed that 8.1 percent (95% confidence interval [CI], 2.7-17.8%) of the urine samples were positive for drugs (4.8% for cocaine, 1.6% for amphetamine, and 1.6% for both); 8.1 percent reported drug use during the preceding 30 days in the questionnaire and only one tested positive for the drug in the urine sample. No sample was positive for cannabinoids. In total, at least 14.5 percent (95% CI, 6.9-25.8%) had used illicit drugs during the preceding 30 days based on self-reports and urine testing. Drivers who reported involvement in traffic injuries the year before more often tested positive for drugs in biological samples (P illicit stimulants was common among professional truck drivers transporting grain loads. Thus, actions are needed to reduce drug use among truck drivers in order to prevent drug-related road traffic injuries.

Deaths Involving Fentanyl, Fentanyl Analogs, and U-47700 - 10 States, July-December 2016.

Science.gov (United States)

O'Donnell, Julie K; Halpin, John; Mattson, Christine L; Goldberger, Bruce A; Gladden, R Matthew

2017-11-03

Preliminary estimates of U.S. drug overdose deaths exceeded 60,000 in 2016 and were partially driven by a fivefold increase in overdose deaths involving synthetic opioids (excluding methadone), from 3,105 in 2013 to approximately 20,000 in 2016 (1,2). Illicitly manufactured fentanyl, a synthetic opioid 50-100 times more potent than morphine, is primarily responsible for this rapid increase (3,4). In addition, fentanyl analogs such as acetylfentanyl, furanylfentanyl, and carfentanil are being detected increasingly in overdose deaths (5,6) and the illicit opioid drug supply (7). Carfentanil is estimated to be 10,000 times more potent than morphine (8). Estimates of the potency of acetylfentanyl and furanylfentanyl vary but suggest that they are less potent than fentanyl (9). Estimates of relative potency have some uncertainty because illicit fentanyl analog potency has not been evaluated in humans. This report describes opioid overdose deaths during July-December 2016 that tested positive for fentanyl, fentanyl analogs, or U-47700, an illicit synthetic opioid, in 10 states participating in CDC's Enhanced State Opioid Overdose Surveillance (ESOOS) program.* Fentanyl analogs are similar in chemical structure to fentanyl but not routinely detected because specialized toxicology testing is required. Fentanyl was detected in at least half of opioid overdose deaths in seven of 10 states, and 57% of fentanyl-involved deaths also tested positive for other illicit drugs, such as heroin. Fentanyl analogs were present in >10% of opioid overdose deaths in four states, with carfentanil, furanylfentanyl, and acetylfentanyl identified most frequently. Expanded surveillance for opioid overdoses, including testing for fentanyl and fentanyl analogs, assists in tracking the rapidly changing illicit opioid market and informing innovative interventions designed to reduce opioid overdose deaths.

Cocaine and other illicit drugs in airborne particulates in urban environments: A reflection of social conduct and population size

International Nuclear Information System (INIS)

Viana, M.; Postigo, C.; Querol, X.; Alastuey, A.; Lopez de Alda, M.J.; Barcelo, D.; Artinano, B.; Lopez-Mahia, P.; Garcia Gacio, D.; Cots, N.

2011-01-01

Levels of cocaine and other psychoactive substances in atmospheric particulate matter (PM) were determined in urban environments representing distinct social behaviours with regard to drug abuse: night-life, university and residential areas. Three cities (with population >1 million and 3 for cocaine, 23-34 pg/m 3 for cannabinoids, and 5-90 pg/m 3 for heroin. The highest levels were recorded on weekends, with factors with respect to weekdays of 1-3 for cocaine, 1-2 for cannabinoids and 1.1-1.7 for heroin. Higher levels were detected in the night-life areas, pointing towards consumption and trafficking as major emission sources, and possibly ruling out drug manufacture. The similarities in temporal trends at all sites suggested a city-scale transport of psychoactive substances. Correlations were detected between cocaine and amphetamine consumption (r 2 = 0.98), and between heroin and cannabinoids (r 2 >0.82). - Highlights: → Cocaine, heroin, cannabis and related illicit drugs are found in detectable amounts in urban air. → Illicit drug consumption and small-scale trafficking are the major emission sources. → Illicit drugs remain in atmospheric particles and are transported across cities during at least 5 days. → Levels of illicit drugs increase from residential to night-life areas, and maximise on weekends. → Correlations between illicit drugs were detected, suggesting differences in consumer groups. - The presence of illicit drugs in atmospheric particles can be used to track illicit drug abuse.

Will growth in cryptomarket drug buying increase the harms of illicit drugs?

Science.gov (United States)

Aldridge, Judith; Stevens, Alex; Barratt, Monica J

2018-05-01

Cryptomarkets-on-line, anonymous market-places for illicit goods and services that specialize mainly in drugs-account for a small but rapidly growing share of the illicit drug market in many countries. Policy responses so far are based generally on the assumption that their rise will only increase drug harms. In this contribution for debate, we question this assumption. We provide a narrative review of the emerging literature connected to drug cryptomarkets. We use MacCoun & Reuter's formula to understand the effect of population-level increases in use on total harm as depending on the level of harm associated with each unit of use. We then consider the potential for cryptomarkets to increase or decrease the harms and benefits related to each unit of drug use, with specific attention to the quality of drugs sold and the non-drug-related harms and benefits for customers. It is likely that cryptomarkets will increase both the amount and the range of substances that are sold. However, we argue that the effects on harms will depend upon whether cryptomarkets also increase the quality and safety of products that are sold, provide harm-reducing information to consumers and reduce transactional conflict involved in drug purchasing. There is an emerging and rapidly growing evidence base connected to the macro and micro harms and benefits of cryptomarkets for drug users. Future researchers should use appropriately matched comparative designs to establish more firmly the differential harms and benefits of sourcing drugs both on- and off-line. While it is unlikely that the on-line drug trade can be eradicated completely, cryptomarkets will respond to regulation and enforcement in ways that have complex, and sometimes unanticipated, effects on both harms and benefits. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Midwives experiences of establishing partnerships: working with pregnant women who use illicit drugs.

Science.gov (United States)

Miles, Maureen; Chapman, Ysanne; Francis, Karen; Taylor, Beverley

2014-10-01

To present the interpreted experiences of midwives who choose to work with pregnant women who also use illicit drugs. Twelve (n=12) Australian midwives were interviewed. Each interview was audio-taped, de-identified and transcribed. The interviews were analysed using a systematic, thematic analysis approach informed by Heideggarian hermeneutic phenomenology. Three themes identified from the data that encapsulate the experience were establishing partnerships, making a difference, and letting go and redefining practice. The interpretations of establishing partnerships which includes engagement, genuine regard and compassion, with a subtheme courting the system are presented in this paper. The midwives' experiences were both positive and negative, as they were rewarded and challenged by the needs of women who use illicit drugs and the systems in which they worked. The midwives in this study found that establishing partnerships was essential to their work. They appraised their experience of working with pregnant women who used illicit drugs and found strategies that attempted to meet the needs of the women, the system and themselves. The participants revealed that to support women and families who use illicit drugs in their community, partnerships must be based on deep respect and trust. Significant components engagement, genuine regard and compassion that are central to midwifery partnerships require revisiting to address the needs of this vulnerable population of women. Copyright © 2013 Elsevier Ltd. All rights reserved.

Cocaine and other illicit drugs in airborne particulates in urban environments: A reflection of social conduct and population size

Energy Technology Data Exchange (ETDEWEB)

Viana, M [Institute for Environmental Assessment and Water Research (IDAEA-CSIC), C/Jordi Girona 18, 08034 Barcelona (Spain); Postigo, C [Institute for Environmental Assessment and Water Research (IDAEA-CSIC), C/Jordi Girona 18, 08034 Barcelona (Spain); Querol, X [Institute for Environmental Assessment and Water Research (IDAEA-CSIC), C/Jordi Girona 18, 08034 Barcelona (Spain); Alastuey, A [Institute for Environmental Assessment and Water Research (IDAEA-CSIC), C/Jordi Girona 18, 08034 Barcelona (Spain); Lopez de Alda, M.J., E-mail: mlaqam@cid.csic.es [Institute for Environmental Assessment and Water Research (IDAEA-CSIC), C/Jordi Girona 18, 08034 Barcelona (Spain); Barcelo, D [Institute for Environmental Assessment and Water Research (IDAEA-CSIC), C/Jordi Girona 18, 08034 Barcelona (Spain); King Saud University, Box 2454, Riyadh 11451 (Saudi Arabia); Artinano, B [Centre for Energy, Environment and Technology Research (CIEMAT), Av. Complutense 22, 28040 Madrid (Spain); Lopez-Mahia, P [Department of Analytical Chemistry, University of A Coruna, Campus A Zapateira, 15071 A Coruna (Spain); Garcia Gacio, D., E-mail: dgarcia@udc.es [Department of Analytical Chemistry, University of A Coruna, Campus A Zapateira, 15071 A Coruna (Spain); Cots, N [Department of the Environment, Catalonia Regional Government, Av. Diagonal 525, 08193 Barcelona (Spain)

2011-05-15

Levels of cocaine and other psychoactive substances in atmospheric particulate matter (PM) were determined in urban environments representing distinct social behaviours with regard to drug abuse: night-life, university and residential areas. Three cities (with population >1 million and <0.3 million inhabitants) were selected. Mean daily levels of drugs in PM were 11-336 pg/m{sup 3} for cocaine, 23-34 pg/m{sup 3} for cannabinoids, and 5-90 pg/m{sup 3} for heroin. The highest levels were recorded on weekends, with factors with respect to weekdays of 1-3 for cocaine, 1-2 for cannabinoids and 1.1-1.7 for heroin. Higher levels were detected in the night-life areas, pointing towards consumption and trafficking as major emission sources, and possibly ruling out drug manufacture. The similarities in temporal trends at all sites suggested a city-scale transport of psychoactive substances. Correlations were detected between cocaine and amphetamine consumption (r{sup 2} = 0.98), and between heroin and cannabinoids (r{sup 2}>0.82). - Highlights: > Cocaine, heroin, cannabis and related illicit drugs are found in detectable amounts in urban air. > Illicit drug consumption and small-scale trafficking are the major emission sources. > Illicit drugs remain in atmospheric particles and are transported across cities during at least 5 days. > Levels of illicit drugs increase from residential to night-life areas, and maximise on weekends. > Correlations between illicit drugs were detected, suggesting differences in consumer groups. - The presence of illicit drugs in atmospheric particles can be used to track illicit drug abuse.

NELIS - a Neutron Inspection System for Detection of Illicit Drugs

International Nuclear Information System (INIS)

Barzilov, Alexander P.; Womble, Phillip C.; Vourvopoulos, George

2003-01-01

NELIS (Neutron ELemental Inspection System) is currently being developed to inspect cargo pallets for illicit drugs. NELIS must be used in conjunction with an x-ray imaging system to optimize the inspection capabilities at ports of entry. Pulsed fast-thermal neutron analysis is utilized to measure the major and minor chemical elements in a non-destructive and non-intrusive manner. Fourteen-MeV neutrons produced with a pulsed d-T neutron generator are the interrogating particles. NELIS analyzes the characteristic gamma rays emitted from the object that are produced by nuclear reactions from fast and thermal neutrons. These gamma rays have different energies for each chemical element, and act as their fingerprints. Since the elemental composition of illicit drugs is quite different from that of innocuous materials, drugs hidden in pallets are identified through the comparison of expected and measured elemental composition and ratios. Results of tests of the system will be discussed

Use and Abuse of Alcohol and Illicit Drugs in US Adolescents

Science.gov (United States)

Swendsen, Joel; Burstein, Marcy; Case, Brady; Conway, Kevin P.; Dierker, Lisa; He, Jianping; Merikangas, Kathleen R.

2013-01-01

Context Comprehensive descriptions of substance use and abuse trajectories have been lacking in nationally representative samples of adolescents. Objective To examine the prevalence, age at onset, and sociodemographic correlates of alcohol and illicit drug use and abuse among US adolescents. Design Cross-sectional survey of adolescents using a modified version of the Composite International Diagnostic Interview. Setting Combined household and school adolescent samples. Participants Nationally representative sample of 10 123 adolescents aged 13 to 18 years. Main Outcome Measures Lifetime estimates of alcohol and illicit substance use and DSM-IV diagnoses of abuse, with or without dependence. Results By late adolescence, 78.2% of US adolescents had consumed alcohol, 47.1% had reached regular drinking levels defined by at least 12 drinks within a given year, and 15.1% met criteria for lifetime abuse. The opportunity to use illicit drugs was reported by 81.4% of the oldest adolescents, drug use by 42.5%, and drug abuse by 16.4%. The median age at onset was 14 years for alcohol abuse with or without dependence, 14 years for drug abuse with dependence, and 15 years for drug abuse without dependence. The associations observed by age, sex, and race/ ethnicity often varied significantly by previous stage of use. Conclusions Alcohol and drug use is common in US adolescents, and the findings of this study indicate that most cases of abuse have their initial onset in this important period of development. Prevention and treatment efforts would benefit from careful attention to the correlates and risk factors that are specific to the stage of substance use in adolescents. PMID:22474107

Use of licit and illicit drugs at the University of Alfenas.

Science.gov (United States)

Fiorini, João Evangelista; Alves, Adriana Luiza; Ferreira, Luciano Resende; Fiorini, Celso Maia; Durães, Sandro Willian; Santos, Ricardo Luiz Diniz; Nascimento, Luiz Carlos do; Geraldini, Andréa Mantelo Vicente; Ortiz, Cássia de Fátima

2003-01-01

This paper reports the study of drug consumption carried out within the population of undergraduate students from 2 colleges of Alfenas, in the state of Minas Gerais state. Both licit and illicit drugs were studied, including alcohol, tobacco, marijuana, cocaine, heroin, crack, inhalants, glue, tranquilizers, stimulants, and others. The research included a wide bibliographical search and the application of a questionnaire to approximately 23% of the students (total of 6500 students). A total of 1500 students participated in this investigation. The results demonstrated that there was a significant consumption of both licit and illicit drugs. The pattern of drug consumption in the research sample was similar to other investigations conducted in Brazil and in other countries. It was observed that 55% of the university students use drugs. However, the most surprising finding was that most of the students (88%) answered "yes" to the inquiry, "Have you already tried any type of drug, including alcohol and cigarettes?" The students revealed that they had taken drugs even prior to the admission to the university. The results suggest clearly that the university environment does not necessarily represent the starting point for student drug consumption.

Prevalence and predictors of illicit drug use among school-going ...

African Journals Online (AJOL)

% females) reported having ever used marijuana or glue. ... Conclusions: Public health intervention aimed to prevent marijuana or glue use among adolescents should be designed with the understanding that illicit drug use may be associated ...

Media Exposure and Tobacco, Illicit Drugs, and Alcohol Use among Children and Adolescents: A Systematic Review

Science.gov (United States)

Nunez-Smith, Marcella; Wolf, Elizabeth; Huang, Helen Mikiko; Chen, Peggy G.; Lee, Lana; Emanuel, Ezekiel J.; Gross, Cary P.

2010-01-01

The authors systematically reviewed 42 quantitative studies on the relationship between media exposure and tobacco, illicit drug, and alcohol use among children and adolescents. Overall, 83% of studies reported that media was associated with increased risk of smoking initiation, use of illicit drugs, and alcohol consumption. Of 30 studies…

[Prevalence of illicit drug use and associated factors during pregnancy in the BRISA cohort].

Science.gov (United States)

Rocha, Priscila Coimbra; Britto e Alves, Maria Teresa Seabra Soares de; Chagas, Deysianne Costa das; Silva, Antônio Augusto Moura da; Batista, Rosangela Fernandes Lucena; Silva, Raimundo Antonio da

2016-01-01

This study analyzes the prevalence of illicit drug use and associated factors during pregnancy. This was a cross-sectional study of participants in the BRISA prenatal care cohort. Frequencies and hierarchical logistic regression were used. Estimated prevalence rates were 1.45% for illicit drug use, 22.32% for alcohol consumption, and 4.22% for smoking. The study population was mostly young (81% in the 20-34-year bracket), with 9 to 11 years of schooling (75.55%), with more than half of the women outside the workforce (52.18%), and in economic class "C" (67.61%). Pregnant women showed a high level of stress (24.46%), moderate to intense anxiety (40.84%), and severe depressive symptoms (28.8%). Approximately half (49.72%) of the pregnant women reported some type of violence, and they had wide networks (72.77%) and low social support (65.21%). Use of legal drugs, high stress levels, and single parenthood were independently associated with illicit drug use in pregnancy.

Correlates of Illicit Drug Use Among Indigenous Peoples in Canada: A Test of Social Support Theory.

Science.gov (United States)

Cao, Liqun; Burton, Velmer S; Liu, Liu

2018-02-01

Relying on a national stratified random sample of Indigenous peoples aged 19 years old and above in Canada, this study investigates the correlates of illicit drug use among Indigenous peoples, paying special attention to the association between social support measures and illegal drug use. Results from multivariate logistical regression show that measures of social support, such as residential mobility, strength of ties within communities, and lack of timely counseling, are statistically significant correlates of illicit drug use. Those identifying as Christian are significantly less likely to use illegal drugs. This is the first nationwide analysis of the illicit drug usage of Indigenous peoples in Canada. The results are robust because we have controlled for a range of comorbidity variables as well as a series of sociodemographic variables. Policy implications from these findings are discussed.

Gender discrimination, educational attainment, and illicit drug use among U.S. women.

Science.gov (United States)

Carliner, Hannah; Sarvet, Aaron L; Gordon, Allegra R; Hasin, Deborah S

2017-03-01

While gender inequality has been a topic of concern for decades, little is known about the relationship between gender discrimination and illicit drug use. Further, whether this association varies by education level is unknown. Among 19,209 women participants in Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (2004-2005), we used logistic regression to test the association between gender discrimination (measured with four items from the Experiences of Discrimination instrument) and three outcomes: past-year illicit drug use, frequent drug use, and drug use disorders. We then tested whether associations differed by education level. Gender discrimination was reported by 9% of women and was associated with past-year drug use [adjusted odds ratio (aOR) = 2.67; 95% confidence interval (CI) 2.17-3.29], frequent drug use (aOR = 2.82; CI 1.99-4.00), and past-year drug use disorders (aOR = 3.15; CI 2.16-4.61). All specific domains of gender discrimination (on the job, in public, with institutions, being called a sexist name) were associated with all drug use outcomes. The association between gender discrimination and past-year drug use was stronger among women with less than a high school education (aOR = 6.33; CI 3.38-11.85) compared to those with more education (aOR = 2.45; CI 1.97-3.04; p interaction  Gender discrimination is consistently and strongly associated with illicit drug use and drug use disorders among U.S. women, with significantly higher odds for drug use among women with less than a high school education. Future research should examine whether explicitly addressing distress from discrimination could benefit women in drug treatment, especially among clients with lower educational attainment.

Attributions for Abstinence from Illicit Drugs by University Students

Science.gov (United States)

Rosenberg, Harold; Baylen, Chelsea; Murray, Shanna; Phillips, Kristina; Tisak, Marie S.; Versland, Amelia; Pristas, Erica

2008-01-01

Aim: To assess college students' attributions for abstinence from alcohol and illicit drugs. Method: We recruited 125 undergraduates to rate the degree to which each of 41 listed reasons influenced their abstention from six specific substances (alcohol, MDMA/ecstasy, inhalants, cocaine, marijuana, and hallucinogens). Findings: Internal consistency…

The social cost of alcohol, tobacco and illicit drugs in France, 1997.

Science.gov (United States)

Fenoglio, Philippe; Parel, Véronique; Kopp, Pierre

2003-01-01

AIM, DESIGN AND SETTING: The economic costs of alcohol, tobacco and illicit drugs to French society are estimated using a cost of illness framework. For the cause of disease or death (using ICD-9 categories), pooled relative risk estimates from meta-analyses were combined with prevalence data by age and gender to derive the proportion attributable to alcohol, tobacco and/or illicit drugs. The resulting estimates of attributable deaths and hospitalizations were used to calculate the associated health care, law enforcement, productivity and other costs. The results were compared with those of other studies, and sensitivity analyses were conducted by alternative ways of measuring risk attribution and costs. The use of alcohol, tobacco and illicit drugs cost more than 200 billion francs (FF) in France in 1997, representing 3714 FF per capita or 2.7% of the gross domestic product (GDP). Alcohol is the drug that gives rise to the greatest cost in France, i.e. 115420.91 million FF (1.42% of GDP) or an expenditure per capita of 1966 FF in 1997. Alcohol takes more than half of the social cost of drugs to society. The greatest share of the social cost of alcohol comes from the loss of productivity (57555.66 million FF), due to premature death (53168.60 million FF), morbidity (3884.0 million FF) and imprisonment (503.06 million FF). Tobacco leads to a social cost of 89256.90 million FF, that is an expenditure per capita of 1520.56 FF or 1.1% of GDP. Productivity losses amount to 50446.70 million FF, with losses of 42765.80 million FF as a result of premature death and 7680.90 million FF linked to morbidity. Health care costs for tobacco occupy second place at 26973.70 million FF. Illicit drugs generate a social cost of 13350.28 million FF, that is an expenditure per capita of 227.43 FF or 0.16% of GDP. Productivity losses reach 6099.19 million FF, with 5246.92 million FF linked to imprisonment and 852.27 million FF to premature death. The cost of enforcing the law for illicit

Piroxicam overdose

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/002534.htm Piroxicam overdose To use the sharing features on this page, please enable JavaScript. Piroxicam is a nonsteroidal anti-inflammatory drug (NSAID) used ...

Ibuprofen overdose

Science.gov (United States)

... this page: //medlineplus.gov/ency/article/002655.htm Ibuprofen overdose To use the sharing features on this page, please enable JavaScript. Ibuprofen is a type of nonsteroidal anti-inflammatory drug ( ...

Adverse childhood experiences and consumption of alcohol, tobacco and illicit drugs among adolescents of a Brazilian birth cohort.

Science.gov (United States)

Gonçalves, Helen; Soares, Ana Luiza Gonçalves; Santos, Ana Paula Gomes Dos; Ribeiro, Camila Garcez; Bierhals, Isabel Oliveira; Vieira, Luna Strieder; Hellwig, Natália Limões; Wehrmeister, Fernando C; Menezes, Ana M B

2016-11-03

The objective of this study was to investigate the association between adverse childhood experiences (ACEs) and the use of alcohol, tobacco and illicit drugs among adolescents from a Brazilian cohort. The occurrence of five ACEs, the use of alcohol and tobacco and trying illicit drugs were investigated in the 1993 Pelotas birth cohort at the age of 15 (n = 4,230). A score was created for the ACEs and their association with the use of substances was evaluated. Around 25% of adolescents consumed alcohol, 6% smoked and 2.1% reported having used drugs at least once in their lives. The ACEs were associated with the use of alcohol, tobacco and illicit drugs. A dose-response relation between the number of ACEs and the substance use was found, particularly with regard to illicit drugs. The occurrence of ACEs was positively associated with the use of alcohol, tobacco and illicit drugs among adolescents and the risk may be different for men and women. These results point to the fact that strategies for preventing the use of substances should include interventions both among adolescents and within the family environment.

Enantiomeric profiling of chiral illicit drugs in a pan-European study

NARCIS (Netherlands)

Castrignanò, E.; Yang, Z.; Bade, R.; Baz-Lomba, J.A.; Castiglioni, S.; Causanilles, A.; Covaci, A.; Gracia-Lor, E.; Hernández, F.; Kinyua, J.; McCall, A.-K.; van Nuijs, A.L.N.; Ort, C.; Plósz, B.G.; Ramin, P.; Rousis, N.I.; Ryu, Y.; Thomas, K.V.; de Voogt, P.; Zuccato, E.; Kasprzyk-Hordern, B.

2018-01-01

The aim of this paper is to present the first study on spatial and temporal variation in the enantiomeric profile of chiral drugs in eight European cities. Wastewater-based epidemiology (WBE) and enantioselective analysis were combined to evaluate trends in illicit drug use in the context of their

Coffee Shops and Compromise : Separated Illicit Drug Markets in the Netherlands

NARCIS (Netherlands)

J-P.C. Grund (Jean-Paul); J. Breeksema (Joost)

2013-01-01

textabstractBuilding on a long history and culture of tolerance, the Dutch responded to illicit drugs with decades of pragmatic measures free of judgment. A central element of modern Dutch drug policy was a crucial decision to establish a legal and practical separation of cannabis— judged to pose

"Shotgunning" as an illicit drug smoking practice.

Science.gov (United States)

Perlman, D C; Perkins, M P; Paone, D; Kochems, L; Salomon, N; Friedmann, P; Des Jarlais, D C

1997-01-01

There has been a rise in illicit drug smoking in the United States. "Shotgunning" drugs (or "doing a shotgun") refers to the practice of inhaling smoke and then exhaling it into another individual's mouth, a practice with the potential for the efficient transmission of respiratory pathogens. Three hundred fifty-four drug users (239 from a syringe exchange and 115 from a drug detoxification program) were interviewed about shotgunning and screened for tuberculosis (TB). Fifty-nine (17%; 95% CI 12.9%-20.9%) reported shotgunning while smoking crack cocaine (68%), marijuana (41%), or heroin (2%). In multivariate analysis, age alcohol to intoxication (OR 2.2, 95% CI 1.1-4.3), having engaged in high-risk sex (OR 2.6, 95% CI 1.04-6.7), and crack use (OR 6.0, 95% CI 3.0-12) were independently associated with shotgunning. Shotgunning is a frequent drug smoking practice with the potential to transmit respiratory pathogens, underscoring the need for education of drug users about the risks of specific drug use practices, and the ongoing need for TB control among active drug users.

The Effect of Race on Provider Decisions to Test for Illicit Drug Use in the Peripartum Setting

Science.gov (United States)

KUNINS, HILLARY VEDA; BELLIN, ERAN; CHAZOTTE, CYNTHIA; DU, EVELYN; ARNSTEN, JULIA HOPE

2010-01-01

Background Testing for illicit drugs may expose women who test positive to severe legal and social consequences. It is unknown whether racial disparities in drug testing practices underlie observed disparities in legal and social consequences of positive tests. Methods Using administrative hospital and birth certificate data, we analyzed factors associated with both receipt and results of illicit drug testing among women with live births during 2002–2003. We assessed the independent association of race and other sociodemographic factors with both receipt of a drug test by the mother or her newborn infant and positive maternal or neonatal toxicology results, after controlling for obstetrical conditions and birth outcomes associated with maternal substance abuse. Results Of the 8487 women with live births, 244 mother-newborn pairs (3%) were tested for illicit drug use. Black women and their newborns were 1.5 times more likely to be tested for illicit drugs as nonblack women in multivariable analysis. However, race was not independently associated with a positive result. Conclusions We identified racial differences in rates of testing for illicit drug use between black and nonblack women. We found equivalent positivity rates among tested black and nonblack women. The prevalence of drug use among untested women is unknown, however, so although tested women had equivalent rates of substance use detected, whether black and nonblack substance users are equally likely to be identified in the course of peripartum care remains uncertain. PMID:17388741

Illicit drugs: contaminants in the environment and utility in forensic epidemiology.

Science.gov (United States)

Daughton, Christian G

2011-01-01

The published literature that addresses the many facets of pharmaceutical ingredients as environmental contaminants has grown exponentially since the 1990s. Although there are several thousand active ingredients used in medical pharmaceuticals worldwide, illicit drug ingredients (IDIs) have generally been excluded from consideration. Medicinal and illicit drugs have been treated separately in environmental research even though they pose many of the same concerns regarding the potential for both human and ecological exposure. The overview presented here covers the state of knowledge up until mid-2010 regarding the origin, occurrence, fate, and potential for biological effects of IDIs in the environment. Similarities exist with medical pharmaceuticals, particularly with regard to the basic processes by which these ingredients enter the environment--excretion of unmetabolized residues (including via sweat), bathing, disposal, and manufacturing. The features of illicit drugs that distinguish them from medical pharmaceuticals are discussed. Demarcations between the two are not always clear, and a certain degree of overlap adds additional confusion as to what exactly defines an illicit drug; indeed, medical pharmaceuticals diverted from the legal market or used for non-medicinal purposes ar also captured in discussions of illicit drugs. Also needing consideration as par tof the universe of IDIs are the numerous adulterants and synthesis impurities often encountered in these very impure preparations. many of these extraneous chemicals have high biological activity themselves. In contract to medical pharmaceuticals, comparatively little is know about the fate and effects of IDIs in the environment. Environmental surveys for IDIs have revealed their presence in sewage wastewaters, raw sewage sludge and processed sludge (biosolids), and drinking water. Nearly nothing is known, however, regarding wildlife exposure to IDIs, especially aquatic exposure such as indicated by

NAGD regimen for the coma of drug-related overdose.

Science.gov (United States)

Rappolt, R T; Gay, G R; Decker, W J; Inaba, D S

1980-07-01

A specific arousal therapy with NAGD (Naloxone, Activated Charcoal, Glucagon, Doxapram) is outlined for victims of drug overdose in comatose and semi-comatose states. Several direct benefits accrue if early awakening or lightening of such patients is safely accomplished. There are: 1) elimination of need for prolonged intubation or tracheostomy; 2) patient's ability to tell which drug(s) were taken; 3) excessively frantic and vigorous supportive treatment is obviated; and 4) the overall hospital stay is shortened. The NAGD regimen has been found to effectively, safely, and predictably reverse coma. Therapy consists of: naloxone 0.8 mg to 1.6 mg intravenously; large-bore orogastric tube instillation of 100 gm to 120 gm activated charcoal slurry; glucagon 1 mg to 2 mg intravenously; and, in selected cases, doxapram 1 mg/kg to 2 mg/kg intravenously.

Binge drinking and illicit drug use among adolescent students.

Science.gov (United States)

Raposo, Jakelline Cipriano Dos Santos; Costa, Ana Carolina de Queiroz; Valença, Paula Andréa de Melo; Zarzar, Patrícia Maria; Diniz, Alcides da Silva; Colares, Viviane; Franca, Carolina da

2017-09-04

To estimate the prevalence of illicit drug use and its association with binge drinking and sociodemographic factors among adolescent students. This is a cross-sectional study with probabilistic conglomerate sampling, involving 1,154 students, aged 13 to 19 years old, from the public school system, in the city of Olinda, State of Pernambuco, Brazil, carried out in 2014. We used the Youth Risk Behavior Survey questionnaire, validated for use with Brazilian adolescents. The Chi-square test (≤ 0.05) and Poisson regression analysis were used to estimate the prevalence ratios, with 95% confidence intervals. Use in life of illicit drugs was four times more prevalent among students who reported binge drinking (95%CI 3.19-5.45). Being in the age group of 16 to 19 years, being male, and having no religion were also significantly associated with illicit drug use. The prevalence of use in life of illicit drugs was higher in this study than in other studies carried out in Brazil and it was strongly associated with binge drinking. This factor was associated with gender, age, and religion. Estimar a prevalência do uso de drogas ilícitas e sua associação com binge drinking e fatores sociodemográficos entre estudantes adolescentes. Estudo transversal com amostra probabilística por conglomerado, envolvendo 1.154 estudantes, de 13 a 19 anos de idade, da rede pública de ensino, no município de Olinda, PE, 2014. Foi utilizado o questionário Youth Risk Behavior Survey, validado para uso com adolescentes brasileiros. Para análise dos dados foi utilizado o teste do Qui-quadrado (≤ 0,05) e análise de regressão de Poisson, para estimar razões de prevalência, com intervalos com 95% de confiança. O uso na vida de drogas ilícitas foi quatro vezes mais prevalente entre os estudantes que relataram o binge drinking (IC95% 3,19-5,45). Estar na faixa etária de 16 a 19 anos, ser do sexo masculino e não ter religião também foram significativamente associados ao uso de drogas

ILLICIT DOPAMINE TRANSIENTS: RECONCILING ACTIONS OF ABUSED DRUGS

Science.gov (United States)

Covey, Dan P.; Roitman, Mitchell F.; Garris, Paul A.

2014-01-01

Phasic increases in brain dopamine are required for cue-directed reward seeking. While compelling within the framework of appetitive behavior, the view that illicit drugs hijack reward circuits by hyper-activating these dopamine transients is inconsistent with established psychostimulant pharmacology. However, recent work reclassifying amphetamine (AMPH), cocaine, and other addictive dopamine-transporter inhibitors (DAT-Is) supports transient hyper-activation as a unifying hypothesis of abused drugs. We argue here that reclassification also identifies generating burst firing by dopamine neurons as a keystone action. Unlike natural rewards, which are processed by sensory systems, drugs act directly on the brain. Consequently, to mimic natural reward and exploit reward circuits, dopamine transients must be elicited de novo. Of available drug targets, only burst firing achieves this essential outcome. PMID:24656971

Non-natural manners of death among users of illicit drugs: Substance findings.

Science.gov (United States)

Delaveris, Gerd Jorunn M; Teige, Brita; Rogde, Sidsel

2014-05-01

The aim of the study was to explore differences and similarities between the various non-natural manners of death (accident, suicide, homicide) regarding toxicological findings in illicit drug users. Medicolegal autopsy reports from the Institute of Forensic Medicine University of Oslo concerning deaths from 2000 to 2009 were investigated. Those aged 20-59 whose manner of death was non-natural and who tested positive for any narcotic drug (morphine/heroin, amphetamines, ecstasy, cannabis, LSD, PCP, and high levels of GHB in addition to methadone and buprenorphine) were selected. All substance findings were registered and categorized (narcotics, ethanol, and medicinal products). Of the 1603 autopsies that met the selection criteria, 1204 were accidental intoxications, 122 accidents other than intoxication, 114 suicides by intoxication, 119 non-intoxication suicides, and 44 victims of homicide. Poly drug use was found in all manners of death. The drug profile as well as the mean number of substances (illicit drugs and medicinal products) varied from 2.9 to 4.6 substances per case, depending on the manner of death. Intoxication suicides had the highest number of substances and a total drug profile similar to accidental intoxications. Non-intoxication suicides had a total drug profile similar to homicide and accidents other than intoxication. The number of substances found per case increased during the decade, mainly due to increased findings of methadone, cannabis, amphetamines, and benzodiazepines. Methadone findings increased much more than buprenorphine. Methadone was found 20 times more often than buprenorphine in accidental intoxication cases. In summary, poly drug findings are common in adults who suffer a non-natural death while using illicit drugs. The different manners of death have some specific characteristics and significant differences regarding drug profile. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Global reach of direct-to-consumer advertising using social media for illicit online drug sales.

