Psychosis and Substance Abuse: Cause, Effect or Coincidence?

1995 ◽  
Vol 40 (6) ◽  
pp. 174-176 ◽  
Author(s):  
S.M. Lawrie ◽  
J.K. Hutchison ◽  
S.R. Sweeney ◽  
M.R. Fernando ◽  
C.A. McAdam ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Odds Ratio ◽  
Drug Users ◽  
Illicit Drug ◽  
Further Education ◽  
Urine Specimen ◽  
Functional Psychoses ◽  
Drug History ◽  
The Usa ◽  
Drug And Alcohol

An association between substance abuse and major psychiatric illness is increasingly well recognised, but most studies have been conducted in the USA and have focussed upon patients with schizophrenia rather than other disorders. We conducted a survey of 38 consecutively admitted patients with DSM-III-R functional psychoses. A semi-structured substance abuse interview was administered and a urine specimen for drug metabolite screening requested. The prevalence of cigarette smoking (63%) and current illicit drug use (26%) were higher than general population norms. The 16 subjects with schizophrenia and related disorders were more likely to smoke cigarettes than the 22 patients with an affective disorder (p=0.008, odds ratio 8.4, 95% CI 1.3–69.6), and showed tendencies to more illicit drug and alcohol consumption. Illicit drug users were more likely to have a forensic history and less likely to have entered further education. Substance abuse is common among patients with psychoses, particularly in those with schizophrenia and related disorders. All psychotic patients should have a detailed drug history taken, and therapeutic attempts made to reduce consumption.

scholarly journals Increasing presence of xylazine in heroin and/or fentanyl deaths, Philadelphia, Pennsylvania, 2010–2019

2021 ◽  
pp. injuryprev-2020-043968
Author(s):  
Jewell Johnson ◽  
Lia Pizzicato ◽  
Caroline Johnson ◽  
Kendra Viner
Keyword(s):  
Public Health ◽  
United States ◽  
Drug Users ◽  
Active Drug ◽  
Illicit Drug ◽  
Adverse Outcomes ◽  
Drug Supply ◽  
Health Consequences ◽  
Potential Health ◽  
The Usa

Reports from active drug users state that xylazine, the veterinary tranquilliser, has been increasing in the illicit drug supply in Philadelphia. To describe trends and characteristics of unintentional deaths from heroin and/or fentanyl overdose with xylazine detections occurring in Philadelphia, Pennsylvania, the Philadelphia Department of Public Health analysed data on deaths from unintentional heroin and/or fentanyl overdose from the Philadelphia Medical Examiner’s Office over a 10-year period (2010–2019). Xylazine went from being detected in less than 2% cases of fatal heroin and/or fentanyl overdose between 2010 and 2015 to 262 (31%) of the 858 fatal heroin and/or fentanyl overdose cases in 2019. Currently, information is limited on the presence of xylazine in continental United States. Xylazine’s association with adverse outcomes in other locations indicates that potential health consequences should also be monitored in the USA. Whenever possible, jurisdictions should consistently test for xylazine.

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

2015 ◽  
Vol 28 (4) ◽  
pp. 577-589 ◽  
Author(s):  
Namkee G. Choi ◽  
Diana M. DiNitto ◽  
C. Nathan Marti ◽  
Bryan Y. Choi
Keyword(s):  
Older Adults ◽  
Drug Use ◽  
Drug Users ◽  
Illicit Drugs ◽  
Illicit Drug ◽  
Service Providers ◽  
Illicit Drug Use ◽  
Middle Aged ◽  
Suicidal Thoughts ◽  
The Usa

ABSTRACTBackground: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.Methods: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.Results: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.Conclusions: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.

scholarly journals Drug addiction and alcoholism as predictors for tuberculosis treatment default in Brazil: a prospective cohort study

2017 ◽  
Vol 145 (16) ◽  
pp. 3516-3524 ◽  
Author(s):  
M. R. SILVA ◽  
J. C. PEREIRA ◽  
R. R. COSTA ◽  
J. A. DIAS ◽  
M. D. C. GUIMARÃES ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Drug Addiction ◽  
Odds Ratio ◽  
Drug Users ◽  
Reference Group ◽  
Hospital Unit ◽  
Hard Drug ◽  
Tb Treatment ◽  
Treatment Default ◽  
Cure Rates

