scholarly journals Clinical impact of COVID-19 on people with substance use disorders

2020 ◽  
Author(s):  
G Vallecillo ◽  
R Perelló ◽  
R Güerri ◽  
F Fonseca ◽  
M Torrens
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Severe Pneumonia ◽  
Epidemiological Studies ◽  
Urban Hospital ◽  
Increased Risk ◽  
Disorder Treatment ◽  
Low Incidence ◽  
The Impact ◽  
Larger Sample

Abstract Background People with substance use disorders are considered at increased risk of COVID-19 and its more serious complications, however data on the impact of COVID-19 are lacking. The study aimed to describe the clinical characteristics and outcomes of COVID-19 on people with substance use disorders. Methods an observational study was carried out including patients aged ≥ years with COVID-19 pneumonia admitted to an urban hospital during March 12 to June 21,2020. Results Among 2078 patients admitted, 27 (1.3%) were people with substance use disorders: 23(85.2%) were men with a median age of 56.1 + 10.3 years and. The main SUD were alcohol in 18(66.7%) patients, heroine in 6(22.2%) and cocaine in 3(11.1%) and 24(88.8%) patients were on ongoing substance use disorder treatment. One or more comorbidities associated to COVID-19 risk were observed in 18(66.6%) of patients. During a median length of stay of 10 days (IQR:7-19), severe pneumonia developed in 7(25.9%) patients, acute respiratory distress syndrome in 5 (18.5%) and none died. Conclusion Larger sample sizes and sero-epidemiological studies are needed to confirm the low incidence of severe COVID-19 on patients with SUD.

A whole-of-population study of the prevalence and patterns of criminal offending in people with schizophrenia and other mental illness

2012 ◽  
Vol 43 (9) ◽  
pp. 1869-1880 ◽  
Author(s):  
V. A. Morgan ◽  
F. Morgan ◽  
G. Valuri ◽  
A. Ferrante ◽  
D. Castle ◽  
...  
Keyword(s):  
Mental Illness ◽  
Substance Use ◽  
Substance Use Disorders ◽  
Psychiatric Illness ◽  
Diagnostic Category ◽  
Epidemiological Studies ◽  
Case Register ◽  
People With Mental Illness ◽  
Increased Risk ◽  
History Of

BackgroundLarge epidemiological studies are needed to better understand the prevalence and profile of offending by people with mental illness. This study used a whole-of-population design to examine the prevalence, type and pattern of offending across all psychiatric diagnoses, including schizophrenia, compared to the general population.MethodWe used whole-of-population longitudinal record-linked data for a cohort of all Western Australians born 1955–1969 to determine arrest history over the period 1985–1996 and to ascertain recorded history of psychiatric illness. Of the cohort, 116 656 had been arrested and 40 478 were on the psychiatric case register.ResultsThe period prevalence of arrest for people with any psychiatric illness was 32.1%. The highest arrest prevalence, by diagnostic category, was for substance use disorders (59.4%); the prevalence for schizophrenia was 38.7%. Co-morbid substance use disorders significantly increased risk of arrest in people with schizophrenia. The prevalence of mental illness among offenders was 11.1%: 6.5% of offenders had substance use disorders and 1.7% had schizophrenia. For the majority of offenders with a psychiatric illness, first arrest preceded first contact with mental health services; for schizophrenia only, this proportion was increasing over time. The mean percentage annual change in the number of arrests during 1985–1996 rose significantly for offenders with a psychiatric illness other than schizophrenia and dropped significantly for those with no mental illness. Compared to non-psychiatric offenders, offenders with schizophrenia were more likely to offend alone, to offend in open places and to target strangers.ConclusionsOur findings open the way to an informed approach to the management of offenders with mental illness.

Epidemiology of Substance Use Disorders

2013 ◽  
pp. 772-788
Author(s):  
Denise B. Kandel ◽  
Mei-Chen Hu ◽  
Pamela C. Griesler
Keyword(s):  
Substance Use ◽  
Animal Models ◽  
Substance Use Disorders ◽  
Illicit Drugs ◽  
Secondary Analysis ◽  
Epidemiological Studies ◽  
Data Sets ◽  
Gateway Hypothesis ◽  
Increased Risk ◽  
The One

This chapter reviews the epidemiology of substance use, abuse and dependence on alcohol, nicotine and illicit drugs in the population among adults and adolescents; comorbidity with psychiatric disorders; the importance of early onset; and animal models of the Gateway Hypothesis. Existing epidemiological studies and reports have many limitations, necessitating extensive secondary analysis of the data sets to overcome some of those limitations. Nicotine is the most addictive of the drugs and the most chronic addiction. It is the one substance for which dependence is higher among women than men. Adolescence is a period of increased risk for drug abuse and dependence among last year users. Psychiatric comorbidity with substance use disorders is high, especially for antisocial personality disorder. Animal models of the Gateway Hypothesis have uncovered basic mechanisms of nicotine action in the brain.