Science.gov (United States)

Mackey, Tim Ken; Liang, Bryan A

2013-05-29

Illicit or rogue Internet pharmacies are a recognized global public health threat that have been identified as utilizing various forms of online marketing and promotion, including social media. To assess the accessibility of creating illicit no prescription direct-to-consumer advertising (DTCA) online pharmacy social media marketing (eDTCA2.0) and evaluate its potential global reach. We identified the top 4 social media platforms allowing eDTCA2.0. After determining applicable platforms (ie, Facebook, Twitter, Google+, and MySpace), we created a fictitious advertisement advertising no prescription drugs online and posted it to the identified social media platforms. Each advertisement linked to a unique website URL that consisted of a site error page. Employing Web search analytics, we tracked the number of users visiting these sites and their location. We used commercially available Internet tools and services, including website hosting, domain registration, and website analytic services. Illicit online pharmacy social media content for Facebook, Twitter, and MySpace remained accessible despite highly questionable and potentially illegal content. Fictitious advertisements promoting illicit sale of drugs generated aggregate unique user traffic of 2795 visits over a 10-month period. Further, traffic to our websites originated from a number of countries, including high-income and middle-income countries, and emerging markets. Our results indicate there are few barriers to entry for social media-based illicit online drug marketing. Further, illicit eDTCA2.0 has globalized outside US borders to other countries through unregulated Internet marketing.

Illicit drugs in wastewater of the city of Zagreb (Croatia) - Estimation of drug abuse in a transition country

International Nuclear Information System (INIS)

Terzic, Senka; Senta, Ivan; Ahel, Marijan

2010-01-01

A comprehensive study of various psychoactive substances and their metabolites was performed in the wastewater treatment plant of the city of Zagreb (780 000 inhabitants) using liquid chromatography/tandem mass spectrometry (LC-MS-MS). The estimation of drug abuse for five different illicit drugs, including heroin, cocaine, marijuana, amphetamine and ecstasy, was made on the basis of their representative excretion rates, which were determined over a period of 8 months. Marijuana (1000 kg/year), heroin (75 kg/year) and cocaine (47 kg/year) were found to be the most frequently consumed illicit drugs, while the consumption of amphetamine-type drugs was much lower (1-3 kg/year). A comparison with other reports indicated that drug abuse profiles in transition countries might be different from those reported for Western Europe, in particular with respect to the comparatively increased consumption of heroin. Enhanced consumption of stimulating drugs (cocaine and ectasy) was systematically detected during weekends. - Wastewater analysis is a promising complementary tool to assess drug abuse patterns.

Illicit drugs in wastewater of the city of Zagreb (Croatia) - Estimation of drug abuse in a transition country

Energy Technology Data Exchange (ETDEWEB)

Terzic, Senka, E-mail: terzic@irb.h [Division for Marine and Environmental Research, Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb (Croatia); Senta, Ivan; Ahel, Marijan [Division for Marine and Environmental Research, Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb (Croatia)

2010-08-15

A comprehensive study of various psychoactive substances and their metabolites was performed in the wastewater treatment plant of the city of Zagreb (780 000 inhabitants) using liquid chromatography/tandem mass spectrometry (LC-MS-MS). The estimation of drug abuse for five different illicit drugs, including heroin, cocaine, marijuana, amphetamine and ecstasy, was made on the basis of their representative excretion rates, which were determined over a period of 8 months. Marijuana (1000 kg/year), heroin (75 kg/year) and cocaine (47 kg/year) were found to be the most frequently consumed illicit drugs, while the consumption of amphetamine-type drugs was much lower (1-3 kg/year). A comparison with other reports indicated that drug abuse profiles in transition countries might be different from those reported for Western Europe, in particular with respect to the comparatively increased consumption of heroin. Enhanced consumption of stimulating drugs (cocaine and ectasy) was systematically detected during weekends. - Wastewater analysis is a promising complementary tool to assess drug abuse patterns.

[Use of illicit drugs and critical perspectives of drug users' relatives and acquaintances in Northern Rio de Janeiro City, Brazil].

Science.gov (United States)

Vargens, Octavio Muniz da Costa; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto

2009-01-01

This article presents the partial results of a multicenter, qualitative study, which involved seven Latin-American countries and Canada. The results presented refer to Northern Rio de Janeiro (city), Brazil. The objective of the study was to describe the perspective of relatives/acquaintances of illicit drug users about protective and risk factors, prevention initiatives, treatment services, and legal aspects regarding illicit drugs. Interviews were performed with 99 individuals, who reported being affected by their relationship with an illicit drug user (relative or acquaintance), approaching their perspectives regarding the key-domains. Most participants were women (73.7%); relatives who used drugs were mostly men (78.2%); the most consumed drug was marijuana (77.8%). The highlighted protective factor was having recreational-sports activities in the community (88.9%), and the risk factor was curiosity for trying something new (94.4%). The main treatment services were Church Groups (51.5%), and participants stated that laws should be more punitive (82.8%). In conclusion, this information is essential to fight against drug use/abuse, showing that there is a need for actions that consider different perspectives at different levels.

Structural equation modeling of the effects of racism, LGBTQ discrimination, and internalized oppression on illicit drug use in LGBTQ people of color.

Science.gov (United States)

Drazdowski, Tess K; Perrin, Paul B; Trujillo, Michael; Sutter, Megan; Benotsch, Eric G; Snipes, Daniel J

2016-02-01

Experiences with lesbian, gay, bisexual, transgender, or queer (LGBTQ) discrimination and racism have both been associated with mental health problems and illicit drug use. However, the cumulative effects of both forms of discrimination--and resulting internalized oppression--on illicit drug use in LGBTQ people of color (POC) has not been examined in the research literature. Using online questionnaires, this study collected self-report data from 200 LGBTQ POC about their experiences with racism, LGBTQ discrimination, internalized racism, internalized LGBTQ discrimination, and illicit drug use. Two structural equation models yielded adequate fit indices in which experiences with racism and LGBTQ discrimination led to more internalized oppression, which then led to greater illicit drug use magnitude. LGBTQ discrimination was directly related to increased internalized oppression, which was positively associated with illicit drug use magnitude; the relationship between LGBTQ discrimination and illicit drug use magnitude was mediated by internalized oppression in both models. However, racism and the interaction between racism and LGBTQ discrimination did not show valid direct effects on internalized oppression or indirect effects on illicit drug use magnitude. LGBTQ POC can be the targets of both racism and LGBTQ discrimination, although the current study found that the most psychologically damaging effects may come from LGBTQ discrimination. Interventions meant to decrease or prevent illicit drug use in LGBTQ POC may benefit from helping participants examine the links among LGBTQ discrimination, internalized oppression, and illicit drug use as a coping strategy, focusing on substituting more adaptive coping. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

ILLICIT DOPAMINE TRANSIENTS: RECONCILING ACTIONS OF ABUSED DRUGS

OpenAIRE

Covey, Dan P.; Roitman, Mitchell F.; Garris, Paul A.

2014-01-01

Phasic increases in brain dopamine are required for cue-directed reward seeking. While compelling within the framework of appetitive behavior, the view that illicit drugs hijack reward circuits by hyper-activating these dopamine transients is inconsistent with established psychostimulant pharmacology. However, recent work reclassifying amphetamine (AMPH), cocaine, and other addictive dopamine-transporter inhibitors (DAT-Is) supports transient hyper-activation as a unifying hypothesis of abuse...

Illicit Drugs, Policing and the Evidence-Based Policy Paradigm

Science.gov (United States)

Ritter, Alison; Lancaster, Kari

2013-01-01

The mantra of evidence-based policy (EBP) suggests that endeavours to implement evidence-based policing will produce better outcomes. However there is dissonance between the rhetoric of EBP and the actuality of policing policy. This disjuncture is critically analysed using the case study of illicit drugs policing. The dissonance may be ameliorated…

Focused use of drug screening in overdose patients increases impact on management.

Science.gov (United States)

Erdmann, Andreas; Werner, Dominique; Hugli, Olivier; Yersin, Bertrand

2015-01-01

Drug poisoning is a common cause for attendance in the emergency department. Several toxicology centres suggest performing urinary drug screens, even though they rarely influence patient management. Measuring the impact on patient management, in a University Emergency Department with approximately 40 000 admissions annually, of a rapid urinary drug screening test using specifically focused indications. Drug screening was restricted to patients having a first psychotic episode or cases demonstrating respiratory failure, coma, seizures, a sympathomimetic toxidrome, severe opiate overdose necessitating naloxone, hypotension, ventricular arrhythmia, acquired long QT or QRS >100 ms, and high-degree heart block. Retrospective analysis of Triage® TOX drug screen tests performed between September 2009 and November 2011, and between January 2013 and March 2014. A total of 262 patients were included, mean age 35 ± 14.6 (standard deviation) years, 63% men; 29% poisoning with alcohol, and 2.3% deaths. Indications for testing were as follows: 34% were first psychotic episodes; 20% had acute respiratory failure; 16% coma; 8% seizures; 8% sympathomimetic toxidromes; 7% severe opioid toxidromes; 4% hypotension; 3% ventricular arrhythmias or acquired long QT intervals on electrocardiogram. A total of 78% of the tests were positive (median two substances, maximum five). The test resulted in drug-specific therapy in 6.1%, drug specific diagnostic tests in 13.3 %, prolonged monitoring in 10.7% of methadone-positive tests, and psychiatric admission in 4.2%. Overall, 34.3% tests influenced patient management. In contrast to previous studies showing modest effects of toxicological testing, restricted use of rapid urinary drug testing increases the impact on management of suspected overdose patients in the ED.

Body pushing, prescription drugs and hospital admission.

Science.gov (United States)

Byard, Roger W; Kenneally, Michaela

2017-09-01

A 39-year-old man died of multi-organ failure complicating mixed drug toxicity that included methadone, oxazepam, oxycodone and nitrazepam. His past medical history involved alcohol and poly-substance abuse with chronic self-harm and suicidal ideation. There had been multiple hospital admissions for drug overdoses. At autopsy the most unusual finding was of two packages of 10 tablets each, wrapped in thin plastic film within the rectum. The insertion of drugs into body orifices and cavities has been termed body pushing to distinguish it from body packing where illicit drugs are wrapped and swallowed for transport and smuggling, and body stuffing where small amounts of loosely wrapped or unwrapped drugs are swallowed to conceal evidence from police. This case demonstrates that body pushing may not always involve illicit drugs or attempted concealment from police or customs officials. It appears that the drugs had been hidden to ensure an additional supply during the time of residence in hospital. The extent to which body pushing is currently being used by patients to smuggle drugs into secure medical facilities is yet to be determined.

Illicit drug use and abuse/dependence: modeling of two-stage variables using the CCC approach.

Science.gov (United States)

Agrawal, A; Neale, M C; Jacobson, K C; Prescott, C A; Kendler, K S

2005-06-01

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.

The use of illicit drugs as self-medication in the treatment of cluster headache: Results from an Italian online survey.

Science.gov (United States)

Di Lorenzo, C; Coppola, G; Di Lorenzo, G; Bracaglia, M; Rossi, P; Pierelli, F

2016-02-01

Cluster headache (CH) patients often receive unsatisfactory treatment and may explore illicit substances as alternatives. We aimed to explore this use of illicit drugs for CH treatment. We invited CH patients from an Internet-based self-help group to complete a questionnaire regarding their therapeutic use of illicit substances. Of the 54 respondents, 29 were classified as chronic and 39 were drug-resistant cases. Fifty patients had previously tried subcutaneous sumatriptan, 40 had tried O2, and 48 had tried at least one prophylactic treatment. All 54 patients specified that they were dissatisfied with conventional treatments. Thirty-four patients had used cannabinoids, 13 cocaine, 8 heroin, 18 psilocybin, 12 lysergic acid amide (LSA), and 4 lysergic acid diethylamide (LSD). Some patients with intractable CH decided to try illicit drugs concomitantly with cessation of medical care. Most of these patients found suggestions for illicit drug use on the Internet. Many patients seemed to underestimate the judicial consequences of, and had an overestimated confidence in the safety of, such illicit treatments. Physicians are often not informed by patients of their choice to use illicit drugs. This leads to questions regarding the true nature of the physician-patient relationship among dissatisfied CH patients. © International Headache Society 2015.

Reasons for recent marijuana use in relation to use of other illicit drugs among high school seniors in the United States.

Science.gov (United States)

Palamar, Joseph J; Griffin-Tomas, Marybec; Kamboukos, Dimitra

2015-01-01

Studies show that illicit cannabis (marijuana) use is related to use of other illicit drugs and that reasons for use are related to frequency of marijuana use. However, research is needed to examine whether specific reasons for marijuana use are associated with use of other illicit drugs. Data from recent marijuana-using high school seniors were examined from 12 cohorts of Monitoring the Future (Weighted n = 6481) to examine whether reasons for recent marijuana use are associated with use of eight other illicit drugs. Using "to experiment" decreased odds of reporting use of each drug and using to decrease effects of other drugs increased odds of reporting use of each drug. In multivariable models, using marijuana "to experiment" decreased the odds for reporting use of hallucinogens other than LSD and narcotics other than heroin. Using marijuana for "insight" increased the odds for use of hallucinogens other than LSD, and use due to "boredom" increased the odds for reporting use of powder cocaine and hallucinogens other than LSD. Using marijuana to increase effects of other drugs increased odds of reporting use of each of the eight drugs, and using it to decrease other drug effects increased odds of reporting use of crack, hallucinogens other than LSD, and amphetamine/stimulants. This study helped identify illicit marijuana users who are more likely to report use of other illicit drugs. Prevention efforts need to focus on students who report certain reasons for marijuana use as they may be at risk for use of other illicit drugs.

Characteristics of pregnant illicit drug users and associations between cannabis use and perinatal outcome in a population-based study.

NARCIS (Netherlands)

Gelder, M.M.H.J. van; Reefhuis, J.; Caton, A.R.; Werler, M.M.; Druschel, C.M.; Roeleveld, N.

2010-01-01

BACKGROUND: According to the 2004 National Survey on Drug Use and Health, 4.6% of American women reported use of an illicit drug during pregnancy. Previous studies on illicit drug use during pregnancy and perinatal outcomes showed inconsistent results. METHODS: This population-based study included

The global diversion of pharmaceutical drugs. India: the third largest illicit opium producer?

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Paoli, Letizia; Greenfield, Victoria A; Charles, Molly; Reuter, Peter

2009-03-01

This paper explores India's role in the world illicit opiate market, particularly its role as a producer. India, a major illicit opiate consumer, is also the sole licensed exporter of raw opium: this unique status may be enabling substantial diversion to the illicit market. Participant observation and interviews were carried out at eight different sites. Information was also drawn from all standard secondary sources and the analysis of about 180 drug-related criminal proceedings reviewed by Indian High Courts and the Supreme Court from 1985 to 2001. Diversion from licit opium production takes place on such a large scale that India may be the third largest illicit opium producer after Afghanistan and Burma. With the possible exceptions of 2005 and 2006, 200-300 tons of India's opium may be diverted yearly. After estimating India's opiate consumption on the basis of UN-reported prevalence estimates, we find that diversion from licit production might have satisfied a quarter to more than a third of India's illicit opiate demand to 2004. India is not only among the world's largest consumer of illicit opiates but also one of the largest illicit opium producers. In contrast to all other illicit producers, India owes the latter distinction not to blatantly illicit cultivation but to diversion from licit cultivation. India's experience suggests the difficulty of preventing substantial leakage, even in a relatively well-governed nation.

[Risk indicators associated with the consumption of illicit drugs by schoolchildren in a community in the south of Brazil].

Science.gov (United States)

Backes, Dirce Stein; Zanatta, Fabrício Batistin; Costenaro, Regina Santini; Rangel, Rosiane Filipin; Vidal, Janice; Kruel, Cristina Saling; de Mattos, Karen Mallo

2014-03-01

This study sought to identify the risk indicators associated with the consumption of illicit drugs by schoolchildren in public schools in a community in the south of Brazil. This is a non-experimental cross-sectional study conducted with 535 students of primary schoolchildren from six public schools. Data were collected using a questionnaire between October 2011 and March 2012. The results were presented by simple and relative distribution of frequency and odds ratio (OR) and the 95% reliability intervals were calculated to verify the association between the dependent and independent variables. Multivariate analysis was also performed using the question "have you ever used illicit drugs?" Univariate analysis revealed an association between family income, color, period in which the child studied, failure to pass annual tests, use of methods of prevention, smoking habit and knowing someone who uses drugs with the fact of having experimented with the use of illicit drugs. After multivariate analysis, the smoking habit was the only indicator significantly associated with the question of having made use of illicit drugs. The results indicate that the smoking habit is an important indicator of the predictive risk for the use of illicit drugs.

Illicit drug use and violence in acute psychosis among acute adult ...

African Journals Online (AJOL)

Keywords: Illicit drug use, violence, acute psychosis, psychiatric hospital. ... violence and substance abuse. Methods ... and identifiable data were anonymized and/or stored in .... only a handful had urine tests done at the referral centres.

Forces of Habit: Global SOF's Role in Countering Illicit Drug Trafficking

OpenAIRE

Paul Rexton Kan

2014-01-01

Illicit drug trafficking is a prominent national security issue in a globalizing world. Drug trafficking intersects with major security issues such as rogue and narco-states, weak and failing states, insurgencies and terrorism, transnational organized crime and protracted intrastate conflicts. These are the same issues that sets the operational environment for the deployment of SOF. Rather than treating drug trafficking as a singular and separate security issue, global SOF counternarcotics op...

Illicit dopamine transients: reconciling actions of abused drugs.

Science.gov (United States)

Covey, Dan P; Roitman, Mitchell F; Garris, Paul A

2014-04-01

Phasic increases in brain dopamine are required for cue-directed reward seeking. Although compelling within the framework of appetitive behavior, the view that illicit drugs hijack reward circuits by hyperactivating these dopamine transients is inconsistent with established psychostimulant pharmacology. However, recent work reclassifying amphetamine (AMPH), cocaine, and other addictive dopamine-transporter inhibitors (DAT-Is) supports transient hyperactivation as a unifying hypothesis of abused drugs. We argue here that reclassification also identifies generating burst firing by dopamine neurons as a keystone action. Unlike natural rewards, which are processed by sensory systems, drugs act directly on the brain. Consequently, to mimic natural rewards and exploit reward circuits, dopamine transients must be elicited de novo. Of available drug targets, only burst firing achieves this essential outcome. Copyright © 2014 Elsevier Ltd. All rights reserved.

Global Reach of Direct-to-Consumer Advertising Using Social Media for Illicit Online Drug Sales

Science.gov (United States)

Liang, Bryan A

2013-01-01

Background Illicit or rogue Internet pharmacies are a recognized global public health threat that have been identified as utilizing various forms of online marketing and promotion, including social media. Objective To assess the accessibility of creating illicit no prescription direct-to-consumer advertising (DTCA) online pharmacy social media marketing (eDTCA2.0) and evaluate its potential global reach. Methods We identified the top 4 social media platforms allowing eDTCA2.0. After determining applicable platforms (ie, Facebook, Twitter, Google+, and MySpace), we created a fictitious advertisement advertising no prescription drugs online and posted it to the identified social media platforms. Each advertisement linked to a unique website URL that consisted of a site error page. Employing Web search analytics, we tracked the number of users visiting these sites and their location. We used commercially available Internet tools and services, including website hosting, domain registration, and website analytic services. Results Illicit online pharmacy social media content for Facebook, Twitter, and MySpace remained accessible despite highly questionable and potentially illegal content. Fictitious advertisements promoting illicit sale of drugs generated aggregate unique user traffic of 2795 visits over a 10-month period. Further, traffic to our websites originated from a number of countries, including high-income and middle-income countries, and emerging markets. Conclusions Our results indicate there are few barriers to entry for social media–based illicit online drug marketing. Further, illicit eDTCA2.0 has globalized outside US borders to other countries through unregulated Internet marketing. PMID:23718965

Human Drug Discrimination: Elucidating the Neuropharmacology of Commonly Abused Illicit Drugs.

Science.gov (United States)

Bolin, B Levi; Alcorn, Joseph L; Reynolds, Anna R; Lile, Joshua A; Stoops, William W; Rush, Craig R

2016-06-07

Drug-discrimination procedures empirically evaluate the control that internal drug states have over behavior. They provide a highly selective method to investigate the neuropharmacological underpinnings of the interoceptive effects of drugs in vivo. As a result, drug discrimination has been one of the most widely used assays in the field of behavioral pharmacology. Drug-discrimination procedures have been adapted for use with humans and are conceptually similar to preclinical drug-discrimination techniques in that a behavior is differentially reinforced contingent on the presence or absence of a specific interoceptive drug stimulus. This chapter provides a basic overview of human drug-discrimination procedures and reviews the extant literature concerning the use of these procedures to elucidate the underlying neuropharmacological mechanisms of commonly abused illicit drugs (i.e., stimulants, opioids, and cannabis) in humans. This chapter is not intended to review every available study that used drug-discrimination procedures in humans. Instead, when possible, exemplary studies that used a stimulant, opioid, or Δ 9 -tetrahydrocannabinol (the primary psychoactive constituent of cannabis) to assess the discriminative-stimulus effects of drugs in humans are reviewed for illustrative purposes. We conclude by commenting on the current state and future of human drug-discrimination research.

Sampling of illicit drugs for quantitative analysis--part II. Study of particle size and its influence on mass reduction.

Science.gov (United States)

Bovens, M; Csesztregi, T; Franc, A; Nagy, J; Dujourdy, L

2014-01-01

The basic goal in sampling for the quantitative analysis of illicit drugs is to maintain the average concentration of the drug in the material from its original seized state (the primary sample) all the way through to the analytical sample, where the effect of particle size is most critical. The size of the largest particles of different authentic illicit drug materials, in their original state and after homogenisation, using manual or mechanical procedures, was measured using a microscope with a camera attachment. The comminution methods employed included pestle and mortar (manual) and various ball and knife mills (mechanical). The drugs investigated were amphetamine, heroin, cocaine and herbal cannabis. It was shown that comminution of illicit drug materials using these techniques reduces the nominal particle size from approximately 600 μm down to between 200 and 300 μm. It was demonstrated that the choice of 1 g increments for the primary samples of powdered drugs and cannabis resin, which were used in the heterogeneity part of our study (Part I) was correct for the routine quantitative analysis of illicit seized drugs. For herbal cannabis we found that the appropriate increment size was larger. Based on the results of this study we can generally state that: An analytical sample weight of between 20 and 35 mg of an illicit powdered drug, with an assumed purity of 5% or higher, would be considered appropriate and would generate an RSDsampling in the same region as the RSDanalysis for a typical quantitative method of analysis for the most common, powdered, illicit drugs. For herbal cannabis, with an assumed purity of 1% THC (tetrahydrocannabinol) or higher, an analytical sample weight of approximately 200 mg would be appropriate. In Part III we will pull together our homogeneity studies and particle size investigations and use them to devise sampling plans and sample preparations suitable for the quantitative instrumental analysis of the most common illicit

Misuse of prescription and illicit drugs among high-risk young adults in Los Angeles and New York

Directory of Open Access Journals (Sweden)

Stephen E. Lankenau

2012-02-01

Full Text Available Background. Prescription drug misuse among young adults is increasingly viewed as a public health concern, yet most research has focused on student populations and excluded high-risk groups. Furthermore, research on populations who report recent prescription drug misuse is limited. This study examined patterns of prescription drug misuse among high-risk young adults in Los Angeles (LA and New York (NY, which represent different local markets for illicit and prescription drugs. Design and Methods. Between 2009 and 2011, 596 young adults (16 to 25 years old who had misused prescription drugs within the past 90 days were interviewed in Los Angeles and New York. Sampling was stratified to enroll three groups of high-risk young adults: injection drug users (IDUs; homeless persons; and polydrug users. Results. In both sites, lifetime history of receiving a prescription for an opioid, tranquilizer, or stimulant was high and commonly preceded misuse. Moreover, initiation of opioids occurred before heroin and initiation of prescription stimulants happened prior to illicit stimulants. NY participants more frequently misused oxycodone, heroin, and cocaine, and LA participants more frequently misused codeine, marijuana, and methamphetamine. Combining prescription and illicit drugs during drug using events was commonly reported in both sites. Opioids and tranquilizers were used as substitutes for other drugs, e.g., heroin, when these drugs were not available. Conclusion. Patterns of drug use among high-risk young adults in Los Angeles and New York appear to be linked to differences in local markets in each city for illicit drugs and diverted prescription drugs.

Use of illicit drugs by adolescents and young adults of an urban settlement in Brazil

OpenAIRE

Guimarães, Rafael Alves; Souza, Márcia Maria de; Caetano, Karlla Antonieta Amorim; Teles, Sheila Araujo; Matos, Marcos André de

2018-01-01

Summary Objective: To estimate the prevalence and factors associated with illicit drug use by adolescents and young adults of a formal urban settlement. Method: Cross-sectional study including adolescents and young adults 12-24 years of an urban settlement in the Midwest Region of Brazil. Data were collected using a structured questionnaire and analyzed using Stata, version 12.0. We used Poisson regression model to estimate the factors associated with illicit drug use. Results: Of the tota...

Adolescents' use of alcohol, tobacco and illicit drugs in relation to prenatal alcohol exposure: modifications by gender and ethnicity.

Science.gov (United States)

Pfinder, Manuela; Liebig, Stefan; Feldmann, Reinhold

2014-01-01

The study aimed to investigate (a) the association between low to moderate prenatal alcohol exposure (PAE) and the use of alcohol, tobacco and illicit drugs in adolescence and (b) whether the associations are modified by gender and ethnicity. The subjects of the study were 5922 children and adolescents, aged from 11 to 17 years, enrolled in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents (the KiGGS study). Information on PAE is based on parental self-report questionnaires. Use of alcohol, tobacco and illicit drugs was assessed through self-report questionnaires for adolescents. Low to moderate PAE was associated with an increased risk of drinking alcohol (adjusted odds ratio (OR) 1.73, 95% confidence interval (CI) 1.34, 2.18) and also of illicit drug use (adjusted OR 1.62, 95% CI 1.23, 2.14). The associations between PAE and the use of alcohol, tobacco and illicit drugs differed according to gender and ethnicity. Gender-stratified analyses resulted in adverse effects of PAE on drinking alcohol, smoking and illicit drug use in females; however, in German males, the associations disappeared. Stronger associations between PAE and the outcome measures were found in non-Germans. Our findings indicate that low to moderate levels of maternal alcohol intake during pregnancy are a risk factor for use of alcohol, tobacco and illicit drugs by the offspring, with stronger associations in females and non-Germans.

Impact of use of alcohol and illicit drugs by AIDS patients on adherence to antiretroviral therapy in Bahia, Brazil.

Science.gov (United States)

Teixeira, Celia; Dourado, Maria De Lourdes; Santos, Marcio P; Brites, Carlos

2013-05-01

Use of alcohol and illicit drugs is a common finding among HIV-infected individuals, but there are many open questions about its impact on adherence to antiretroviral therapy and virological outcomes. Our study aimed to evaluate the impact of the use of alcohol and illicit drugs on the adherence to antiretroviral therapy (ART) among patients starting ART in Salvador, Brazil. We followed up 144 AIDS patients initiating ART for a 6-month period. At baseline, they were interviewed about demographics, behavior, and use of illicit drugs and alcohol. All of them had HIV-1 RNA plasma viral load and CD4(+)/CD8(+) cells count measured before starting therapy. After 60 days of treatment they were asked to answer a new questionnaire on adherence to ART. All patients were monitored during the following months, and new CD4(+) cell count/HIV-1 RNA plasma viral load determinations were performed after 6 months of therapy. Optimal adherence to therapy was defined by self-reported questionnaire, by 95% use of prescribed drug doses, and by using plasma HIV-1 RNA viral load as a biological marker. A total of 61 (42.4%) patients reported alcohol use, 7 (4.9%) used illicit drugs, and 17 (11.8%) used both alcohol and illicit drugs. Being in a steady relationship was protective to nonadherence (95% CI: 0.18-0.84). Missing more than two medical visits was also associated with a 68% higher likelihood of nonadherence (95% CI: 0.10-1.02). After logistic regression we detected a higher risk of nonadherence for patients declaring use of alcohol plus illicit drugs (odds ratio=6.0; 95% CI: 1.78-20.28) or high-intensity use of alcohol (odds ratio=3.29; 95% CI: 1.83-5.92). AIDS patients using alcohol and/or illicit drugs are socially vulnerable, and need specific and flexible programs, combining mental health care, harm reduction strategies, and assisted drug therapy to maximize the chances of successful use of ART.

Illicit Drugs: Contaminants in the Environment and Utility in Forensic Epidemiology

Science.gov (United States)

The published literature surrounding the origin, occurrence, fate, and effects of illicit drug ingredients (IDIs) in the environment is examined. Similarities exist with medical pharmaceuticals, particularly with regard to the basic processes by which these ingredients enter the ...

Trends in drug overdose deaths in England and Wales 1993-98: methadone does not kill more people than heroin.

Science.gov (United States)

Hickman, Matthew; Madden, Peter; Henry, John; Baker, Allan; Wallace, Chris; Wakefield, Jon; Stimson, Gerry; Elliott, Paul

2003-04-01

To test the hypothesis that methadone is responsible for a greater increase in overdose deaths than heroin, and causes proportionally more overdose deaths than heroin at weekends. Multivariate analysis of 3961 death certificates mentioning heroin, morphine and/or methadone held on the Office for National Statistics drug-related poisoning mortality database from 1993 to 1998 in England and Wales. Percentage increase in deaths by year by drug, odds ratio (OR) of dying at the weekend from methadone-related overdose compared to dying from heroin/morphine overdose. From 1993 to 1998, annual opiate overdose deaths increased from 378 to 909. There was a 24.7% (95% confidence interval (CI) 22-28%) yearly increase in heroin deaths compared to 9.4% (95% CI 6-13%) for methadone only. This difference was significant (P < 0.001 by test of interaction) after adjustment for sex, age group, polydrug use, area of residence and underlying cause of death. The largest number of deaths occurred on Saturday (673). The OR of death from methadone overdose on Saturday and Sunday was 1.48 (95% CI 1.29-1.71) for methadone-only deaths compared to dying from heroin/morphine at the weekend after adjustment for other covariates, but the OR was not significant (1.09, 95% CI 0.95-1.25) if the weekend was defined as Friday and Saturday. There was no evidence that the threefold increase in deaths over time was due to methadone. There was equivocal support only for the hypothesis that there was an excess of deaths from methadone at weekends. Increased interventions to prevent overdose among injectors in England and Wales are long overdue.

Detection of illicit drugs in impaired driver saliva by a field-usable SERS analyzer

Science.gov (United States)

Shende, Chetan; Huang, Hermes; Farquharson, Stuart

2014-05-01

One of the greatest dangers of drug use is in combination with driving. According to the most recent National Highway Traffic Safety Administration (NHTSA) studies, more than 11% of drivers tested positive for illicit drugs, while 18% of drivers killed in accidents tested positive for illicit, prescription or over-the-counter drugs. Consequently, there is a need for a rapid, noninvasive, roadside drug testing device, similar to the breathalyzers used by law enforcement officials to estimate blood alcohol levels of impaired drivers. In an effort to satisfy this need we have been developing a sampling kit that allows extraction of drugs from 1 mL of saliva and detection by surfaceenhanced Raman spectroscopy using a portable Raman analyzer. Here we describe the development of the sampling kit and present measurements of diazepam at sub μg/mL concentrations measured in ~15 minutes.

Coffee Shops and Compromise: Separated Illicit Drug Markets in the Netherlands

OpenAIRE

Grund, Jean-Paul; Breeksema, Joost

2013-01-01

textabstractBuilding on a long history and culture of tolerance, the Dutch responded to illicit drugs with decades of pragmatic measures free of judgment. A central element of modern Dutch drug policy was a crucial decision to establish a legal and practical separation of cannabis— judged to pose “acceptable” risks to consumers and society—from hard drugs associated with unacceptable risk. This policy effectively decriminalized possession and use of cannabis and opened the door for tolerated ...

Naproxen sodium overdose

Science.gov (United States)

... page: //medlineplus.gov/ency/article/002507.htm Naproxen sodium overdose To use the sharing features on this page, please enable JavaScript. Naproxen sodium is a nonsteroidal anti-inflammatory drug (NSAID) used ...

Overdose prevention for injection drug users: lessons learned from naloxone training and distribution programs in New York City.

Science.gov (United States)

Piper, Tinka Markham; Rudenstine, Sasha; Stancliff, Sharon; Sherman, Susan; Nandi, Vijay; Clear, Allan; Galea, Sandro

2007-01-25

Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs). Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United States, drug users are being trained in naloxone administration and given naloxone for immediate and successful reversals of opiate overdoses. There has been very little formal description of the challenges faced in the development and implementation of large-scale IDU naloxone administration training and distribution programs and the lessons learned during this process. During a one year period, over 1,000 participants were trained in SKOOP (Skills and Knowledge on Opiate Prevention) and received a prescription for naloxone by a medical doctor on site at a syringe exchange program (SEP) in New York City. Participants in SKOOP were over the age of 18, current participants of SEPs, and current or former drug users. We present details about program design and lessons learned during the development and implementation of SKOOP. Lessons learned described in the manuscript are collectively articulated by the evaluators and implementers of the project. There were six primary challenges and lessons learned in developing, implementing, and evaluating SKOOP. These include a) political climate surrounding naloxone distribution; b) extant prescription drug laws; c) initial low levels of recruitment into the program; d) development of participant appropriate training methodology; e) challenges in the design of a suitable formal evaluation; and f) evolution of program response to naloxone. Other naloxone distribution programs may anticipate similar challenges to SKOOP and we identify mechanisms to address them. Strategies include being flexible in program planning and implementation, developing evaluation

Perspectives on Health among Adult Users of Illicit Stimulant Drugs in Rural Ohio

Science.gov (United States)

Siegal, Harvey A.; Draus, Paul J.; Carlson, Robert G.; Falck, Russel S.; Wang, Jichuan

2006-01-01

Context: Although the nonmedical use of stimulant drugs such as cocaine and methamphetamine is increasingly common in many rural areas of the United States, little is known about the health beliefs of people who use these drugs. Purpose: This research describes illicit stimulant drug users' views on health and health-related concepts that may…

Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature.