SUMMARYThis study aimed to evaluate the risk factors for tuberculosis (TB) treatment default in a priority city for disease control in Brazil. A cohort of TB cases diagnosed from 2008 to 2009 was followed up from patients’ entry into three outpatient sites, in Juiz de Fora, Minas Gerais (Brazil), until the recording of the outcomes. Drug addiction, alcoholism and treatment site appeared to be independently associated with default. Current users of crack as the hardest drug (odds ratio (OR) 12·25, 95% confidence interval (CI) 3·04–49·26) were more likely to default than other hard drug users (OR 5·67, 95% CI 1·34–24·03), former users (OR 4·12, 95% CI 1·11–15·20) and those not known to use drugs (reference group). Consumers at high risk of alcoholism (OR 2·94, 95% CI 1·08–7·99) and those treated in an outpatient hospital unit (OR 8·22, 95% CI 2·79–24·21%) also were more likely to default. Our results establish that substance abuse was independently associated with default. National TB programmes might be more likely to achieve their control targets if they include interventions aimed at improving adherence and cure rates, by diagnosing and treating substance abuse concurrently with standard TB therapy.

scholarly journals Association of Substance Abuse, Violence, HIV/AIDS (SAVA) Syndrome with STI and HIV-Infection Among Injecting Drug Users in Six Cities of Russian Federation

Medicina ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 48-62
Author(s):  
A. N. Barinova ◽  
◽  
A. A. Lebedeva ◽  
N. N. Ladnaya ◽  
B. M. Tayts ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Hiv Infection ◽  
Sexual Violence ◽  
Binge Drinking ◽  
Sex Work ◽  
Russian Federation ◽  
Drug Users ◽  
Syringe Sharing ◽  
Separate Analysis ◽  
The Usa

Introduction. Described at the beginning of HIV epidemics in the USA syndrome (or syndemia) of substance abuse, violence and AIDS (SAVA) still continue to be an important risk factor for HIV-infection acquisition. The goal of this study was to analyze association between SAVA and STI and also new cases of HIV infection among IDU in six cities in Russian Federation. Materials and methods. Analysis is based on the data from bio-behavioral survey conducted in six Russian cities with help of respondent-driven sampling. Results. It was found no statistically significant association between SAVA and STI after correction for sampling, but without correction STI prevalence in group without SAVA was 4.1% and in group with SAVA and binge drinking – 9,2% (р=0.04). Stratified analysis showed that it is impossible to combine data from males and females and in case of separate analysis statistically significant association between SAVA and STI exists in females (р=0,027). Analysis with adjustment for interview site, gender and age SAVA with binge drinking significantly elevates STI risk (OR=2.69 [95%CI=1.21... 5.99], р=0.016). Study of association between SAVA components and new cases of HIV found that experience of physical and/or sexual violence combined with binge drinking increase risk of HIV acquisition (adjusted for interview site, gender, age, needle/syringe sharing, education and sex work OR=4.03 [95%CI=1.19...13.69], р=0.026). Experience of physical and/or sexual violence combined with binge drinking was significantly associated with such HIV risk factors as needle and syringe sharing (OR=3.07 [95%CI=1.02...9.24], p=0.046) and sex work (OR=17.29 [95%CI=3.83...77.96], p<0.001). Conclusion. SAVA existence should be taken into account when planning preventive measures in Russian Federation and existing programs of comprehensive prevention should have components designed to decrease consequences of syndemia.

Substance Abuse and Drug-Related Death, Suicidal Ideation, and Suicide: A Review

Crisis ◽  
1999 ◽  
Vol 20 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Annie Mino ◽  
Arnaud Bousquet ◽  
Barbara Broers
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Substance Abuse ◽  
Suicidal Ideation ◽  
Family Support ◽  
Drug Users ◽  
Suicide Attempts ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Hiv Epidemic

The high mortality rate among drug users, which is partly due to the HIV epidemic and partly due to drug-related accidental deaths and suicides, presents a major public health problem. Knowing more about prevalence, incidence, and risk factors is important for the development of rational preventive and therapeutic programs. This article attempts to give an overview of studies of the relations between substance abuse, suicidal ideation, suicide, and drug-related death. Research in this field is hampered by the absence of clear definitions, and results of studies are rarely comparable. There is, however, consensus about suicidal ideation being a risk factor for suicide attempts and suicide. Suicidal ideation is also a predictor of suicide, especially among drug users. It is correlated with an absence of family support, with the severity of the psychosocial dysfunctioning, and with multi-drug abuse, but also with requests for treatment. Every clinical examination of a drug user, not only of those who are depressed, should address the possible presence of suicidal ideation, as well as its intensity and duration.

