scholarly journals Commentary

2000 ◽  
Vol 6 (1) ◽  
pp. 39-40
Author(s):  
Roch Cantwell
Keyword(s):  
Illicit Drugs ◽  
Substance Misuse ◽  
Illicit Drug ◽  
Information Gathering ◽  
Drug Misuse ◽  
High Prevalence ◽  
The Rich ◽  
The Uk ◽  
Tabloid Journalism ◽  
Timely Reminder

In the sometimes sensational world of illicit drug reportage, there is one unsung villain. While heroin misuse remains the bête noir of tabloid journalism, ecstasy the demon of the dance floors and cocaine caricatured as the choice of the rich and famous, amphetamine misuse has lurked the shadows. Its use defies such simple categorisation and spans several groups in society. Bruce has provided a timely reminder of this neglected area in substance misuse literature and, in the process, has highlighted the relevance of basic information gathering as the most important tool in the armamentorium of drug misuse workers. The lack of prominence given to what they describe as a “hidden epidemic” is striking. Could this be because amphetamine misuse is a less prevalent problem than that of other illicit drugs? Evidence suggests otherwise. Amphetamine is the second most common illicit drug seized in the UK (after cannabis). It is easily produced and used in a variety of modes, and recent research confirms a high prevalence of misuse in this country reflecting that found in North American and Australian literature.

Problems due to use of alcohol and other psychoactive substances

Psychiatry ◽  
2019 ◽  
Author(s):  
Rebecca McKnight ◽  
Jonathan Price ◽  
John Geddes
Keyword(s):  
Illicit Drugs ◽  
Substance Misuse ◽  
Classification Systems ◽  
Drug Misuse ◽  
Psychoactive Substances ◽  
Victorian England ◽  
True Incidence ◽  
Medicinal Use ◽  
The Individual ◽  
The Uk

Archaeological evidence has demonstrated that for at least the past 10,000 years humans have been using psychoactive substances. From the chewing of coca leaves in Ancient Peru (c.4000– 3000 bce) to the popular use of laudanum in Victorian England, the recreational, cultural, and medicinal use of ‘mind- altering’ substances has been widespread. As of 2016, alcohol and other psychoactive substances remain a leading cause of medical and social problems world­wide: humans are clearly vulnerable to their attrac­tion. Although a myriad of substances are available, only a few are commonly used, and all tend to produce similar harms upon the individual and society. This chapter will provide a general approach to managing a patient presenting with a problem stemming from substance misuse. It is extremely difficult to gather accurate data on the use of substances in the general population, especially if they are illegal. It is therefore likely that most figures are underestimations of the true incidence. The WHO estimates that tobacco, alcohol, and illicit drugs are a factor in 12.4 per cent of all deaths worldwide. This is a stark reminder of the severity that problems associated with substance usage can reach, but the morbidity sur­rounding them affects a much wider section of society. In the UK, 80 per cent of adults drink alcohol, 19 per cent smoke tobacco, and 30 per cent admit to having used an illegal drug at least once in their lifetime. Worldwide, the highest prevalence of drug misuse is found in the 16- to 30- year age group, with males outnumbering females at a ratio of 4 to 1. Table 29.1 shows a selection of epidemiological figures associ­ated with commonly used substances. Substance misuse is associated with an array of con­fusing terminology, the majority describing different disorders that may occur due to use of any substance. The following terms are internationally agreed and ap­pear in major classification systems:… ● Intoxication is the direct psychological and physical effects of the substance that are dose dependent and time limited. They are individual to the substance and typically include both pleasurable and unpleasant symptoms.

