scholarly journals Open secret, or imagined problem: Drug and alcohol use in Tanzanian road traffic accident drivers

2020 ◽  
Author(s):  
Adeline Rose Dozois ◽  
Paulina Nkondora ◽  
Erin E Noste ◽  
Juma Mfinanga ◽  
Hendry R Sawe ◽  
...  
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Alcohol Use ◽  
Drug Use ◽  
Alcohol Use Disorder ◽  
Screening Tool ◽  
Road Traffic ◽  
World Health ◽  
Urine Drug Screen ◽  
Research Assistants

Abstract Background Road traffic accidents (RTAs) have emerged as an important public health problem in low and middle-income countries, where 90% of RTA deaths occur. The World Health Organization has suggested strategies to address excess mortality from RTAs including efforts to combat driving while intoxicated. The association between substance use and RTAs is well known in high-income countries, but data is more limited in low-resource settings including Tanzania. The objective of this study is to examine the prevalence of drug use, alcohol use, and substance use disorders in Tanzanian RTA drivers. Methods This prospective observational study was conducted in the Emergency Department of Muhimbili National Hospital, a national referral hospital in Dar es Salaam, Tanzania. Research assistants available 24 hours per day enrolled adult drivers who presented within 24 hours of an RTA. In eligible patients, research assistants collected a saliva test of blood alcohol content (BAC) and a urine drug screen (UDS), and administered a validated substance abuse screening tool, the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Patients were excluded from individual analyses if they could not produce a saliva or urine test or answer questions. Primary outcomes were rates of positive BAC, UDS and self-reported high-risk alcohol and drug use patterns. Descriptive statistics were calculated using Excel. Results We screened 5264 trauma patients and enrolled 538, in whom 191 had a BAC, 362 had a UDS, and 417 had a complete ASSIST. Fifteen of 191 patients (7.8%) had a positive BAC, and 68/362 (18.7%) patients had a UDS that was positive for at least one drug. Based on the ASSIST, 104/417 (24.5%) of patients were at moderate or high risk for alcohol use disorder. Few were at risk for disordered use of other non-tobacco substances. Conclusion In our population of drivers presenting within 24 hours of an RTA, positive BAC and UDS tests were rare. A substantial portion of the population was at moderate to high risk for an alcohol use disorder. Ideal screening for substance use in trauma populations may involve a verbal screening tool, particularly when the time between injury and hospital arrival is delayed.

The Relationships of Perpetrator and Victim Substance Use to the Sexual Aggression of Rapists and Child Molesters

Sexual Abuse ◽  
2011 ◽  
Vol 24 (4) ◽  
pp. 307-327 ◽  
Author(s):  
Nayla R. Hamdi ◽  
Raymond A. Knight
Keyword(s):  
Substance Use ◽  
Alcohol Use ◽  
Drug Use ◽  
Sexual Aggression ◽  
Child Molesters ◽  
Positive Association ◽  
Treatment Center ◽  
Child Molestation ◽  
Sexual Crimes ◽  
Research Assistants

Objective: This study investigated substance use in rape and child molestation. We hypothesized that perpetrator substance use would be associated with a greater increase in rapists’ aggression in sexual crimes compared with that of child molesters. We also predicted that victim substance use would be negatively related to both rapists and child molesters’ aggression in sexual crimes. Method: The sample included 245 male rapists and 273 male child molesters who had been evaluated at the Massachusetts Treatment Center (MTC) between 1959 and 1991 for potential civil commitment. Data were obtained from offenders’ archival records and were coded by trained research assistants on perpetrator and victim substance use and perpetrator aggression in sexual crimes. Results: Analyses showed that the magnitude of the positive association between perpetrator alcohol use and aggression in sexual crimes did not differ between rapists and child molesters. In contrast, perpetrator drug use was associated with increased aggression among child molesters only. Victim substance use was related to increased aggression among rapists only. Conclusions: The results indicate that victim substance use and perpetrator drug use, but not perpetrator alcohol use, are differentially related to the aggression of rapists and child molesters in sexual crimes. Those findings imply that substance use may play different roles depending on offender type.