Science.gov (United States)

Tofighi, Babak; Nicholson, Joseph M; McNeely, Jennifer; Muench, Frederick; Lee, Joshua D

2017-07-01

Mobile phone use has increased dramatically and concurrent with rapid developments in mobile phone-based health interventions. The integration of text messaging interventions promises to optimise the delivery of care for persons with substance dependence with minimal disruption to clinical workflows. We conducted a systematic review to assess the acceptability, feasibility and clinical impact of text messaging interventions for persons with illicit drug and alcohol dependence. Studies were required to evaluate the use of text messaging as an intervention for persons who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition criterion for a diagnosis of illicit drug and/or alcohol dependence. Authors searched for articles published to date in MEDLINE (pubmed.gov), the Cochrane Library, EMBASE, CINAHL, Google Scholar and PsychINFO. Eleven articles met the search criteria for this review and support the acceptability and feasibility of text messaging interventions for addressing illicit drug and alcohol dependence. Most studies demonstrated improved clinical outcomes, medication adherence and engagement with peer support groups. Text messaging interventions also intervened on multiple therapeutic targets such as appointment attendance, motivation, self-efficacy, relapse prevention and social support. Suggestions for future research are described, including intervention design features, clinician contact, privacy measures and integration of behaviour change theories. Text messaging interventions offer a feasible platform to address a range of substances (i.e. alcohol, methamphetamine, heroin and alcohol), and there is increasing evidence supporting further larger-scale studies. [Tofighi B, Nicholson JM, McNeely J, Muench F, Lee JD. Mobile phone messaging for illicit drug and alcohol dependence: A systematic review of the literature. Drug Alcohol Rev 2017;36:477-491]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Economic-Social Analysis of Global Illicit Drug Trade

OpenAIRE

Salahedin Ghaderi

2003-01-01

Political unstability, less respect to the role of law, low life standards and suitable conditions for poppy/coca cultivation, have all affected on growing illicit drug international trafficking. Colombia is the center for global cocaine industry. Colombians had to use ship in the Carribean but now they pass Mexico where the costs are half of using ship. Mexican traffickers permit that the domestic poppy plants turned into herion, Colombian cocaine transited to USA and methamephtamine manufac...

Buying drugs on a Darknet market: A better deal? Studying the online illicit drug market through the analysis of digital, physical and chemical data.

Science.gov (United States)

Rhumorbarbe, Damien; Staehli, Ludovic; Broséus, Julian; Rossy, Quentin; Esseiva, Pierre

2016-10-01

Darknet markets, also known as cryptomarkets, are websites located on the Darknet and designed to allow the trafficking of illicit products, mainly drugs. This study aims at presenting the added value of combining digital, chemical and physical information to reconstruct sellers' activities. In particular, this research focuses on Evolution, one of the most popular cryptomarkets active from January 2014 to March 2015. Evolution source code files were analysed using Python scripts based on regular expressions to extract information about listings (i.e., sales proposals) and sellers. The results revealed more than 48,000 listings and around 2700 vendors claiming to send illicit drug products from 70 countries. The most frequent categories of illicit drugs offered by vendors were cannabis-related products (around 25%) followed by ecstasy (MDA, MDMA) and stimulants (cocaine, speed). The cryptomarket was then especially studied from a Swiss point of view. Illicit drugs were purchased from three sellers located in Switzerland. The purchases were carried out to confront digital information (e.g., the type of drug, the purity, the shipping country and the concealment methods mentioned on listings) with the physical analysis of the shipment packaging and the chemical analysis of the received product (purity, cutting agents, chemical profile based on minor and major alkaloids, chemical class). The results show that digital information, such as concealment methods and shipping country, seems accurate. But the illicit drugs purity is found to be different from the information indicated on their respective listings. Moreover, chemical profiling highlighted links between cocaine sold online and specimens seized in Western Switzerland. This study highlights that (1) the forensic analysis of the received products allows the evaluation of the accuracy of digital data collected on the website, and (2) the information from digital and physical/chemical traces are complementary to

Illicit Drug Use Among South Korean Offenders: Assessing the Generality of Social Learning Theory.

Science.gov (United States)

Yun, Minwoo; Kim, Eunyoung

2015-10-01

Since the mid-1990s, illicit drug use has become a problem in Korean society. This trend is likely due to the rapid globalization and expansion that occurred with the Internet revolution, which led to greater numbers of people socially learning about drug culture. The current study attempts to uncover criminogenic causality of such social learning about drug use by studying adult felony drug offenders in South Korea. The data used for the study were obtained from self-reported surveys, originally collected by the Korean Institution of Criminology (KIC). The final sample comprised 1,452 felony offenders convicted of illicit drug use, and their responses were analyzed with a set of multiple logistic regression tests. The current study found supportive evidence for the generalizability of social learning theory from the sample of the South Korean adult drug offenders. We argue that the current study provides additional empirical evidence that supports the generalizability of social learning theory. © The Author(s) 2014.

Forces of Habit: Global SOF's Role in Countering Illicit Drug Trafficking

Directory of Open Access Journals (Sweden)

Paul Rexton Kan

2014-07-01

Full Text Available Illicit drug trafficking is a prominent national security issue in a globalizing world. Drug trafficking intersects with major security issues such as rogue and narco-states, weak and failing states, insurgencies and terrorism, transnational organized crime and protracted intrastate conflicts. These are the same issues that sets the operational environment for the deployment of SOF. Rather than treating drug trafficking as a singular and separate security issue, global SOF counternarcotics operations must adapt previous approaches to new realities.

Compulsive Buying: Earlier Illicit Drug Use, Impulse Buying, Depression, and Adult ADHD Symptoms

Science.gov (United States)

Brook, Judith S.; Zhang, Chenshu; Brook, David W.; Leukefeld, Carl G.

2015-01-01

This longitudinal study examined the association between psychosocial antecedents, including illicit drug use, and adult compulsive buying (CB) across a 29-year time period from mean age 14 to mean age 43. Participants originally came from a community-based random sample of residents in two upstate New York counties. Multivariate linear regression analysis was used to study the relationship between the participant’s earlier psychosocial antecedents and adult CB in the fifth decade of life. The results of the multivariate linear regression analyses showed that gender (female), earlier adult impulse buying (IB), depressive mood, illicit drug use, and concurrent ADHD symptoms were all significantly associated with adult CB at mean age 43. It is important that clinicians treating CB in adults should consider the role of drug use, symptoms of ADHD, IB, depression, and family factors in CB. PMID:26165963

Long-term follow-up of patients treated for psychotic symptoms that persist after stopping illicit drug use.

Science.gov (United States)

Deng, Xianhua; Huang, Zhibiao; Li, Xuewu; Li, Yi; Wang, Yi; Wu, Dongling; Gao, Beiling; Yang, Xi

2012-10-01

The long-term outcome of patients diagnosed with drug-induced psychotic disorders in China is unknown. Assess the course of illness and severity of psychiatric symptoms in patients previously admitted to a psychiatric hospital for treatment of psychotic symptoms that were induced by the use of illicit drugs. Patients with psychotic symptoms at the time of their first psychiatric admission who had used illicit drugs in the month prior to admission were followed up 13 to 108 months after admission. Patients and coresident family members were interviewed about post-discharge drug use and psychotic symptoms. The 258 identified patients were primarily young, unemployed males whose most common drug of abuse was methamphetamines and who had been abusing drugs for an average of 7 years at the time of admission. Among these patients 189 (73%) were located and reinterviewed; 168 (89%) had restarted illicit drug use and 25 (13%) had required rehospitalization over the follow-up period. In 114 patients (60%) the psychotic symptoms resolved in less than 1 month after stopping the drugs, in 56 (30%) the symptoms persisted for 1 to 6 months, and in 19 (10%) the symptoms persisted for longer than 6 months (in 8 of these the diagnosis had changed to schizophrenia). Compared to the other two groups, patients whose symptoms persisted more than 6 months were more likely to have a family history of mental illness, an earlier age of onset and a longer duration of drug abuse prior to the index admission; they were also more likely to have been re-hospitalized during the follow-up period and to have psychotic symptoms at the time of follow-up. Most patients with substance-induced psychotic disorders in our sample had a good long-term prognosis but those who started illegal drug use early, used drugs for prolonged periods, or had a family history of psychiatric illnesses were more likely to develop a chronic psychosis. Further prospective studies are needed to determine the relationship of

An Initial evaluation of law enforcement overdose training in Rhode Island.

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Saucier, Cory D; Zaller, Nickolas; Macmadu, Alexandria; Green, Traci C

2016-05-01

To assess initial change in knowledge, self-efficacy, and anticipated behaviors among Rhode Island law enforcement officers on drug overdose response and prevention. Law enforcement officers (N=316) voluntarily completed a pre-post evaluation immediately before and after taking part in overdose prevention and response trainings. Assessment items included measures of knowledge (Brief Overdose Recognition and Response Assessment (BORRA)), self-efficacy, attitudes toward drugs and overdose prevention, awareness of the Good Samaritan Law, and open-ended items pertaining to overdose knowledge and response behaviors. Non-parametric tests measured within-group and between-group differences. Wilcoxon Signed Rank tests and Kruskal-Wallis tests evaluated changes in BORRA scores and self-efficacy items. McNemar's tests assessed changes regarding the Good Samaritan law and open-ended items. Wilcoxon Signed Rank tests measured post-training change in attitudes. Law enforcement officers demonstrated statistically significant improvements in self-efficacy (identifying signs of opioid overdose, naloxone indication, counseling witnesses in overdose prevention, and referring witnesses for more information), overdose identification knowledge (BORRA mean increased from 7.00 to 10.39), naloxone administration knowledge (BORRA mean increased from 10.15 to 12.59), Good Samaritan Law awareness (17.9% increase after training), and anticipated behaviors in response to future observed overdose (65.7% changed from passive to active response post training). Harm reduction programs can provide law enforcement officers with the knowledge and skills necessary to intervene and reduce overdose mortality. Given the statistically significant improvements in self-efficacy, attitudinal changes, and Good Samaritan law awareness, law enforcement officers are more prepared to actively interact with drug users during a drug-involved emergency. Copyright © 2016. Published by Elsevier Ireland Ltd.

The prevalence of violence and relation to depression and illicit drug use among incarcerated women in Recife, Brazil.

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Reed, Elizabeth; Raj, Anita; Falbo, Gilliatt; Caminha, Fatima; Decker, Michele R; Kaliel, Deborah C; Missmer, Stacey A; Molnar, Beth E; Silverman, Jay G

2009-01-01

To assess the prevalence and different types of violence experienced by women prisoners in Brazil and the effects of violence on women's depression and illicit drug use. Participants (N=377) were incarcerated women from a state prison in a northeastern city of Brazil. Multivariate logistic regression models (adjusted for age, education, partner status, prison history, drug related offense, and sentencing status) were used to assess associations between each type of violence (physical abuse, sexual abuse, and life threats) and each outcome variable: recent depression and illicit drug use. The majority of participants (87%) reported experiencing some type of violence in their lifetime, including physical violence (83%), sexual victimization (36%), and threats on their life (29%.) Sexual violence was significantly related to both recent depression (Odds Ratio (OR)=2.8; 95% Confidence Interval (CI)=1.4-5.3) and recent substance use (OR=2.7; 95% CI=1.6-4.4) in adjusted models. Experiences of life threats were also significantly associated with illicit drug use (OR=2.2; 95% CI: 1.3-3.7), as was physical violence (OR=2.4; 95% CI: 1.2-4.9); however, neither of these latter two violence variables were significantly associated with depression. Reports of lifetime violence victimization among this incarcerated sample of women were extremely prevalent and relevant to women's depression and illicit drug use. Prison efforts to address women's depression and illicit drug use may be most effective by incorporating aspects related to women's history of victimization, especially given the high rates of violence experienced by women in this sample.

Using quantitative wastewater analysis to measure daily usage of conventional and emerging illicit drugs at an annual music festival.

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Lai, Foon Yin; Thai, Phong K; O'Brien, Jake; Gartner, Coral; Bruno, Raimondo; Kele, Benjamin; Ort, Christoph; Prichard, Jeremy; Kirkbride, Paul; Hall, Wayne; Carter, Steve; Mueller, Jochen F

2013-11-01

Wastewater analysis provides a non-intrusive way of measuring drug use within a population. We used this approach to determine daily use of conventional illicit drugs [cannabis, cocaine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA)] and emerging illicit psychostimulants (benzylpiperazine, mephedrone and methylone) in two consecutive years (2010 and 2011) at an annual music festival. Daily composite wastewater samples, representative of the festival, were collected from the on-site wastewater treatment plant and analysed for drug metabolites. Data over 2 years were compared using Wilcoxon matched-pair test. Data from 2010 festival were compared with data collected at the same time from a nearby urban community using equivalent methods. Conventional illicit drugs were detected in all samples whereas emerging illicit psychostimulants were found only on specific days. The estimated per capita consumption of MDMA, cocaine and cannabis was similar between the two festival years. Statistically significant (P popularity in music settings. Our study demonstrated that wastewater analysis can objectively capture changes in substance use at a music setting without raising major ethical issues. It would potentially allow effective assessments of drug prevention strategies in such settings in the future. © 2013 Australasian Professional Society on Alcohol and other Drugs.

A Structural Model of the Retail Market for Illicit Drugs.

Science.gov (United States)

Galenianos, Manolis; Gavazza, Alessandro

2017-03-01

We estimate a model of illicit drugs markets using data on purchases of crack cocaine. Buyers are searching for high-quality drugs, but they determine drugs' quality (i.e., their purity) only after consuming them. Hence, sellers can rip off first-time buyers or can offer higher-quality drugs to induce buyers to purchase from them again. In equilibrium, a distribution of qualities persists. The estimated model implies that if drugs were legalized, in which case purity could be regulated and hence observable, the average purity of drugs would increase by approximately 20 percent and the dispersion would decrease by approximately 80 percent. Moreover, increasing penalties may raise the purity and affordability of the drugs traded by increasing sellers’ relative profitability of targeting loyal buyers versus first-time buyers.

Are patients with panic disorder respiratory subtype more vulnerable to tobacco, alcohol or illicit drug use?

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Rafael C. Freire

2013-01-01

Full Text Available BACKGROUND: Studies have documented high use of tobacco, alcohol and illicit drugs in patients with panic disorder (PD. The comorbid substance use disorders worsen the prognosis of mood and anxiety disorders. The respiratory subtype (RS of PD seems to represent a more severe and distinct form of this disorder associated with higher familial history of PD and more comorbidity with other anxiety disorders. OBJECTIVES: Describe the patterns of tobacco, alcohol or illicit drug use in PD patients, and also to ascertain if patients with the RS use these substances more than those of the non-respiratory subtype. METHODS: This is a cross-sectional study with 71 PD patients. The Alcohol Use Disorders Identification Test and Fagerstrom Tobacco Questionnaire were used in the evaluation. Patients with four or five respiratory symptoms were classified in the RS, the remaining patients were classified as non-respiratory subtype. RESULTS: In our sample 31.0% were smokers, 11.3% were hazardous alcohol users and none of them was using illicit drugs. There were no differences between the respiratory and non-respiratory subtypes regarding the use of tobacco, alcohol, cannabis, cocaine, stimulants and hallucinogens. DISCUSSION: The RS was not correlated to the use of tobacco, alcohol and illicit drugs. Additional epidemiological and clinical studies focusing the relationship between PD and substance use are warranted.

Determination of Inorganic Ion Profiles of Illicit Drugs by Capillary Electrophoresis.

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Evans, Elizabeth; Costrino, Carolina; do Lago, Claudimir L; Garcia, Carlos D; Roux, Claude; Blanes, Lucas

2016-11-01

A portable capillary electrophoresis instrument with dual capacitively coupled contactless conductivity detection (C 4 D) was used to determine the inorganic ionic profiles of three pharmaceutical samples and precursors of two illicit drugs (contemporary samples of methylone and para-methoxymethamphetamine). The LODs ranged from 0.10 μmol/L to 1.25 μmol/L for the 10 selected cations, and from 0.13 μmol/L to 1.03 μmol/L for the eight selected anions. All separations were performed in less than 6 min with migration times and peak area RSD values ranging from 2 to 7%. The results demonstrate the potential of the analysis of inorganic ionic species to aid in the identification and/or differentiation of unknown tablets, and real samples found in illicit drug manufacture scenarios. From the resulting ionic fingerprint, the unknown tablets and samples can be further classified. © 2016 American Academy of Forensic Sciences.

Breaking the Taboo: Illicit Drug Use among Adolescents with Type 1 Diabetes Mellitus

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Anna M. Hogendorf

2016-01-01

Full Text Available Background. The aim of the study was to explore the prevalence of illicit drug use in a group of Polish adolescents with type 1 diabetes (DM1 in comparison with a national cohort of their healthy peers. Methods. Two hundred and nine adolescents with DM1, aged 15–18 years, were studied in 2013 with an anonymous questionnaire prepared for the European School Survey Project on Alcohol and Other Drugs (ESPAD. The control group was a representative sample of 12114 students at the same age who took part in ESPAD in 2011. Metabolic control was regarded as good if self-reported HbA1c was <8% or poor if HbA1c was ≥8%. Results. Lifetime prevalence of illicit drug use was lower among adolescents with DM1 than in the control group [58 (28% versus 5524 (46%, p=10-5]. Cannabis preparations were the most frequently used substances [38 (18.3% versus 3976 (33.1%, p=10-5], followed by tranquilizers, sedatives, and amphetamine. Lifetime and last 12-month use of cannabis were associated with poorer glycemic control (HbA1c ≥ 8%, p<0.01 and 0.02, respectively. Conclusions. Adolescents with DM1 report using illicit drugs to a lesser extent than their healthy peers. The use of cannabis is associated with a poorer metabolic control in teens with DM1.

Protocol of the impact of alternative social assistance disbursement on drug-related harm (TASA) study: a randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugs.

Science.gov (United States)

Richardson, Lindsey; Laing, Allison; Milloy, M-J; Maynard, Russ; Nosyk, Bohdan; Marshall, Brandon; Grafstein, Eric; Daly, Patricia; Wood, Evan; Montaner, Julio; Kerr, Thomas

2016-07-29

Government social assistance payments seek to alleviate poverty and address survival needs, but their monthly disbursement may cue increases in illicit drug use. This cue may be magnified when assistance is disbursed simultaneously across the population. Synchronized payments have been linked to escalations in drug use and unintended but severe drug-related harms, including overdose, as well as spikes in demand for health, social, financial and police services. The TASA study examines whether changing payment timing and frequency can mitigate drug-related harm associated with synchronized social assistance disbursement. The study is a parallel arm multi-group randomized controlled trial in which 273 participants are randomly allocated for six assistance cycles to a control or one of two intervention arms on a 1:1:1 basis. Intervention arm participants receive their payments: (1) monthly; or (2) semi-monthly, in each case on days that are not during the week when cheques are normally issued. The study partners with a community-based credit union that has developed a system to vary social assistance payment timing. The primary outcome is a 40 % increase in drug use during the 3 days beginning with cheque issue day compared to other days of the month. Bi-weekly follow-up interviews collect participant information on this and secondary outcomes of interest, including drug-related harm (e.g. non-fatal overdose), exposure to violence and health service utilization. Self-reported data will be supplemented with participant information from health, financial, police and government administrative databases. A longitudinal, nested, qualitative parallel process evaluation explores participant experiences, and a cost-effectiveness evaluation of different disbursement scenarios will be undertaken. Outcomes will be compared between control and intervention arms to identify the impacts of alternative disbursement schedules on drug-related harm resulting from synchronized income

Protocol of the impact of alternative social assistance disbursement on drug-related harm (TASA study: a randomized controlled trial to evaluate changes to payment timing and frequency among people who use illicit drugs

Directory of Open Access Journals (Sweden)

Lindsey Richardson

2016-07-01

Full Text Available Abstract Background Government social assistance payments seek to alleviate poverty and address survival needs, but their monthly disbursement may cue increases in illicit drug use. This cue may be magnified when assistance is disbursed simultaneously across the population. Synchronized payments have been linked to escalations in drug use and unintended but severe drug-related harms, including overdose, as well as spikes in demand for health, social, financial and police services. Methods/design The TASA study examines whether changing payment timing and frequency can mitigate drug-related harm associated with synchronized social assistance disbursement. The study is a parallel arm multi-group randomized controlled trial in which 273 participants are randomly allocated for six assistance cycles to a control or one of two intervention arms on a 1:1:1 basis. Intervention arm participants receive their payments: (1 monthly; or (2 semi-monthly, in each case on days that are not during the week when cheques are normally issued. The study partners with a community-based credit union that has developed a system to vary social assistance payment timing. The primary outcome is a 40 % increase in drug use during the 3 days beginning with cheque issue day compared to other days of the month. Bi-weekly follow-up interviews collect participant information on this and secondary outcomes of interest, including drug-related harm (e.g. non-fatal overdose, exposure to violence and health service utilization. Self-reported data will be supplemented with participant information from health, financial, police and government administrative databases. A longitudinal, nested, qualitative parallel process evaluation explores participant experiences, and a cost-effectiveness evaluation of different disbursement scenarios will be undertaken. Outcomes will be compared between control and intervention arms to identify the impacts of alternative disbursement schedules on

The use of triangle diagram in the detection of explosive and illicit drugs

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Sudac, Davorin; Baricevic, Martina; Obhodas, Jasmina; Franulovic, Andrej; Valkovic, Vladivoj

2010-04-01

A tagged neutron inspection system has been used for the detection of explosive and illicite drugs. Simulant of the RDX explosive was measured in different environments and its gamma ray spectra were compared with the gamma ray spectra of benign materials like paper, sugar and rise. "Fingerprint" of the RDX simulant was found by detecting the nitrogen as well as by making the triangle plot which coordinates show the carbon and oxygen content and density. Density was obtained by measuring the intensity of the transmited tagged neutrons. Hence, the presence of the simulant can be confirmed by using two different methods. The possibility of using the triangle plot for detection of illicit drugs like heroin, cocain and marihuana is also discused.

Harassment, discrimination, violence, and illicit drug use among young men who have sex with men.

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Wong, Carolyn F; Weiss, George; Ayala, George; Kipke, Michele D

2010-08-01

We examined the relationship among social discrimination, violence, and illicit drug use among an ethnically diverse cohort of young men who have sex with men (YMSM) residing in Los Angeles. Five Hundred twenty-six YMSM (aged 18-24 years) were recruited using a venue-based, stratified probability sampling design. Surveys assessed childhood financial hardship, violence (physical assault, sexual assault, intimate partner violence), social discrimination (homophobia and racism), and illicit drug use in the past 3 months. Analyses examined main and interaction effects of key variables on drug use. Experiences of financial hardship, physical intimate partner violence and homophobia predicted drug use. Although African American participants were less likely to report drug use than their Caucasian peers, those who experienced greater sexual racism were at significantly greater risk for drug use. Racial/ethnic minority YMSM were at increased risk for experiencing various forms of social discrimination and violence that place them at increased risk for drug use.

Compulsive buying: Earlier illicit drug use, impulse buying, depression, and adult ADHD symptoms.

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Brook, Judith S; Zhang, Chenshu; Brook, David W; Leukefeld, Carl G

2015-08-30

This longitudinal study examined the association between psychosocial antecedents, including illicit drug use, and adult compulsive buying (CB) across a 29-year time period from mean age 14 to mean age 43. Participants originally came from a community-based random sample of residents in two upstate New York counties. Multivariate linear regression analysis was used to study the relationship between the participant's earlier psychosocial antecedents and adult CB in the fifth decade of life. The results of the multivariate linear regression analyses showed that gender (female), earlier adult impulse buying (IB), depressive mood, illicit drug use, and concurrent ADHD symptoms were all significantly associated with adult CB at mean age 43. It is important that clinicians treating CB in adults should consider the role of drug use, symptoms of ADHD, IB, depression, and family factors in CB. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Genotoxic effects induced by the exposure to an environmental mixture of illicit drugs to the zebra mussel.

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Parolini, Marco; Magni, Stefano; Castiglioni, Sara; Binelli, Andrea

2016-10-01

Despite the growing interest on the presence of illicit drugs in freshwater ecosystems, just recently the attention has been focused on their potential toxicity towards non-target aquatic species. However, these studies largely neglected the effects induced by exposure to complex mixtures of illicit drugs, which could be different compared to those caused by single psychoactive molecules. This study was aimed at investigating the genetic damage induced by a 14-day exposure to a realistic mixture of the most common illicit drugs found in surface waters worldwide (cocaine, benzoylecgonine, amphetamine, morphine and 3,4-methylenedioxymethamphetamine) on the zebra mussel (Dreissena polymorpha). The mixture caused a significant increase of DNA fragmentation and triggered the apoptotic process and micronuclei formation in zebra mussel hemocytes, pointing out its potential genotoxicity towards this bivalve species. Copyright © 2016 Elsevier Inc. All rights reserved.

Unintended messages in online advertising to youth: illicit drug imagery in a Canadian sports marketing campaign.

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Auger, Nathalie; Daniel, Mark; Knäuper, Bärbel; Dourian, Tara; Raynault, Marie-France

2015-04-01

We assessed the potential for harmful messages in online advertisements targeted to youth, using the example of the Canadian "Light It Up" marketing campaign from a large sports corporation. We undertook a cluster randomized controlled trial of 20 secondary school classes in Montreal, Canada. Classes were randomly allocated to view a "Light It Up" advertisement (n = 205) or a neutral comparison advertisement (n = 192). The main outcome measures were self-reports of illicit drug messages in the advertisements. Of the students, 22.9% reported that the "Light It Up" advertisement contained illicit drug messages compared with 1.0% for the comparison advertisement (relative risk, 22.0; 95% confidence interval, 6.5-74.9). Although meant to promote sports, youth in this study believed that the "Light It Up" advertisement was related to illicit drugs. The campaign illustrates how advertisements may inadvertently market unwanted behaviors to children. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

The role of general parenting and cannabis-specific parenting practices in adolescent cannabis and other illicit drug use.

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Vermeulen-Smit, E; Verdurmen, J E E; Engels, R C M E; Vollebergh, W A M

2015-02-01

To investigate general and cannabis-specific parenting practices in relation to adolescent cannabis and other illicit drug use. Data were derived from the Dutch National School Survey on Substance Use among students (N=3209; aged 12-16 years) and one of their parents in 2011. Logistic regression analyses revealed that 1) parental cannabis use was significantly related to more adolescent lifetime and recent cannabis use, and 2) restrictive cannabis-specific parental rules were associated with less adolescent recent cannabis and lifetime use of other illicit drugs, even when controlled for sociodemographic factors, general parenting, adolescent tobacco use, and tobacco-specific parenting. In addition, no significant interaction was observed between parental cannabis use and cannabis-specific rules in their relation to adolescent cannabis and other illicit drug use, indicating that cannabis rules are evenly associated with adolescent drug use for families with and without parental cannabis experience. In addition to general parenting practices, restrictive cannabis-specific rules are related to lower adolescent cannabis and other illicit drug rates. Parents who ever used cannabis have children with a higher prevalence of cannabis use. However, their restrictive cannabis-specific rules are equally related to a lower chance of adolescent cannabis use. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Illicit drug use in South Africa: Findings from a 2008 national ...

African Journals Online (AJOL)

Africa. Method. A multistage random population sample of 15 828 people age .15 (56.3% women) was included in the survey. Illicit drug use was assessed by 2 sections of the Alcohol, Smoking and Substance use Involvement Screening Test (ASSIST). Frequency analyses for different age groups, geolocality, educational ...

Sport participation and alcohol and illicit drug use in adolescents and young adults: a systematic review of longitudinal studies.

Science.gov (United States)

Kwan, Matthew; Bobko, Sarah; Faulkner, Guy; Donnelly, Peter; Cairney, John

2014-03-01

Sport participation can play an important and positive role in the health and development of children and youth. One area that has recently been receiving greater attention is the role that sport participation might play in preventing drug and alcohol use among youth. The current study is a systematic review of 17 longitudinal studies examining the relationship between sport participation and alcohol and drug use among adolescents. Results indicated that sport participation is associated with alcohol use, with 82% of the included studies (14/17) showing a significant positive relationship. Sport participation, however, appears to be related to reduced illicit drug use, especially use of non-cannabis related drugs. Eighty percent of the studies found sport participation associated with decreased illicit drug use, while 50% of the studies found negative association between sport participation and marijuana use. Further investigation revealed that participation in sports reduced the risk of overall illicit drug use, but particularly during high school; suggesting that this may be a critical period to reduce or prevent the use of drugs through sport. Future research must better understand what conditions are necessary for sport participation to have beneficial outcomes in terms of preventing alcohol and/or illicit drug use. This has been absent in the extent literature and will be central to intervention efforts in this area. Copyright © 2013 Elsevier Ltd. All rights reserved.

Comparisons between the attitudes of student nurses and other health and social care students toward illicit drug use: An attitudinal survey.

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Harling, Martyn R

2017-01-01

In the context of a recent emphasis on compassion in the delivery of health care, the current study set out to measure the attitudes of different groups of health and social care students toward illicit drug users. Previous research has identified variations in the attitudes of different groups of health and social care professionals toward working with illicit drug users. Nurses, in particular, have been reported as holding moralistic or stereotypical views of illicit drug users. However, few studies have measured the attitudes of student nurses or compared their attitudes to other health and social care students. This article describes the use of a bespoke attitude scale to measure the attitudes of cohorts of student nurses, clinical psychology trainees, health and social care, social work and midwifery students at the start of their course (N=308). Results indicated that student nurses had the least tolerant attitudes, reinforcing the need for a specific educational focus on working with illicit drug users in nurse education. Variations between student groups indicate that Interprofessional Education can provide an opportunity to improve attitudes toward illicit drug users, particularly amongst student nurses. Copyright © 2016 Elsevier Ltd. All rights reserved.

[Illicit drug use and the critical perspectives of drug users' relatives and acquaintances in Northern Rio de Janeiro City, Brazil].

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Loyola, Cristina Maria Douat; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto

2009-01-01

This article presents the partial results of a multicenter, cross-temporal study, which was performed using multiple methods, and involved seven Latin-American countries and Canada. The results presented refer to the city center of Rio de Janeiro (n=108). The central question of the study was: 'How do illicit drug users' relatives and acquaintances describe protective and risk factors, prevention initiatives, treatment services, laws and policies regarding illicit drugs?' The quantitative data was collected using an instrument containing closed questions. In total, 108 young adults (18 years of age or older) were interviewed, who stated being affected by the drug although they were not users. For 104 interviewees (96%), negligence is the family dynamics that causes the greatest exposure to drugs, and 106 (98%) consider that parent support is what offers the greatest protection. Policies, the police and the criminal system have neither reduced drug use nor do they protect users.

Illicit drugs and their metabolites in 36 rivers that drain into the Bohai Sea and north Yellow Sea, north China.

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Wang, De-Gao; Zheng, Qiu-Da; Wang, Xiao-Ping; Du, Juan; Tian, Chong-Guo; Wang, Zhuang; Ge, Lin-Ke

2016-08-01

Illicit drugs and their metabolites have recently been recognized as an emerging group of contaminants due to their potential ecotoxicological impact in aquatic ecosystems. To date, information on the occurrence of these compounds in the aquatic environment of China remains limited. In this study, we collected surface water samples from 36 rivers in north China that discharge into the Bohai Sea and north Yellow Sea and measured the concentrations of amphetamine-like compounds, ketamines, cocainics, and opioids. The occurrence and spatial patterns of these substances show significant differences between the rivers and regions. Two designer drugs, methamphetamine (METH) and ketamine (KET), were the most abundant compounds detected in the entire set of samples (detection frequency of 92 and 69 %). The concentrations of METH and KET ranged from illicit drugs consumed in China. The high concentrations of these illicit drugs and their metabolites were found in areas that have a high population density. The riverine input of total illicit drugs into the Bohai Sea and north Yellow Sea was estimated to be in the range of 684 to 1160 kg per year.

Identification of illicit drugs by using SOM neural networks

Energy Technology Data Exchange (ETDEWEB)

Liang Meiyan; Shen Jingling; Wang Guangqin [Beijing Key Lab for Terahertz Spectroscopy and Imaging, Key Laboratory of Terahertz Optoelectronics, Ministry of Education, Department of Physics, Capital Normal University, Beijing 100037 (China)], E-mail: liangyan661982@163.com, E-mail: jinglingshen@gmail.com, E-mail: pywgq2004@163.com

2008-07-07

Absorption spectra of six illicit drugs were measured by using the terahertz time-domain spectroscopy technique in the range 0.2-2.6 THz and then clustered with self-organization feature map (SOM) artificial neural network. After the network training process, the spectra collected at another time were identified successfully by the well-trained SOM network. An effective distance was introduced as a quantitative criterion to decide which cluster the new spectra were affiliated with.

Binge drinking and illicit drug use among adolescent students

OpenAIRE

Jakelline Cipriano dos Santos Raposo; Ana Carolina de Queiroz Costa; Paula Andréa de Melo Valença; Patrícia Maria Zarzar; Alcides da Silva Diniz; Viviane Colares; Carolina da Franca

2017-01-01

ABSTRACT OBJECTIVE To estimate the prevalence of illicit drug use and its association with binge drinking and sociodemographic factors among adolescent students. METHODS This is a cross-sectional study with probabilistic conglomerate sampling, involving 1,154 students, aged 13 to 19 years old, from the public school system, in the city of Olinda, State of Pernambuco, Brazil, carried out in 2014. We used the Youth Risk Behavior Survey questionnaire, validated for use with Brazilian adolesc...

