Do Stimulants Reduce the Risk for Alcohol and Substance Use in Youth With ADHD? A Secondary Analysis of a Prospective, 24-Month Open-Label Study of Osmotic-Release Methylphenidate

2016 ◽  
Vol 21 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Paul Hammerness ◽  
Carter Petty ◽  
Stephen V. Faraone ◽  
Joseph Biederman
Keyword(s):  
Clinical Trial ◽  
Substance Use ◽  
Drug Use ◽  
Secondary Analysis ◽  
Self Report ◽  
Open Label ◽  
Stimulant Treatment ◽  
Alcohol And Drug Use ◽  
The Impact ◽  
Youth With Adhd

Objective: The purpose of this study was to examine the impact of stimulant treatment on risk for alcohol and illicit drug use in adolescents with ADHD. Method: Analysis of data derived from a prospective open-label treatment study of adolescent ADHD ( n = 115, 76% male), and a historical, naturalistic sample of ADHD ( n = 44, 68% male) and non-ADHD youth ( n = 52, 73% male) of similar age and sex. Treatment consisted of extended-release methylphenidate in the clinical trial or naturalistic stimulant treatment. Self-report of alcohol and drug use was derived from a modified version of the Drug Use Screening Inventory. Results: Rates of alcohol and drug use in the past year were significantly lower in the clinical trial compared with untreated and treated naturalistic ADHD comparators, and similar to rates in non-ADHD comparators. Conclusion: Well-monitored stimulant treatment may reduce the risk for alcohol and substance use in adolescent ADHD.

Effects of lifetime tobacco, alcohol and drug use on psychological and behavioral problems among 10th grade students in Istanbul

2015 ◽  
Vol 27 (4) ◽  
pp. 405-413 ◽  
Author(s):  
Cuneyt Evren ◽  
Bilge Evren ◽  
Muge Bozkurt ◽  
Arzu Ciftci-Demirci
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Behavioral Problems ◽  
Sensation Seeking ◽  
Self Report ◽  
Alcohol And Drug Use ◽  
Independent Variables ◽  
10Th Grade ◽  
Behavioral Variables ◽  
Dependent Variables

Abstract Aims: The aim of this study was to determine the effects of life-time tobacco, alcohol, and substance use on psychological and behavioral variables among 10th grade students in Istanbul/Turkey. Materials and methods: This study employed a cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul. The questionnaire featured a section about use of substances, including tobacco, alcohol, and drugs. The depression, anxiety, anger, assertiveness, sensation seeking and impulsiveness subscales of the Psychological Screening Test for Adolescents (PSTA) were used. The analyses were conducted based on 4957 subjects. Results: Logistic regression analyses were conducted with each school with the related and behavioral variables as the dependent variables. Gender, tobacco, alcohol, and drug use being the independent variables. All four independent variables predicted the dependent variables. Lifetime tobacco and drug use had significant effects on all the subscale score, whereas lifetime alcohol use had significant effects on all the subscale scores other than lack of assertiveness, and male gender was a significant covariant for all the subscale scores. Drug use showed the highest effect on dependent variables. Interaction was found between effects of tobacco and alcohol on anxiety, whereas interactions were found between effects of tobacco and drugs on lack of assertiveness and impulsiveness. Conclusion: The findings suggested that male students with lifetime tobacco, alcohol or drug use have particularly high risk of psychological and behavioral problems. The unique effects of substance clusters on these problems may be useful in developing secondary preventive practices for substance use and abuse problems in Istanbul.

scholarly journals Design and Methods of a Randomized Cross-over Clinical Trial of Unfiltered Cigarettes on Smoking Behavior and Toxicant Exposure: Study Protocol for a Randomized Cross-over Clinical Trial

2020 ◽  
Author(s):  
Eyal Oren ◽  
Kim Pulvers ◽  
Devan R. Romero ◽  
Casey Barber ◽  
Erika Carter ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Scientific Evidence ◽  
Smoking Behavior ◽  
Baseline Period ◽  
Self Report ◽  
Open Label ◽  
Study Results ◽  
Single Use ◽  
State And Local ◽  
The Impact