Substance Use and Exposure to Adverse Childhood Experiences in Undergraduate and Graduate Nursing Students

2020 ◽  
Vol 26 (4) ◽  
pp. 354-363
Author(s):  
Brayden N. Kameg ◽  
Dawn Lindsay ◽  
Heeyoung Lee ◽  
Ann Mitchell
Keyword(s):  
Substance Use ◽  
Drug Abuse ◽  
Nursing Students ◽  
High Risk ◽  
Alcohol Use ◽  
Substance Misuse ◽  
Screening Tool ◽  
Cross Sectional ◽  
Health Crisis ◽  
Adverse Childhood

BACKGROUND: Substance misuse remains a public health crisis and contributor to morbidity and mortality. The nursing workforce is not immune to the impacts of substance misuse as rates are thought to mirror those of the general population. Additionally, as substance misuse often begins in adolescence or early adulthood, prevalence of misuse among practicing nurses highlights the fact that students are also at risk. OBJECTIVES: The purpose of this study was to examine rates and patterns of substance use and adverse childhood experience (ACE) exposure among nursing students while also examining associations between substance use and ACE exposure. METHOD: This study utilizes a cross-sectional and descriptive design through the provision of email surveys to nursing students. Email surveys consisting of the Alcohol Use Disorders Identification Test, the Drug Abuse Screening Tool 10-item survey, the ACE Questionnaire, and a demographic inquiry were distributed via Qualtrics survey software. RESULTS: A total of 662 individuals participated in the survey, the majority of whom self-identified as female, were undergraduate students, and were between 18 and 21 years. Moderate- to high-risk alcohol use was identified in 20% of students, while moderate- to high-risk drug use was identified in 3.6% of students. More than half of students endorsed exposure to at least one ACE. Significant associations were found between the Drug Abuse Screening Tool 10-item survey and the ACE Questionnaire. CONCLUSIONS: The results of this study have significant implications for nursing educators and must inform groundwork for the development of policies and interventions that are evidence based, nonpunitive, and trauma informed.

scholarly journals The role of pubertal timing in the link between family history of alcohol use disorder and late adolescent substance use

2020 ◽  
Vol 210 ◽  
pp. 107955
Author(s):  
Alexander S. Weigard ◽  
Jillian E. Hardee ◽  
Robert A. Zucker ◽  
Mary M. Heitzeg ◽  
Adriene M. Beltz
Keyword(s):  
Substance Use ◽  
Family History ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Pubertal Timing ◽  
Adolescent Substance Use ◽  
Late Adolescent ◽  
Adolescent Substance ◽  
History Of

Extrastriatal Dopamine D2/3 Receptor Availability in Alcohol Use Disorder and Individuals at High Risk

2022 ◽  
pp. 1-10
Author(s):  
Gianna Spitta ◽  
Tobias Gleich ◽  
Kristin Zacharias ◽  
Oisin Butler ◽  
Ralph Buchert ◽  
...  
Keyword(s):  
High Risk ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Protective Factor ◽  
Region Of Interest ◽  
Anterior Cingulate ◽  
Dopamine D2 ◽  
Positron Emission ◽  
Significant Difference ◽  
Meta Analyses