Identification of illicit drugs by using SOM neural networks

International Nuclear Information System (INIS)

Liang Meiyan; Shen Jingling; Wang Guangqin

2008-01-01

Absorption spectra of six illicit drugs were measured by using the terahertz time-domain spectroscopy technique in the range 0.2-2.6 THz and then clustered with self-organization feature map (SOM) artificial neural network. After the network training process, the spectra collected at another time were identified successfully by the well-trained SOM network. An effective distance was introduced as a quantitative criterion to decide which cluster the new spectra were affiliated with

Overdose prevention for injection drug users: Lessons learned from naloxone training and distribution programs in New York City

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Nandi Vijay

2007-01-01

Full Text Available Abstract Background Fatal heroin overdose is a significant cause of mortality for injection drug users (IDUs. Many of these deaths are preventable because opiate overdoses can be quickly and safely reversed through the injection of Naloxone [brand name Narcan], a prescription drug used to revive persons who have overdosed on heroin or other opioids. Currently, in several cities in the United States, drug users are being trained in naloxone administration and given naloxone for immediate and successful reversals of opiate overdoses. There has been very little formal description of the challenges faced in the development and implementation of large-scale IDU naloxone administration training and distribution programs and the lessons learned during this process. Methods During a one year period, over 1,000 participants were trained in SKOOP (Skills and Knowledge on Opiate Prevention and received a prescription for naloxone by a medical doctor on site at a syringe exchange program (SEP in New York City. Participants in SKOOP were over the age of 18, current participants of SEPs, and current or former drug users. We present details about program design and lessons learned during the development and implementation of SKOOP. Lessons learned described in the manuscript are collectively articulated by the evaluators and implementers of the project. Results There were six primary challenges and lessons learned in developing, implementing, and evaluating SKOOP. These include a political climate surrounding naloxone distribution; b extant prescription drug laws; c initial low levels of recruitment into the program; d development of participant appropriate training methodology; e challenges in the design of a suitable formal evaluation; and f evolution of program response to naloxone. Conclusion Other naloxone distribution programs may anticipate similar challenges to SKOOP and we identify mechanisms to address them. Strategies include being flexible in

New drugs on the street: changing inner city patterns of illicit consumption

National Research Council Canada - National Science Library

Singer, Merrill

2005-01-01

.... 16, No. 1/2 2000. The journal is renumbered to start as Vol. 1, No. 1 2002. New Drugs on the Street: Changing Inner City Patterns of Illicit Consumption, edited by Merrill Singer, PhD (Vol. 4, No. 2, 2005). "ESSENTIAL READING for anyone in the drug use area who wants to be brought up-to-date on the current state of the field. This edited ...

Physician experience and rates of plasma HIV-1 RNA suppression among illicit drug users: an observational study

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Sangsari Sassan

2012-01-01

Full Text Available Abstract Background Despite the availability of antiretroviral therapy (ART, suboptimal treatment outcomes have been observed among HIV-seropositive illicit drug users. As there is an urgent need to improve responses to antiretroviral therapy among this population, we undertook this study to evaluate the role of physician experience on rates of plasma HIV-1 RNA suppression following initiation of ART. Methods Using data from a community-recruited cohort of HIV-positive illicit drug users, we used Cox proportional hazards regression to model the time to plasma viral HIV RNA Results Between May 1996 and December 2008, 267 individuals initiated ART among whom 227 (85% achieved a plasma HIV RNA Conclusions In this setting of universal HIV/AIDS care, illicit drug users with more experienced physicians exhibited faster rates of plasma viral load suppression. These findings argue for specialized services to help optimize HIV treatment outcomes among this population.

Carbamazepine overdose after exposure to simethicone: a case report

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Guneysel Ozlem

2008-07-01

Full Text Available Abstract Introduction Carbamazepine is an anticonvulsant drug and is also used as a treatment for patients with manic-depressive illness, post-herpetic neuralgia or phantom limb pain. The drug itself has many drug interactions. Simethicone is an antifoaming agent and is reported to be an inert material with no known drug interaction with carbamazepine. Case presentation We present a case of a patient who was routinely using carbamazepine 400 mg three times per day and levetiracetam 500 mg twice daily, and experienced carbamazepine overdose after exposure to simethicone. After cessation of simethicone therapy normal drug levels of carbamazepine were obtained again with the standard dose of the drug. The mechanism of interaction is unknown but the risk of overdose should be considered when prescribing simethicone to a patient who is using carbamazepine. Conclusion Simethicone and carbamazepine, when taken together, may be a cause of carbamazepine toxicity. The risk of carbamazepine overdose should be considered when prescribing simethicone to a patient who is using carbamazepine.

Illicit drugs and pharmaceuticals in the environment--forensic applications of environmental data. Part 1: Estimation of the usage of drugs in local communities.

Science.gov (United States)

Kasprzyk-Hordern, Barbara; Dinsdale, Richard M; Guwy, Alan J

2009-06-01

Pharmaceuticals and recently also illicit drugs have been recognised as emerging environmental contaminants due to their potential environmental impact: frequent occurrence, persistence and risk to aquatic life and humans. This manuscript is part one of the two-part study aiming to provide a better understanding and application of environmental data not only for environmental aims but also to meet forensic objectives. An attempt to use wastewater data is made in order to verify patterns of the usage of drugs (in particular illicit) in local communities. The average usage of cocaine in South Wales was estimated at 0.9 g day(-1) 1000 people(-1), which equals 1 tonne of this drug used or disposed of to sewage annually in Wales. The calculated usage of amphetamine denoted 2.5 g day(-1) 1000 people(-1) and is suspected to be an overestimate. Because no analysis of enantiomers of amphetamine was undertaken, no distinction between amphetamine's legal and illicit usage could be made.

A series of forensic toxicology and drug seizure cases involving illicit fentanyl alone and in combination with heroin, cocaine or heroin and cocaine.

Science.gov (United States)

Marinetti, Laureen J; Ehlers, Brooke J

2014-10-01

The Montgomery County Coroner's Office Toxicology Section and the Miami Valley Regional Crime Lab (MVRCL) Drug Chemistry Section have been receiving case work in drug seizures, death cases and human performance cases involving products marketed as heroin or as illicit fentanyl. Upon analysis by the Drug Chemistry Section, these products were found to contain various drug(s) including illicit fentanyl only, illicit fentanyl and heroin, illicit fentanyl and cocaine and illicit fentanyl, heroin and cocaine. Both the Chemistry and Toxicology Sections began seeing these combinations starting in late October 2013. The percentage of the combinations encountered by the MVRCL as well as the physical appearance of the product, and the results of presumptive screening tests will be discussed. The demographics of the users and the results of toxicology and autopsy findings on the decedents will also be discussed. According to regional drug task force undercover agents, there is evidence that some of the products are being sold as illicit fentanyl and not just as a heroin product. Also, there is no evidence to support that the fentanyl source is being diverted from pharmaceutical grade fentanyl. The chemistry section currently has over 109 confirmed cases, and the toxicology section currently has 81 confirmed drug deaths, 8 driving under the influence of drugs and 1 suicidal hanging. Both sections are continuing to see these cases at the present time. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Relationships between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence among Filipino Americans.

Science.gov (United States)

Gee, Gilbert C; Delva, Jorge; Takeuchi, David T

2007-05-01

We examined associations between self-reported unfair treatment and prescription medication use, illicit drug use, and alcohol dependence. We used data from the Filipino American Community Epidemiological Survey, a cross-sectional investigation involving 2217 Filipino Americans interviewed in 1998-1999. Multinomial logistic and negative binomial regression analyses were used in assessing associations between unfair treatment and the substance use categories. Reports of unfair treatment were associated with prescription drug use, illicit drug use, and alcohol dependence after control for age, gender, location of residence, employment status, educational level, ethnic identity level, nativity, language spoken, marital status, and several health conditions. Unfair treatment may contribute to illness and subsequent use of prescription medications. Furthermore, some individuals may use illicit drugs and alcohol to cope with the stress associated with such treatment. Addressing the antecedents of unfair treatment may be a potential intervention route.

Law enforcement attitudes toward overdose prevention and response

Science.gov (United States)

Green, Traci C.; Zaller, Nickolas; Palacios, Wilson R.; Bowman, Sarah E.; Ray, Madeline; Heimer, Robert; Case, Patricia

2014-01-01

Background Law enforcement is often the first to respond to medical emergencies in the community, including overdose. Due to the nature of their job, officers have also witnessed first-hand the changing demographic of drug users and devastating effects on their community associated with the epidemic of nonmedical prescription opioid use in the United States. Despite this seminal role, little data exist on law enforcement attitudes toward overdose prevention and response. Methods We conducted key informant interviews as part of a 12-week Rapid Assessment and Response (RAR) process that aimed to better understand and prevent nonmedical prescription opioid use and overdose deaths in locations in Connecticut and Rhode Island experiencing overdose “outbreaks.” Interviews with 13 law enforcement officials across three study sites were analyzed to uncover themes on overdose prevention and naloxone. Results Findings indicated support for law enforcement involvement in overdose prevention. Hesitancy around naloxone administration by laypersons was evident. Interview themes highlighted officers’ feelings of futility and frustration with their current overdose response options, the lack of accessible local drug treatment, the cycle of addiction, and the pervasiveness of easily accessible prescription opioid medications in their communities. Overdose prevention and response, which for some officers included law enforcement-administered naloxone, were viewed as components of community policing and good police-community relations. Conclusion Emerging trends, such as existing law enforcement medical interventions and Good Samaritan Laws, suggest the need for broader law enforcement engagement around this pressing public health crisis, even in suburban and small town locations, to promote public safety. PMID:24051061

Law enforcement attitudes toward overdose prevention and response.

Science.gov (United States)

Green, Traci C; Zaller, Nickolas; Palacios, Wilson R; Bowman, Sarah E; Ray, Madeline; Heimer, Robert; Case, Patricia

2013-12-01

Law enforcement is often the first to respond to medical emergencies in the community, including overdose. Due to the nature of their job, officers have also witnessed first-hand the changing demographic of drug users and devastating effects on their community associated with the epidemic of nonmedical prescription opioid use in the United States. Despite this seminal role, little data exist on law enforcement attitudes toward overdose prevention and response. We conducted key informant interviews as part of a 12-week Rapid Assessment and Response (RAR) process that aimed to better understand and prevent nonmedical prescription opioid use and overdose deaths in locations in Connecticut and Rhode Island experiencing overdose "outbreaks." Interviews with 13 law enforcement officials across three study sites were analyzed to uncover themes on overdose prevention and naloxone. Findings indicated support for law enforcement involvement in overdose prevention. Hesitancy around naloxone administration by laypersons was evident. Interview themes highlighted officers' feelings of futility and frustration with their current overdose response options, the lack of accessible local drug treatment, the cycle of addiction, and the pervasiveness of easily accessible prescription opioid medications in their communities. Overdose prevention and response, which for some officers included law enforcement-administered naloxone, were viewed as components of community policing and good police-community relations. Emerging trends, such as existing law enforcement medical interventions and Good Samaritan Laws, suggest the need for broader law enforcement engagement around this pressing public health crisis, even in suburban and small town locations, to promote public safety. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Multi-residue screening of prioritised human pharmaceuticals, illicit drugs and bactericides in sediments and sludge.

Science.gov (United States)

Langford, Katherine H; Reid, Malcolm; Thomas, Kevin V

2011-08-01

A robust multi-residue method was developed for the analysis of a selection of pharmaceutical compounds, illicit drugs and personal care product bactericides in sediments and sludges. Human pharmaceuticals were selected for analysis in Scottish sewage sludge and freshwater sediments based on prescription, physico-chemical and occurrence data. The method was suitable for the analysis of the selected illicit drugs amphetamine, benzoylecgonine, cocaine, and methamphetamine, the pharmaceuticals atenolol, bendroflumethiazide, carbamazepine, citalopram, diclofenac, fluoxetine, ibuprofen, and salbutamol, and the bactericides triclosan and triclocarban in sewage sludge and freshwater sediment. The method provided an overall recovery of between 56 and 128%, RSDs of between 2 and 19% and LODs of between 1 and 50 ng g(-1). Using the methodology the human pharmaceuticals atenolol, carbamazepine and citalopram and the bactericides triclosan and triclocarban were detected in Scottish sewage sludge. The illicit drugs cocaine, its metabolite benzoylecgonine, amphetamine and methamphetamine were not detected in any of the samples analysed. Triclosan and triclocarban were present at the highest concentrations with triclocarban detected in all but one sample and showing a pattern of co-occurrence in both sludge and sediment samples.

Occurrence of illicit drugs in water and wastewater and their removal during wastewater treatment.

Science.gov (United States)

Yadav, Meena K; Short, Michael D; Aryal, Rupak; Gerber, Cobus; van den Akker, Ben; Saint, Christopher P

2017-11-01

This review critically evaluates the types and concentrations of key illicit drugs (cocaine, amphetamines, cannabinoids, opioids and their metabolites) found in wastewater, surface water and drinking water sources worldwide and what is known on the effectiveness of wastewater treatment in removing such compounds. It is also important to amass information on the trends in specific drug use as well as the sources of such compounds that enter the environment and we review current international knowledge on this. There are regional differences in the types and quantities of illicit drug consumption and this is reflected in the quantities detected in water. Generally, the levels of illicit drugs in wastewater effluents are lower than in raw influent, indicating that the majority of compounds can be at least partially removed by conventional treatment processes such as activated sludge or trickling filters. However, the literature also indicates that it is too simplistic to assume non-detection equates to drug removal and/or mitigation of associated risks, as there is evidence that some compounds may avoid detection via inadequate sampling and/or analysis protocols, or through conversion to transformation products. Partitioning of drugs from the water to the solids fraction (sludge/biosolids) may also simply shift the potential risk burden to a different environmental compartment and the review found no information on drug stability and persistence in biosolids. Generally speaking, activated sludge-type processes appear to offer better removal efficacy across a range of substances, but the lack of detail in many studies makes it difficult to comment on the most effective process configurations and operations. There is also a paucity of information on the removal effectiveness of alternative treatment processes. Research is also required on natural removal processes in both water and sediments that may over time facilitate further removal of these compounds in receiving

Paradigms of public policies for licit and illicit drugs in Brazil.

Science.gov (United States)

Gigliotti, Analice; Ribeiro, Marcelo; Tapia Aguilera, Amarílis; Rezende, Elton; Ogata Perrenoud, Luciane

2014-01-01

Brazil is a country of continental dimensions that, over the last 3 decades, has been making increased efforts to develop effective public policies for controlling the use of both licit and illicit psychoactive substances. In the case of licit drugs, Brazil was a pioneer in following the guidance of the World Health Organization for tobacco control and has witnessed surprising results relating to reduction of smoking prevalence and correlated morbidity and mortality. Today, Brazil has a national structure for organizing, applying, and monitoring laws relating to tobacco. However, in the field of illicit drugs, with crack consumption as a paradigm, the situation is the opposite: its use has been increasing year by year and is being consumed at increasingly young ages and by all social classes. Thus, it is becoming an enormous challenge for public policies relating to prevention and treatment. In this context, the aim of this article is to present a review of the epidemiological data relating to tobacco and crack use in Brazil, with an analysis on the impact of public policies for controlling consumption over recent years. Despite the efforts made over the last 3 decades, Brazil still has a long way to go in order to construct a consistent and effective national drugs policy.

[Alcohol and illicit drug use and its influence on the sexual behavior of teenagers from Minas Gerais State, Brazil].

Science.gov (United States)

Bertoni, Neilane; Bastos, Francisco I; Mello, Maeve Brito de; Makuch, Maria Yolanda; Sousa, Maria Helena de; Osis, Maria José; Faúndes, Anibal

2009-06-01

This article summarizes the findings of a survey including 5,981 students from public schools in Minas Gerais State, Brazil. The analysis assessed the influence of drug use on sexual practices. Among the boys engaged in relationships with casual partners who stated having used illicit drugs, 55.7% reported consistent condom use, as compared to 65.4% among those not reporting such habits. Among boys engaged in relationships with stable partners who reported illicit drug use, consistent condom use was reported by 42.7%, versus 64.1% among those not reporting such habits. In the subgroup of boys engaged in stable relationships who did not report illicit drug use, consistent condom use was less frequent among those that used alcohol/cigarettes, compared to those who did not drink or smoke (60.7% vs. 71.1%). Girls were less likely than boys to use condoms consistently, regardless of the nature of their relationships, without a noticeable influence of drug use. Policies to prevent drug abuse, sexually transmitted diseases, and unplanned pregnancy should be fully integrated.

Illicit Drug Markets Among New Orleans Evacuees Before and Soon After Hurricane Katrina.

Science.gov (United States)

Dunlap, Eloise; Johnson, Bruce D; Morse, Edward

2007-09-01

This paper analyzes illicit drug markets in New Orleans before and after Hurricane Katrina and access to drug markets following evacuation at many locations and in Houston. Among New Orleans arrestees pre-Katrina, rates of crack and heroin use and market participation was comparable to New York and higher than in other southern cities. Both cities have vigorous outdoor drug markets. Over 100 New Orleans evacuees provide rich accounts describing the illicit markets in New Orleans and elsewhere. The flooding of New Orleans disrupted the city's flourishing drug markets, both during and immediately after the storm. Drug supplies, though limited, were never completely unavailable. Subjects reported that alcohol or drugs were not being used in the Houston Astrodome, and it was a supportive environment. Outside the Astrodome, they were often approached by or could easily locate middlemen and drug sellers. Evacuees could typically access illegal drug markets wherever they went. This paper analyzes the impact of a major disaster upon users of illegal drugs and the illegal drug markets in New Orleans and among the diaspora of New Orleans evacuees following Hurricane Katrina. This analysis includes data from criminal justice sources that specify what the drug markets were like before this disaster occurred. This analysis also includes some comparison cities where no disaster occurred, but which help inform the similarities and differences in drug markets in other cities. The data presented also include an initial analysis of ethnographic interview data from over 100 New Orleans Evacuees recruited in New Orleans and Houston.

DETECTION OF ILLICIT DRUGS IN MUNICIPAL WASTEWATER STREAMS USING INTEGRATIVE SAMPLERS AND LC MASS SPECTROMETRY

Science.gov (United States)

A technique has been developed which has the potential to map regions of concern for increased drug usage and/or production by monitoring the input of chemical into the waterways. This approach can provide near "real-time" data on illegal activities. Determination of illicit drug...

Patterns of, and Factors Associated With, Illicit Pharmaceutical Opioid Analgesic Use in a Prospective Cohort of People Who Inject Drugs in Melbourne, Australia.

Science.gov (United States)

Horyniak, Danielle; Agius, Paul A; Degenhardt, Louisa; Reddel, Siobhan; Higgs, Peter; Aitken, Campbell; Stoové, Mark; Dietze, Paul

2015-01-01

People who inject drugs (PWID) are a key population engaging in pharmaceutical opioid analgesic (PO) use, yet little is known about patterns of illicit PO use among this group. The aims of this research were to measure the prevalence and frequency of lifetime and past-month illicit PO use and injection in a sample of regular PWID, to examine patterns of past-month illicit PO use within individuals over time, and to identify factors independently associated with past-month illicit PO use. Data were drawn from a prospective cohort study of regular PWID (N = 666) in Melbourne, Australia. Data from five waves of annual data collection (including baseline) were analyzed descriptively and using generalized estimating equations (GEE). At baseline, 59% of participants reported lifetime illicit PO use and 20% reported past-month use, predominantly through injecting. Most illicit PO users at baseline transitioned to nonuse of illicit POs across the study period. In multivariable GEE analysis, factors associated with past-month illicit PO use included past-year arrest [adjusted odds ratio (AOR): 1.39], opioids other than heroin as drug of choice (AOR: 5.14), experiencing poorer physical health (AOR: 0.98) and a range of other drug use variables. We found little evidence of ongoing illicit PO use among those followed up, with illicit PO use linked to polydrug use more broadly. Nonetheless, trends in illicit PO use among PWID should continue to be monitored and harm reduction interventions implemented to reduce the associated public health risks.

Young people who use drugs engaged in harm reduction programs in New York City: Overdose and other risks.

Science.gov (United States)

Calvo, Michele; MacFarlane, Jessica; Zaccaro, Heather; Curtis, Matthew; Cabán, María; Favaro, Jamie; Passannante, Marian R; Frost, Taeko

2017-09-01

Little is known about the engagement of young people who use drugs (PWUD) in harm reduction programs (HRPs), and few studies have included non-opioid users and non-injectors. While HRPs have effectively engaged PWUD, young people are under-represented in their services. The Injection Drug Users Health Alliance Citywide Study (IDUCS) is the largest community-based study of PWUD in HRPs in the US. From 2014-2015, 2421 HRP participants across New York City (NYC) completed a cross-sectional survey. We investigated differences in socio-demographics, service utilization, and risk behaviors between young (aged 18-30) and older participants and examined factors associated with overdose among young participants. The study included 257 young participants. They were significantly more likely than older participants to be white, educated, uninsured, unstably housed or homeless, and have a history of incarceration and residential drug treatment. They were more likely to report recent overdose but less likely to report knowledge of naloxone. Young participants also had higher rates of alcohol, marijuana, benzodiazepine, and injection drug use, and related risk behaviors such as public injection. Factors associated with past year overdose among young participants included experiencing symptoms of psychological distress (AOR=9.71), being unstably housed or homeless (AOR=4.39), and utilizing detox (AOR=4.20). Young PWUD who access services at HRPs in NYC differ significantly from their older counterparts. New York City and other urban centers that attract young PWUD should consider implementing harm reduction oriented services tailored to the unique needs of young people. Copyright © 2017. Published by Elsevier B.V.

Illicit drugs and pharmaceuticals in the environment - Forensic applications of environmental data. Part 1: Estimation of the usage of drugs in local communities

Energy Technology Data Exchange (ETDEWEB)

Kasprzyk-Hordern, Barbara, E-mail: b.kasprzyk-hordern@hud.ac.u [University of Huddersfield, Department of Chemical and Biological Sciences, Queensgate, Huddersfield HD1 3DH (United Kingdom); University of Glamorgan, Sustainable Environment Research Centre, Faculty of Health, Sport and Science, Pontypridd CF37 1DL (United Kingdom); Dinsdale, Richard M.; Guwy, Alan J. [University of Glamorgan, Sustainable Environment Research Centre, Faculty of Health, Sport and Science, Pontypridd CF37 1DL (United Kingdom)

2009-06-15

Pharmaceuticals and recently also illicit drugs have been recognised as emerging environmental contaminants due to their potential environmental impact: frequent occurrence, persistence and risk to aquatic life and humans. This manuscript is part one of the two-part study aiming to provide a better understanding and application of environmental data not only for environmental aims but also to meet forensic objectives. An attempt to use wastewater data is made in order to verify patterns of the usage of drugs (in particular illicit) in local communities. The average usage of cocaine in South Wales was estimated at 0.9 g day{sup -1} 1000 people{sup -1}, which equals 1 tonne of this drug used or disposed of to sewage annually in Wales. The calculated usage of amphetamine denoted 2.5 g day{sup -1} 1000 people{sup -1} and is suspected to be an overestimate. Because no analysis of enantiomers of amphetamine was undertaken, no distinction between amphetamine's legal and illicit usage could be made. - Wastewater as an indicative source of information can be used in forensic applications.

Illicit drugs and pharmaceuticals in the environment - Forensic applications of environmental data. Part 1: Estimation of the usage of drugs in local communities

International Nuclear Information System (INIS)

Kasprzyk-Hordern, Barbara; Dinsdale, Richard M.; Guwy, Alan J.

2009-01-01

Pharmaceuticals and recently also illicit drugs have been recognised as emerging environmental contaminants due to their potential environmental impact: frequent occurrence, persistence and risk to aquatic life and humans. This manuscript is part one of the two-part study aiming to provide a better understanding and application of environmental data not only for environmental aims but also to meet forensic objectives. An attempt to use wastewater data is made in order to verify patterns of the usage of drugs (in particular illicit) in local communities. The average usage of cocaine in South Wales was estimated at 0.9 g day -1 1000 people -1 , which equals 1 tonne of this drug used or disposed of to sewage annually in Wales. The calculated usage of amphetamine denoted 2.5 g day -1 1000 people -1 and is suspected to be an overestimate. Because no analysis of enantiomers of amphetamine was undertaken, no distinction between amphetamine's legal and illicit usage could be made. - Wastewater as an indicative source of information can be used in forensic applications.

Prevalence and risk of injury in Europe by driving with alcohol, illicit drugs and medicines.

NARCIS (Netherlands)

Bernhoft, I.M. Hels, T. Lyckegaard, A. Houwing, S. & Verstraete, A.G.

2012-01-01

Prevalence and injury risk of driving with alcohol, illicit drugs and medicines have been estimated as part of the DRUID (Driving under the Influence of Drugs, Alcohol and Medicines) project of FP6. Prevalence in the driving population was based on roadside surveys in thirteen European countries,

Prevalence of HCV infection and associated factors among illicit drug users in Breves, State of Pará, northern Brazil.

Science.gov (United States)

Pacheco, Suzy Danielly Barbosa; Silva-Oliveira, Gláucia Caroline; Maradei-Pereira, Luciana Maria Cunha; Crescente, José Ângelo Barletta; Lemos, José Alexandre Rodrigues de; Oliveira-Filho, Aldemir Branco de

2014-01-01

Illicit drug users (DUs) are vulnerable to hepatitis C virus (HCV) infection. The shared use of illicit drugs is the main method of HCV transmission. A cross-sectional study was conducted in Breves, in northern Brazil. We surveyed 187 DUs to determine the prevalence of and factors associated with HCV infection. The prevalence of anti-HCV antibodies was 36.9%, and the prevalence of hepatitis C virus-ribonucleic acid (HCV-RNA) was 31%. Hepatitis C virus infection was associated with tattoos, intravenous drug use, shared use of equipment for drug use, drug use for longer than 3 years, and daily drug use. Strategies for preventing and controlling HCV transmission should be implemented among DUs.

Factors influencing alcohol and illicit drug use amongst first year medical students

NARCIS (Netherlands)

Popescu, Codruta Alina; Bob, Mihai Horatiu; Junjan, Veronica; Armean, Sebastian Mihai; Buzoianu, Anca Dana

2014-01-01

The aims of this study were a) to investigate patterns of alcohol, smoking and illicit drug use and b) evaluate the relationship between substance abuse and personality factors in a cohort of 267 first year medical students. 12.3 % (men) and 11.8% (female) medical students reported to be drinking

Direct detection of illicit drugs from biological fluids by desorption/ionization mass spectrometry with nanoporous silicon microparticles.

Science.gov (United States)

Guinan, T M; Kirkbride, P; Della Vedova, C B; Kershaw, S G; Kobus, H; Voelcker, N H

2015-12-07

Surface-assisted laser desorption/ionization mass spectrometry (SALDI-MS) is a high throughput analytical technique capable of detecting low molecular weight analytes, including illicit drugs, and with potential applications in forensic toxicology as well as athlete and workplace testing, particularly for biological fluids (oral fluids, urine and blood). However, successful detection of illicit drugs using SALDI-MS often requires extraction steps to reduce the inherent complexity of biological fluids. Here, we demonstrate an all-in-one extraction and analytical system consisting of hydrophobically functionalized porous silicon microparticles (pSi-MPs) for affinity SALDI-MS of prescription and illicit drugs. This novel approach allows for the analysis of drugs from multiple biological fluids without sample preparation protocols. The effect of pSi-MP size, pore diameter, pore depth and functionalization on analytical performance is investigated. pSi-MPs were optimized for the rapid and high sensitivity detection of methadone, cocaine and 3,4-methylenedioxymethamphetamine (MDMA). This optimized system allowed extraction and detection of methadone from spiked saliva and clinical urine samples. Furthermore, by detecting oxycodone in additional clinical saliva and plasma samples, we were able to demonstrate the versatility of the pSi-MP SALDI-MS technique.

Beware the yellow slimming pill: fatal 2,4-dinitrophenol overdose.

Science.gov (United States)

Holborow, Alexander; Purnell, Richard M; Wong, Jenny Frederina

2016-04-04

An industrial chemical, 2,4-dinitrophenol (DNP), has found use as a weight loss drug. It is extremely toxic in overdose and has a narrow therapeutic window with significant interindividual variability in metabolism. The rise in internet-based sales and distribution of this drug has seen an increased incidence of both accidental and intentional overdose presenting to emergency departments across the UK. No antidote currently exists and overdose is often fatal despite management based on current recommendations. We report a case of intentional overdose of DNP in a young man and discuss the current treatment guidelines. The case highlights the need for an increased awareness among frontline medical staff of the effects of DNP poisoning and questions the need for a more aggressive approach in the management of acute toxicity. 2016 BMJ Publishing Group Ltd.

Role of individual, peer and family factors in the use of cannabis and other illicit drugs: A longitudinal analysis among Finnish adolescent twins

NARCIS (Netherlands)

T. Korhonen (Tellervo); A.C. Huizink (Anja); D.M. Dick (Danielle); L. Pulkkinen (Lea); R.J. Rose (Richard); J. Kaprio (Jaakko)

2008-01-01

textabstractBackground: Although use of illicit drugs shows varying degree of heritability, the influence of shared and unique environmental factors predominate among adolescents. We explored factors predicting use of cannabis and other illicit drugs among Finnish adolescent twins. Methods: We used

Clinical Effects of Synthetic Cannabinoid Receptor Agonists Compared with Marijuana in Emergency Department Patients with Acute Drug Overdose.

Science.gov (United States)

Zaurova, Milana; Hoffman, Robert S; Vlahov, David; Manini, Alex F

2016-12-01

Synthetic cannabinoid receptor agonists (SCRAs) are heterogeneous compounds originally intended as probes of the endogenous cannabinoid system or as potential therapeutic agents. We assessed the clinical toxicity associated with recent SCRA use in a large cohort of drug overdose patients. This subgroup analysis of a large (n = 3739) drug overdose cohort study involved consecutive ED patients at two urban teaching hospitals collected between 2009 and 2013. Clinical characteristics of patients with the exposure to SCRAs (SRCA subgroup) were compared with those from patients who smoked traditional cannabinoids (marijuana subgroup). Data included demographics, exposure details, vital signs, mental status, and basic chemistries gathered as part of routine clinical care. Study outcomes included altered mental status and cardiotoxicity. Eighty-seven patients reported exposure to any cannabinoid, of whom 17 reported SCRAs (17 cases, 70 controls, mean age 38.9 years, 77 % males, 31 % Hispanic). There were no significant differences between SRCA and marijuana with respect to demographics (age, gender, and race/ethnicity), exposure history (suicidality, misuse, and intent), vital signs, or serum chemistries. Mental status varied between SRCA and marijuana, with agitation significantly more likely in SCRA subgroup (OR = 3.8, CI = 1.2-11.9). Cardiotoxicity was more pronounced in the SCRA subgroup with dysrhythmia significantly more likely (OR = 9.2, CI = 1.0-108). In the first clinical study comparing the adverse effects of SCRA overdose vs. marijuana controls in an ED population, we found that SCRA overdoses had significantly pronounced neurotoxicity and cardiotoxicity compared with marijuana.

Comparison between self-report and hair analysis of illicit drug use in a community sample of middle-age men

OpenAIRE

Ledgerwood, David M.; Goldberger, Bruce A.; Risk, Nathan K.; Lewis, Collins E.; Price, Rumi Kato

2008-01-01

Discrepancies between biological assays and self-report of illicit drug use could undermine epidemiological research findings. Two objectives of the present study are to examine the degree of agreement between self-reported illicit drug use and hair analysis in a community sample of middle-aged men, and to identify factors that may predict discrepancies between self-report and hair testing. Male participants followed since 1972 were interviewed about substance use, and hair samples were analy...

Lifetime use of illicit drugs and associated factors among Brazilian schoolchildren, National Adolescent School-based Health Survey (PeNSE 2012)

OpenAIRE

Rogério Lessa Horta; Bernardo Lessa Horta; Andre Wallace Nery da Costa; Rogério Ruscitto do Prado; Maryane Oliveira-Campos; Deborah Carvalho Malta

2014-01-01

OBJECTIVE: This study aimed at describing the prevalence of illicit drug use among 9th grade students in the morning period of public and private schools in Brazil, and assessing associated factors. METHOD: The Brazilian survey PeNSE (National Adolescent School-based Health Survey) 2012 evaluated a representative sample of 9th grade students in the morning period, in Brazil and its five regions. The use of illicit drugs at least once in life was assessed for the most commonly used drugs,...

Prevalence of HCV infection and associated factors among illicit drug users in Breves, State of Pará, northern Brazil

Directory of Open Access Journals (Sweden)

Suzy Danielly Barbosa Pacheco

2014-06-01

Full Text Available Introduction: Illicit drug users (DUs are vulnerable to hepatitis C virus (HCV infection. The shared use of illicit drugs is the main method of HCV transmission. Methods: A cross-sectional study was conducted in Breves, in northern Brazil. We surveyed 187 DUs to determine the prevalence of and factors associated with HCV infection. Results: The prevalence of anti-HCV antibodies was 36.9%, and the prevalence of hepatitis C virus-ribonucleic acid (HCV-RNA was 31%. Hepatitis C virus infection was associated with tattoos, intravenous drug use, shared use of equipment for drug use, drug use for longer than 3 years, and daily drug use. Conclusions: Strategies for preventing and controlling HCV transmission should be implemented among DUs.

Identification of designer drug 2C-E (4-ethyl-2, 5-dimethoxy-phenethylamine) in urine following a drug overdose.

Science.gov (United States)

Van Vrancken, Michael J; Benavides, Raul; Wians, Frank H

2013-01-01

In recent years, access to information regarding acquisition and synthesis of newer designer drugs has been at an all-time high due largely to the Internet. As these drugs have become more prevalent, laboratory techniques have been developed and refined to identify and screen for this burgeoning population of drugs. This provides a unique opportunity for learning about many of these methods. Laboratory testing techniques and instrumentation are obscure to many health care professionals, yet their results are crucial. Here, we present a case of an overdose of an uncommon designer drug (2C-E) and discuss the basics of liquid chromatography and mass spectrometry, two important techniques used in isolating and identifying the drug. Although often overlooked and taken for granted, these techniques can play a pivotal role in the diagnosis and subsequent management of select patients.

Prevalence and associated factors of illicit drug use among university students in the association of southeast Asian nations (ASEAN).