Abstract Background: Plastic filters on cigarette butts are a widespread source of non-biodegradable, toxic environmental waste. State and local legislation to ban the sale of single-use cigarettes may be considered to prevent this waste, but scientific evidence on the impact of switching smokers to unfiltered cigarettes on smoking behavior and toxicant exposures is needed to inform this policy. We have designed an open-label, randomized, 9-week, cross-over clinical trial of adult filtered cigarette smokers who switch to unfiltered cigarettes.Methods: The trial involves a 1-week baseline period, 2 weeks of smoking filtered or unfiltered cigarettes (groups randomly assignd), a 3-week washout period, another 1-week baseline period, and a crossover to 2-weeks of smoking the opposite condition (filtered or unfiltered cigarettes). We will determine changes in: 1) observed topography (i.e., puff count, puff volume) and cigarettes smoked per day (via butt counts and self-report); 2) expired carbon monoxide (CO), urinary cotinine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and volatile organic compound (VOC) excretion; and 3) knowledge and attitudes toward unfiltered cigarettes, satisfaction with smoking, and intention to quit if they were not able to smoke filtered cigarettes.Discussion: This comprehensive proof-of-principle study will provide preliminary evidence to develop a research project with a larger sample size. Study results will inform proposed state or local legislation to ban the sale of single-use filtered cigarettes in order to eliminate the environmental impact of cigarette butt waste stemming from the single-use plastic filter. Trial Registration: NCT03749876

Early Substance Use and School Achievement: An Examination of Latino, White, and African American Youth

2002 ◽  
Vol 32 (3) ◽  
pp. 921-943 ◽  
Author(s):  
Cynthia Perez McCluskey ◽  
Marvin D. Krohn ◽  
Alan J. Lizotte ◽  
Monica L. Rodriguez
Keyword(s):  
High School ◽  
Substance Use ◽  
African American ◽  
Drug Use ◽  
African American Males ◽  
Life Course Perspective ◽  
Alcohol And Drug Use ◽  
School Completion ◽  
The Impact ◽  
The Relationship

This study examines the impact of early substance use on school completion. From a life-course perspective, early deviance can interrupt adolescent development, including education. Studies have cited substance use in early adolescence as a risk factor for school dropout; however, few studies examine the relationship with diverse samples. Using longitudinal data from the Rochester Youth Development Study, we examine the impact of early alcohol and drug use on high school completion relative to other risk factors for Latino, White, and African American males. Once family, school, and life events are considered, early alcohol and drug use exerts an independent influence on the failure to complete high school for White and African American males. Among Latino males, the relationship between early use and school completion appears to be mediated by impregnating a partner

scholarly journals P106: Healthcare utilization among homeless and/or substance using adults presenting to the ED

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S114-S114
Author(s):  
V.V. Puri ◽  
K. Dong ◽  
B.H. Rowe ◽  
S.W. Kirkland ◽  
C. Vandenberghe ◽  
...  
Keyword(s):  
Substance Use ◽  
Risk Factor ◽  
High Risk ◽  
Drug Use ◽  
Acute Care ◽  
Unstable Housing ◽  
Alcohol And Drug Use ◽  
Ed Visits ◽  
The Impact

Introduction: Substance use and unstable housing are associated with heavy use of the Emergency Department (ED). This study examined the impact of substance use and unstable housing on the probability of future ED use. Methods: Case-control study of patients presenting to an urban ED. Patients were eligible if they were unstably housed for the past 30 days, and/or if their chief complaint was related to substance use. Following written informed consent, patients completed a baseline survey and health care use was tracked via electronic medical records for the next six months. Controls were enrolled in a 1:4 ratio. More than 2 ED visits during the follow-up was pre-specified as a measure of excess ED use. Descriptive analyses included proportions and medians with interquartile ranges (IQR). Binomial logistic regression models were used to estimate the impact of housing status, high-risk alcohol use (AUDIT) and drug use (DUDIT), and combinations of these factors on subsequent acute care system contacts (ED visits + admissions). We controlled for age, gender, comorbidities at baseline, and baseline presenting acuity. Results: 41 controls, 46 substance using, 91 unstably housed, and 31 both unstably housed and substance using patients were enrolled (n = 209). Median ED visits during follow up were 0 (IQR: 0-1.0) for controls, 1.0 (IQR: 0-3.3) for substance using, 1.0 (IQR: 0-4.0) for unstably housed and 4 (IQR: 2-12.3) for unstably housed and substance using patients. The median acute care system contacts over the same period was 1.0 (IQR 0-2.0) for controls, 1.0 (IQR: 0-4.0) for substance using, 1.0 (IQR: 0-5.0) for unstably housed and 4.5 (IQR: 2.8-14.3) for unstably housed and substance using patients. Being unstably housed was the factor most strongly associated with having > 2 ED visits (b=3.288, p<0.005) followed by high-risk alcohol and drug use (b=2.149, p<0.08); high risk alcohol use alone was not significantly associated with ED visits (b=1.939, p<0.1). The number of comorbidities present at baseline was a small but statistically significant additional risk factor (b=0.478, p<0.05). The model correctly predicted 70.1% of patients’ ED utilization status. Conclusion: Unstable housing is a substantial risk factor for ED use; high-risk alcohol and drug use, and comorbidities at baseline increased this risk. The intensity of excess ED use was greatest in patients who were unstably housed and substance using.

