Impact of tobacco and illicit drug use in the care of adolescent and young adults with sarcoma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18657-e18657
Author(s):  
Rushad Machhi ◽  
Amanda Marie Parkes
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Tobacco Use ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Chemotherapy Dose ◽  
Delays In Diagnosis ◽  
Oncology Providers ◽  
Current Tobacco ◽  
Dose Reductions

e18657 Background: Despite adolescent and young adults (AYAs) representing the patient population most likely to initiate and use tobacco and illicit drugs, studies of their impact have thus far focused on older cancer patients or those in survivorship. As sarcomas often serve as a model for AYA care and are associated with poor psychosocial function, frequent delays in diagnosis, and outcomes related to chemotherapy dose density, we sought to understand the impact of tobacco and illicit drug use on diagnosis, chemotherapy delays and dose reductions, and no-show rates in AYAs with sarcoma. Methods: Retrospective chart review was performed on adult AYA patients (18-39 years) with sarcoma seen at least once in 2019 at the University of Wisconsin, identifying documentation of tobacco, marijuana, and other illicit drug use and comparing to pre-identified cancer outcomes including days from symptom onset to tissue diagnosis (with delay defined as > 120 days from symptoms to diagnosis), chemotherapy delays > 1 week and dose reductions, and appointment no-show rates. Current substance use was defined as use following cancer diagnosis. Results: We identified 46 AYAs with sarcoma, with documented tobacco use in 20% as current (9/46), 13% as former (6/46) and 67% as none (31/46). Marijuana and illicit drug use were less frequent at 17% (8/46) and 7% (3/46) respectively. Delayed diagnoses were more common in patients with current tobacco use (6/9, 67%) as compared with former or non-smokers (12/37, 32%, p = 0.12) and were seen in all patients with illicit drug use (3/3, 100%), as compared with only 35% without illicit drug use (15/43, p = 0.05). Of the 24 patients who received chemotherapy, chemotherapy delays and dose reductions were more common in current tobacco users at 86% (6/7) and 29% (2/7) respectively, as compared with patients with former or no tobacco use at 71% (12/17) and 18% (3/17) respectively. Chemotherapy dose reductions were also more common in patients with illicit drug use (2/3, 67%) versus no illicit drug use (3/21, 14%, p = 0.10). Appointment no-show rates were higher in current tobacco users versus former or non-smokers, with 44% (4/9) versus 27% (10/37) with a no-show rate > 5%. In patients with documented substance use, oncology providers documented 93% of tobacco use (14/15) but only 38% marijuana use (3/8) and 33% illicit drug use (1/3) and no oncology providers documented a cessation plan. Conclusions: Current tobacco and illicit drug use in AYAs with sarcoma were associated with delays in diagnosis, increased chemotherapy delays and dose reductions, and higher no-show rates, highlighting modifiable risk factors. Even more strikingly, oncology providers had low rates of documentation of marijuana and illicit drug use in AYAs and no documentation of plans for cessation, highlighting a lost opportunity and the need for more standardized substance use assessment and evidence-based cessation interventions for AYAs with cancer.

Peer and Community Influences on Adolescent Substance Use in the Context of Adverse Childhood Experiences

2021 ◽  
pp. 073112142110187
Author(s):  
Haley Stritzel
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Adverse Childhood Experiences ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Peer Influences ◽  
Childhood Experiences ◽  
Community Influences ◽  
Adverse Childhood ◽  
Peer Substance Use

Both adverse childhood experiences (ACEs) and peer influences consistently predict early tobacco, alcohol, and illicit drug use. However, less research considers how peer and community influences contribute to or modify the association between ACEs and early substance use. This study addresses these gaps in the literature by analyzing multilevel, longitudinal data from the Project on Human Development in Chicago Neighborhoods (PHDCN; N = 1,912). Unstructured socializing and peer substance use largely explained the association between ACEs and drinking, smoking cigarettes, and illicit drug use in the past month. A history of ACEs magnified the association between peer substance use and the number of cigarettes smoked. Collective efficacy also shaped the associations between peer influences, ACEs, and substance use, but in different ways depending on the substance use outcome analyzed.

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.

Do men who have sex with men who report alcohol and illicit drug use before/during sex (chemsex) present moderate/high risk for substance use disorders?