Substance misuse and dependence: older people deserve better services

1999 ◽  
Vol 9 (4) ◽  
pp. 327-342 ◽  
Author(s):  
Ilana B Crome ◽  
Ed Day
Keyword(s):  
Older People ◽  
Large Scale ◽  
Substance Misuse ◽  
Drug Misuse ◽  
Definition Of ◽  
The Uk ◽  
Available Information

It is not easy to establish with any confidence the prevalence of drug misuse in older people. The issue is confounded by variations in definition of what constitutes ‘elderly’ and ‘drug misuse’, and by the types of sample used (Tables 1 and 2). There are few large-scale studies in the UK, and much of the information has been extrapolated from the American findings. The available information can be organized into four main areas:

scholarly journals Substance misuse in adolescents

2000 ◽  
Vol 6 (3) ◽  
pp. 201-210 ◽  
Author(s):  
Harith Swadi
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Drug Use ◽  
Health Services ◽  
Substance Misuse ◽  
Preventive Measures ◽  
Treatment Services ◽  
High Prevalence ◽  
The Uk

There is increasing evidence that substance misuse among British adolescents is escalating (Miller & Plant, 1996; Sutherland & Willner, 1998). Swadi (1992) found that, among adolescents aged 12–17 years referred to mental health services, the prevalence of drug use was 13.1% (16.3% among boys and 9.3% among girls). Despite this relatively high prevalence, there are very few organised treatment services for adolescents in the UK. Instead, there is extensive emphasis on prevention even though there is no universal agreement on what prevention can achieve. This approach also overlooks the fact that a significant number of adolescents fail to respond to preventive measures in any form.

scholarly journals The Destructive Capacity of Drug Abuse: An Overview Exploring the Harmful Potential of Drug Abuse Both to the Individual and to Society

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Thomas Peter Fox ◽  
Govind Oliver ◽  
Sophie Marie Ellis
Keyword(s):  
Drug Abuse ◽  
Substance Misuse ◽  
Crack Cocaine ◽  
Illegal Drug ◽  
Drug Misuse ◽  
Western World ◽  
Public Health Perspective ◽  
Published Evidence ◽  
The Individual ◽  
The Uk

From a public health perspective, substance abuse has long been a source of major concern, both for the individual’s health and for wider society as a whole. The UK has the highest rates of recorded illegal drug misuse in the western world. In particular, it has comparatively high rates of heroin and crack cocaine use. Substances that are considered harmful are strictly regulated according to a classification system that takes into account the harms and risks of taking each drug (see the tables) (Nutt et al. (2007)). The adverse effects of drug abuse can be thought of in three parts that together determine the overall harm in taking it: (1) the direct physical harm of the substance to the individual user, (2) the tendency of the drug to induce dependence, and (3) the effect of abuse of the drug on families, communities, and society (Gable (2004, 1993)). In this report, we discuss published evidence relating to the harm of substance misuse and consider the neuropsychopharmacological mechanisms behind addiction in an attempt to gain an improved picture of the potential devastation that abuse of these substances may evoke.

Plasma Methadone Measurements and Their Role in Methadone Detoxification Programs

1992 ◽  
Vol 38 (3) ◽  
pp. 420-425 ◽  
Author(s):  
K Wolff ◽  
A W Hay ◽  
D Raistrick
Keyword(s):  
Illicit Drugs ◽  
Illicit Drug ◽  
Plasma Concentrations ◽  
Opioid Addiction ◽  
Withdrawal Symptoms ◽  
Drug Misuse ◽  
Plasma Measurements ◽  
Methadone Program

Abstract We monitored eight patients who were receiving a decreasing dose of methadone for treatment for opioid addiction (detoxification). Patients with plasma concentrations of methadone less than 0.05 mg/L experienced withdrawal symptoms, relapsed, and re-abused illicit drugs. Four patients took extra methadone (illicitly obtained) during detoxification. None of the eight patients in our study were successfully weaned off methadone: all left the methadone detoxification program before the completion of treatment. Two patients subsequently returned to a fixed methadone program elsewhere, and four relapsed and returned to illicit drug misuse. Plasma measurements may help clinicians assess patients during methadone detoxification.