Science.gov (United States)

Yi, Siyan; Peltzer, Karl; Pengpid, Supa; Susilowati, Indri Hapsari

2017-04-06

Illicit drug use among university students has been recognized as a global public health issue in recent years. It may lead to poor academic performance that in turn leads to poor productivity in their later life. This study explores prevalence of and factors associated with illicit drug use among university students in the Association of Southeast Asian Nations (ASEAN). This multi-country cross-sectional study was conducted in 2015 in Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Vietnam. A multi-stage cluster sampling was used to select undergraduate students from one or two universities in each country for self-administered questionnaire survey. Multivariate logistic regression analyses was performed to explore risk factors related to illicit drug use. Participants included 7,923 students with a mean age of 20.6 years (SD = 2.8), ranging from 18-30 years. The overall prevalence of frequent (≥10 times), infrequent (1-9 times) and ever (at least once) illicit drug use in the past 12 months was 2.2, 14.7, and 16.9%, respectively. After adjustment, male students were significantly less likely to be infrequent (1-9 times vs. never), but significantly more likely to be ever users compared to females. Compared to those living with parents/guardians, students living away from parents/guardians were significantly less likely to be frequent (≥10 times vs. never) and infrequent users. Students from lower-middle-income countries were significantly more likely to be frequent and infrequent users, but significantly less likely to be ever users compared to those from upper-middle or high-income countries. Students with poor subjective health status were significantly more likely to be frequent users compared to those who reported good subjective health status. Students who reported binge drinking in the past month were significantly more likely to be infrequent users, but significantly less likely to be ever users. Our

CDC Vital Signs: Prescription Painkiller Overdoses (Opioids): A Growing Epidemic, Especially Among Women

Science.gov (United States)

... health care providers and the public about prescription drug misuse, abuse, suicide, and overdose, and the risks for women. Developing and evaluating programs and policies that prevent and treat prescription drug abuse and overdose, while making sure patients have access ...

Modelling Illicit Drug Fate in Sewers for Wastewater-Based Epidemiology

DEFF Research Database (Denmark)

Ramin, Pedram

was found during festival period as compared to normal weekdays. Wastewater-based epidemiology is a truly interdisciplinary approach in which engineering tools, including models developed and tested in this thesis, can be beneficial for the accurate estimation of drug consumption in urban areas........ Sewer systems can be considered as biological reactors, in which the concentration of organic chemicals present in wastewater can be impacted by in-sewer processes during hydraulic residence time. Illicit drug biomarkers, as trace organic chemicals in the range of nanograms to micrograms per liter...... on sorption and transformation of drug biomarkers in raw wastewater and sewer biofilms; and (ii) developing modelling tools – by combining and extending existing modelling frameworks – to predict such processes. To achieve this goal, a substantial part of this thesis was dedicated to the experimental...

Overdose Deaths Among Homeless Persons

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... Twitter Overdose Deaths Among Homeless Persons January 2013 Homelessness is a persistent problem—nearly 690,000 people ... will ultimately help address the tragic problem of homelessness too, as many homeless people cite drug or ...

Energy drink consumption among young Australian adults: associations with alcohol and illicit drug use.

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Trapp, Georgina S A; Allen, Karina L; O'Sullivan, Therese; Robinson, Monique; Jacoby, Peter; Oddy, Wendy H

2014-01-01

Energy drinks are becoming increasingly popular among young people. The purpose of this study was to determine the prevalence of energy drink consumption and its associations with socio-demographic characteristics, alcohol, cigarette and illicit drug use in a population-based sample of young adults participating in the Western Australian Pregnancy Cohort (Raine) Study. We used self-administered questionnaires to assess energy drink consumption patterns, alcohol intake, cigarette and illicit drug use at the 20-year cohort follow-up. Data was also collected on socio-demographics, physical activity, body mass index (BMI) and dietary intake. Our sample included 1234 participants (47% male, mean age 20 ± 0.5 years). We considered energy-drink consumption as a categorical (users versus non-users) variable. Overall, 48% of participants consumed energy drinks at least once per month, with an average intake of 1.31 ± 0.75 cans per day amongst energy drink users. The most significant correlates of energy drink use were being in part-time or full-time employment, being male, being a cigarette smoker, having heavier alcoholic spirit consumption patterns and being an ecstasy user (all pconsumption patterns be a cigarette smoker and use illicit drugs relative to non-users. More research is needed regarding the health risks associated with energy drink use in young adults, including their possible role in the development of substance abuse problems. Copyright © 2013. Published by Elsevier Ireland Ltd.

Prevalence of prescription and illicit drugs in pregnancy-associated non-natural deaths of Florida mothers, 1999-2005.

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Hardt, Nancy; Wong, Tit D; Burt, Martha J; Harrison, Ross; Winter, Will; Roth, Jeffrey

2013-11-01

Abuse of prescription and illicit drugs has been rapidly increasing. This study examines the prevalence of drug use in the non-natural deaths of pregnant or recently pregnant women. Records from Florida's Pregnancy Associated Mortality Review conducted between 1999 and 2005 (n = 415) were linked to 385 toxicology reports obtained from Florida medical examiners' offices. The final study sample consisted of 169 drug-positive, pregnancy-associated non-natural deaths. Of these, 86 were positive for both blood and urine, 64 were positive for blood only and five for urine only, and the remainder were positive for some other specimen. Among these deaths, 91 cases (54%) involved prescription drugs, 78 cases (46%) involved illicit drugs, and 69 cases (41%) involved alcohol. Opioids constituted the majority of deaths associated with prescription drugs. Substantial co-use of opioids and benzodiazepines was seen. Pregnant or recently pregnant women may have more interactions with healthcare providers, which may present more opportunities for intervention and prevention. © 2013 American Academy of Forensic Sciences.

Allegheny County Fatal Accidental Overdoses

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Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Fatal accidental overdose incidents in Allegheny County, denoting age, gender, race, drugs present, zip code of incident and zip code of residence. Zip code of...

Perceptions of parental bonding in freebase cocaine users versus non-illicit drug users

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Marcia Pettenon

2014-01-01

Full Text Available Background & objectives: Evidence has suggested that parenting styles have peculiar characteristics in families with drug-related issues. This study was undertaken to investigate the perception of crack (smoke cocaine users and non-users about parental bonding quality regarding care and control in Brazil. Methods: A total of 198 hospitalized crack users and 104 users of any non-illicit drug were assessed using the Parental Bonding Instrument (PBI, the sixth version of the Addiction Severity Index (ASI and Mini International Neuropsychiatric Interview (MINI. Results: Adjusted logistic regression analysis showed that crack users were more likely (OR adj = 9.68; 95% CI: 2.82, 33.20 to perceive neglectful mothers, as well as more likely (OR adj = 4.71, 95% CI: 2.17, 10.22 to perceive controlling and affectionless fathers in comparison with non-illicit drug users who were more likely to perceive optimal parenting. Interpretation & conclusions: Our findings indicate that the perception of neglectful mothers and affectionless controlling fathers may be associated with the tendency of the children to be less resilient when facing stressful events, leading them to a greater risk to use crack.

Perceptions of parental bonding in freebase cocaine users versus non-illicit drug users

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Pettenon, Márcia; Kessler, Felix Henrique Paim; Guimarães, Luciano S. P.; Pedroso, Rosemeri Siqueira; Hauck, Simone; Pechansky, Flavio

2014-01-01

Background & objectives: Evidence has suggested that parenting styles have peculiar characteristics in families with drug-related issues. This study was undertaken to investigate the perception of crack (smoke cocaine) users and non-users about parental bonding quality regarding care and control in Brazil. Methods: A total of 198 hospitalized crack users and 104 users of any non-illicit drug were assessed using the Parental Bonding Instrument (PBI), the sixth version of the Addiction Severity Index (ASI) and Mini International Neuropsychiatric Interview (MINI). Results: Adjusted logistic regression analysis showed that crack users were more likely (ORadj = 9.68; 95% CI: 2.82, 33.20) to perceive neglectful mothers, as well as more likely (ORadj = 4.71, 95% CI: 2.17, 10.22) to perceive controlling and affectionless fathers in comparison with non-illicit drug users who were more likely to perceive optimal parenting. Interpretation & conclusions: Our findings indicate that the perception of neglectful mothers and affectionless controlling fathers may be associated with the tendency of the children to be less resilient when facing stressful events, leading them to a greater risk to use crack. PMID:25109717

Patterns and correlates of illicit drug selling among youth in the USA

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Ahmedani B

2011-05-01

Full Text Available Michael G Vaughn1, Jeffrey J Shook2, Brian E Perron3, Arnelyn Abdon4, Brian Ahmedani51School of Social Work, School of Public Health and Department of Public Policy Studies, Saint Louis University, St Louis, MO USA; 2School of Social Work, University of Pittsburgh, Pittsburgh, PA USA; 3School of Social Work, University of Michigan, Ann Arbor, MI USA; 4School of Economics, University of the Philippines, Quezon City, Philippines; 5Henry Ford Health System, Detroit MI, USAPurpose: Despite the high rates of drug selling among youth in juvenile justice and youth residing in disadvantage neighborhoods, relatively little is known about the patterns of illicit drug selling among youth in the general population.Methods: Using the public-use data file from the adolescent sample (N = 17 842 in the 2008 National Survey on Drug Use and Health (NSDUH, this study employed multiple logistic regression to compare the behavioral, parental involvement, and prevention experiences of youth who sold and did not sell illicit drugs in the past year.Results: Findings from a series of logistic regression models indicated youth who sold drugs were far more likely to use a wide variety of drugs and engage in delinquent acts. Drug-selling youth were significantly less likely to report having a parent involved in their life and have someone to talk to about serious problems but were more likely to report exposure to drug prevention programming.Conclusion: Selling of drugs by youth appears to be a byproduct of substance abuse and deviance proneness, and the prevention programs these youth experience are likely a result of mandated exposure derived from contact with the criminal justice system. Assuming no major drug supply side reductions, policies, and practices associated with increasing drug abuse treatment, parental involvement and supervision, and school engagement are suggested.Keywords: drug distribution, prevention, adolescent risk, youth experiences, parental

Qualitative and quantitative temporal analysis of licit and illicit drugs in wastewater in Australia using liquid chromatography coupled to mass spectrometry.

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Bade, Richard; White, Jason M; Gerber, Cobus

2018-01-01

The combination of qualitative and quantitative bimonthly analysis of pharmaceuticals and illicit drugs using liquid chromatography coupled to mass spectrometry is presented. A liquid chromatography-quadrupole time of flight instrument equipped with Sequential Window Acquisition of all THeoretical fragment-ion spectra (SWATH) was used to qualitatively screen 346 compounds in influent wastewater from two wastewater treatment plants in South Australia over a 14-month period. A total of 100 compounds were confirmed and/or detected using this strategy, with 61 confirmed in all samples including antidepressants (amitriptyline, dothiepin, doxepin), antipsychotics (amisulpride, clozapine), illicit drugs (cocaine, methamphetamine, amphetamine, 3,4-methylenedioxymethamphetamine (MDMA)), and known drug adulterants (lidocaine and tetramisole). A subset of these compounds was also included in a quantitative method, analyzed on a liquid chromatography-triple quadrupole mass spectrometer. The use of illicit stimulants (methamphetamine) showed a clear decrease, levels of opioid analgesics (morphine and methadone) remained relatively stable, while the use of new psychoactive substances (methylenedioxypyrovalerone (MDPV) and Alpha PVP) varied with no visible trend. This work demonstrates the value that high-frequency sampling combined with quantitative and qualitative analysis can deliver. Graphical abstract Temporal analysis of licit and illicit drugs in South Australia.

Prevalence of HCV infection and associated factors among illicit drug users in Breves, State of Pará, northern Brazil

OpenAIRE

Pacheco,Suzy Danielly Barbosa; Silva-Oliveira,Gláucia Caroline; Maradei-Pereira,Luciana Maria Cunha; Crescente,José Ângelo Barletta; Lemos,José Alexandre Rodrigues de; Oliveira-Filho,Aldemir Branco de

2014-01-01

Introduction: Illicit drug users (DUs) are vulnerable to hepatitis C virus (HCV) infection. The shared use of illicit drugs is the main method of HCV transmission. Methods: A cross-sectional study was conducted in Breves, in northern Brazil. We surveyed 187 DUs to determine the prevalence of and factors associated with HCV infection. Results: The prevalence of anti-HCV antibodies was 36.9%, and the prevalence of hepatitis C virus-ribonucleic acid (HCV-RNA) was 31%. Hepatitis C virus infec...

Polydrug use of illicit drugs among adolescents in Hogar Crea of Barba de Heredia and Cartago

Directory of Open Access Journals (Sweden)

Ligia Murillo Castro

2013-04-01

Full Text Available The main objective of this research is to analyze polydrug use of illicit drugs in teenagers of both genders intwo nongovernmental organizations of Costa Rica. It depicts the problems with polydrug use with the qualitativeresearch using two focal groups of teenagers. They relate, with the technique of collage, their own experienceswith the way they use illicit drugs. The research showed that the most commonly used drugs are marihuana andcocaine mixed with tobacco, also the time they consume it goes from 2 months to 4 years. Furthermore, they facetheir recovery in a special center, assuming the experience with consuming brings negative consequences likedeath, crime and jail in some cases. However, they hope to defeat the addiction and look for a better future bygoing through with the program established in the organization and also with the support of their families.

Prescription Drug Diversion: Predictors of Illicit Acquisition and Redistribution in Three U.S. Metropolitan Areas.

Science.gov (United States)

Harris, Shana; Nikulina, Valentina; Gelpí-Acosta, Camila; Morton, Cory; Newsome, Valerie; Gunn, Alana; Hoefinger, Heidi; Aikins, Ross; Smith, Vivian; Barry, Victoria; Downing, Martin J

2015-12-02

Prescription drug diversion, the transfer of prescription drugs from lawful to unlawful channels for distribution or use, is a problem in the United States. Despite the pervasiveness of diversion, there are gaps in the literature regarding characteristics of individuals who participate in the illicit trade of prescription drugs. This study examines a range of predictors (e.g., demographics, prescription insurance coverage, perceived risk associated with prescription drug diversion) of membership in three distinct diverter groups: individuals who illicitly acquire prescription drugs, those who redistribute them, and those who engage in both behaviors. Data were drawn from a cross-sectional Internet study ( N = 846) of prescription drug use and diversion patterns in New York City, South Florida, and Washington, D.C.. Participants were classified into diversion categories based on their self-reported involvement in the trade of prescription drugs. Group differences in background characteristics of diverter groups were assessed by Chi-Square tests and followed up with multivariate logistic regressions. While individuals in all diversion groups were more likely to be younger and have a licit prescription for any of the assessed drugs in the past year than those who did not divert, individuals who both acquire and redistribute are more likely to live in New York City, not have prescription insurance coverage, and perceive fewer legal risks of prescription drug diversion. Findings suggest that predictive characteristics vary according to diverter group.

Overdose beliefs and management practices among ethnic Vietnamese heroin users in Sydney, Australia

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Maher Lisa

2009-04-01

Full Text Available Abstract Background Ethnic Vietnamese injecting drug users (IDUs in Australia draw on a range of beliefs and etiologic models, sometimes simultaneously, in order to make sense of health and illness. These include understandings of illness as the result of internal imbalances and Western concepts of disease causation including germ/pollution theory. Methods Observational fieldwork and in-depth interviews were conducted between 2001 and 2006 in neighbourhoods characterised by high proportions of Asian background IDUs and street-based drug markets. Eligibility criteria for the study were: 1 ethnic Vietnamese cultural background; 2 aged 16 years and over and; 3 injected drugs in the last 6 months. Results Participants commonly attempted to treat heroin overdose by withdrawing blood (rút máu from the body. Central to this practice are cultural beliefs about the role and function of blood in the body and its relationship to illness and health. Participants' beliefs in blood were strongly influenced by understandings of blood expressed in traditional Chinese and Vietnamese medicine. Many participants perceived Western drugs, particularly heroin, as "hot" and "strong". In overdose situations, it was commonly believed that an excessive amount of drugs (particularly heroin entered the bloodstream and traveled to the heart, making the heart work too hard. Withdrawing blood was understood to reduce the amount of drugs in the body which in turn reduced the effects of drugs on the blood and the heart. Conclusion The explanatory model of overdose employed by ethnic Vietnamese IDUs privileges traditional beliefs about the circulatory, rather than the respiratory, system. This paper explores participants' beliefs about blood, the effects of drugs on blood and the causes of heroin overdose in order to document the explanatory model of overdose used by ethnic Vietnamese IDUs. Implications for overdose prevention, treatment and management are identified and

Can price get the monkey off our back? A meta-analysis of illicit drug demand.

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Gallet, Craig A

2014-01-01

Because of the increased availability of price data over the past 15 years, several studies have estimated the demand for illicit drugs, providing 462 estimates of the price elasticity. Results from estimating several meta-regressions reveal that these price elasticity estimates are influenced by a number of study characteristics. For instance, the price elasticity differs across drugs, with its absolute value being smallest for marijuana, compared with cocaine and heroin. Furthermore, price elasticity estimates are sensitive to whether demand is modeled in the short-run or the long-run, measures of quantity and price, whether or not alcohol and other illicit drugs are included in the specification of demand, and the location of demand. However, a number of other factors, including the functional form of demand, several specification issues, the type of data and method used to estimate demand, and the quality of the publication outlet, have less influence on the price elasticity. Copyright © 2013 John Wiley & Sons, Ltd.

Illicit online marketing of lorcaserin before DEA scheduling.

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Liang, Bryan A; Mackey, Tim K; Archer-Hayes, Ashley N; Shinn, Linda M

2013-05-01

Antiobesity drugs have been marketed illicitly by "no prescription" online pharmacies after approval and scheduling by the drug enforcement agency. We assess whether antiobesity drug Belviq® (lorcaserin HCl) was available from illicit online vendors before DEA-scheduling when sales are unauthorized. Online searches of "buy Belviq no prescription" examining first five result pages marketing the drug. Searches were performed from 11/5/2012-12/8/2012, prior to DEA scheduing. Belviq® is actively marketed by "no prescription" online vendors despite official unavailability and prescription requirements. Approaches included direct-to-consumer advertising using descriptive website URLs; linking to illicit marketers; and directing customers to other weight-loss websites for additional marketing. Finally, large quantities were marketed by business-to-business vendors. Illicit online "no prescription" pharmacies are marketing unauthorized, suspect antiobesity drugs before DEA scheduling and permitted marketing. Regulators must legally intercede to ensure patient safety, and providers must educate patients about online-sourcing risks. Copyright © 2013 The Obesity Society.

Reducing risk for illicit drug use and prescription drug misuse: High school gay-straight alliances and lesbian, gay, bisexual, and transgender youth.

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Heck, Nicholas C; Livingston, Nicholas A; Flentje, Annesa; Oost, Kathryn; Stewart, Brandon T; Cochran, Bryan N

2014-04-01

Previous research suggests that lesbian, gay, bisexual, and transgender (LGBT) youth are at elevated risk for using illicit drugs and misusing prescription drugs relative to heterosexual youth. Previous research also indicates that LGBT youth who attend high schools with a gay-straight alliance (GSA) report having fewer alcohol problems and lower levels of cigarette smoking. The present study investigates whether the absence of a GSA is associated with risk for illicit drug use and prescription drug misuse in a sample of 475 LGBT high school students (M age=16.79) who completed an online survey. After controlling for demographic variables and risk factors associated with illicit drug use, the results of 12 logistic regression analyses revealed that LGBT youth attending a high school without a GSA evidenced increased risk for using cocaine (adjusted odds ratio [adjOR]=3.11; 95% confidence interval [95% CI]=1.23-7.86), hallucinogens (adjOR=2.59; 95% CI=1.18-5.70), and marijuana (adjOR=2.22; 95% CI=1.37-3.59) relative to peers attending a high school with a GSA. Youth without a GSA also evidenced increased risk for the misuse of ADHD medication (adjOR=2.00; 95% CI=1.02-3.92) and prescription pain medication (adjOR=2.00; 95% CI=1.10-3.65). These findings extend the research base related to GSAs and further demonstrate the importance of providing LGBT youth with opportunities for socialization and support within the school setting. Important limitations of the present study are reviewed. Copyright © 2014 Elsevier Ltd. All rights reserved.

Estimating the prevalence of illicit opioid use in New York City using multiple data sources

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McNeely Jennifer

2012-06-01

Full Text Available Abstract Background Despite concerns about its health and social consequences, little is known about the prevalence of illicit opioid use in New York City. Individuals who misuse heroin and prescription opioids are known to bear a disproportionate burden of morbidity and mortality. Service providers and public health authorities are challenged to provide appropriate interventions in the absence of basic knowledge about the size and characteristics of this population. While illicit drug users are underrepresented in population-based surveys, they may be identified in multiple administrative data sources. Methods We analyzed large datasets tracking hospital inpatient and emergency room admissions as well as drug treatment and detoxification services utilization. These were applied in combination with findings from a large general population survey and administrative records tracking prescriptions, drug overdose deaths, and correctional health services, to estimate the prevalence of heroin and non-medical prescription opioid use among New York City residents in 2006. These data were further applied to a descriptive analysis of opioid users entering drug treatment and hospital-based medical care. Results These data sources identified 126,681 cases of opioid use among New York City residents in 2006. After applying adjustment scenarios to account for potential overlap between data sources, we estimated over 92,000 individual opioid users. By contrast, just 21,600 opioid users initiated drug treatment in 2006. Opioid users represented 4 % of all individuals hospitalized, and over 44,000 hospitalizations during the calendar year. Conclusions Our findings suggest that innovative approaches are needed to provide adequate services to this sizeable population of opioid users. Given the observed high rates of hospital services utilization, greater integration of drug services into medical settings could be one component of an effective approach to

Methamphetamine overdose

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... dialysis (kidney machine) Destruction of muscles, which can lead to amputation An extremely large methamphetamine overdose can cause death. Alternative Names Intoxication - amphetamines; Intoxication - uppers; Amphetamine intoxication; Uppers overdose; Overdose - ...

EXPERIMENTATION AND REGULAR USE OF ILLICIT DRUGS BY STUDENTS IN THE CITY OF BRAGANÇA, NORTHEASTERN PARÁ.

OpenAIRE

Clemenes Prata Araújo; Lizabete Almeida Castor; Valcirene Gomes Guimarães - Nunes; Adriana Marques de Oliveira - Miranda; Gláucia Caroline Silva - Oliveira; Aldemir Branco de Oliveira F ilho

2013-01-01

This study determined the prevalence and factors associated with illicit drug useamongstudents inhighschools in the municipality of Bragança, Pará, northern Brazil. School-based cross-sectional study, a total of five public schools and 1632 students in the municipality ofBragança. The self-administered questionnaire was adapted from other epidemiological studies tothe appropriate population group, with rigorous procedure, guaranteeing anonymity andconfidentiality. The prevalence of illicit dr...

Occurrence of illicit drugs and selected pharmaceuticals in Slovak municipal wastewater.

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Bodík, Igor; Mackuľak, Tomáš; Fáberová, Milota; Ivanová, Lucia

2016-10-01

We analyzed illicit drugs and their metabolites and pharmaceuticals in wastewater from 15 selected wastewater treatment plants (WWTPs) in Slovakia. Our results indicate that methamphetamine is one of the most commonly used illegal drugs in all the regions of Slovakia monitored in this study. Compared with the international results, the Slovak cities of Dunajská Streda (479 mg/day/1000inh) and Trnava (354 mg/day/1000inh) are among the cities with the largest numbers of methamphetamine users in Europe. These results indicate an increase in the incidence of drugs in big cities and in the satellite cities (Trnava and Dunajská Streda) near Bratislava. These results also confirm the police statistics about production and use of illicit drugs in Slovakia. The highest specific loads of cocaine were found in Bratislava (112 mg/day/1000inh), followed by Petržalka (74 mg/day/1000inh). Compared with other European cities, Bratislava and the other Slovak cities in this study have a relatively low number of COC consumers. The ecstasy load in wastewater from larger cities also significantly increased over the weekend and during music festivals. The highest 2-year mean concentrations of THC-COOH, a cannabis biomarker, were observed in the sewage from BA-Petržalka and BA-Central (191 and 171 ng/L, respectively). A first complex monitoring of pharmaceuticals in all therapeutic groups was also realized in selected Slovak WWTPs. Occurrence of wide spectrum of pharmaceuticals with very high concentrations as well as consumptions were observed mainly in small Slovak cities. Considering all 120 monitored pharmaceuticals, Valsartan had the highest concentrations: 6000 ng/L, on average.

Making sense of differing overdose mortality: contributions to improved understanding of European patterns.

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Waal, Helge; Gossop, Michael

2014-01-01

The European Monitoring Centre for Drugs and Drug Addiction, EMCDDA, publishes statistics for overdose deaths giving a European mean number, and ranking nations in a national 'league table' for overdose deaths. The interpretation of differing national levels of mortality is more problematic and more complex than is usually recognised. Different systems are used to compile mortality data and this causes problems for cross-national comparisons. Addiction behaviour can only be properly understood within its specific social and environmental ecology. Risk factors for overdose, such as the type of drug consumed, and the route of administration, are known to differ across countries. This paper describes problems associated with ranking and suggests how mortality data might be used in high-level countries aiming at reduction in the number of overdose deaths. Copyright © 2013 S. Karger AG, Basel.

Detection of illicit online sales of fentanyls via Twitter.

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Mackey, Tim K; Kalyanam, Janani

2017-01-01

A counterfeit fentanyl crisis is currently underway in the United States.  Counterfeit versions of commonly abused prescription drugs laced with fentanyl are being manufactured, distributed, and sold globally, leading to an increase in overdose and death in countries like the United States and Canada.  Despite concerns from the U.S. Drug Enforcement Agency regarding covert and overt sale of fentanyls online, no study has examined the role of the Internet and social media on fentanyl illegal marketing and direct-to-consumer access.  In response, this study collected and analyzed five months of Twitter data (from June-November 2015) filtered for the keyword "fentanyl" using Amazon Web Services.  We then analyzed 28,711 fentanyl-related tweets using text filtering and a machine learning approach called a Biterm Topic Model (BTM) to detect underlying latent patterns or "topics" present in the corpus of tweets.  Using this approach we detected a subset of 771 tweets marketing the sale of fentanyls online and then filtered this down to nine unique tweets containing hyperlinks to external websites.  Six hyperlinks were associated with online fentanyl classified ads, 2 with illicit online pharmacies, and 1 could not be classified due to traffic redirection.  Importantly, the one illicit online pharmacy detected was still accessible and offered the sale of fentanyls and other controlled substances direct-to-consumers with no prescription required at the time of publication of this study.   Overall, we detected a relatively small sample of Tweets promoting illegal online sale of fentanyls.  However, the detection of even a few online sellers represents a public health danger and a direct violation of law that demands further study.

[Family and acquaintances of illicit drug users: community perspectives on laws and public policies in Western Rio de Janeiro, Brazil].

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Silva, Jaqueline da; Brands, Bruna; Adlaf, Edward; Giesbrecht, Norman; Simich, Laura; Wright, Maria da Gloria Miotto

2009-01-01

This article is part of the study 'Illicit Drug Use in Seven Latin American Countries and Canada: Critical Perspectives of Family and Familiars' (7LACC), which investigated four domains: protective and risk factors; preventive initiatives; treatment facilities; and laws and policies. The article presents a section of the results based on four items of the laws and policies domain--as perceived by the family and acquaintances of illicit drug users living in the community. Participants were recruited in urban primary health care units located in Western Rio de Janeiro (city), Brazil. This multi-method, cross-temporal study performed interviews with 100 adults (18 years of age or older), all cognitively healthy. Results and key conclusions included non-compliance with the fundamental principles of the Unique Health System Legislation / Law 8.080/90 and the erroneous implementation of laws and public policies on illicit drug.

Lifetime use of illicit drugs and associated factors among Brazilian schoolchildren, National Adolescent School-based Health Survey (PeNSE 2012).

Science.gov (United States)

Horta, Rogério Lessa; Horta, Bernardo Lessa; da Costa, Andre Wallace Nery; do Prado, Rogério Ruscitto; Oliveira-Campos, Maryane; Malta, Deborah Carvalho

2014-01-01

This study aimed at describing the prevalence of illicit drug use among 9th grade students in the morning period of public and private schools in Brazil, and assessing associated factors. The Brazilian survey PeNSE (National Adolescent School-based Health Survey) 2012 evaluated a representative sample of 9th grade students in the morning period, in Brazil and its five regions. The use of illicit drugs at least once in life was assessed for the most commonly used drugs, such as marijuana, cocaine, crack, solvent-based glue, general ether-based inhalants, ecstasy and oxy. Data were subjected to descriptive analysis, and Pearson's χ² test and logistic regression was used in the multivariate analysis. The use of illicit drugs at least once in life was reported by 7.3% (95%CI 5.3 - 9.4) of the respondents. Logistic regression was used for multivariate analysis and the evidences suggest that illicit drug use is associated to social conditions of greater consumption power, the use of alcohol and tobacco, behaviors related to socialization, such as having friends or sexual activity, and also the perception of loneliness, loose contact between school and parents and experiences of abuse in the family environment. The outcome was inversely associated with close contact with parents and parental supervision. In addition to the association with the processes of socialization and consumption, the influence of family and school is expressed in a particularly protective manner in different records of direct supervision and care.

Characterization and Management of Patients with Heroin versus Nonheroin Opioid Overdoses: Experience at an Academic Medical Center.

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Morizio, Kate M; Baum, Regan A; Dugan, Adam; Martin, Julia E; Bailey, Abby M

2017-07-01

To characterize the differences between patients who had heroin and nonheroin opioid overdoses and to determine whether there were any significant differences in their management with regard to the naloxone use. Retrospective cohort study. Large academic medical center. A total of 923 patients admitted to the medical center who were identified for overdose by heroin or other opiate-related narcotics between January 2010 and September 2015; 480 patients experienced a nonheroin opioid overdose event, and 443 patients experienced a heroin overdose event. Patients presenting with heroin overdose tended to be younger and male, with higher rates of hepatitis C virus (HCV) infection compared with those presenting with nonheroin opioid overdose (pevent, history of injection drug use, and history of prescription opioid abuse compared with the nonheroin group (pevent with the same drug. The proportion of patients presenting with a heroin overdose steadily increased from 2010-2015; the number of patients presenting to the emergency department with nonheroin opioid overdoses steadily decreased. As rates of heroin overdose increased each year, the incidence of HCV infection increased dramatically. This study indicates that the incidence of heroin overdoses has significantly increased over the last several years, and the rates of HCV infection 4-fold since the start of the study period. Patients admitted for nonheroin opioid overdose were more likely to be admitted to the hospital and intensive care unit compared with those admitted for heroin overdose. The rise in overdose events only further illustrates a gap in our understanding of the cycle of addiction, drug abuse, and overdose events. © 2017 Pharmacotherapy Publications, Inc.

Wastewater-based assessment of regional and temporal consumption patterns of illicit drugs and therapeutic opioids in Croatia.

Science.gov (United States)

Krizman, Ivona; Senta, Ivan; Ahel, Marijan; Terzic, Senka

2016-10-01

A comprehensive study of spatial and temporal consumption patterns of the selected illicit drugs (heroin, cocaine, amphetamine, MDMA, methamphetamine, cannabis) and therapeutic opioids (codeine, methadone) has been performed in six Croatian cities by applying wastewater-based epidemiology. The investigated cities (Bjelovar, Vinkovci, Varazdin, Karlovac, Zadar and Zagreb) varied widely in the population size (27,000-688,000 inhabitants) as well as in the number of registered drug consumers included in compulsory and voluntary medical treatment and rehabilitation programs (30-513 persons/100,000 inhabitants of age 15-64). The most consumed illicit drugs were cannabis (10-70doses/day/1000 inhabitants), heroin (consumption of amphetamine-type drugs was much lower (consumption of illegal drugs was generally associated with larger urban centers (Zagreb and Zadar) however comparatively high consumption rate of cocaine, MDMA and methadone was determined in some smaller cities as well. The overall average dose number of 3 major illegal stimulants (cocaine, MDMA, amphetamine) was rather similar to the number of corresponding heroin doses, which is in disagreement with a comparatively much higher proportion of heroin users in the total number of registered drug users in Croatia. Furthermore, the illicit drug consumption pattern in the large continental city (Zagreb) was characterized by a significant enhancement of the consumption of all stimulants during the weekend, which could not be confirmed neither for the coastal city of Zadar nor for the remaining small continental cities. On the other hand, the city of Zadar exhibited a significant increase of stimulant drug usage during summer vacation period, as a result of pronounced seasonal changes of the population composition and lifestyle in coastal tourist centers. The obtained results represent a valuable complementary data source for the optimisation and implementation of strategies to combat drug abuse in Croatia

Performance Measures of Diagnostic Codes for Detecting Opioid Overdose in the Emergency Department.

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Rowe, Christopher; Vittinghoff, Eric; Santos, Glenn-Milo; Behar, Emily; Turner, Caitlin; Coffin, Phillip O

2017-04-01

Opioid overdose mortality has tripled in the United States since 2000 and opioids are responsible for more than half of all drug overdose deaths, which reached an all-time high in 2014. Opioid overdoses resulting in death, however, represent only a small fraction of all opioid overdose events and efforts to improve surveillance of this public health problem should include tracking nonfatal overdose events. International Classification of Disease (ICD) diagnosis codes, increasingly used for the surveillance of nonfatal drug overdose events, have not been rigorously assessed for validity in capturing overdose events. The present study aimed to validate the use of ICD, 9th revision, Clinical Modification (ICD-9-CM) codes in identifying opioid overdose events in the emergency department (ED) by examining multiple performance measures, including sensitivity and specificity. Data on ED visits from January 1, 2012, to December 31, 2014, including clinical determination of whether the visit constituted an opioid overdose event, were abstracted from electronic medical records for patients prescribed long-term opioids for pain from any of six safety net primary care clinics in San Francisco, California. Combinations of ICD-9-CM codes were validated in the detection of overdose events as determined by medical chart review. Both sensitivity and specificity of different combinations of ICD-9-CM codes were calculated. Unadjusted logistic regression models with robust standard errors and accounting for clustering by patient were used to explore whether overdose ED visits with certain characteristics were more or less likely to be assigned an opioid poisoning ICD-9-CM code by the documenting physician. Forty-four (1.4%) of 3,203 ED visits among 804 patients were determined to be opioid overdose events. Opioid-poisoning ICD-9-CM codes (E850.2-E850.2, 965.00-965.09) identified overdose ED visits with a sensitivity of 25.0% (95% confidence interval [CI] = 13.6% to 37.8%) and

Externalizing behaviors and cigarette smoking as predictors for use of illicit drugs: a longitudinal study among Finnish adolescent twins.