<b><i>Introduction:</i></b> Reduced striatal dopamine D2/3 receptor availability in alcohol use disorder (AUD) has been demonstrated in recent clinical studies and meta-analyses. However, only a limited number of studies investigated extrastriatal D2/3 availability in AUD or in at-risk populations. In line with a dimensional understanding of addiction, extrastriatal dopaminergic neuroadaptations have been suggested to be relevant from a pathobiological perspective. <b><i>Methods:</i></b> We investigated D2/3 receptor availability via <sup>18</sup>F-fallypride positron emission tomography applying a region of interest (ROI) approach. We selected ROIs for the prefrontal cortex (PFC) and the anterior cingulate cortex (ACC). Our sample included 19 healthy controls (low risk [LR]), 19 individuals at high risk (HR) to develop addiction, and 20 recently detoxified AUD patients. <b><i>Results:</i></b> We found significantly higher D2/3 receptor availability of HR compared to AUD in the left and right rostral ACC (rACC), as well as in the left ventrolateral PFC (vlPFC). We did not observe a significant difference between AUD and LR. After corrections for multiple comparisons none of the ROIs reached significance throughout the group comparison. The D2/3 receptor availability in the left rACC was inversely correlated with symptom severity assessed with the Alcohol Dependency Scale. <b><i>Discussion:</i></b> To our knowledge, the present work is the first study investigating extrastriatal D2/3 receptor availabilities in individuals at HR and patients with AUD. The observation that D2/3 receptor availabilities are highest in HR might suggest that their pathobiology differs from subjects with AUD. Future studies are necessary to clarify the intraindividual course of this biomarker over different disease stages and its possible role as a risk or protective factor.

scholarly journals A Cascade of Care for Alcohol Use Disorder: Using 2015-2018 National Survey on Drug Use and Health Data to Identify Gaps in Care

2020 ◽  
Author(s):  
Carrie M. Mintz ◽  
Sarah M. Hartz ◽  
Sherri L. Fisher ◽  
Alex T. Ramsey ◽  
Elvin H. Geng ◽  
...  
Keyword(s):  
Health Care ◽  
Alcohol Use ◽  
Drug Use ◽  
Brief Intervention ◽  
Alcohol Use Disorder ◽  
Alcohol Misuse ◽  
Health Data ◽  
Health Care Settings ◽  
The Past ◽  
Cascade Of Care

ABSTRACTBackgroundAlthough effective treatments exist, alcohol use disorder (AUD) is undertreated. We used a cascade of care framework to understand gaps in care between diagnosis and treatment for persons with AUD.MethodsUsing 2015-2018 National Survey on Drug Use and Health data, we evaluated the following steps in the cascade of care: 1) prevalence of adults with AUD; 2) proportion of adults who utilized health care in the past 12 months; 3) were screened about alcohol use; 4) received a brief intervention about alcohol misuse; 5) received information about treatment for alcohol misuse; and 6) proportion of persons with AUD who received treatment. Analyses were stratified by AUD severity.ResultsOf the 171,766 persons included in the sample, weighted prevalence of AUD was 7.9% (95% CI 7.7-8.0%). Persons with AUD utilized health care settings at similar rates as those without AUD. Cascades of care showed the majority of individuals with AUD utilized health care and were screened about alcohol use, but the percent who received the subsequent steps of care decreased substantially. For those with severe AUD, 83.5% (CI: 78.3%-88.7%) utilized health care in the past 12 months, 73.5% (CI: 68.1%-78.9%) were screened for alcohol use, 22.7% (CI: 19.4%-26.0%) received a brief intervention, 12.4% (CI: 10%-14.7%) received information about treatment, and 20.5% (CI: 18%-23.1%) were treated for AUD. The greatest decrease in the care continuum occurred from screening to brief intervention and referral to treatment. More persons with severe AUD received treatment than were referred, indicating other pathways to treatment outside of the healthcare system.ConclusionsPersons with AUD utilize health care at high rates and are frequently screened about alcohol use, but few receive treatment. Health care settings-particularly primary care settings-represent a prime opportunity to implement pharmacologic treatment for AUD to improve outcomes in this high-risk population.

Meaning in Life and Substance Use

2017 ◽  
Vol 60 (1) ◽  
pp. 3-19
Author(s):  
Matthew Csabonyi ◽  
Lisa J. Phillips
Keyword(s):  
Substance Use ◽  
Young Adults ◽  
Alcohol Use ◽  
Drug Use ◽  
Meaning In Life ◽  
Life Questionnaire ◽  
Cigarette Use ◽  
Search For Meaning ◽  
Lower Alcohol ◽  
Meaning In Life Questionnaire