Young people and substance misuse

2018 ◽  
Vol 11 (11) ◽  
pp. 601-607
Author(s):  
Irene Hernandez Sanchez
Keyword(s):  
Substance Misuse ◽  
Warning Signs ◽  
Assessment Tools ◽  
Drug Misuse ◽  
Mental Performance ◽  
Illegal Drug Use ◽  
And Performance ◽  
The Uk ◽  
Drunk Alcohol

In the UK in 2017, 9% of pupils aged 11–15 reported having drunk alcohol in the previous week, which is the lowest rate since the 1980s. Illegal drug use in the previous year reported by 15-year olds halved between 2001 and 2014. Despite these promising figures, adolescence is deemed to be decisive for future biopsychosocial development and performance. Initiation during adolescence may therefore have long-term implications, affecting mental performance and educational outcomes. This article focuses on patterns of drug misuse in teenagers. The warning signs of drug misuse and useful assessment tools are also introduced. For the purposes of this article, alcohol will be defined as a drug.

Multiple Exclusion Homelessness in the UK: Key Patterns and Intersections

2011 ◽  
Vol 10 (4) ◽  
pp. 501-512 ◽  
Author(s):  
Suzanne Fitzpatrick ◽  
Sarah Johnsen ◽  
Michael White
Keyword(s):  
Substance Misuse ◽  
Institutional Care ◽  
Drug Misuse ◽  
Multi Stage ◽  
Low Threshold ◽  
The Uk ◽  
High Degree ◽  
Personal Trauma ◽  
Very High ◽  
Prevalent Form

This article presents preliminary results from a multi-stage quantitative study of ‘multiple exclusion homelessness’ (MEH) in seven urban locations across the UK. It demonstrates a very high degree of overlap between a range of experiences associated with ‘deep social exclusion’ – namely, homelessness, substance misuse, institutional care and ‘street culture’ activities (such as begging and street drinking). It also provides evidence to support the contention that homelessness is a particularly prevalent form of exclusion, with its experience reported as widespread by those accessing low threshold support services targeted at other dimensions of deep exclusion, such as drug misuse. Further, the analysis presented indicates that the nature of MEH varies geographically, with the profile of the population affected looking quite different in Westminster (London) than in the other urban locations. The main explanation for this appears to be the exceptionally high proportion of migrants in the MEH population in Westminster, who tend to report lower overall levels of personal trauma and vulnerability than the indigenous MEH population.

scholarly journals Piloting the UK’s First Home-Office-Licensed Pharmacist-Led Drug Checking Service at a Community Substance Misuse Service

2020 ◽  
Vol 10 (8) ◽  
pp. 121
Author(s):  
Amira Guirguis ◽  
Rosalind Gittins ◽  
Fabrizio Schifano
Keyword(s):  
Public Health ◽  
Illicit Drugs ◽  
Substance Misuse ◽  
Synthetic Cannabinoids ◽  
Cascade Process ◽  
Home Office ◽  
Ethical Decisions ◽  
Drug Sample ◽  
Drug Checking ◽  
The Uk

(1) Introduction: Drug-related deaths in the UK are at concerning high levels. The unknown content and purity of illicit substances can cause unpredictable adverse effects and thus a public health risk with no sign of abating. On-site drug checking is a public health strategy that has previously been implemented, predominantly in festival settings, but without Home Office licensing. (2) Aims: The aim of this study was to pilot the UK’s first pharmacist-led, Home Office-licensed community drug checking service. (3) Methods: A bespoke protocol incorporating legally, professionally and ethically binding documents was implemented. This free, confidential service ran between February and March 2019, was available to anyone over 18 who were purposefully recruited, gave informed consent and agreed to relinquish their drug sample. Samples were checked on-site within an established Substance Misuse Service (SMS) using a handheld Raman spectrometer to determine likely drug content and adulterants. In parallel, participants completed a questionnaire about their substance use and the drug sample(s) being tested. A pharmacist-led multidisciplinary approach was adopted to discuss the analytical findings. Informed by the results of the analysis and the questionnaire, people who used the service received tailored harm reduction advice. (4) Results and Discussion: The pilot operated for a total of four days over four weeks. Eleven people visited and relinquished a total of thirteen samples. Half of the participants had previously overdosed and were known to the SMS. Seventy per cent were male, all were White British individuals, 30% were employed and two people disclosed visiting from another nearby town. Samples included what was thought to be heroin, synthetic cannabinoids, stimulants, benzodiazepines and LSD and none required activation of the “alerts cascade” process. Most participants drank alcohol regularly and the concomitant use of traditional illicit drugs and prescribed medication (including opioids, anxiolytics and antidepressants) with sedating profiles was common. Given some of the ethical decisions and interpretation of the results, specialist pharmacist involvement was deemed essential. (5) Conclusions: This pilot demonstrated the proof-of-concept that a pharmacist-led Home Office-licensed drug checking service can be successfully implemented in community SMSs.