The Role of Negative Affect in the Course of Substance Use Disorders

2018 ◽  
Author(s):  
Elizabeth D. Reese ◽  
Jennifer Y. Yi ◽  
Ryan P. Bell ◽  
Stacey B. Daughters
Keyword(s):  
Substance Use ◽  
Negative Affect ◽  
Substance Use Disorders ◽  
Substance Use Disorder ◽  
Theoretical Models ◽  
Central Mechanism ◽  
Substance Use Treatment ◽  
Increased Risk ◽  
The Impact

Negative affect (NA) plays a prominent role in theoretical models characterizing the course of substance use disorders and is thus considered a central mechanism contributing to maintenance of symptoms and increased risk for relapse. This chapter overviews theoretical models of substance use, highlighting the impact of NA within the addiction cycle. In this context, it examines the evidence linking NA to substance use disorder (SUD) development, maintenance, and relapse, highlighting the association between NA and addiction-specific processes including withdrawal and craving. It concludes with a discussion of current substance use treatment approaches that target NA, including promising new pharmacological and neurobiological treatments.

Parenting and adult mood, anxiety and substance use disorders in female twins: an epidemiological, multi-informant, retrospective study

2000 ◽  
Vol 30 (2) ◽  
pp. 281-294 ◽  
Author(s):  
K. S. KENDLER ◽  
J. MYERS ◽  
C. A. PRESCOTT
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Three Dimensions ◽  
Adult Daughters ◽  
Retrospective Reports ◽  
Increased Risk ◽  
Co Morbidity ◽  
Substance Abuse Disorders ◽  
Paternal Parenting ◽  
The Impact

Background. Although parenting has long been considered an important risk factor for subsequent psychopathology, most investigations of this question have studied a single informant, clinical populations, one or a few disorders and did not consider relevant covariates.Methods. Three dimensions of parenting (coldness, protectiveness and authoritarianism) were measured by combining the retrospective reports from adult female twins, their co-twins, and their mothers and fathers. We assessed by personal interview, lifetime history in the twins of eight common psychiatric and substance abuse disorders and a range of predictors of parenting. Analyses were performed using logistic regression.Results. Examined individually, high levels of coldness and authoritarianism were modestly but significantly associated with increased risk for nearly all disorders, while the impact of protectiveness was more variable. These associations declined modestly when putative predictors of parenting were added as covariates. Maternal and paternal parenting were equally associated with outcomes in adult daughters. When coldness, protectiveness and authoritarianism were examined together, nearly all significant associations were seen solely with coldness. Few significant interactions were found between maternal and paternal parenting or between coldness, protectiveness and authoritarianism. The shared experience of these three dimensions of parenting predicts a quite small correlation in liability to these disorders in dizygotic twin pairs (e.g. r < 0·04).Conclusion. In women, parenting behaviour, especially levels of coldness, is probably causally related to risk for a broad range of adult psychiatric disorders. The impact of parenting on substance use disorders may be largely mediated through their co-morbidity with major depression, phobias and generalized anxiety disorder. In general population samples, the association of poor parenting with psychiatric illness is modest, largely non-specific and explains little of the observed aggregation of these disorders in families.

scholarly journals The impact of poly-traumatization on treatment outcomes in young people with substance use disorders

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sidsel Karsberg ◽  
Morten Hesse ◽  
Michael Mulbjerg Pedersen ◽  
Ruby Charak ◽  
Mads Uffe Pedersen
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Psychological Trauma ◽  
Well Being ◽  
Traumatic Experiences ◽  
Treatment Entry ◽  
Trauma Types ◽  
Using Data ◽  
The Impact ◽  
Drug Use Disorder

Abstract Background It is believed that clients with psychological trauma experiences have a poor prognosis with regard to treatment participation and outcomes for substance use disorders. However, knowledge on the effect of the number of trauma experiences is scarce. Methods Using data from drug use disorder (DUD) treatment in Denmark, we assessed the impact of having experienced multiple potentially traumatic experiences on DUD treatment efficacy. Baseline and follow-up data from 775 young participants (mean age = 20.2 years, standard deviation = 2.6) recruited at nine treatment centers were included in analyses. Results Analyses showed that participants who were exposed multiple trauma experiences also reported a significantly higher intake of cannabis at treatment entry, and a lower well-being score than participants who reported less types or no types of victimization experiences. During treatment, patients with multiple types of trauma experiences showed a slower rate of reduction of cannabis than patients with few or no trauma experiences. The number of trauma types was not associated with number of sessions attended or the development of well-being in treatment. Conclusion Overall, the results show that although traumatized youth in DUD treatment show up for treatment, helping them to reduce substance use during treatment is uniquely challenging. Trial registration ISRCTN88025085, date of registration: 29.08.2016, retrospectively registered.