Science.gov (United States)

Korhonen, Tellervo; Levälahti, Esko; Dick, Danielle M; Pulkkinen, Lea; Rose, Richard J; Kaprio, Jaakko; Huizink, Anja C

2010-12-01

We examined whether externalizing problem behaviors (hyperactivity-impulsivity, aggressiveness, and inattention) predict illicit drug use independently, or whether their associations with drug use are mediated through cigarette smoking. We used a prospective longitudinal design within the FinnTwin12-17 study among Finnish adolescents with baseline at age 12 and follow-up surveys at ages 14 and 17. Path models were conducted with Mplus and included 1992 boys and 2123 girls. The outcome was self-reported ever use of cannabis or other illicit drugs at age 17. The predictors were: externalizing behaviors (hyperactivity-impulsivity, aggressiveness, and inattention) assessed by teachers and parents (age 12) and self-reported cigarette smoking (age 14). The findings differed across behavior studied. The association of hyperactivity-impulsivity with drug use was mostly mediated through earlier cigarette smoking. Concerning aggressiveness and inattention, the results were different among girls than boys. Among girls no significant mediation occurred, whereas among boys more consistent evidence on mediation was seen. Consistently in all models, the direct association of early cigarette smoking on drug use was strong and highly significant. We conclude that the associations of externalizing problem behaviors with illicit drug use are partially mediated through cigarette smoking. Although interventions targeting externalizing problem behaviors may protect adolescents from early onset smoking and subsequently experimenting with drugs, interventions to prevent cigarette smoking initiation are also important in reducing risk of later drug use.

Detection and identification of explosives and illicit drugs using neutron based techniques

International Nuclear Information System (INIS)

Papp, A.; Csikai, J.; Debrecen University,

2011-01-01

Some methods developed in collaboration between the ATOMKI and IEP for bulk hydrogen analysis and for the detection and identification of illicit drugs are presented. Advantages and limitations of neutron techniques (reflection, transmission, elastic and inelastic scatterings, leakage spectra and angular yields of Be(d,n), Pu-Be, D-D, D-T and 252 Cf neutrons transmitted from thick samples, effects of hidden materials) are discussed. (author)

Relationship between hunger, adherence to antiretroviral therapy and plasma HIV RNA suppression among HIV-positive illicit drug users in a Canadian setting.

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Anema, Aranka; Kerr, Thomas; Milloy, M-J; Feng, Cindy; Montaner, Julio S G; Wood, Evan

2014-04-01

Food insecurity may be a barrier to achieving optimal HIV treatment-related outcomes among illicit drug users. This study therefore, aimed to assess the impact of severe food insecurity, or hunger, on plasma HIV RNA suppression among illicit drug users receiving antiretroviral therapy (ART). A cross-sectional Multivariate logistic regression model was used to assess the potential relationship between hunger and plasma HIV RNA suppression. A sample of n = 406 adults was derived from a community-recruited open prospective cohort of HIV-positive illicit drug users, in Vancouver, British Columbia (BC), Canada. A total of 235 (63.7%) reported "being hungry and unable to afford enough food," and 241 (59.4%) had plasma HIV RNA hunger was associated with lower odds of plasma HIV RNA suppression (Odds Ratio = 0.59, 95% confidence interval [CI]: 0.39-0.90, p = 0.015). In multivariate analyses, this association was no longer significant after controlling for socio-demographic, behavioral, and clinical characteristics, including 95% adherence (Adjusted Odds Ratio [AOR] = 0.65, 95% CI: 0.37-1.10, p = 0.105). Multivariate models stratified by 95% adherence found that the direction and magnitude of this association was not significantly altered by the adherence level. Hunger was common among illicit drug users in this setting. Although, there was an association between hunger and lower likelihood of plasma HIV RNA suppression, this did not persist in adjusted analyses. Further research is warranted to understand the social-structural, policy, and physical factors shaping the HIV outcomes of illicit drug users.

Prescription Drug Diversion: Predictors of Illicit Acquisition and Redistribution in Three U.S. Metropolitan Areas

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Shana Harris

2015-12-01

Full Text Available Objective: Prescription drug diversion, the transfer of prescription drugs from lawful to unlawful channels for distribution or use, is a problem in the United States. Despite the pervasiveness of diversion, there are gaps in the literature regarding characteristics of individuals who participate in the illicit trade of prescription drugs. This study examines a range of predictors (e.g., demographics, prescription insurance coverage, perceived risk associated with prescription drug diversion of membership in three distinct diverter groups: individuals who illicitly acquire prescription drugs, those who redistribute them, and those who engage in both behaviors. Methods: Data were drawn from a cross-sectional Internet study (N = 846 of prescription drug use and diversion patterns in New York City, South Florida, and Washington, D.C.. Participants were classified into diversion categories based on their self-reported involvement in the trade of prescription drugs. Group differences in background characteristics of diverter groups were assessed by Chi-Square tests and followed up with multivariate logistic regressions. Results: While individuals in all diversion groups were more likely to be younger and have a licit prescription for any of the assessed drugs in the past year than those who did not divert, individuals who both acquire and redistribute are more likely to live in New York City, not have prescription insurance coverage, and perceive fewer legal risks of prescription drug diversion. Conclusion: Findings suggest that predictive characteristics vary according to diverter group.

Illicit drug detection using energy dispersive x-ray diffraction

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Cook, E. J.; Griffiths, J. A.; Koutalonis, M.; Gent, C.; Pani, S.; Horrocks, J. A.; George, L.; Hardwick, S.; Speller, R.

2009-05-01

Illicit drugs are imported into countries in myriad ways, including via the postal system and courier services. An automated system is required to detect drugs in parcels for which X-ray diffraction is a suitable technique as it is non-destructive, material specific and uses X-rays of sufficiently high energy to penetrate parcels containing a range of attenuating materials. A database has been constructed containing the measured powder diffraction profiles of several thousand materials likely to be found in parcels. These include drugs, cutting agents, packaging and other innocuous materials. A software model has been developed using these data to predict the diffraction profiles which would be obtained by X-ray diffraction systems with a range of suggested detector (high purity germanium, CZT and scintillation), source and collimation options. The aim of the model was to identify the most promising system geometries, which was done with the aid of multivariate analysis (MVA). The most promising systems were constructed and tested. The diffraction profiles of a range of materials have been measured and used to both validate the model and to identify the presence of drugs in sample packages.

Unintentional prescription opioid-related overdose deaths: description of decedents by next of kin or best contact, Utah, 2008-2009.

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Johnson, Erin M; Lanier, William A; Merrill, Ray M; Crook, Jacob; Porucznik, Christina A; Rolfs, Robert T; Sauer, Brian

2013-04-01

Little is known about the characteristics that may predispose an individual to being at risk for fatal overdose from prescription opioids. To identify characteristics related to unintentional prescription opioid overdose deaths in Utah. Interviews were conducted (October 2008-October 2009) with a relative or friend most knowledgeable about the decedent's life. Analyses involved 254 decedents aged 18 or older, where cause of death included overdose on at least one prescription opioid. Decedents were more likely to be middle-aged, Caucasian, non-Hispanic/Latino, less educated, not married, or reside in rural areas than the general adult population in Utah. In the year prior to death, 87.4 % were prescribed prescription pain medication. Reported potential misuse prescription pain medication in the year prior to their death was high (e.g., taken more often than prescribed [52.9 %], obtained from more than one doctor during the previous year [31.6 %], and used for reasons other than treating pain [29.8 %, almost half of which "to get high"]). Compared with the general population, decedents were more likely to experience financial problems, unemployment, physical disability, mental illness (primarily depression), and to smoke cigarettes, drink alcohol, and use illicit drugs. The primary source of prescription pain medication was from a healthcare provider (91.8 %), but other sources (not mutually exclusive) included: for free from a friend or relative (24 %); from someone without their knowledge (18.2 %); purchase from a friend, relative, or acquaintance (16.4 %); and purchase from a dealer (not a pharmacy) (11.6 %). The large majority of decedents were prescribed opioids for management of chronic pain and many exhibited behaviors indicative of prescribed medication misuse. Financial problems, unemployment, physical disability, depression, and substance use (including illegal drugs) were also common.

Rural Adolescent Alcohol, Tobacco, and Illicit Drug Use: A Comparison of Students in Victoria, Australia, and Washington State, United States

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Coomber, Kerri; Toumbourou, John W.; Miller, Peter; Staiger, Petra K.; Hemphill, Sheryl A.; Catalano, Richard F.

2011-01-01

Purpose: There are inconsistent research findings regarding the impact of rurality on adolescent alcohol, tobacco, and illicit substance use. Therefore, the current study reports on the effect of rurality on alcohol, tobacco, and illicit drug use among adolescents in 2 state representative samples in 2 countries, Washington State (WA) in the…

Individual and population level impacts of illicit drug use, sexual risk behaviours on sexually transmitted infections among young Aboriginal and Torres Strait Islander people: results from the GOANNA survey

Directory of Open Access Journals (Sweden)

Handan Wand

2016-07-01

Full Text Available Abstract Background Sexually transmitted infections (STIs have been increasing among Australian Indigenous young people for over two decades. Little is known about the association between alcohol and other drug use and sexual risk behaviours and diagnosis of STIs among this population. Methods A cross-sectional, community based self-administered survey was conducted among young Aboriginal people aged 16–29 years of age. Questionnaires included socio-demographic characteristics, knowledge, sexual risk behaviours alcohol and other drug use and health service access including self-reported history of diagnosis with a STI. Logistic regression models and population attributable risks were used to assess individual and population level impacts of illicit drug use on high risk sexual behaviours and ever reported diagnosis of an STI. Results Of the 2877 participants, 2320 (81 % identified as sexually active and were included in this study. More than 50 % of the study population reported that they had used at least one illicit drug in past year. Cannabis, ecstasy and methamphetamines were the three most commonly used illicit drugs in the past year. The prevalence of self-reported STI diagnosis was 25 %. Compared with people who did not report using illicit drugs, risky alcohol use and sexual behaviours including inconsistent condom use, multiple sexual partners in the past year and sex with casual partners were all significantly higher among illicit drug users. In adjusted analysis, participants who reported using illicit drugs were significantly more likely to engage in sexual risk behaviours and to ever have been diagnosed with an STI. Adjusted Odds Ratios ranged from 1.86 to 3.00 (males and from 1.43 to 2.46 (females. At the population level, more than 70 % of the STI diagnoses were attributed to illicit drug-use and sexual risk behaviours for males and females. Conclusion Illicit drug use in this population is relatively high compared to other

Capillary electrophoresis: principles and applications in illicit drug analysis.

Science.gov (United States)

Tagliaro, F; Turrina, S; Smith, F P

1996-02-09

Capillary electrophoresis, which appeared in the early 1980s, is now rapidly expanding into many scientific disciplines, including analytical chemistry, biotechnology and biomedical and pharmaceutical sciences. In capillary electrophoresis,electrokinetic separations are carried out in tiny capillaries at high voltages (10-30 kV), thus obtaining high efficiencies (N > 10(5)) and excellent mass sensitivities (down to 10(-18)-10(-20) moles). The main features of capillary electrophoresis are: versatility of application (from inorganic ions to large DNA fragments), use of different separation modes with different selectivity, extremely low demands on sample volume, negligible running costs, possibility of interfacing with different detection systems, ruggedness and simplicity of instrumentation. Capillary electrophoresis applications in forensic sciences have appeared only recently, but are now rapidly growing, particularly in forensic toxicology. The present paper briefly describes the basic principles of capillary electrophoresis, from both the instrumental and analytical points of view. Furthermore, the main applications in the analysis of illicit/controlled drugs in both illicit preparations and biological samples are presented and discussed (43 references). It is concluded that the particular separation mechanism and the high complementarity of this technique to chromatography makes capillary electrophoresis a new powerful tool of investigation in the hands of forensic toxicologists.

Opioid overdose prevention training with naloxone, an adjunct to basic life support training for first-year medical students.

Science.gov (United States)

Berland, Noah; Fox, Aaron; Tofighi, Babak; Hanley, Kathleen

2017-01-01

Opioid overdose deaths have reached epidemic proportions in the United States. This problem stems from both licit and illicit opioid use. Prescribing opioids, recognizing risky use, and initiating prevention, including opioid overdose prevention training (OOPT), are key roles physicians play. The American Heart Association (AHA) modified their basic life support (BLS) algorithms to consider naloxone in high-risk populations and when a pulse is appreciated; however, the AHA did not provide OOPT. The authors' intervention filled this training deficiency by teaching medical students opioid overdose resuscitation with a Train-the-Trainer model as part of mandatory BLS training. The authors introduced OOPT, following a Train-the-Trainer model, into the required basic life support (BLS) training for first-year medical students at a single medical school in a large urban area. The authors administered pre- and post-evaluations to assess the effects of the training on opioid overdose knowledge, self-reported preparedness to respond to opioid overdoses, and attitudes towards patients with substance use disorders (SUDs). In the fall 2014, 120 first-year medical students received OOPT. Seventy-three students completed both pre- and posttraining evaluations. Improvements in knowledge about and preparedness to respond to opioid overdoses were statistically significant (P support dissemination of OOPT as a part of BLS training for all medical students, and potentially all BLS providers.

Analysis of illicit drugs seized in the Province of Florence from 2006 to 2016.

Science.gov (United States)

Bertol, Elisabetta; Bigagli, Laura; D'Errico, Stefano; Mari, Francesco; Palumbo, Diego; Pascali, Jennifer P; Vaiano, Fabio

2018-03-01

Comprehension of illicit drug market's features at local level is useful to plan and to correctly set-up specific informative and contrast activities. In this paper we report trends, purities and consumption estimations of illicit substances available on the Florentine territory from 2006 to 2016. These data were obtained by the analysis of 10,451 samples seized by the Law Enforcement Agencies in case of personal use offence. Analytical procedures consisted in targeted and untargeted analyses by gas chromatography-flame ionization detector, gas chromatography-mass spectrometry and liquid chromatography-tandem mass spectrometry. The most detected substances were: cannabis (78.0%; resin: 51.7%; herb: 26.3%), cocaine (10.4%), opiates (6.6%; heroin: 6.5%; morphine: 0.1%), ketamine (1.4%), amphetamines (1.3%; 3,4-methylenedioxymethamphetamine - MDMA -: 0.7%; methamphetamine: 0.6%; amphetamine: market, while THC content in cannabis seizures was unexpectedly below the European mean values. Starting from 2015, a total of 5 new psychoactive substances (NPS) were detected in seized material, mainly composed of white powders (pentedrone, 3-methylmethcathinone, 4-fluoroamphetamine, methoxethamine and AB-FUBINACA). Most of the seizures (75.5%) were from young male adults (14-34 years old). These data contribute to highlight new trends in the illicit drug market in the Tuscany area, but also to verify the persistence of old habits of drug consumption, confirming the need for more effective counteraction and prevention plans, especially among young people, where the diffusion of the legal highs is worrisome, also in consideration of the young age and the unconsciousness of the possible health effects. Copyright © 2018 Elsevier B.V. All rights reserved.

"Injection first": a unique group of injection drug users in Tijuana, Mexico.

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Morris, Meghan D; Brouwer, Kimberly C; Lozada, Remedios M; Gallardo, Manuel; Vera, Alicia; Strathdee, Steffanie A

2012-01-01

Using baseline data from a study of injection drug users (IDUs) in Tijuana, Mexico (N = 1,052), we identified social and behavioral factors associated with injecting at the same age or earlier than other administration routes of illicit drug use (eg, "injection first") and examined whether this IDU subgroup had riskier drug using and sexual behaviors than other IDUs. Twelve-percent "injected first." Characteristics independently associated with a higher odds of "injection first" included being younger at first injection, injecting heroin as their first drug, being alone at the first injection episode, and having a sexual debut at the same age or earlier as when they initiated drug use; family members' illicit drug use was associated with lower odds of injecting first. When adjusting for age at first injection and number of years injecting, "injection first" IDUs had lower odds of ever overdosing, and ever trading sex. On the other hand, they were less likely to have ever been enrolled in drug treatment, and more commonly obtained their syringes from potentially unsafe sources. In conclusion, a sizable proportion of IDUs in Tijuana injected as their first drug using experience, although evidence that this was a riskier subgroup of IDUs was inconclusive.  Copyright © American Academy of Addiction Psychiatry.

Predominance of alcohol and illicit drugs among traffic accidents fatalities in an urban area of Brazil.

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Pelição, Fabrício Souza; Peres, Mariana Dadalto; Pissinate, Jauber Fornaciari; de Paula, Daniela Mendes Louzada; de Faria, Maria das Graças Corrêa; Nakamura-Palacios, Ester Miyuki; De Martinis, Bruno Spinosa

2016-10-02

The objective of this study was to determine the prevalence of alcohol and illicit drug use among victims of fatal traffic accidents in the Metropolitan Region of Vitória, Brazil, during the period 2011-2012. Blood samples were collected and analyzed for the presence of drugs from 391 deceased victims of traffic crashes that occurred in the Metropolitan Region of Vitória, Brazil. The victims included drivers, passengers, and pedestrians. Sociodemographic variables such as age, gender, day of the week, and period of the year in which the accidents occurred were recorded. The analyses were performed by a gas chromatography-flame ionization method for alcohol and by a gas chromatography-mass spectrometry for amphetamines, cocaine, and cannabis. The results showed that 44.8% (n = 175) of all cases were positive for alcohol and/or illicit drugs. The detection of alcohol and/or drugs was more frequent in young males, aged 17 to 34, whose samples were positive in 46.8% of cases. Small differences among drivers, passengers, and pedestrians were observed (drivers = 45.9%, passengers = 46.4%, and pedestrians = 45.6%). In general, the most prevalent drug was alcohol, with 141 positive cases (36.1%), followed by cocaine, with 47 positive cases (12%). Amphetamines and cannabis had positivity rates of 4.1 and 4.3%, with 16 and 17 positive cases, respectively. The combined use of alcohol and other drugs was found in 36 cases (9.2%). Crack cocaine use was observed in 27.7% of the positive cases for cocaine. For the effective reduction of traffic accidents related to driving under influence of drugs (DUID), we suggest the intensification of enforcement actions against the use of alcohol by drivers, the definition of which illicit drugs should be surveyed, as well the cutoff values, the promotion of changing legislation to oblige drivers to provide samples for toxicological testing, and the establishment of public information programs and specific actions aimed at young drivers to

Methadone-Related Overdose Deaths in a Liberal Opioid Maintenance Treatment Programme

DEFF Research Database (Denmark)

Tjagvad, C.; Skurtveit, Svetlana; Linnet, K.

2016-01-01

methadone-related overdose deaths in a liberal OMT programme. Methods: Drug-overdose deaths (n = 130) with detection of methadone in Copenhagen, Aarhus, and Odense Municipality, Denmark, during the period 2008-2011 were identified from a registry. Cases with and without prescribed methadone as OMT were...

Epidemiology of overdose episodes from the period prior to hospitalization for drug poisoning until discharge in Japan: An exploratory descriptive study using a nationwide claims database.

Science.gov (United States)

Okumura, Yasuyuki; Sakata, Nobuo; Takahashi, Kunihiko; Nishi, Daisuke; Tachimori, Hisateru

2017-08-01

Little is known about the nationwide epidemiology of the annual rate, causative substance, and clinical course of overdose-related admission. We aimed to describe the epidemiology of overdose episodes from the period prior to hospitalization for drug poisoning until discharge to home. We assessed all cases of admission due to overdose (21,663 episodes) in Japan from October 2012 through September 2013 using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. The annual rate of overdose admission was 17.0 per 100,000 population. Women exhibited two peaks in admission rates at 19-34 years (40.9 per 100,000) and ≥75 years (27.8 per 100,000). Men exhibited one peak in the admission rate at ≥75 years (23.7 per 100,000). Within 90 days prior to overdose, ≥60% and ≥9% of patients aged 19-49 years received a prescription for benzodiazepines and barbiturates, respectively. In addition, 59% of patients aged ≥75 years received a prescription for benzodiazepines prior to overdose, 47% had a history of congestive heart failure, and 24% had a diagnosis of poisoning by cardiovascular drugs. The proportion of patients with recent psychiatric treatments decreased with age (65.1% in those aged 35-49 years and 13.9% in those aged ≥75 years). The findings emphasize the need for overdose prevention programs that focus on psychiatric patients aged 19-49 years who are prescribed benzodiazepines or barbiturates and on non-psychiatric patients aged ≥75 years who are prescribed benzodiazepines or digitalis. Copyright © 2017 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

Successful use of haemodialysis to treat phenobarbital overdose.

Science.gov (United States)

Hoyland, Kimberley; Hoy, Michael; Austin, Richard; Wildman, Martyn

2013-11-21

A 50-year-old woman presented with coma caused by a phenobarbital overdose, requiring intubation and admission to critical care. She was an international visitor and had been prescribed the drug for night-sedation. Phenobarbital is a long-acting barbiturate, which in an overdose can cause central nervous system depression, respiratory failure and haemodynamic instability; these patients can remain obtunded for many days. After initial supportive therapy, she was dialysed to help in the elimination of the drug. Haemodialysis resulted in a markedly reduced plasma level of phenobarbital, which decreased the length of intubation and stay in the critical care unit and aided full recovery.

‘If Ya Wanna End War and Stuff, You Gotta Sing Loud’—A Survey of the Provisional Agreement between FARC and Colombia on Illicit Drugs

Directory of Open Access Journals (Sweden)

Francesco Seatzu

2016-01-01

Full Text Available Although still neglected in legal writings, the 2014 agreement on illicit drugs between the FARC and the Colombian Government deserves attention for a number of reasons, including that it was conceived as an essential part of the broader strategy for peace in Colombia, as well as because of its aim of eradicating illicit crops. Starting with some remarks on the Colombian ‘drug war’ and the policy and legal arguments for classifying the Colombian armed conflict as a non-international armed conflict (NIAC, the paper will then proceed with an analysis of the main reasons behind the drafting of a partial agreement on illicit drugs between the FARC and Colombia in 2014. Next, the paper will address the relevant sections and enforcement mechanisms for putting the provisions of the agreement into effect. An assessment of how the 2014 agreement has addressed the issue of drug trafficking and the issues concerning drug related crimes will also be considered. The paper will conclude with the lessons to be drawn from the new Agreement on illicit drugs.

Transactional Sex among Noninjecting Illicit Drug Users: Implications for HIV Transmission.

Science.gov (United States)

Guimarães, Rafael Alves; Rodovalho, Aurélio Goulart; Fernandes, Inaina Lara; Silva, Graciele Cristina; de Felipe, Rodrigo Lopes; Vera, Ivânia; Gregório, Valéria Duarte; Lucchese, Roselma

2016-01-01

Noninjecting illicit drug users (NIDUs) present high risk for HIV infection, due especially to transactional sex. This study aimed to estimate the prevalence and risk factors for transactional sex among NIDUs in the Southwest region of Goiás State, Central Brazil. The prevalence of self-reported transactional sex was 22.8%. Prevalence in women and men was 52.7% and 16.8%, respectively, a significant difference (p drugs, and history of sexual violence were risk factors for transactional sex in women. A high prevalence of transactional sex was observed among NIDUs. This risk behavior may contribute to the high rates of HIV among this population and their social networks and in the general population.

A Mixture-Model Approach to Linking ADHD to Adolescent Onset of Illicit Drug Use

Science.gov (United States)

Malone, Patrick S.; Van Eck, Kathryn; Flory, Kate; Lamis, Dorian A.

2010-01-01

Prior research findings have been mixed as to whether attention-deficit/hyperactivity disorder (ADHD) is related to illicit drug use independent of conduct problems (CP). With the current study, the authors add to this literature by investigating the association between trajectories of ADHD symptoms across childhood and adolescence and onset of…

Illicit drugs, testing, prevention and work in France: ethical and legal issues.

Science.gov (United States)

Fantoni-Quinton, Sophie; Bossu, Bernard; Morgenroth, Thomas; Frimat, Paul

2010-09-01

The use of illicit drugs in the workplace raises issues pertaining to prevention and safety and the responsibility of the various members of staff. It also brings into question the interface between work and private life. If employees are in theory responsible for their own safety and risk heavy penalties in the event of the consumption of illicit drugs in the workplace, such behaviour has to be proved. In reality, the worker can only be partially and marginally held liable, given the fact that the employer is prohibited from infringing on their rights and liberties (restrictions on the searching of their personal belongings and lockers as well as on the carrying out of breath testing and saliva testing under restrictive conditions). Employers have for their part a broader range of responsibilities and, above all, an absolute obligation to achieve specific goals in terms of health and safety resulting in the need to take action. In accordance with the International Labour Organization recommendations, European and national legislation, the employer has to implement a suitable preventive policy. However, where is the balance between prevention and repression? Very few studies have raised these issues and our aim is to precisely situate the place of drug testing in the employer's repressive arsenal in France and to try to answer the legal and ethical issues raised. Thus, for example, repression can only be acceptable when it deals with moderate and non-addicted users, or it could be tantamount to discrimination.

Transformation and sorption of illicit drug biomarkers in sewer systems: understanding the role of suspended solids in raw wastewater

DEFF Research Database (Denmark)

Ramin, Pedram; Brock, Andreas Libonati; Polesel, Fabio

2016-01-01

substrates (primary metabolic processes) and transformation of illicit drug biomarkers (secondary metabolic processes) by suspended biomass. Sixteen drug biomarkers were targeted, including mephedrone, methadone, cocaine, heroin, codeine and tetrahydrocannabinol (THC) and their major human metabolites. Batch...

Externalizing behaviors and cigarette smoking as predictors for use of illicit drugs: a longitudinal study among Finnish adolescent twins

NARCIS (Netherlands)

Korhonen, T.; Levälahti, E.; Dick, D.M.; Pulkkinen, L.; Rose, R.J.; Kaprio, J.; Huizink, A.C.

2010-01-01

We examined whether externalizing problem behaviors (hyperactivity-impulsivity, aggressiveness, and inattention) predict illicit drug use independently, or whether their associations with drug use are mediated through cigarette smoking. We used a prospective longitudinal design within the

Externalizing Behaviors and Cigarette Smoking as Predictors for Use of Illicit Drugs: A Longitudinal Study Among Finnish Adolescent Twins

NARCIS (Netherlands)

Korhonen, T.; Levälahti, E.; Dick, D.M.; Pulkkinen, L.; Rose, R.J.; Kaprio, J.; Huizink, A.C.

2010-01-01

We examined whether externalizing problem behaviors (hyperactivity-impulsivity, aggressiveness, and inattention) predict illicit drug use independently, or whether their associations with drug use are mediated through cigarette smoking. We used a prospective longitudinal design within the

Transactional Sex among Noninjecting Illicit Drug Users: Implications for HIV Transmission

OpenAIRE

Guimar?es, Rafael Alves; Rodovalho, Aur?lio Goulart; Fernandes, Inaina Lara; Silva, Graciele Cristina; de Felipe, Rodrigo Lopes; Vera, Iv?nia; Greg?rio, Val?ria Duarte; Lucchese, Roselma

2016-01-01

Noninjecting illicit drug users (NIDUs) present high risk for HIV infection, due especially to transactional sex. This study aimed to estimate the prevalence and risk factors for transactional sex among NIDUs in the Southwest region of Goi?s State, Central Brazil. The prevalence of self-reported transactional sex was 22.8%. Prevalence in women and men was 52.7% and 16.8%, respectively, a significant difference (p < 0.001). Crack use and history of sexually transmitted infections (STI) were ri...

Estimation of illicit drug use in the main cities of Colombia by means of urban wastewater analysis

Energy Technology Data Exchange (ETDEWEB)

Bijlsma, Lubertus; Botero-Coy, Ana M. [Research Institute for Pesticides and Water (IUPA), University Jaume I, Castellón (Spain); Rincón, Rolando J. [Chemistry Department, Faculty of Sciences, University Antonio Nariño (Colombia); Peñuela, Gustavo A. [Grupo GDCON, Facultad de Ingeniería, Universidad de Antioquia, 70 # 52-21, Medellin (Colombia); Hernández, Félix, E-mail: felix.hernandez@uji.es [Research Institute for Pesticides and Water (IUPA), University Jaume I, Castellón (Spain)

2016-09-15

Wastewater-based epidemiology (WBE) relies on the principle that traces of compounds, which a population is exposed to or consume, are excreted unchanged or as metabolites in urine and/or feces, and ultimately end up in the sewer network. Measuring target metabolic residues i.e. biomarkers in raw urban wastewater allows identifying the exposure or use of substances of interest in a community. Up to date, the most popular application of WBE is the estimation of illicit drug use and studies have been made mainly across Europe, which has allowed estimating and comparing drug use in many European cities. However, until now a comprehensive study applying WBE on the most frequently consumed illicit drugs has not been performed in South American countries. In this work, we applied this approach to samples from Colombia, selecting two of the most populated cities: Bogotá and Medellin. Several biomarkers were selected to estimate drug use of cocaine, cannabis, amphetamine, methamphetamine, MDMA (ecstasy), heroin and ketamine. Composite samples (24-h) were collected at the corresponding municipal wastewater treatment plants. Sample treatment was performed at location by applying solid-phase extraction (SPE). Before SPE, the samples were spiked with appropriate isotope labeled internal standards. In parallel, samples (spiked with the analytes under study at two concentration levels) were also processed for quality control. Analysis of influent wastewater was made by liquid chromatography-tandem mass spectrometry, with triple quadrupole analyzer. Data shown in this paper reveal a high use of cocaine by the population of the selected Colombian cities, particularly from Medellin, while the use of other illicit drugs were low. The relevance of using quality control samples, particularly in collaborative studies, as those presented in this work, where research groups from different countries participate and where the samples had to be shipped overseas, is highlighted in this

Estimation of illicit drug use in the main cities of Colombia by means of urban wastewater analysis

International Nuclear Information System (INIS)

Bijlsma, Lubertus; Botero-Coy, Ana M.; Rincón, Rolando J.; Peñuela, Gustavo A.; Hernández, Félix

2016-01-01

Wastewater-based epidemiology (WBE) relies on the principle that traces of compounds, which a population is exposed to or consume, are excreted unchanged or as metabolites in urine and/or feces, and ultimately end up in the sewer network. Measuring target metabolic residues i.e. biomarkers in raw urban wastewater allows identifying the exposure or use of substances of interest in a community. Up to date, the most popular application of WBE is the estimation of illicit drug use and studies have been made mainly across Europe, which has allowed estimating and comparing drug use in many European cities. However, until now a comprehensive study applying WBE on the most frequently consumed illicit drugs has not been performed in South American countries. In this work, we applied this approach to samples from Colombia, selecting two of the most populated cities: Bogotá and Medellin. Several biomarkers were selected to estimate drug use of cocaine, cannabis, amphetamine, methamphetamine, MDMA (ecstasy), heroin and ketamine. Composite samples (24-h) were collected at the corresponding municipal wastewater treatment plants. Sample treatment was performed at location by applying solid-phase extraction (SPE). Before SPE, the samples were spiked with appropriate isotope labeled internal standards. In parallel, samples (spiked with the analytes under study at two concentration levels) were also processed for quality control. Analysis of influent wastewater was made by liquid chromatography-tandem mass spectrometry, with triple quadrupole analyzer. Data shown in this paper reveal a high use of cocaine by the population of the selected Colombian cities, particularly from Medellin, while the use of other illicit drugs were low. The relevance of using quality control samples, particularly in collaborative studies, as those presented in this work, where research groups from different countries participate and where the samples had to be shipped overseas, is highlighted in this

Self-identification of nonpharmaceutical fentanyl exposure following heroin overdose.

Science.gov (United States)

Griswold, Matthew K; Chai, Peter R; Krotulski, Alex J; Friscia, Melissa; Chapman, Brittany; Boyer, Edward W; Logan, Barry K; Babu, Kavita M

2018-01-01

To compare user self-identification of nonpharmaceutical fentanyl exposure with confirmatory urine drug testing in emergency department (ED) patients presenting after heroin overdose. This was a cross-sectional study of adult ED patients who presented after a heroin overdose requiring naloxone administration. Participants provided verbal consent after which they were asked a series of questions regarding their knowledge, attitudes and beliefs toward heroin and nonpharmaceutical fentanyl. Participants also provided urine samples, which were analyzed using liquid chromatography coupled to quadrupole time-of-flight mass spectrometry to identify the presence of fentanyl, heroin metabolites, other clandestine opioids, common pharmaceuticals and drugs of abuse. Thirty participants were enrolled in the study period. Ten participants (33%) had never required naloxone for an overdose in the past, 20 participants (67%) reported recent abstinence, and 12 participants (40%) reported concomitant cocaine use. Naloxone was detected in all urine drug screens. Heroin or its metabolites were detected in almost all samples (93.3%), as were fentanyl (96.7%) and its metabolite, norfentanyl (93.3%). Acetylfentanyl was identified in nine samples (30%) while U-47700 was present in two samples (6.7%). Sixteen participants self-identified fentanyl in their heroin (sensitivity 55%); participants were inconsistent in their qualitative ability to identify fentanyl in heroin. Heroin users presenting to the ED after heroin overdose requiring naloxone are unable to accurately identify the presence of nonpharmaceutical fentanyl in heroin. Additionally, cutting edge drug testing methodologies identified fentanyl exposures in 96.7% of our patients, as well as unexpected clandestine opioids (like acetylfentanyl and U-47700).

Drug-Induced QT Prolongation as a Result of an Escitalopram Overdose in a Patient with Previously Undiagnosed Congenital Long QT Syndrome

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Paul Singh

2014-01-01

Full Text Available We present a case of drug-induced QT prolongation caused by an escitalopram overdose in a patient with previously undiagnosed congenital LQTS. A 15-year-old Caucasian female presented following a suicide attempt via an escitalopram overdose. The patient was found to have a prolonged QT interval with episodes of torsades de pointes. The patient was admitted to the telemetry unit and treated. Despite the resolution of the torsades de pointes, she continued to demonstrate a persistently prolonged QT interval. She was seen by the cardiology service and diagnosed with congenital long QT syndrome. This case illustrates the potential for an escitalopram overdose to cause an acute QT prolongation in a patient with congenital LQTS and suggests the importance of a screening electrocardiogram prior to the initiation of SSRIs, especially in patients at high risk for QT prolongation.