scholarly journals Associations between History of Hospitalization for Violence Victimization and Substance-Use Patterns among Adolescents: A 2017 Korean National Representative Survey

2018 ◽  
Vol 15 (7) ◽  
pp. 1543
Author(s):  
Yeji Lee ◽  
Kang-Sook Lee
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Secondary Data ◽  
Web Based ◽  
Alcohol And Drug Use ◽  
Violence Victimization ◽  
Use Patterns ◽  
Chi Squared ◽  
History Of ◽  
Victimization Experience

Violence victimization can adversely affect adolescents’ long-term health. Existing research has mainly focused on the link between victimization and substance use; however, the evidence obtained to date has been inconsistent. This study, using a Korean national representative sample, examined the association between violence victimization and substance-use patterns (including tobacco, alcohol, and drug use) in terms of sex and number of violence victimization experiences. We analyzed secondary data from the 2017 Korean Youth Risk Behavior Web-based Survey. Chi-squared test analyses and logistic regression analysis were used to examine substance use in terms of violence victimization; additionally, p-values for trends were calculated to reveal the dose-response relationship per number of violence victimization experiences. We consequently found that participants’ rates of tobacco, alcohol, and drug use were higher among those who experienced violence victimization than among those who did not. For each substance-use-related variable, the greater the violence victimization experience, the higher the odds of substance use (p for trend < 0.001). Early intervention may help prevent the development of substance use, especially among adolescents who have experienced violence victimization. Prevention efforts regarding substance abuse and violence prevention should be included in school curricula to effectively prevent adverse health consequences among adolescents.

scholarly journals Impact of Abstinence and of Reducing Illicit Drug Use Without Abstinence on Human Immunodeficiency Virus Viral Load

2019 ◽  
Vol 70 (5) ◽  
pp. 867-874 ◽  
Author(s):  
Robin M Nance ◽  
Maria Esther Perez Trejo ◽  
Bridget M Whitney ◽  
Joseph A C Delaney ◽  
Fredrick L Altice ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Substance Use ◽  
Viral Load ◽  
Drug Use ◽  
Viral Suppression ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Hiv Viral Load ◽  
Immunodeficiency Virus ◽  
The Impact

Abstract Background Substance use is common among people living with human immunodeficiency virus (PLWH) and a barrier to achieving viral suppression. Among PLWH who report illicit drug use, we evaluated associations between HIV viral load (VL) and reduced use of illicit opioids, methamphetamine/crystal, cocaine/crack, and marijuana, regardless of whether or not abstinence was achieved. Methods This was a longitudinal cohort study of PLWH from 7 HIV clinics or 4 clinical studies. We used joint longitudinal and survival models to examine the impact of decreasing drug use and of abstinence for each drug on viral suppression. We repeated analyses using linear mixed models to examine associations between change in frequency of drug use and VL. Results The number of PLWH who were using each drug at baseline ranged from n = 568 (illicit opioids) to n = 4272 (marijuana). Abstinence was associated with higher odds of viral suppression (odds ratio [OR], 1.4–2.2) and lower relative VL (ranging from 21% to 42% by drug) for all 4 drug categories. Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with VL suppression (OR, 2.2, 1.6, respectively). Reducing frequency of illicit opioid or methamphetamine/crystal use without abstinence was associated with lower relative VL (47%, 38%, respectively). Conclusions Abstinence was associated with viral suppression. In addition, reducing use of illicit opioids or methamphetamine/crystal, even without abstinence, was also associated with viral suppression. Our findings highlight the impact of reducing substance use, even when abstinence is not achieved, and the potential benefits of medications, behavioral interventions, and harm-reduction interventions.

scholarly journals Electronic self-administered screening for substance use in adult primary care patients: feasibility and acceptability of the tobacco, alcohol, prescription medication, and other substance use (myTAPS) screening tool

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Angéline Adam ◽  
Robert P. Schwartz ◽  
Li-Tzy Wu ◽  
Geetha Subramaniam ◽  
Eugene Laska ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Drug Use ◽  
Rapid Assessment ◽  
Secondary Analysis ◽  
Ease Of Use ◽  
Assessment Instrument ◽  
Electronic Screening ◽  
Primary Care Patients ◽  
Lower Education