Gastrostomy Tubes Placed in Children With Neurologic Impairment: Associated Morbidity and Mortality

2021 ◽  
pp. 088307382110001
Author(s):  
Jody L. Lin ◽  
Joseph Rigdon ◽  
Keith Van Haren ◽  
MyMy Buu ◽  
Olga Saynina ◽  
...  
Keyword(s):  
Severe Pneumonia ◽  
Sensitivity Analyses ◽  
Tube Placement ◽  
Composite Outcome ◽  
Eligibility Criteria ◽  
Risk Of Death ◽  
Cox Proportional Hazard ◽  
Neurologic Impairment ◽  
Increased Risk ◽  
The Impact

Background: Gastrostomy tube (G-tube) placement for children with neurologic impairment with dysphagia has been suggested for pneumonia prevention. However, prior studies demonstrated an association between G-tube placement and increased risk of pneumonia. We evaluate the association between timing of G-tube placement and death or severe pneumonia in children with neurologic impairment. Methods: We included all children enrolled in California Children’s Services between July 1, 2009, and June 30, 2014, with neurologic impairment and 1 pneumonia hospitalization. Prior to analysis, children with new G-tubes and those without were 1:2 propensity score matched on sociodemographics, medical complexity, and severity of index hospitalization. We used a time-varying Cox proportional hazard model for subsequent death or composite outcome of death or severe pneumonia to compare those with new G-tubes vs those without, adjusting for covariates described above. Results: A total of 2490 children met eligibility criteria, of whom 219 (9%) died and 789 (32%) had severe pneumonia. Compared to children without G-tubes, children with new G-tubes had decreased risk of death (hazard ratio [HR] 0.47, 95% confidence interval [CI] 0.39-0.55) but increased risk of the composite outcome (HR 1.21, CI 1.14-1.27). Sensitivity analyses using varied time criteria for definitions of G-tube and outcome found that more recent G-tube placement had greater associated risk reduction for death but increased risk of severe pneumonia. Conclusion: Recent G-tube placement is associated with reduced risk of death but increased risk of severe pneumonia. Decisions to place G-tubes for pulmonary indications in children with neurologic impairment should weigh the impact of severe pneumonia on quality of life.

The impact of intolerance of emotional distress and uncertainty on veterans with co-occurring PTSD and substance use disorders

2016 ◽  
Vol 41 ◽  
pp. 73-81 ◽  
Author(s):  
Anne N. Banducci ◽  
Sarah J. Bujarski ◽  
Marcel O. Bonn-Miller ◽  
Amee Patel ◽  
Kevin M. Connolly
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Emotional Distress ◽  
The Impact

Abstract 228: National Prevalence of Substance Use Disorders Among Hospitalized Heart Failure Patients

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Sarah C Snow ◽  
Gregg C Fonarow ◽  
Joseph A Ladapo ◽  
Donna L Washington ◽  
Katherine Hoggatt ◽  
...  
Keyword(s):  
Heart Failure ◽  
Substance Use ◽  
Native American ◽  
Drug Use ◽  
Substance Use Disorders ◽  
Age Groups ◽  
Opioid Use ◽  
Drug Use Disorders ◽  
Increased Risk ◽  
Drug Use Disorder

Background: Several cardiotoxic substances contribute to the development of heart failure (HF). The burden of comorbid substance use disorders (SUD) among patients with HF is under-characterized. Objectives: To describe the national burden of comorbid SUD (tobacco, alcohol, or drug use disorders) among hospitalized HF patients in the U.S. Methods: We used data from the 2014 National Inpatient Sample to calculate the proportion of hospitalizations for a primary HF admission with tobacco, alcohol, or drug use disorder diagnoses, accounting for demographic factors. Drug use disorder analysis was further sub-divided into specific illicit substance categories. Results: There were a total of 989,080 HF hospitalizations of which 35.3% (n=348,995) had a documented SUD. Tobacco use disorder (TUD) was most common (n= 327,220, 33.1%) followed by drug use disorder (DUD) (n=34,600, 3.5%) and alcohol use disorder (AUD) (n=34,285, 3.5%). Female sex was associated with less TUD (OR 0.59; 95% CI, 0.58-0.60), AUD (OR 0.23; 95% CI, 0.22-0.25) or DUD (OR 0.58; 95% CI 0.55-0.62). Tobacco, alcohol, cocaine, and opioid use disorders were highest among HF patients age 45 to 55, while cannabis and amphetamine use was highest in those <45 years. Native American race (versus White) was associated with increased risk of AUD (OR 1.67; 95% CI 1.27-2.20). Black race was associated with increased risk of AUD (OR 1.09; 95% CI 1.02-1.16) or DUD (OR 1.63; 95% CI 1.53-1.74). Medicaid insurance (versus Medicare) was associated with greater TUD (OR 1.27; 95% CI 1.23-1.32), AUD (OR 1.74; 95% CI 1.62-1.87), and DUD (OR 2.15; 95% CI 2.01-2.30). Decreasing quartiles of median household income were associated with increasing SUD. Conclusions: Comorbid SUD disproportionately affects certain HF populations, including men, younger age groups, lower SES patients, and race/ethnic minorities. Further research on interventions to improve prevention and treatment of SUD among hospitalized HF patients are needed given the high rates of SUD in this population. Systematically screening hospitalized HF patients for SUD may reveal opportunities for treatment and secondary prevention.

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