The Going Out In Sydney App: Evaluating the Utility of a Smartphone App for Monitoring Real-World Illicit Drug Use and Police Encounters Among Festival and Club Goers

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Caitlin Elizabeth Hughes

2017-06-01

Full Text Available Gaining accurate information on illicit drug use and policing in real-world settings is a challenge. This study examines the utility of a smartphone app (‘Going Out In Sydney’ to prospectively follow up illicit drug use and policing encounters at music festivals and licensed entertainment precincts in Sydney, Australia. In all, 38 regular festival and licensed entertainment venue attendees used the app to log nights out over a 3-month period, including (1 where they went (eg, festival, nightclub, (2 the prevalence of illicit drug use, and (3 the incidence and nature of police encounters. A survey and interview were then conducted about the utility of the app. The app enabled rich data collection (n = 353 entries about illicit drug use and policing at both target settings. Follow-up surveys indicated that most participants were extremely satisfied with the ease of use of the app and privacy afforded, and compared with other data collection modes, such as paper-based logs and online surveys, rated the app the most desirable method of data collection. This suggests smartphone apps may be a viable option for future studies on illicit drug use and policing of drugs.

Enantiomeric profiling of chiral illicit drugs in a pan-European study

DEFF Research Database (Denmark)

Castrignanò, Erika; Yang, Zhugen; Bade, Richard

2018-01-01

The aim of this paper is to present the first study on spatial and temporal variation in the enantiomeric profile of chiral drugs in eight European cities. Wastewater-based epidemiology (WBE) and enantioselective analysis were combined to evaluate trends in illicit drug use in the context....... High loads of racemic methamphetamine were detected in Oslo (EF = 0.49 ± 0.02). This is in contrast to other European cities where S-(+)-methamphetamine was the predominant enantiomer. This indicates different methods of methamphetamine synthesis and/or trafficking routes in Oslo, compared...... with the other cities tested. An enrichment of MDMA with the R-(−)-enantiomer was observed in European wastewaters indicating MDMA consumption rather than disposal of unused drug. MDA's chiral signature indicated its enrichment with the S-(+)-enantiomer, which confirms its origin from MDMA metabolism in humans...

Trends in the use of illicit substances in Thailand: Results from national household surveys.

Science.gov (United States)

Angkurawaranon, Chaisiri; Jiraporncharoen, Wichuda; Likhitsathian, Surinporn; Thaikla, Kanittha; Kanato, Manop; Perngparn, Usaneya; Assanangkornchai, Sawitri; Aramrattana, Apinun

2018-02-27

Thailand borders some of the world's largest methamphetamine and opioid producing countries and trafficking routes. Thailand's 'War on Drugs' campaign was launched in 2003. This study reports trends in illicit substance use in Thailand over the period 2001-2011. National Household surveys on illicit drug use were conducted in 2001, 2003, 2007, 2008 and 2011. A stratified multi-stage cluster random sampling technique was implemented for each survey. Provinces in four regions were systematically selected using a probability proportionate to the size of the targeted population. Participants were interviewed using structured questionnaires on their history of substance use. The prevalence of illicit drug use within the past drastically decreased from 4.5% in 2001 to 1.0% in 2003 (P survey. Other types of illicit drugs were less commonly used in Thailand. There was a decrease in prevalence of illicit drug use within the past year between 2001 and 2003 in Thailand. Since 2003, the past year prelavence of illicit drug use has remained relatively stable. From 2001 to 2011, cannabis, kratom and yaba have remained the three most commonly reported types of illicit drugs used in Thailand. © 2018 Australasian Professional Society on Alcohol and other Drugs.

Is cannabis an illicit drug or a medicine? A quantitative framing analysis of Israeli newspaper coverage.

Science.gov (United States)

Sznitman, Sharon R; Lewis, Nehama

2015-05-01

Various countries and states, including Israel, have recently legalized cannabis for therapeutic purposes (CTP). These changes have received mass media coverage and prompted national and international dialogue about the status of cannabis and whether or not it can be defined as a (legitimate) medicine, illicit and harmful drug, or both. News media framing may influence, and be influenced by, public opinion regarding CTP and support for CTP license provisions for patients. This study examines the framing of CTP in Israeli media coverage and the association between media coverage and trends in the provision of CTP licenses in Israel over time. All published news articles relevant to CTP and the framing of cannabis (N=214) from the three highest circulation newspapers in Israel were content analyzed. Articles were published between January 2007 and June 2013, a period in which CTP licenses granted by the Ministry of Health increased substantially. In the majority of CTP news articles (69%), cannabis was framed as a medicine, although in almost one third of articles (31%) cannabis was framed as an illicit drug. The relative proportion of news items in which cannabis was framed as an illicit drug fluctuated during the study period, but was unrelated to linear or curvilinear trends in CTP licensing. The relatively large proportion of news items framing cannabis as a medicine is consistent with growing support for the expansion of the Israel's CTP program. Copyright © 2015 Elsevier B.V. All rights reserved.

The prison system in the Czech Republic: Analysis of the current state of illicit drug use and prevention and treatment measures

Czech Academy of Sciences Publication Activity Database

Miovský, Michal; Gajdošíková, H.

2005-01-01

Roč. 16, č. 4 (2005), s. 262-266 ISSN 0955-3959 Institutional research plan: CEZ:AV0Z70250504 Keywords : Criminal offences * drug crime * illicit drugs * drug user * prevetntion and treatment measures Subject RIV: AN - Psychology

Searching for truth: internet search patterns as a method of investigating online responses to a Russian illicit drug policy debate.

Science.gov (United States)

Zheluk, Andrey; Gillespie, James A; Quinn, Casey

2012-12-13

This is a methodological study investigating the online responses to a national debate over an important health and social problem in Russia. Russia is the largest Internet market in Europe, exceeding Germany in the absolute number of users. However, Russia is unusual in that the main search provider is not Google, but Yandex. This study had two main objectives. First, to validate Yandex search patterns against those provided by Google, and second, to test this method's adequacy for investigating online interest in a 2010 national debate over Russian illicit drug policy. We hoped to learn what search patterns and specific search terms could reveal about the relative importance and geographic distribution of interest in this debate. A national drug debate, centering on the anti-drug campaigner Egor Bychkov, was one of the main Russian domestic news events of 2010. Public interest in this episode was accompanied by increased Internet search. First, we measured the search patterns for 13 search terms related to the Bychkov episode and concurrent domestic events by extracting data from Google Insights for Search (GIFS) and Yandex WordStat (YaW). We conducted Spearman Rank Correlation of GIFS and YaW search data series. Second, we coded all 420 primary posts from Bychkov's personal blog between March 2010 and March 2012 to identify the main themes. Third, we compared GIFS and Yandex policies concerning the public release of search volume data. Finally, we established the relationship between salient drug issues and the Bychkov episode. We found a consistent pattern of strong to moderate positive correlations between Google and Yandex for the terms "Egor Bychkov" (r(s) = 0.88, P < .001), "Bychkov" (r(s) = .78, P < .001) and "Khimki"(r(s) = 0.92, P < .001). Peak search volumes for the Bychkov episode were comparable to other prominent domestic political events during 2010. Monthly search counts were 146,689 for "Bychkov" and 48,084 for "Egor Bychkov", compared to 53

Adolescent Perceptions of Body Weight and Attractiveness: Important Issues in Alcohol and Illicit Drug Use?

Science.gov (United States)

Page, Randy M.; And Others

1995-01-01

Examined relationship between adolescent self-perception of body weight and physical attractiveness and the use of alcohol and drugs in high school students (n=1,915). In general, adolescents dissatisfied with their appearance used illicit substances and got drunk more often than those satisfied with their appearance. (SNR)

Stress Process of Illicit Drug Use among U.S. Immigrants' Adolescent Children: A Longitudinal Study

Science.gov (United States)

Choo, Hyekyung

2012-01-01

This study examined a full path model of stress process for predicting illicit drug use among Asian and Latino immigrants' adolescent children. Using 2-year longitudinal data (National Longitudinal Study of Adolescent Health) from a sample of adolescents with Asian or Latino immigrant parents (N = 2,353), the study explored structural…

A critical examination of the introduction of drug detection dogs for policing of illicit drugs in New South Wales, Australia using Kingdon’s ‘multiple streams’ heuristic

NARCIS (Netherlands)

Lancaster, Kari; Ritter, Alison; Hughes, Caitlin; Hoppe, Robertus

2017-01-01

This paper critically analyses the introduction of drug detection dogs as a tool for policing of illicit drugs in New South Wales, Australia. Using Kingdon’s ‘multiple streams’ heuristic as a lens for analysis, we identify how the issue of drugs policing became prominent on the policy agenda, and

Safe and unsafe spaces: Non-fatal overdose, arrest, and receptive syringe sharing among people who inject drugs in public and semi-public spaces in Baltimore City.

Science.gov (United States)

Hunter, Kyle; Park, Ju Nyeong; Allen, Sean T; Chaulk, Patrick; Frost, Taeko; Weir, Brian W; Sherman, Susan G

2018-04-13

The spaces in which drug use occurs constitutes a key aspect of the "risk environment" of people who inject drugs (PWID). We aimed to add nuance to the characterization of "safe" and "unsafe" spaces in PWID's environments to further understand how these spaces amplify the risk of morbidities associated with injection drug use. PWID were recruited through the Baltimore City syringe service program and through peer referral. Participants completed a socio-behavioral survey. Multivariable logistic regression was used to identify associations between utilization of public, semi-public and private spaces with arrest, non-fatal overdose, and receptive syringe sharing. The sample of PWID (N = 283) was mostly 45 years and older (54%), male (69%), Black (55%), and heroin users (96%). Compared to PWID who primarily used private settings, the adjusted odds of recent overdose were greater among PWID who mostly used semi-public and public locations to inject drugs. We also found independent associations between arrest and semi-public spaces, and between receptive syringe sharing and public spaces (all p spaces where PWID can reduce their risk of overdose, likelihood of arrest and blood-borne diseases, and the dual potential of the environment in promoting health and risk. Copyright © 2018 Elsevier B.V. All rights reserved.

Illicit Drug Analysis Using Two-Dimension Liquid Chromatography/Tandem Mass Spectrometry.

Science.gov (United States)

Mallet, Claude; Botch-Jones, Sabra

2016-10-01

For the identification of illicit drugs in forensic toxicological casework, analysis can be delayed and potentially compromised due to lengthy sample preparation techniques. For a complete forensic identification, a robust methodology is required and the current trend in forensic laboratories is the use of liquid chromatography coupled to mass spectrometry (LC/MS or LC/MS-MS). However, to achieve satisfactory results, extensive and time-consuming sample preparation protocols are required to reach sub-ng/mL levels. The concept of sequential 2D extraction was designed to capture the retention behavior of a target analyte in response to various extraction parameters. Therefore, optimized conditions can be selected to excise a region of interest during extraction. The utilization of multi-dimensional chromatography combined with a micro-extraction technique was evaluated to decrease sample preparation time while enhancing the separation integrity observed with current single-dimensional chromatography techniques. A wide range of illicit drugs were spiked in human urine and extracted using three extraction protocols for performance evaluation. The extraction process was performed using a reversed-phase solid phase extraction (SPE) in 1D, 2D-optimized, 2D-sequential and cumulative elution modes. The chosen 2D chromatography conditions that were used in this application were identified using a 6 × 6 automated methods development protocol (144 methods total). The extraction of urine samples containing target analytes was completed in less than 20 min. The analysis was performed using 200 µL of the final organic solvent (MeOH) extracts. The limit of detection for all drugs was measured at 100 pg/mL (ppt) from a 1 mL sample volume. Several analytes showed excellent signal at 10 pg/mL (ppt). © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Test Sample for the Spatially Resolved Quantification of Illicit Drugs on Fingerprints Using Imaging Mass Spectrometry

NARCIS (Netherlands)

Muramoto, S.; Forbes, T.P.; van Asten, A.C.; Gillen, G.

2015-01-01

A novel test sample for the spatially resolved quantification of illicit drugs on the surface of a fingerprint using time-of-flight secondary ion mass spectrometry (ToF-SIMS) and desorption electrospray ionization mass spectrometry (DESI-MS) was demonstrated. Calibration curves relating the signal

Liver transplant associated with paracetamol overdose: Results from the seven-country SALT study

NARCIS (Netherlands)

S.E. Gulmez (Sinem Ezgi); D. Larrey (Dominique); G.P. Pageaux; J. Bernuau (Jacques); F. Bissoli (Franco); Y. Horsmans (Yves); D. Thorburn (Douglas); P.A. McCormick (P. Aiden); B.H.Ch. Stricker (Bruno); M. Toussi (Massoud); S. Lignot-Maleyran (Séverine); S. Micon (Sophie); F. Hamoud (Fatima); R. Lassalle (Régis); J. Jové (Jérémy); P. Blin (Patrick); N. Moore (Nicholas)

2015-01-01

textabstractAims Acute drug overdose, especially with paracetamol, may cause acute liver failure leading to registration for transplantation (ALFT). Population statistics and between-country differences for ALFT related to overdose have been poorly described. The aim of the present study was to

A Critical Examination of the Introduction of Drug Detection Dogs for Policing of Illicit Drugs in New South Wales, Australia Using Kingdon's "Multiple Streams" Heuristic

Science.gov (United States)

Lancaster, Kari; Ritter, Alison; Hughes, Caitlin; Hoppe, Robert

2017-01-01

This paper critically analyses the introduction of drug detection dogs as a tool for policing of illicit drugs in New South Wales, Australia. Using Kingdon's "multiple streams" heuristic as a lens for analysis, we identify how the issue of drugs policing became prominent on the policy agenda, and the conditions under which the…

Posturografia estática em dependentes de drogas ilícitas e álcool Static posturography in addicted to illicit drugs and alcohol

Directory of Open Access Journals (Sweden)

Daniela Affonso Moreira

2012-10-01

Full Text Available O uso de drogas ilícitas e álcool pode afetar o equilíbrio corporal. OBJETIVO: Avaliar o equilíbrio corporal à posturografia estática em dependentes de drogas ilícitas, com ou sem abuso de álcool. Desenho de Estudo: Caso controle prospectivo. MÉTODOS: Quarenta e sete usuários de drogas ilícitas, com ou sem abuso de álcool e um grupo controle homogêneo constituído de 47 indivíduos hígidos foram submetidos a uma avaliação otoneurológica, incluindo a posturografia do Balance Rehabilitation Unit. RESULTADOS: A média dos valores da área do limite de estabilidade foi significantemente menor (p The use of illicit drugs and alcohol can affect body balance. AIM: To evaluate balance control with static posturography in individuals addicted to illicit drugs, with or without alcohol abuse. Study design: Case-control, prospective. METHODS: 47 users of illicit drugs, with or without alcohol abuse, and a homogeneous control group consisting of 47 healthy individuals were submitted to a neurotological evaluation including Balance Rehabilitation Unit posturography. RESULTS: The stability threshold mean values were significantly lower (p < 0.0001 in users of illicit drugs, with or without alcohol abuse when compared to the control group; the mean values for sway velocity and ellipse area in all evaluated conditions were significantly higher (p <0.05 in the experimental group when compared to the control group, except for the ellipse area in static force surface and opened eyes (p = 0.168. CONCLUSION: The balance control of individuals addicted to illicit drugs with or without alcohol abuse could present stability threshold, sway velocity and ellipse area abnormalities in static posturography.

Self-reported cannabis products and other illicit drugs consumption in older school-age children in Northern Lithuania: a comparison between 2006 and 2012.

Science.gov (United States)

Miniauskienė, Dalia; Jurgaitienė, Dalia; Strukčinskienė, Birutė

2014-01-01

Cannabis use is widespread among young people in Europe. The aim of this study was to analyze and to compare the associations between the self-reported consumption of cannabis products and other illicit drugs among older schoolchildren in 2006 and in 2012. Two cross-sectional surveys were conducted in 2006 and 2012 in Northern Lithuania. In total 3447 young people aged 17-19 years were investigated (1585 male and 1862 female). For this survey, the ESPAD questionnaire was used. In Northern Lithuania, the schoolchildren aged 17-19 years self-reported that 16.7% in 2006 and 23.9% in 2012 of them tried cannabis products. The consumption of cannabis products in the age group of 17 years increased from 14.9% in 2006 to 21.5% in 2012. The consumption of cannabis together with alcohol increased from 7.6% to 14.3%. Cannabis consumers more often tried amphetamines, heroin, LSD, cocaine, crack, ecstasy, hallucinogenic mushrooms, and injective drugs. In 2012, cannabis consumers girls less than boys used only crack and injective drugs; all other illicit drugs they used the same often as boys. The cannabis products consumption in schoolchildren has increased by 7%. Nearly twofold increase was observed in the consumption of cannabis together with alcohol. Young people who used cannabis products more often tried other illicit drugs. There were no differences by gender in the consumption of illicit drugs among cannabis consumers. Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

Searching for Truth: Internet Search Patterns as a Method of Investigating Online Responses to a Russian Illicit Drug Policy Debate

Science.gov (United States)

Gillespie, James A; Quinn, Casey

2012-01-01

Background This is a methodological study investigating the online responses to a national debate over an important health and social problem in Russia. Russia is the largest Internet market in Europe, exceeding Germany in the absolute number of users. However, Russia is unusual in that the main search provider is not Google, but Yandex. Objective This study had two main objectives. First, to validate Yandex search patterns against those provided by Google, and second, to test this method's adequacy for investigating online interest in a 2010 national debate over Russian illicit drug policy. We hoped to learn what search patterns and specific search terms could reveal about the relative importance and geographic distribution of interest in this debate. Methods A national drug debate, centering on the anti-drug campaigner Egor Bychkov, was one of the main Russian domestic news events of 2010. Public interest in this episode was accompanied by increased Internet search. First, we measured the search patterns for 13 search terms related to the Bychkov episode and concurrent domestic events by extracting data from Google Insights for Search (GIFS) and Yandex WordStat (YaW). We conducted Spearman Rank Correlation of GIFS and YaW search data series. Second, we coded all 420 primary posts from Bychkov's personal blog between March 2010 and March 2012 to identify the main themes. Third, we compared GIFS and Yandex policies concerning the public release of search volume data. Finally, we established the relationship between salient drug issues and the Bychkov episode. Results We found a consistent pattern of strong to moderate positive correlations between Google and Yandex for the terms "Egor Bychkov" (r s = 0.88, P < .001), “Bychkov” (r s = .78, P < .001) and “Khimki”(r s = 0.92, P < .001). Peak search volumes for the Bychkov episode were comparable to other prominent domestic political events during 2010. Monthly search counts were 146,689 for “Bychkov” and

Motivation deficits and use of alcohol and illicit drugs among individuals with schizophrenia.

Science.gov (United States)

Bahorik, Amber L; Greeno, Catherine G; Cochran, Gerald; Cornelius, Jack R; Eack, Shaun M

2017-07-01

This study examined the impact of substance use on intrinsic motivation and evaluated the association between intrinsic motivation and substance use recovery among individuals with schizophrenia. Alcohol and illicit drug use and intrinsic motivation were evaluated at baseline and 6-months for 1434 individuals with schizophrenia from the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) using self-rated substance use assessments and a derived motivation measure from the Heinrichs-Carpenter Quality of Life Scale. Results revealed patients had moderate motivation deficits overall and a considerable number were using alcohol or illicit drugs at baseline (n=576; 40.2%). Regression models at baseline showed patients with low levels of motivation had higher odds of substance use and those who were using substances had greater motivation deficits. At 6-months, substance using patients continued to demonstrate greater motivation deficits; however, those with high levels of motivation exhibited a greater reduction in their use of substances. Findings remained significant after adjusting for clinical confounds and were consistent across any substance, alcohol, and cannabis use. Our results emphasize concerns about substance use compounding motivation deficits in schizophrenia, and suggest that disentangling the motivation-substance use relationship in schizophrenia may facilitate efforts aimed at ameliorating these challenges and improving outcomes. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Effects of the summer holiday season on UV filter and illicit drug concentrations in the Korean wastewater system and aquatic environment.

Science.gov (United States)

Kim, Ki Yong; Ekpeghere, Kalu Ibe; Jeong, Hee-Jin; Oh, Jeong-Eun

2017-08-01

Seasonal variations in the concentrations of eight ultraviolet (UV) filters and 22 illicit drugs including their metabolites in the Korean aquatic environment were investigated. Seawater samples from three beaches, water samples from two rivers, and influents and effluents from three wastewater treatment plants were analyzed. The UV filter concentrations in the seawater, river water, and effluent samples were 39.4-296, 35.4-117, and 6.84-51.1 ng L -1 , respectively. The total UV filter concentrations in the seawater samples were 1.9-4.4 times higher at the peak of the holiday season than outside the peak holiday season. An environmental risk assessment showed that ethylhexyl methoxy cinnamate (EHMC) could cause adverse effects on aquatic organisms in the seawater at the three beaches during the holiday period. Seven of the 22 target illicit drugs including their metabolites were detected in the wastewater influent samples, and the total illicit drug concentrations in the influent samples were 0.08-65.4 ng L -1 . The estimated daily consumption rates for cis-tramadol (Cis-TRM), methamphetamine (MTP), meperidine (MEP), and codeine (COD) were 25.7-118.4, 13.8-36.1, 1.36-12.6, and 1.75-8.64 mg d -1 (1000 people) -1 , respectively. In popular vacation area, the illicit drug consumption rates (Cis-TRM, MTP and MEP) were 1.6-2.6 times higher at the peak of the summer holiday season than at the beginning of the summer. Copyright © 2017 Elsevier Ltd. All rights reserved.

Young Risk Takers: Alcohol, Illicit Drugs, and Sexual Practices among a Sample of Music Festival Attendees

Science.gov (United States)

Jenkinson, Rebecca; Bowring, Anna; Dietze, Paul; Hellard, Margaret; Lim, Megan S. C.

2014-01-01

Background. Alcohol and other drug use and sexual risk behaviour are increasing among young Australians, with associated preventable health outcomes such as sexually transmissible infections (STIs) on the rise. Methods. A cross-sectional study of young people's health behaviours conducted at a music festival in Melbourne, Australia, in 2011. Results. 1365 young people aged 16–29 completed the survey; 62% were female with a mean age of 20 years. The majority (94%, n = 1287) reported drinking alcohol during the previous 12 months; among those, 32% reported “binge” drinking (6+ drinks) at least weekly. Half (52%) reported ever using illicit drugs and 25% reported past month use. One-quarter (27%) were identified as being at risk of STIs through unprotected sex with new or casual partners during the previous 12 months. Multivariable analyses found that risky sexual behaviour was associated with younger age (≤19 years), younger age of sexual debut (≤15 years), having discussed sexual health/contraception with a doctor, regular binge drinking, and recent illicit drug use. Conclusion. Substance use correlated strongly with risky sexual behaviour. Further research should explore young people's knowledge of alcohol/drug-related impairment and associated risk-taking behaviours, and campaigns should encourage appropriate STI testing among music festival attendees. PMID:26316974

Tobacco, cannabis, and other illicit drug use among Finnish adolescent twins: causal relationship or correlated liabilities?

NARCIS (Netherlands)

Huizink, A.C.; Levälahti, E.; Korhonen, T.; Dick, D.M.; Pulkkinen, L.; Rose, R.J.; Kaprio, J.

2010-01-01

Objective: Among Finnish adolescent twins, we compared (a) a model that describes a direct impact of liability to tobacco use on cannabis and other illicit drug use with (b) a model that included a shared underlying liability for these substances. Furthermore, the extent to which genetic and

Presence of dual diagnosis between users and non-users of licit and illicit drugs in Brazil

Directory of Open Access Journals (Sweden)

Mariana Bandeira Formiga

2015-12-01

Full Text Available ABSTRACT Objective Investigate the occurrence of dual diagnosis in users of legal and illegal drugs. Methods It is an analytical, cross-sectional study with a quantitative approach, non-probabilistic intentional sampling, carried out in two centers for drug addiction treatment, by means of individual interviews. A sociodemographic questionnaire, the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST and the Mini-International Neuropsychiatric Interview (MINI were used. Results One hundred and ten volunteers divided into abstinent users (group 1, alcoholics (group 2 and users of alcohol and illicit drugs (group 3. The substances were alcohol, tobacco, crack and marijuana. A higher presence of dual diagnosis in group 3 (71.8% was observed, which decreased in group 2 (60% and 37.1% of drug abstinent users had psychiatric disorder. Dual diagnosis was associated with the risk of suicide, suicide attempts and the practice of infractions. The crack consumption was associated with the occurrence of major depressive episode and antisocial personality disorder. Conclusion It was concluded that the illicit drug users had a higher presence of dual diagnosis showing the severity of this clinical condition. It is considered essential that this clinical reality is included in intervention strategies in order to decrease the negative effects of consumption of these substances and provide better quality of life for these people.

Maternal hair analysis for the detection of illicit drugs, medicines, and alcohol exposure during pregnancy.

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Lendoiro, Elena; González-Colmenero, Eva; Concheiro-Guisán, Ana; de Castro, Ana; Cruz, Angelines; López-Rivadulla, Manuel; Concheiro, Marta

2013-06-01

Drug of abuse consumption throughout pregnancy is a serious public health problem and an important economic cost to the health system. The aim of this work was to compare maternal interview and hair analysis to determine drug consumption throughout pregnancy and to study relations among maternal interview, hair results, and neonatal outcomes. Two hundred nine mothers agreed to participate. After delivery, they were interviewed and a hair sample collected. Hair samples were segmented in trimesters and analyzed for 35 drugs [opioids, cocaine, amphetamines, Δ-tetrahydrocannabinol (THC), ketamine, methadone, antidepressants, benzodiazepines, and hypnotics; limits of quantification 5-100 pg/mg] and for ethyl glucuronide (limit of quantification 10 pg/mg) by liquid chromatography-tandem mass spectrometry. Statistical analysis was performed with χ test and t test. In the interview, 4.3% mothers declared using illicit drugs during pregnancy (cocaine 1.4%, THC 2.9%, and opiates 1%), 3.3% medicines (methadone 1.9%, benzodiazepines 1.9%, and antidepressants 0.5%), 21.5% tobacco, and 13.7% alcohol. Hair analysis showed 15.4% prevalence in illicit drugs (cocaine 12.4%, THC 3.8%, opiates 1%, and ketamine 1%), 22.5% in medicines (methadone 3.3%, benzodiazepines 11%, antidepressants 9.1%, zopiclone 1%, and fentanyl 1.4%), and 3.9% in alcohol. Neonatal abstinence syndrome was developed in 8.1% newborns, all of them from mothers with high methadone-positive hair results (>926.2 pg/mg). Statistically significant lower newborn weight and length were found in neonates from declared smokers compared with nonsmokers (P drug use during pregnancy, except for alcohol. In this preliminary study, no statistically significant differences were found between exposed and nonexposed newborns to drugs, except for tobacco consumption.

Kratom, an Emerging Drug of Abuse: A Case Report of Overdose and Management of Withdrawal.

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Diep, Jack; Chin, David Tian; Gupta, Somdatta; Syed, Faraz; Xiong, Ming; Cheng, Jianguo

2018-04-15

Kratom is an herb indigenous to Southeast Asia with psychoactive opioid compounds, often used as a treatment for chronic pain or opiate withdrawal symptoms. It is legally and readily available via Internet sales and has been identified as an emerging drug of abuse in the United States. Kratom use has been associated with psychosis, seizures, and even death. At lower doses, kratom acts as a stimulant, while at higher doses, it produces analgesia and euphoria. Here, we describe the successful management of kratom overdose and withdrawal in a young man with negative toxicology screens.

Aspirin overdose

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... this page: //medlineplus.gov/ency/article/002542.htm Aspirin overdose To use the sharing features on this page, please enable JavaScript. An overdose of aspirin means you have too much aspirin in your ...

Neurotoxicity screening of (illicit) drugs using novel methods for analysis of microelectrode array (MEA) recordings.

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Hondebrink, L; Verboven, A H A; Drega, W S; Schmeink, S; de Groot, M W G D M; van Kleef, R G D M; Wijnolts, F M J; de Groot, A; Meulenbelt, J; Westerink, R H S

2016-07-01

Annual prevalence of the use of common illicit drugs and new psychoactive substances (NPS) is high, despite the often limited knowledge on the health risks of these substances. Recently, cortical cultures grown on multi-well microelectrode arrays (mwMEAs) have been used for neurotoxicity screening of chemicals, pharmaceuticals, and toxins with a high sensitivity and specificity. However, the use of mwMEAs to investigate the effects of illicit drugs on neuronal activity is largely unexplored. We therefore first characterised the cortical cultures using immunocytochemistry and show the presence of astrocytes, glutamatergic and GABAergic neurons. Neuronal activity is concentration-dependently affected following exposure to six neurotransmitters (glutamate, GABA, serotonin, dopamine, acetylcholine and nicotine). Most neurotransmitters inhibit neuronal activity, although glutamate and acetylcholine transiently increase activity at specific concentrations. These transient effects are not detected when activity is determined during the entire 30min exposure window, potentially resulting in false-negative results. As expected, exposure to the GABAA-receptor antagonist bicuculline increases neuronal activity. Exposure to a positive allosteric modulator of the GABAA-receptor (diazepam) or to glutamate receptor antagonists (CNQX and MK-801) reduces neuronal activity. Further, we demonstrate that exposure to common drugs (3,4-methylenedioxymethamphetamine (MDMA) and amphetamine) and NPS (1-(3-chlorophenyl)piperazine (mCPP), 4-fluoroamphetamine (4-FA) and methoxetamine (MXE)) decreases neuronal activity. MXE most potently inhibits neuronal activity with an IC50 of 0.5μM, whereas 4-FA is least potent with an IC50 of 113μM. Our data demonstrate the importance of analysing neuronal activity within different time windows during exposure to prevent false-negative results. We also show that cortical cultures grown on mwMEAs can successfully be applied to investigate the effects of

Quantitative analysis of terahertz spectra for illicit drugs using adaptive-range micro-genetic algorithm

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Chen, Yi; Ma, Yong; Lu, Zheng; Peng, Bei; Chen, Qin

2011-08-01

In the field of anti-illicit drug applications, many suspicious mixture samples might consist of various drug components—for example, a mixture of methamphetamine, heroin, and amoxicillin—which makes spectral identification very difficult. A terahertz spectroscopic quantitative analysis method using an adaptive range micro-genetic algorithm with a variable internal population (ARVIPɛμGA) has been proposed. Five mixture cases are discussed using ARVIPɛμGA driven quantitative terahertz spectroscopic analysis in this paper. The devised simulation results show agreement with the previous experimental results, which suggested that the proposed technique has potential applications for terahertz spectral identifications of drug mixture components. The results show agreement with the results obtained using other experimental and numerical techniques.

Comparison of toxicity of acute overdoses with citalopram and escitalopram.

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Hayes, Bryan D; Klein-Schwartz, Wendy; Clark, Richard F; Muller, Allison A; Miloradovich, Jane E

2010-07-01

Seizures and QTc prolongation are associated with citalopram poisoning; however, overdose experience with escitalopram is more limited. The goals of this study were to compare citalopram's vs. escitalopram's clinical effects in overdose, including the incidence of seizures. A retrospective review was conducted for single-substance acute overdoses with citalopram and escitalopram, managed in hospitals, that were reported to six U.S. poison centers from 2002-2005. There were 374 citalopram and 421 escitalopram overdose cases. Gender and ages were similar between the two, with 68-70% females and a median age of 20 years for citalopram and 18 years for escitalopram. Median dose by history was 310 mg for citalopram and 130 mg for escitalopram. More serious outcomes were associated with citalopram overdoses (p escitalopram were tachycardia, drowsiness, hypertension, and vomiting. Seizures (30 vs. 1, respectively, p escitalopram cases (p = 0.109). There was an association between increasing dose and severity of outcome for citalopram (p escitalopram (p = 0.011). In children escitalopram cases experienced toxicity, such as drowsiness, nausea/vomiting, and tachycardia. There were no seizures in this age group. Escitalopram seems to be less toxic than citalopram after an acute overdose; seizures and tremors were more common with citalopram. Initial management of overdoses should include seizure precautions for citalopram and cardiac monitoring for both drugs. Copyright 2010 Elsevier Inc. All rights reserved.

THE EFFECT OF ILLICIT TRADE IN NARCOTICS ON GLOBAL ECONOMY

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ALASMARI Khaled

2013-07-01

Illicit markets especially those dealing with narcotics constitute grievous issues to the world’s economies, putting to test global safety, economic progress as well as security and many other aspects. Seemingly, illicit narcotics trade in the last decade – that is 2000 to 2011 underwent a significant boom, resulting from a wide spectrum of illegal drugs such as cocaine as well as heroin among many other hard drugs. In today’s global society, several concerns are emerging on the rise of illicit narcotics trade accompanied with organized crime, chiefly as major hindrances to consistent global economic progress. Apparently, some of the effects of illicit narcotics trade are that; this trade gradually turns upside down business rules, opening way for new unruly market players besides reconfiguring influence in global economics as well as politics. Surprisingly, the revenue from illegal drugs in 2011 alone was roughly 10% of the global GDP. Hence, exaggerating local economies’ incomes and triggering ceaseless conflicts among market players, while at the same time reducing legal business activities likewise disintegrating socioeconomic conditions. An empirical research method was adopted for this study, analyzing illicit trade in narcotics on the global arena as from 2000 to 2011 and its resultant effects. The research findings indicate that, illegal drugs trade particularly on the world economy besides growing at a high rate, it endangers the overall welfare of humans likewise the business environment. This is ostensibly because this trade has high chances of engrossing regional economies into illegal drugs business activities, causing them to neglect sustainable ethical businesses. Now, to effectively address negative economic issues related to illegal drugs trade, there is apparent need for integrated efforts from local as well as international authorities. Such efforts are chiefly to control not only the harmful effects resulting from the use of illicit

Detection of Illicit Drugs by Trained Honeybees (Apis mellifera.