2020 ◽  
Vol 209 ◽  
pp. 107908 ◽  
Author(s):  
Thiago S. Torres ◽  
Leonardo S. Bastos ◽  
Luciana Kamel ◽  
Daniel R.B. Bezerra ◽  
Nilo M. Fernandes ◽  
...  
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Drug Use ◽  
Substance Use Disorders ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Sex With Men

Correlates of alcohol and illicit drug use before commercial sex among transgender women with a history of sex work in China

Sexual Health ◽  
2020 ◽  
Vol 17 (1) ◽  
pp. 45 ◽  
Author(s):  
Qian Wang ◽  
Ruijie Chang ◽  
Ying Wang ◽  
Xueqin Jiang ◽  
Shuxian Zhang ◽  
...  
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Sex Workers ◽  
Female Sex Workers ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Commercial Sex ◽  
Female Sex ◽  
Alcohol And Drugs ◽  
Combined Use

Background Research on substance use among transgender female sex workers in China is scarce. The aims of this study were to examine: (1) the prevalence of alcohol or illicit drug use before commercial sex among this population; and (2) correlates of alcohol and illicit drug use. Methods: Complete survey data were analysed from 397 transgender female sex workers recruited from three of the largest cities in China: Shenyang, Shanghai and Guangzhou. Information was collected about demographics, alcohol or illicit drug use, alone or in combination, and their psychosocial correlates using structured questionnaires. Multinomial logistic regression models were used to examine the association between substance use and its correlates. Results: Before commercial sex, approximately one-third of the sample reported exclusive alcohol use (28.5%), 9.3% reported exclusive drug use and 7.3% reported combined use of alcohol and drugs. Before commercial sex, participants with low self-esteem had twice the odds of using alcohol exclusively (adjusted odds ratio (aOR) 2.05; 95% confidence interval (CI) 1.01–4.17), those with higher levels of loneliness had almost threefold the odds of exclusive drug use (aOR 2.92; 95% CI 1.21–7.07) and those with depression (aOR 2.97; 95% CI 1.11–7.96) and unknown HIV status (aOR 3.00; 95% CI 1.02–8.87) had threefold the odds of combined use of alcohol and drugs. Conclusion: Programs aimed at reducing alcohol or drug use among transgender female sex workers in China may consider adding components that help support mental health and encouraging HIV screening.

scholarly journals Illicit Drug Use and Problem Gambling

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Peter Ferentzy ◽  
W. J. Wayne Skinner ◽  
Flora I. Matheson
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Problem Gambling ◽  
Substance Use Disorders ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Future Research ◽  
Review Of The Literature ◽  
And Gender ◽  
Legal Substances

Problem gambling, substance use disorders, and their cooccurrence are serious public health concerns. We conducted a comprehensive review of the literature to understand the present state of the evidence on these coaddictions. Our main focus was illicit drug use rather than misuse of legal substances. The review covers issues related to gambling as a hidden problem in the illicit drug use community; prevalence, problem gambling, and substance use disorders as kindred afflictions; problem gambling as an addiction similar to illicit drug use; risk factors and problems associated with comorbidity, and gender issues. We end with some suggestions for future research.

scholarly journals Effects of mental health and substance use disorder symptoms on the association between STDs and sexual identity: evidence from the 2017–2019 National Survey on Drug Use and Health

2021 ◽  
Author(s):  
David Adzrago ◽  
Samuel H. Nyarko ◽  
Nnenna Ananaba ◽  
Christine Markham
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Drug Use ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Illicit Drug ◽  
Marijuana Use ◽  
Illicit Drug Use ◽  
Major Depressive ◽  
And Gender

Abstract Background Sexually transmitted disease (STD) cases are rising in the USA, especially among sexual and gender minorities, despite the availability of numerous STD prevention programs. We examined the differences in STD prevalence among sexual and gender minority subgroups with major depressive episode symptoms and substance use dependence. Methods We combined 2017, 2018, and 2019 National Survey on Drug Use and Health (NSDUH) public-use data on adults (N = 127,584) to conduct weighted multivariable logistic regression and margins analyses. Results Approximately 2.05% of the population reported having STDs. The population that had major depressive episode symptoms (AOR = 1.70, 95% CI = 1.46, 1.99), alcohol use dependence (AOR = 1.79, 95% CI = 1.49, 2.16), illicit drug use other than marijuana use dependence (AOR = 2.25, 95% CI = 1.73, 2.92), or marijuana use dependence (AOR = 1.90, 95% CI = 1.57, 2.31) had higher odds of contracting STDs compared to their counterparts. Lesbian/gay (AOR = 2.81, 95% CI = 2.24, 3.54) and bisexual (AOR = 1.95, 95% CI = 1.60, 2.37) individuals had higher odds of contracting STDs. Lesbians/gays with major depressive episode symptoms, alcohol use dependence, or illicit drug use other than marijuana use dependence had the highest probability of having STDs, compared to bisexuals and heterosexuals with major depressive episode symptoms, alcohol use, or illicit drug use other than marijuana use dependence. Bisexuals with marijuana use dependence had the highest probability of STD contraction compared to their lesbian/gay and heterosexual counterparts. Within each sexual identity subgroup, the probability of having STDs was higher for individuals with major depressive episode symptoms, or dependence on alcohol use, illicit drug use other than marijuana use, or marijuana use compared to their counterparts. Conclusion Major depressive episode symptoms, substance use dependence, and sexual and gender minority status had higher risks for STD diagnosis, particularly for sexual and gender minorities with major depressive episode symptoms or substance use dependence. Tailored interventions based on major depressive episode symptoms and substance use dependence may reduce the prevalence of STD, especially among sexual and gender minorities.