Summary and conclusions

2018 ◽  
Author(s):  
Thomas F. Babor ◽  
Jonathan Caulkins ◽  
Benedikt Fischer ◽  
David Foxcroft ◽  
Keith Humphreys ◽  
...  
Keyword(s):  
International Organizations ◽  
Drug Policy ◽  
Drug Users ◽  
Illicit Drug ◽  
Supply And Demand ◽  
Unintended Consequences ◽  
Public Health Approach ◽  
Drug Supply ◽  
The Public ◽  
Balanced Approach

Among the 47 options reviewed in this book, most show some evidence of effectiveness in at least one country, but the evidence is less than definitive for many others, either because the interventions are ineffective, or the research is inadequate. Unfortunately, policies that have shown little or no evidence of effectiveness continue to be the preferred options of many countries and international organizations. The evidence reviewed in this book supports two overarching conclusions. First, an integrated and balanced approach to evidence-informed drug policy is more likely to benefit the public good than uncoordinated efforts to reduce drug supply and demand. Second, by shifting the emphasis toward a public health approach, it may be possible to reduce the extent of illicit drug use, prevent the escalation of new epidemics, and avoid the unintended consequences arising from the marginalization of drug users through severe criminal penalties.

scholarly journals MP018: Exercise prescription by Canadian emergency medicine physicians

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S72-S72
Author(s):  
M. Douglas-Vail ◽  
T. Bechamp ◽  
R. Soegtrop ◽  
M. Columbus ◽  
K. Wood ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Health Promotion ◽  
Exercise Prescription ◽  
Further Education ◽  
Preventative Medicine ◽  
Exercise Habits ◽  
Significant Barrier ◽  
Prescription Rates ◽  
Training Background ◽  
Drug And Alcohol

Introduction: Health promotion and disease prevention have been increasingly recognized as activities within the scope of emergency medicine. Exercise prescription by physicians has been shown to improve outcomes in obesity, cardiovascular disease, and many other diseases. An estimated 600,000 Canadians receive the majority of their care from emergency departments (ED), representing a substantial opportunity for health promotion. Our study examined the frequency of exercise prescription by emergency physicians (EPs) and determined factors that influence decisions to prescribe exercise. Methods: A national, confidential 22-item survey was distributed to Canadian EPs via email by the CAEP survey distribution protocol in November/December 2015. Demographics, exercise prescription rates and self-reported exercise habits were collected. Results: A total of 332 EPs responded. 92.4% of EPs reported being at least moderately active. 62.7% of EPs often or always council their patients about preventative medicine (smoking cessation, drug and alcohol use, diet and safe sex). However, only 23.8% often or always ask about their exercise habits. Even fewer (12.7%) often or always prescribe exercise. Training background significantly predicted level of comfort prescribing exercise. CCFP trained EPs were 5.1 (p = 0.001) times more likely than trained EPs to respond 'yes' they feel comfortable prescribing exercise, and 3.7 (p = .009) times more likely to respond 'sometimes'. CCFP (EM) trained EPs were 3.5 (p < 0.001) times more likely than trained EPs to respond 'yes' they feel comfortable prescribing exercise, and 2.0 (p = .031) times more likely to respond 'sometimes'. 76.1% of respondents believe that other EPs rarely or never prescribe exercise. Of respondents, only 36% feel comfortable prescribing exercise. The majority of EPs (73.4%) believe that the ED environment did not allow adequate time for exercise prescription. Conclusion: The majority of EPs council their patients regarding other forms of preventative medicine but few prescribe exercise to their patients. Available time in the ED was cited as a significant barrier to exercise prescription. CCFP trained EPs are more comfortable prescribing exercise, suggesting that their training may better educate and prepare them to council patients on exercise compared to trained EPs. Further education may be required to standardize an approach to prescribing exercise in the ED.

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