scholarly journals Has illicit drug use become normalised in groups of Swedish youth? A latent class analysis of school survey data from 2012 to 2015

2018 ◽  
Vol 36 (1) ◽  
pp. 21-35 ◽  
Author(s):  
Patrik Karlsson ◽  
Mats Ekendahl ◽  
Josefin Månsson ◽  
Jonas Raninen
Keyword(s):  
Drug Use ◽  
Latent Class Analysis ◽  
Drug Policy ◽  
Drug Users ◽  
Illicit Drugs ◽  
Latent Class ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Illicit Drug Users ◽  
High Prevalence

Background: It is often assumed that illicit drug use has become normalised in the Western world, as evidenced for example by increased prevalence rates and drug-liberal notions in both socially advantaged and disadvantaged youth populations. There is accumulating research on the characteristics of young illicit drug users from high-prevalence countries, but less is known about the users in countries where use is less common. There is reason to assume that drug users in low-prevalence countries may be more disadvantaged than their counterparts in high-prevalence countries, and that the normalisation thesis perhaps does not apply to the former context. Aim: This article aims to explore to what extent such assertions hold true by studying the characteristics of young illicit drug users in Sweden, where prevalence is low and drug policy centres on zero tolerance. Material and Method: We draw on a subsample ( n = 3374) of lifetime users of illicit drugs from four waves of a nationally representative sample of students in 9th and 11th grade (2012–2015). Latent class analysis (LCA) on ten indicators pertaining to illicit drug use identified four classes which we termed “Marijuana testers”, “Marijuana users”, “Cannabinoid users” and “Polydrug users”. Findings: Indications of social advantage/disadvantage such as peer drug use, early substance-use debut and truancy varied across groups, particularly between “Marijuana testers” (low scores) and “Polydrug users” (high scores). Conclusions: Our findings corroborate the idea that the majority of those who have used illicit drugs in the Swedish youth population have tried marijuana a few times only. We discuss whether or not the comparably large share of socially advantaged “Marijuana testers” in a comparably small sample of lifetime users can be interpreted as a sort of normalisation in a prohibitionist drug policy context.

scholarly journals Drug misuse in older people: old problems and new challenges

2010 ◽  
Vol 16 (6) ◽  
pp. 421-429 ◽  
Author(s):  
Vellingiri Raja Badrakalimuthu ◽  
Daphne Rumball ◽  
Ajay Wagle
Keyword(s):  
Older People ◽  
Substance Misuse ◽  
Psychiatric Morbidity ◽  
Drug Misuse ◽  
Diagnostic Ability ◽  
The People ◽  
New Challenges ◽  
The Uk ◽  
And Training ◽  
The Invisible

SummaryVery little attention has been paid to the invisible epidemic of substance misuse among older people in the UK. This article looks at the prevalence of substance misuse in the people over the age of 60. The reasons for difficulty in diagnosing substance misuse are explored and ways to improve diagnostic ability are discussed. Substance misuse leads to severe physical and psychiatric morbidity that is being managed by meagre resources. The article provides recommendations on specific issues related to interventions, biological and psychosocial, and training of psychiatrists.

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