scholarly journals Genetic risk for schizophrenia is associated with substance use in emerging adulthood: an event-level polygenic prediction model

2018 ◽  
Vol 49 (12) ◽  
pp. 2027-2035 ◽  
Author(s):  
Travis T. Mallard ◽  
K. Paige Harden ◽  
Kim Fromme
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Emerging Adulthood ◽  
Genetic Risk ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Clinical Population ◽  
Peak Period ◽  
Polygenic Score ◽  
Age Related

AbstractBackgroundEmerging adulthood is a peak period of risk for alcohol and illicit drug use. Recent advances in psychiatric genetics suggest that the co-occurrence of substance use and psychopathology arises, in part, from a shared genetic etiology. We sought to extend this research by investigating the influence of genetic risk for schizophrenia on trajectories of four substance use behaviors as they occurred across emerging adulthood.MethodYoung adult participants of non-Hispanic European descent provided DNA samples and completed daily reports of substance use for 1 month per year across 4 years (N = 30 085 observations of N = 342 participants). A schizophrenia polygenic score was included in two-level hierarchical linear models designed to test associations between genetic risk for schizophrenia, participant age, and four substance use phenotypes.ResultsParticipants with a greater schizophrenia polygenic score experienced greater age-related increases in the likelihood of using substances across emerging adulthood (p < 0.005). Additionally, our results suggest that the polygenic score was positively associated with participants’ overall likelihood to engage in illicit drug use but not alcohol-related substance use.ConclusionsThis study used a novel combination of polygenic prediction and intensive longitudinal methods to characterize the influence of genetic risk for schizophrenia on patterns of age-related change in substance use across emerging adulthood. Results suggest that genetic risk for schizophrenia has developmentally specific effects on substance use behaviors in a non-clinical population of young adults.

Comorbidity of substance use and psychiatric disorders among inpatients of a General Hospital Psychiatric Unit

2011 ◽  
Vol 26 (S2) ◽  
pp. 85-85
Author(s):  
A. Pachi ◽  
K. Giotakis ◽  
T. Kostaras ◽  
A. Pavla ◽  
A. Christodoulaki ◽  
...  
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Psychiatric Disorders ◽  
General Hospital ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Final Diagnosis ◽  
T Test ◽  
Psychiatric Unit ◽  
Duration Of Hospitalization

IntroductionIn substance – related disorders comorbidity refers to any preexisting or following psychological or psychiatric condition that influence the course and prognosis of a patient.ObjectivesTo determine the extent of comorbid substance use and psychiatric disorders among hospitalized in a General Hospital Psychiatric Unit patients and reveal the implications of treatment in such a unit.MethodAll patients hospitalized during a year, were included in the study. Demographics, final diagnosis, substance of use and means of admission (voluntary or involuntary) were recorded.Results7.4% of the total of 339 inpatients met the diagnostic criteria of comorbid substance use disorders. Eleven of them were diagnosed with alcohol use disorder comorbidity, 7 with illicit drug use comorbidity and 7 with both legal and illicit drug use comorbidity. Among inpatients with comorbid use disorders male patients had a significantly higher percentage versus females (x2 p < 0.05). Mean age of inpatients with comorbidity was significantly less than the mean age of the sample (t-test p < 0.05). Duration of hospitalization for inpatients with comorbidity was 15.16 ± 12.4 days versus 21.2 ± 18.4 days for the rest of patients (t-test p < 0.05). Concerning the way of admission, 72% of inpatients with comorbid use disorders were involuntary admitted (x2 p < 0.05).ConclusionConcerning age, sex and means of admission patients with a psychiatric disorder and substance use disorder comorbidity seem to vary from the rest of inpatients. These parameters are probably associated with serious difficulties in therapeutic compliance and with increased hazard.

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