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Matthias Schott

Full Text Available Illegal drugs exacerbate global social challenges such as substance addiction, mental health issues and violent crime. Police and customs officials often rely on specially-trained sniffer dogs, which act as sensitive biological detectors to find concealed illegal drugs. However, the dog "alert" is no longer sufficient evidence to allow a search without a warrant or additional probable cause because cannabis has been legalized in two US states and is decriminalized in many others. Retraining dogs to recognize a narrower spectrum of drugs is difficult and training new dogs is time consuming, yet there are no analytical devices with the portability and sensitivity necessary to detect substance-specific chemical signatures. This means there is currently no substitute for sniffer dogs. Here we describe an insect screening procedure showing that the western honeybee (Apis mellifera can sense volatiles associated with pure samples of heroin and cocaine. We developed a portable electroantennographic device for the on-site measurement of volatile perception by these insects, and found a positive correlation between honeybee antennal responses and the concentration of specific drugs in test samples. Furthermore, we tested the ability of honeybees to learn the scent of heroin and trained them to show a reliable behavioral response in the presence of a highly-diluted scent of pure heroin. Trained honeybees could therefore be used to complement or replace the role of sniffer dogs as part of an automated drug detection system. Insects are highly sensitive to volatile compounds and provide an untapped resource for the development of biosensors. Automated conditioning as presented in this study could be developed as a platform for the practical detection of illicit drugs using insect-based sensors.

Adulteration Practices of Psychoactive Illicit Drugs: An Updated Review.

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Solimini, Renata; Rotolo, Maria C; Pellegrini, Manuela; Minutillo, Adele; Pacifici, Roberta; Busardò, Francesco P; Zaami, Simona

2017-01-01

Powdery drugs such as cocaine and heroin are frequently adulterated or diluted predominantly to obtain more doses and to increase the drug dealer's profits, but also to enhance, to modify or to oppose drug effects. The aim of this report is to provide an overview of the recent scientific literature on medicines as well as on new psychoactive substances, used as cutting agents (i.e. pharmacologically active adulterants) and on the related adverse health effects on consumers, possibly due to the synergistic effect of the adulterants laced with substances of abuse. A literature search up to January 2017 was performed on MEDLINE, Scopus and Web of Science and reports and documents of international agencies or institutions were also searched. Pharmacologically active substances such as: paracetamol, caffeine, dextromethorphan, clenbuterol for heroin; levamisole, phenacetine, lidocaine, hydroxyzine and diltiazem for cocaine; caffeine and phentermine for amphetamine, have been identified over the years. Furthermore, since cocaine and morphine (this latter as a precursor of heroin) are both extracted from natural products, some impurities and minor alkaloids can be present in the final preparation. In this context, it is worth considering that new psychoactive substances are also used as cutting agents. The wide availability of illicit psychotropic drugs is the most serious hazard threatening consumers. Indeed emergency departments are often responsible in evaluating damages caused not only by the base substance, but also by other eventual compounds added to mimic or antagonize drug effects or simply dilute the drug amount, with a possible harmful synergic toxic action. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Detection of Illicit Drugs by Trained Honeybees (Apis mellifera).

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Schott, Matthias; Klein, Birgit; Vilcinskas, Andreas

2015-01-01

Illegal drugs exacerbate global social challenges such as substance addiction, mental health issues and violent crime. Police and customs officials often rely on specially-trained sniffer dogs, which act as sensitive biological detectors to find concealed illegal drugs. However, the dog "alert" is no longer sufficient evidence to allow a search without a warrant or additional probable cause because cannabis has been legalized in two US states and is decriminalized in many others. Retraining dogs to recognize a narrower spectrum of drugs is difficult and training new dogs is time consuming, yet there are no analytical devices with the portability and sensitivity necessary to detect substance-specific chemical signatures. This means there is currently no substitute for sniffer dogs. Here we describe an insect screening procedure showing that the western honeybee (Apis mellifera) can sense volatiles associated with pure samples of heroin and cocaine. We developed a portable electroantennographic device for the on-site measurement of volatile perception by these insects, and found a positive correlation between honeybee antennal responses and the concentration of specific drugs in test samples. Furthermore, we tested the ability of honeybees to learn the scent of heroin and trained them to show a reliable behavioral response in the presence of a highly-diluted scent of pure heroin. Trained honeybees could therefore be used to complement or replace the role of sniffer dogs as part of an automated drug detection system. Insects are highly sensitive to volatile compounds and provide an untapped resource for the development of biosensors. Automated conditioning as presented in this study could be developed as a platform for the practical detection of illicit drugs using insect-based sensors.

Characterization of hepatitis B virus infection in illicit drug users in the Marajó Archipelago, northern Brazil.

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Andrade, Andréia P; Pacheco, Suzy D B; Silva, Fabricio Q; Pinheiro, Luiz M L; Castro, Jairo A A; Amaral, Carlos E M; Hermes, Renata B; Fischer, Benedikt; Pinho, João R R; Lemos, José Alexandre R; Oliveira-Filho, Aldemir B

2017-01-01

South America is considered to have a low prevalence of hepatitis B virus (HBV) infection, although areas with a relatively high prevalence have been identified in northern Brazil. Few epidemiological studies of populations at risk of HBV infection are available for this region. Given this, in the present study, we investigated the prevalence of HBV and the factors associated with infection among illicit drug users (DUs) in the Marajó Archipelago, northern Brazil. In this cross-sectional study, we collected samples and epidemiological information from DUs in 11 municipalities of the Marajó Archipelago. The diagnosis was established by ELISA and real-time PCR; and genotyping was done by multiplex real-time PCR. Statistical modeling was based on simple and multiple logistical regressions with the Hosmer-Lemeshow test. The mean age of the 466 DUs was 28.4 years, and most were male. The most-consumed illicit drugs were crack cocaine and marijuana. In all, 171 DUs were exposed to HBV, with genotypes A, D and F being identified. The factors associated with higher frequencies of HBV infection were (i) male gender, (ii) age above 35 years, (iii) anti-HIV positivity, (iv) tattoos, (v) the use of injected drugs, (vi) the use of illicit drugs for more than 3 years, (vii) sexual relations without protection, (viii) sexual relations with another DU, and (ix) more than 10 sexual partners in the past 24 months. In summary, this study provides important insights into the dynamics of HBV infection among DUs in the Marajó Archipelago. We hope that these findings will contribute to the development of strategies, actions and public health policies aimed at preventing and controlling this viral infection more effectively.

Medical Emergencies Related to Ethanol and Illicit Drugs at an Annual, Nocturnal, Indoor, Electronic Dance Music Event.

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Calle, Paul; Sundahl, Nora; Maudens, Kristof; Wille, Sarah Mr; Van Sassenbroeck, Diederik; De Graeve, Koen; Gogaert, Stefan; De Paepe, Peter; Devriese, Dieter; Arno, Geert; Blanckaert, Peter

2018-02-01

Introduction Medical problems are frequently encountered during electronic dance music (EDM) events. Problem There are uncertainties about the frequencies and severity of intoxications with different types of recreational drugs: ethanol, "classical" illicit party drugs, and new psychoactive substances (NPS). Statistical data on the medical problems encountered during two editions of an indoor electronic dance event with around 30,000 attendants were retrieved from the Belgian Red Cross (Mechelen, Belgium) database. Data on drug use were prospectively collected from the patient (or a bystander), the clinical presentation, and/or toxicological screening. In the on-site medical station, 487 patients were treated (265 in 2013 and 222 in 2014). The most frequent reasons were trauma (n=171), headache (n=36), gastro-intestinal problems (n=44), and intoxication (n=160). Sixty-nine patients were transferred to a hospital, including 53 with severe drug-related symptoms. Analysis of blood samples from 106 intoxicated patients detected ethanol in 91.5%, 3,4-methylenedioxymethamphetamine (MDMA) in 34.0%, cannabis in 30.2%, cocaine in 7.5%, amphetamine in 2.8%, and gamma-hydroxybutyric acid (GHB) in 0.9% of patients (alone or in combination). In only six of the MDMA-positive cases, MDMA was the sole substance found. In 2014, the neuroleptic drug clozapine was found in three cases and ketamine in one. Additional analyses for NPS were performed in 20 cases. Only in one agitated patient, the psychedelic phenethylamines 25B-NBOMe and 25C-NBOMe were found. At this particular event, recreational drug abuse necessitated on-site medical treatment in one out of 350 attendants and a hospital transfer in one out of 1,000. Ethanol remains the most frequently abused (legal) drug, yet classical illicit recreational drugs are also frequently (co-) ingested. The most worrying observation was high-risk poly-drug use, especially among MDMA users. Regarding NPS, the number of cases was low and the

Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients.

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Sergio Cordovilla-Guardia

Full Text Available Estimate the effectiveness of brief interventions in reducing trauma recidivism in hospitalized trauma patients who screened positive for alcohol and/or illicit drug use.Dynamic cohort study based on registry data from 1818 patients included in a screening and brief intervention program for alcohol and illicit drug use for hospitalized trauma patients. Three subcohorts emerged from the data analysis: patients who screened negative, those who screened positive and were offered brief intervention, and those who screened positive and were not offered brief intervention. Follow-up lasted from 10 to 52 months. Trauma-free survival, adjusted hazard rate ratios (aHRR and adjusted incidence rate ratios (aIRR were calculated, and complier average causal effect (CACE analysis was used.We found a higher cumulative risk of trauma recidivism in the subcohort who screened positive. In this subcohort, an aHRR of 0.63 (95% CI: 0.41-0.95 was obtained for the group offered brief intervention compared to the group not offered intervention. CACE analysis yielded an estimated 52% reduction in trauma recidivism associated with the brief intervention.The brief intervention offered during hospitalization in trauma patients positive for alcohol and/or illicit drug use can halve the incidence of trauma recidivism.

Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients.

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Cordovilla-Guardia, Sergio; Fernández-Mondéjar, Enrique; Vilar-López, Raquel; Navas, Juan F; Portillo-Santamaría, Mónica; Rico-Martín, Sergio; Lardelli-Claret, Pablo

2017-01-01

Estimate the effectiveness of brief interventions in reducing trauma recidivism in hospitalized trauma patients who screened positive for alcohol and/or illicit drug use. Dynamic cohort study based on registry data from 1818 patients included in a screening and brief intervention program for alcohol and illicit drug use for hospitalized trauma patients. Three subcohorts emerged from the data analysis: patients who screened negative, those who screened positive and were offered brief intervention, and those who screened positive and were not offered brief intervention. Follow-up lasted from 10 to 52 months. Trauma-free survival, adjusted hazard rate ratios (aHRR) and adjusted incidence rate ratios (aIRR) were calculated, and complier average causal effect (CACE) analysis was used. We found a higher cumulative risk of trauma recidivism in the subcohort who screened positive. In this subcohort, an aHRR of 0.63 (95% CI: 0.41-0.95) was obtained for the group offered brief intervention compared to the group not offered intervention. CACE analysis yielded an estimated 52% reduction in trauma recidivism associated with the brief intervention. The brief intervention offered during hospitalization in trauma patients positive for alcohol and/or illicit drug use can halve the incidence of trauma recidivism.

Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients

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Fernández-Mondéjar, Enrique; Vilar-López, Raquel; Navas, Juan F.; Portillo-Santamaría, Mónica; Rico-Martín, Sergio; Lardelli-Claret, Pablo

2017-01-01

Objective Estimate the effectiveness of brief interventions in reducing trauma recidivism in hospitalized trauma patients who screened positive for alcohol and/or illicit drug use. Methods Dynamic cohort study based on registry data from 1818 patients included in a screening and brief intervention program for alcohol and illicit drug use for hospitalized trauma patients. Three subcohorts emerged from the data analysis: patients who screened negative, those who screened positive and were offered brief intervention, and those who screened positive and were not offered brief intervention. Follow-up lasted from 10 to 52 months. Trauma-free survival, adjusted hazard rate ratios (aHRR) and adjusted incidence rate ratios (aIRR) were calculated, and complier average causal effect (CACE) analysis was used. Results We found a higher cumulative risk of trauma recidivism in the subcohort who screened positive. In this subcohort, an aHRR of 0.63 (95% CI: 0.41–0.95) was obtained for the group offered brief intervention compared to the group not offered intervention. CACE analysis yielded an estimated 52% reduction in trauma recidivism associated with the brief intervention. Conclusion The brief intervention offered during hospitalization in trauma patients positive for alcohol and/or illicit drug use can halve the incidence of trauma recidivism. PMID:28813444

Intravenous paracetamol overdose in a paediatric patient

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Broeks, Ilse J.; Van Roon, Eric N.; Van Pinxteren-Nagler, Evelyn; De Vries, Tjalling W.

2013-01-01

BACKGROUND: Paracetamol is a widely used drug in children. In therapeutic doses, paracetamol has an excellent safety profile. Since the introduction of the intravenous form in 2004, only three reports of accidental overdose in children have been published. The low number probably is due to

Perceived unmet need and barriers to care amongst street-involved people who use illicit drugs.

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Hyshka, Elaine; Anderson, Jalene Tayler; Wild, T Cameron

2017-05-01

Research on perceived unmet need for care for mental health and substance use problems focuses on general populations to the detriment of hidden populations. This study describes prevalence and correlates of perceived unmet need for care in a community-based sample of street-involved people who use illicit drugs and identifies barriers to care. A sample of 320 street-involved people who use drugs participated in a structured, interviewer-assisted survey in Edmonton, Canada. The survey included the Perceived Need for Care Questionnaire, which assessed unmet need for care for mental health and substance use problems across seven service types. Logistic regression examined the associations between perceived unmet need, extent of socioeconomic marginalisation and problem severity. Barriers underlying unmet service needs were also examined. Most (82%) participants reported unmet need for one or more services during the past year. Odds of reporting one or more unmet needs were elevated amongst participants reporting substantial housing instability (adjusted odds ratio = 2.37; 95% confidence interval 1.19-4.28) and amongst participants meeting criteria for drug dependence (adjusted odds ratio = 1.22; 95% confidence interval 1.03-1.50), even after adjustment for sociodemographic covariates. Structural, rather than motivational barriers were the most commonly reported reasons underlying unmet service needs. Street-involved people who use drugs experience very high rates of perceived unmet need for care for mental health and substance use problems. General population studies on perceived unmet need are insufficient for understanding needs and barriers to care in hidden populations.[Hyshka E, Anderson JT, Wild TC. Perceived unmet need and barriers to care amongst street-involved people who use illicit drugs. Drug Alcohol Rev 2017;36:295-304]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Interest in low-threshold employment among people who inject illicit drugs: implications for street disorder.

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Debeck, Kora; Wood, Evan; Qi, Jiezhi; Fu, Eric; McArthur, Doug; Montaner, Julio; Kerr, Thomas

2011-09-01

Income generation opportunities available to people who use illicit drugs have been associated with street disorder. Among a cohort of injection drug users (IDU) we sought to examine street-based income generation practices and willingness to forgo these sources of income if other low-threshold work opportunities were made available. Data were derived from a prospective community recruited cohort of IDU. We assessed the prevalence of engaging in disorderly street-based income generation activities, including sex work, drug dealing, panhandling, and recycling/salvaging/vending. Using multivariate logistic regressions based on Akaike information criterion and the best subset selection procedure, we identified factors associated with disorderly income generation activities, and assessed willingness to forgo these sources of income during the period of November 2008 to July 2009. Among our sample of 874 IDU, 418 (48%) reported engaging in a disorderly income generation activity in the previous six months. In multivariate analyses, engaging in disorderly income generation activities was independently associated with high intensity stimulant use, as well as binge drug use, having encounters with police, being a victim of violence, sharing used syringes, and injecting in public areas. Among those engaged in disorderly income generation, 198 (47%) reported a willingness to forgo these income sources if given opportunities for low-threshold employment, with sex workers being most willing to engage in alternative employment. Engagement in disorderly street-based income generation activities was associated with high intensity stimulant drug use and various markers of risk. We found that a high proportion of illicit drug users were willing to cease engagement in these activities if they had options for causal low-threshold employment. These findings indicate that there is a high demand for low-threshold employment that may offer important opportunities to reduce drug

Mechanisms of Association between Paternal Alcoholism and Abuse of Alcohol and Other Illicit Drugs among Adolescents

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Peleg-Oren, Neta; Hospital, Michelle; Morris, Staci Leon; Wagner, Eric F.

2013-01-01

The current study examines the effect of paternal alcohol problems on adolescent use of alcohol and other illicit drugs as a function of maternal communication, as well as adolescent social and coping skills (N = 145). Structural equation modeling (SEM) analyses indicated that adolescents with a paternal history of alcohol problems reported higher…

Olanzapine Overdose in a Pin Point Pupil with Altered Sensorium

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Naresh Midha

2017-09-01

Full Text Available Background:Olanzapine is a highly tolerable and easily affordable atypical antipsychotic drug which has been commonly prescribed in both inpatient and outpatient settings for several mental disorders. Olanzapine overdose is commonly seen in psychiatric patients, who attempt suicide by intoxicating themselves with their own prescribed medications. Increased olanzapine use is associated with increased incidence of overdosing. Case Presentation:We are reporting a case of olanzapine overdosage as a cause of pinpoint pupils and altered sensorium with exclusion of other differentials. The mainstay of managementof olanzapine overdose is general supportive and symptomatic measures. Discussion: Pinpoint pupils with altered sensorium and agitation are always an alarming situation for a clinician, because of differentials like organophosphorus poisoning, pontine hemorrhage and opium overdosing. Due to olanzapine overdosage, similar clinical picture can be confusing in the emergency department and early identification of such cases is helpful to decrease the risk of fatality. Conclusion: This case highlights the significance of olanzapine overdosing as a differential diagnosis for patients presented with altered sensorium and pinpoint pupils in the emergency department. Olanzapine overdosage is associated with high morbidity and mortality. Although there is no specific antidote for olanzapine overdose, appropriate history, assessment and early diagnosis are very useful for the better outcome.

The Demand for Antiretroviral Drugs in the Illicit Marketplace: Implications for HIV Disease Management Among Vulnerable Populations.

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Tsuyuki, Kiyomi; Surratt, Hilary L; Levi-Minzi, Maria A; O'Grady, Catherine L; Kurtz, Steven P

2015-05-01

The diversion of antiretroviral medications (ARVs) has implications for the integrity and success of HIV care, however little is known about the ARV illicit market. This paper aimed to identify the motivations for buying illicit ARVs and to describe market dynamics. Semi-structured interviews (n = 44) were conducted with substance-involved individuals living with HIV who have a history of purchasing ARVs on the street. Grounded theory was used to code and analyze interviews. Motivations for buying ARVs on the illicit market were: to repurchase ARVs after having diverted them for money or drugs; having limited access or low quality health care; to replace lost or ruined ARVs; and to buy a back-up stock of ARVs. This study identified various structural barriers to HIV treatment and ARV adherence that incentivized ARV diversion. Findings highlight the need to improve patient-provider relationships, ensure continuity of care, and integrate services to engage and retain high-needs populations.

Contamination Profiles and Mass Loadings of Macrolide Antibiotics and Illicit Drugs from a Small Urban Wastewater Treatment Plant

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Information is limited regarding sources, distribution, environmental behavior, and fate of prescribed and illicit drugs. Wastewater treatment plant (WWTP) effluents can be one of the sources of pharmaceutical and personal care products (PPCP) into streams, rivers and lakes. The ...

Overdose of drugs for attention-deficit hyperactivity disorder: clinical presentation, mechanisms of toxicity, and management.

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Spiller, Henry A; Hays, Hannah L; Aleguas, Alfred

2013-07-01

The prevalence of attention-deficit hyperactivity disorder (ADHD) in the USA is estimated at approximately 4-9% in children and 4% in adults. It is estimated that prescriptions for ADHD medications are written for more than 2.7 million children per year. In 2010, US poison centers reported 17,000 human exposures to ADHD medications, with 80% occurring in children cause an increase in extracellular concentrations of dopamine, norepinephrine, and serotonin in the neocortex. Overdose with modafinil is generally of moderate severity, with reported ingestions of doses up to 8 g. The most common neurological effects include increased anxiety, agitation, headache, dizziness, insomnia, tremors, and dystonia. The management of modafinil overdose is largely supportive, with a focus on sedation, and control of dyskinesias and blood pressure. Atomoxetine is a selective presynaptic norepinephrine transporter inhibitor. The clinical presentation after overdose with atomoxetine has generally been mild. The primary effects have been drowsiness, agitation, hyperactivity, GI upset, tremor, hyperreflexia, tachycardia hypertension, and seizure. The management of atomoxetine overdose is largely supportive, with a focus on sedation, and control of dyskinesias and seizures. Clonidine is a synthetic imidazole derivative with both central and peripheral alpha-adrenergic agonist actions. The primary clinical syndrome involves prominent neurological and cardiovascular effects, with the most commonly reported features of depressed sensorium, bradycardia, and hypotension. While clonidine is an anti-hypertensive medication, a paradoxical hypertension may occur early with overdose. The clinical syndrome after overdose of guanfacine may be mixed depending on central or peripheral alpha-adrenoreceptor effects. Initial clinical effects may be drowsiness, lethargy, dry mouth, and diaphoresis. Cardiovascular effects may depend on time post-ingestion and may present as hypotension or hypertension. The

Brain Histamine -Methyltransferase as a Possible Target of Treatment for Methamphetamine Overdose

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Junichi Kitanaka

2016-01-01

Full Text Available Stereotypical behaviors induced by methamphetamine (METH overdose are one of the overt symptoms of METH abuse, which can be easily assessed in animal models. Currently, there is no successful treatment for METH overdose. There is increasing evidence that elevated levels of brain histamine can attenuate METH-induced behavioral abnormalities, which might therefore constitute a novel therapeutic treatment for METH abuse and METH overdose. In mammals, histamine N -methyltransferase (HMT is the sole enzyme responsible for degrading histamine in the brain. Metoprine, one of the most potent HMT inhibitors, can cross the blood-brain barrier and increase brain histamine levels by inhibiting HMT. Consequently, this compound can be a candidate for a prototype of drugs for the treatment of METH overdose.

Adulterants and diluents in heroin, amphetamine, and cocaine found on the illicit drug market in Aarhus, Denmark

DEFF Research Database (Denmark)

Andreasen, Mette Findal; Lindholst, Christian; Kaa, Elisabet

2009-01-01

of adulterants and diluents present in the drugs. Results are compared with a similar study conducted ten years earlier. The concentrations of the active substances in illicit heroin, amphetamine, and cocaine samples have decreased significantly over a 10-year period. This finding shows that the "cutting...

Social and structural barriers to housing among street-involved youth who use illicit drugs.

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Krüsi, Andrea; Fast, Danya; Small, Will; Wood, Evan; Kerr, Thomas

2010-05-01

In Canada, approximately 150,000 youth live on the street. Street-involvement and homelessness have been associated with various health risks, including increased substance use, blood-borne infections and sexually transmitted diseases. We undertook a qualitative study to better understand the social and structural barriers street-involved youth who use illicit drugs encounter when seeking housing. We conducted 38 semi-structured interviews with street-involved youth in Vancouver, Canada from May to October 2008. Interviewees were recruited from the At-risk Youth Study (ARYS) cohort, which follows youth aged 14 to 26 who have experience with illicit drug use. All interviews were thematically analyzed, with particular emphasis on participants' perspectives regarding their housing situation and their experiences seeking housing. Many street-involved youth reported feeling unsupported in their efforts to find housing. For the majority of youth, existing abstinence-focused shelters did not constitute a viable option and, as a result, many felt excluded from these facilities. Many youth identified inflexible shelter rules and a lack of privacy as outweighing the benefits of sleeping indoors. Single-room occupancy hotels (SROs) were reported to be the only affordable housing options, as many landlords would not rent to youth on welfare. Many youth reported resisting moving to SROs as they viewed them as unsafe and as giving up hope for a return to mainstream society. The findings of the present study shed light on the social and structural barriers street-involved youth face in attaining housing and challenge the popular view of youth homelessness constituting a lifestyle choice. Our findings point to the need for housing strategies that include safe, low threshold, harm reduction focused housing options for youth who engage in illicit substance use.

Transactional Sex among Noninjecting Illicit Drug Users: Implications for HIV Transmission

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Rafael Alves Guimarães

2016-01-01

Full Text Available Noninjecting illicit drug users (NIDUs present high risk for HIV infection, due especially to transactional sex. This study aimed to estimate the prevalence and risk factors for transactional sex among NIDUs in the Southwest region of Goiás State, Central Brazil. The prevalence of self-reported transactional sex was 22.8%. Prevalence in women and men was 52.7% and 16.8%, respectively, a significant difference (p<0.001. Crack use and history of sexually transmitted infections (STI were risk factors for transactional sex in men. Homelessness, crack use, sex under the influence of drugs, and history of sexual violence were risk factors for transactional sex in women. A high prevalence of transactional sex was observed among NIDUs. This risk behavior may contribute to the high rates of HIV among this population and their social networks and in the general population.

21 CFR 1301.92 - Illicit activities by employees.

Science.gov (United States)

2010-04-01

... MANUFACTURERS, DISTRIBUTORS, AND DISPENSERS OF CONTROLLED SUBSTANCES Employee Screening-Non-Practitioners § 1301.92 Illicit activities by employees. It is the position of DEA that employees who possess, sell, use... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Illicit activities by employees. 1301.92 Section...

Correlates of illicit methadone use in New York City: A cross-sectional study

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Frye Victoria

2008-10-01

Full Text Available Abstract Background Despite growing concern about illicit methadone use in the US and other countries, there is little data about the prevalence and correlates of methadone use in large urban areas. We assessed the prevalence and examined correlates of lifetime and recent illicit methadone use in New York City (NYC. Methods 1,415 heroin, crack, and cocaine users aged 15–40 years were recruited in NYC between 2000 and 2004 to complete interviewer-administered questionnaires. Results In multivariable logistic regression, non-injection drug users who used illicit methadone were more likely to be heroin dependent, less than daily methamphetamine users and to have a heroin using sex partner in the last two months. Injection drug users who used illicit methadone were more likely to use heroin daily, share injection paraphernalia and less likely to have been in a detoxification program and to have not used marijuana in the last six months. Conclusion The results overall suggest that illicit (or street methadone use is likely not a primary drug of choice, but is instead more common in concert with other illicit drug use.

COMMUNICATING RISK IN THE CONTEXT OF METHADONE FORMULATION CHANGES: A QUALITATIVE STUDY OF OVERDOSE WARNING POSTERS IN VANCOUVER, CANADA

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Markwick, Nicole; McNeil, Ryan; Anderson, Solanna; Small, Will; Kerr, Thomas

2015-01-01

BACKGROUND British Columbia, Canada’s provincial methadone program recently replaced their existing methadone formulation with a formulation ten times more concentrated. The transition raised concerns about heightened risk of accidental overdose, leading two organizations to disseminate methadone overdose warning posters during the transitional period. This study explores people who use drugs’ (PWUD) perceptions of these warning posters. METHODS Qualitative interviews were conducted with thirty-four PWUD enrolled in methadone maintenance treatment in Vancouver. Participants were recruited from ongoing cohort studies of drug-using individuals. Interview transcripts were analyzed thematically, focusing on participants’ perceptions of the warning posters and potential impacts on drug-related risks. RESULTS Overdose warning posters constituted a key source of information about the methadone formulation change, but did not provide adequate information for all participants. Participants articulated a preference for descriptive language, focusing on changes in concentration rather than “strength”, and universal hazard symbols to effectively communicate overdose risks. CONCLUSION Participants indicated that warnings employing descriptive language more effectively communicated risk of methadone overdose. Future overdose warnings for drug-using populations must provide adequate information for the intended audience, and be communicated to PWUD through multiple channels. PMID:26644025

Pregabalin Use Among Users of Illicit Drugs: A Cross-Sectional Survey in Southern Germany.

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Snellgrove, Brendan J; Steinert, Tilman; Jaeger, Susanne

2017-10-01

The antiepileptic drug pregabalin is one of the best-selling pharmaceutical products worldwide. There are increasing concerns about its potential for misuse and dependence especially among patients with former or current substance use disorders (SUDs). Our objective was to clarify the extent and pattern of pregabalin use as well as motives and predictors in this population. We conducted a cross-sectional study with patients on a detoxification ward for illicit drugs at the Center for Psychiatry, Südwürttemberg, Ravensburg in southern Germany from August 2012 until July 2013. We used an extensive questionnaire, part of the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) Axis I Disorders (SCID-I) and urine samples. Of the 253 participating patients, 56% had used pregabalin at least once. Of these, 92% had acquired it at least in part from illegal sources. The main motives for the use of pregabalin were the attenuation of opioid withdrawal symptoms, the augmentation of other psychotropic substances, and the psychotropic effects of pregabalin itself. Predictors for pregabalin use were opioid and sedative use as well as younger age. The criteria of dependency according to DSM-IV was met by 11% of pregabalin users and 13% of urine samples were positive for pregabalin. Use of pregabalin is common among users of illicit drugs in large parts of southern Germany, with motives for use, acquisition, and mode of use suggesting misuse. The mode of use, especially intake of high doses and concomitant use of other drugs, poses a serious risk to this population, including the development of dependency.

Heavy alcohol use and suicidal behavior among people who use illicit drugs: A cohort study.

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Kennedy, Mary Clare; Marshall, Brandon D L; Hayashi, Kanna; Nguyen, Paul; Wood, Evan; Kerr, Thomas

2015-06-01

People who use illicit drugs (PWUD) are known to experience high rates of suicidal behavior. While heavy alcohol use has been associated with suicide risk, its impact on the suicidal behavior of PWUD has not been well characterized. Therefore, we examined the relationship between heavy alcohol use and suicidal behavior among PWUD in Vancouver, Canada. Data are derived from two prospective cohort studies of PWUD in Vancouver, Canada, from 2005 to 2013. Participants completed questionnaires that elicited information regarding sociodemographics, drug use patterns, and mental health problems, including suicidal behavior. We used recurrent event survival analyses to estimate the independent association between at-risk/heavy drinking (based on National Institute of Alcohol Abuse and Alcoholism [NIAAA] criteria) and risk of incident, self-reported suicide attempts. Of 1757 participants, 162 participants (9.2%) reported 227 suicide attempts over the 8-year study period, resulting in an incidence rate of 2.5 cases per 100 person-years. After adjusting for potential confounders, including intensive illicit drug use patterns, heavy alcohol use (adjusted hazard ratio [AHR] = 1.97; 95% confidence interval [CI] = 1.39, 2.78) was positively associated with an increased risk of suicidal behavior. We observed a high burden of suicidal behavior among a community-recruited sample of PWUD. Heavy alcohol use predicted a higher risk of suicide attempt, independent of other drug use patterns. These findings demonstrate the need for evidence-based interventions to address suicide risk among PWUD, particularly those who are heavy consumers of alcohol. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Contamination profiles, mass loadings, and sewage epidemiology of neuropsychiatric and illicit drugs in wastewater and river waters from a community in the Midwestern United States.

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Skees, Allie J; Foppe, Katelyn S; Loganathan, Bommanna; Subedi, Bikram

2018-08-01

In this study, residues of the neuropsychiatric and illicit drugs including stimulants, opioids, hallucinogens, antischizophrenics, sedatives, and antidepressants were determined in influent and effluent samples from a small wastewater treatment plant, a receiving creek, and river waters in the Four Rivers region of the Midwestern United States. Nineteen neuropsychiatric drugs, eight illicit drugs, and three metabolites of illicit drugs were detected and quantitated in the water samples using HPLC-MS/MS. Residual concentrations of the drugs varied from below the detection limit to sub-μg/L levels. The source of residual cocaine and benzoylecgonine in wastewater is primarily from human consumption of cocaine rather than direct disposal. Wastewater based epidemiology is utilized to estimate the community usage of drugs based on the concentration of drug residues in wastewater, wastewater inflow, and the population served by the centralized wastewater treatment plant. The per-capita consumption rate of methamphetamine (1740 mg/d/1000 people) and amphetamine (970 mg/d/1000 people) found in this study were the highest reported per-capita consumption rates in the USA. Antidepressant venlafaxine found to have the highest environmental emission from the WWTP (333 ± 160 mg/d/1000 people) followed by citalopram (132 ± 60.2 mg/d/1000 people), methamphetamine (111 ± 43.6 mg/d/1000 people), and hydrocodone (108 ± 90.1 mg/d/1000 people). Bee Creek, an immediate receiving water body, is found to be a source of several neuropsychiatric and illicit drugs including methamphetamine, methadone, alprazolam, oxazepam, temazepam, carbamazepine, venlafaxine, citalopram, sertraline, oxycodone, and hydrocodone (p < 0.036) in the Clarks River. Copyright © 2018 Elsevier B.V. All rights reserved.

Distribution of take-home opioid antagonist kits during a synthetic opioid epidemic in British Columbia, Canada: a modelling study

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Michael A Irvine, PhD

2018-05-01

Full Text Available Summary: Background: Illicit use of high-potency synthetic opioids has become a global issue over the past decade. This misuse is particularly pronounced in British Columbia, Canada, where a rapid increase in availability of fentanyl and other synthetic opioids in the local illicit drug supply during 2016 led to a substantial increase in overdoses and deaths. In response, distribution of take-home naloxone (THN overdose prevention kits was scaled up (6·4-fold increase throughout the province. The aim of this study was to estimate the impact of the THN programme in terms of the number of deaths averted over the study period. Methods: We estimated the impact of THN kits on the ongoing epidemic among people who use illicit opioids in British Columbia and explored counterfactual scenarios for the provincial response. A Markov chain model was constructed explicitly including opioid-related deaths, fentanyl-related deaths, ambulance-attended overdoses, and uses of THN kits. The model was calibrated in a Bayesian framework incorporating population data between Jan 1, 2012, and Oct 31, 2016. Findings: 22 499 ambulance-attended overdoses and 2121 illicit drug-related deaths (677 [32%] deaths related to fentanyl were recorded in the study period, mostly since January, 2016. In the same period, 19 074 THN kits were distributed. We estimate that 298 deaths (95% credible interval [CrI] 91–474 were averted by the THN programme. Of these deaths, 226 (95% CrI 125–340 were averted in 2016, following a rapid scale-up in distribution of kits. We infer a rapid increase in fentanyl adulterant at the beginning of 2016, with an estimated 2·3 times (95% CrI 2·0–2·9 increase from 2015 to 2016. Counterfactual modelling indicated that an earlier scale-up of the programme would have averted an additional 118 deaths (95% CrI 64–207. Our model also indicated that the increase in deaths could parsimoniously be explained through a change in the fentanyl