Abstract Background The TAPS Tool is a substance use screening and brief assessment instrument that was developed for use in primary care medical settings. It is one of the first screening instruments to provide rapid assessment of all commonly used substance classes, including illicit and prescription opioids, and is one of the only available screeners designed and validated in an electronic self-administered format (myTAPS). This secondary analysis of data from the TAPS Tool validation study describes the feasibility and acceptability of the myTAPS among primary care patients. Methods Adult patients (N = 2000) from five primary care clinics completed the TAPS Tool on a tablet computer (myTAPS), and in an interviewer-administered format. Requests for assistance and time required were tracked, and participants completed a survey on ease of use, utilization of audio guidance, and format preference. Logistic regression was used to examine outcomes in defined subpopulations, including groups that may have greater difficulty completing an electronic screener, and those that may prefer an electronic self-administered approach. Results Almost all participants (98.3%) reported that the myTAPS was easy to use. The median time to complete myTAPS screening was 4.0 min (mean 4.48, standard deviation 2.57). More time was required by participants who were older, Hispanic, Black, or reported non-medical prescription drug use, while less time was required by women. Assistance was requested by 25% of participants, and was more frequently requested by those who with lower education (OR = 2.08, 95% CI 1.62–2.67) or age > 65 years (OR = 2.79, 95% CI 1.98–3.93). Audio guidance was utilized by 18.3%, and was more frequently utilized by participants with lower education (OR = 2.01, 95% CI 1.54–2.63), age > 65 years (OR = 1.79, 95% CI 1.22–2.61), or Black race (OR = 1.30, 95% 1.01–1.68). The myTAPS format was preferred by women (OR = 1.29, 95% CI 1.00–1.66) and individuals with drug use (OR = 1.43, 95% CI 1.09–1.88), while participants with lower education preferred the interviewer-administered format (OR = 2.75, 95% CI 2.00–3.78). Conclusions Overall, myTAPS screening was feasible and well accepted by adult primary care patients. Clinics adopting electronic screening should be prepared to offer assistance to some patients, particularly those who are older or less educated, and should have the capacity to use an interviewer-administered approach when required.

Comorbidity is associated with disease activity in MS

Neurology ◽  
2020 ◽  
Vol 95 (5) ◽  
pp. e446-e456 ◽  
Author(s):  
Amber Salter ◽  
Kaarina Kowalec ◽  
Kathryn C. Fitzgerald ◽  
Gary Cutter ◽  
Ruth Ann Marrie
Keyword(s):  
Clinical Trial ◽  
Disease Activity ◽  
Cox Regression ◽  
Secondary Analysis ◽  
Large Trial ◽  
Comorbid Conditions ◽  
Comorbidity Burden ◽  
Concomitant Medications ◽  
Comorbidity Status ◽  
The Impact

ObjectiveTo determine whether comorbidity is associated with clinical (relapses, disability worsening) and MRI outcomes in multiple sclerosis (MS) by conducting a secondary analysis of the CombiRx clinical trial.MethodsCombiRx compared interferon beta-1a, glatiramer acetate, and the combination of these agents. For participants eligible for evaluation of 6-month confirmed disability worsening, we used medical history, concomitant medications, and adverse events to ascertain comorbidity status. Comorbid conditions evaluated included hypertension, dyslipidemia, diabetes mellitus, depression, anxiety disorders, and migraine. Clinical outcomes included disease activity consisting of protocol-defined relapses, disability worsening, and MRI activity. We summarized the prevalence of these comorbid conditions and their association with disease activity and its components using multivariable Cox regression.ResultsOf the 1,008 participants randomized, 959 (95.1%) were eligible for assessment of 6-month disability worsening; for this subgroup, the median length of follow-up was 3.4 years (range 0.5–6.9 years). Overall, 55.1% of participants had ≥1 comorbidity at enrollment. After adjustment, anxiety (hazard ratio [HR] 1.25, 95% confidence interval [CI] 1.01–1.55) and dyslipidemia (HR 1.32, 95% CI 1.01–1.72) were associated with an increased hazard of any disease activity, while migraine (HR 0.80, 95% CI 0.67–0.97) was associated with a decreased hazard.ConclusionsIn this large trial population with rigorously obtained outcomes, comorbid conditions were common among participants and influenced disease outcomes, including relapses. The comorbidity burden of clinical trial participants with MS may be an important factor in the outcome of clinical trials. Additional investigations of the impact of comorbidity on clinical trial outcomes and response to disease-modifying therapies are warranted.

Sign in / Sign up

Export Citation Format

Share Document