Viktor Frankl theorized that an absence of meaning in one’s life can result in boredom and apathy—the “existential vacuum”—and attempts to avoid or “escape” the vacuum can include short-acting distracting behaviors. This study investigated whether the presence of meaning (PM) or the search for meaning are associated with alcohol, drug, and cigarette use by young adults, and whether boredom mediates those relationships. Hundred and seventy-six young adults completed the Meaning in Life Questionnaire, the Alcohol Use Disorders Identification Test, and provided information about cigarette and illicit drug use over the preceding year. The results partly support Frankl’s model: higher PM was associated with lower alcohol/other drug use and boredom mediated those relationships, but PM was not related to cigarette smoking. Contrary to Frankl’s model, no relationship was found between search for meaning and alcohol, drug, or cigarette use. This suggests that psychological interventions that assist individuals who use drugs or alcohol to identify meaning or purpose in their lives might reduce levels of drug and alcohol use. The process of searching for meaning may not have substantial direct impact on levels of substance use, but once some meaning was established there may be decreased impetus to continue using drugs and alcohol.

An adolescent with binge drinking

2021 ◽  
pp. 213-220
Author(s):  
Eun Kyung Ellen Kim ◽  
David L. Beckmann
Keyword(s):  
Parent Involvement ◽  
Substance Use ◽  
Family Therapy ◽  
Alcohol Use ◽  
Motivational Interviewing ◽  
Binge Drinking ◽  
Alcohol Use Disorder ◽  
Treatment Medication ◽  
Problematic Alcohol Use ◽  
Risk Taking Behaviors

Alcohol use disorder (AUD) occurs in approximately 5% of adolescents. The diagnosis of AUD requires the presence of at least two signs or symptoms of problematic alcohol use. Adolescent AUD differs from adult AUD in several ways. Adolescents are more likely to engage in binge drinking rather than daily drinking. They are also less likely to experience tolerance or withdrawal and are more likely to engage in risk-taking behaviors related to substance use. All adolescents should be screened for alcohol and other substance use. A motivational interviewing approach should be used. Treatment includes individual and family therapy; parent involvement is an essential component of treatment. Medication options include naltrexone, acamprosate, and disulfiram.

scholarly journals Stability of Drinking Reductions and Long-term Functioning Among Patients with Alcohol Use Disorder

2020 ◽  
Author(s):  
Katie Witkiewitz ◽  
Henry R. Kranzler ◽  
Kevin A. Hallgren ◽  
Deborah S. Hasin ◽  
Arnie P. Aldridge ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Well Being ◽  
Total Sample ◽  
World Health ◽  
End Of Treatment

Abstract Background The World Health Organization (WHO) categorizes alcohol consumption according to grams consumed into low-, medium-, high-, and very-high-risk drinking levels (RDLs). Although abstinence has been considered the ideal outcome of alcohol treatment, reductions in WHO RDLs have been proposed as primary outcomes for alcohol use disorder (AUD) trials. Objective The current study examines the stability of WHO RDL reductions and the association between RDL reductions and long-term functioning for up to 3 years following treatment. Design and Participants Secondary data analysis of patients with AUD enrolled in the COMBINE Study and Project MATCH, two multi-site, randomized AUD clinical trials, who were followed for up to 3 years post-treatment (COMBINE: n = 694; MATCH: n = 806). Measures Alcohol use was measured via calendar-based methods. We estimated all models in the total sample and among participants who did not achieve abstinence during treatment. Key Results One-level RDL reductions were achieved by 84% of patients at the end of treatment, with 84.9% of those individuals maintaining that reduction at a 3-year follow-up. Two-level RDL reductions were achieved by 68% of patients at the end of treatment, with 77.7% of those individuals maintaining that reduction at a 3-year follow-up. One- and two-level RDL reductions at the end of treatment were associated with significantly better mental health, quality of life (including physical quality of life), and fewer drinking consequences 3 years after treatment (p < 0.05), as compared to no change or increased drinking. Conclusion AUD patients can maintain WHO RDL reductions for up to 3 years after treatment. Patients who had WHO RDL reductions functioned significantly better than those who did not reduce their drinking. These findings are consistent with prior reports suggesting that drinking reductions, short of abstinence, yield meaningful improvements in patient health, well-being, and functioning.

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