scholarly journals Substance Use Disorder and COVID-19; Forensic Medicine and Pharmacology Perspectives: A Concise Narrative Review

2021 ◽  
Vol 3 (2) ◽  
pp. 315-330
Author(s):  
Ahmed S. Ali ◽  
Torki Al-Zughaibi ◽  
Assmaa A. Shaker
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Forensic Medicine ◽  
The Body ◽  
Narrative Review ◽  
Risk Of Infection ◽  
Medicine Research ◽  
Defense Systems ◽  
Extensive Search ◽  
Increased Risk

Many investigations have confirmed the link between a substance use disorder (SUD) and the COVID-19 pandemic's increased risk of infection and consequences. This narrative review aims to understand these issues from a pharmacological standpoint, as well as the pandemic's impact on forensic medicine. Research and review articles included in this review were selected through an extensive search of databases such as PubMed and the use of appropriate keywords e.g. “substance use disorder” and “COVID-19”. Due to a weakened immune system and degeneration of the respiratory system's defense systems, SUDs have been shown to increase the risk of COVID-19 infection. Furthermore, some substances raise pro-inflammatory mediators, exposing the body to a cytokine storm. SUD frequently causes secondary comorbidities, such as the liver, lung and cardiovascular disease, complicating the treatment of COVID-19 infections. Some misused substances can compromise the treatment's effectiveness or safety. This study also looked at the effects of the pandemic on forensic medicine. It underlines the importance of developing safe forensic examination procedures and methodologies during pandemics. The use of narcotic substances was documented as one of the reasons for the increase in the frequency of COVID-19 and the severity of its repercussions.

scholarly journals Case Report: CBD Cigarettes for Harm Reduction and Adjunctive Therapy in a Patient With Schizophrenia and Substance Use Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Maximilian Meyer ◽  
Marc Walter ◽  
Stefan Borgwardt ◽  
Alexandra Scheidegger ◽  
Elisabeth Lang ◽  
...  
Keyword(s):  
Substance Use ◽  
Case Report ◽  
Substance Use Disorder ◽  
Adjunctive Therapy ◽  
Cannabis Sativa ◽  
Psychotic Symptoms ◽  
Course Of Disease ◽  
Increased Risk ◽  
Patient Reported ◽  
Continued Use

The treatment of patients with schizophrenia and substance use disorder poses a challenge for clinicians. Continued use of cannabis and cocaine can exacerbate psychotic symptoms and worsen the course of disease. To date, no pharmacotherapy is available for patients with cannabis use disorder (CUD). Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) are the main active constituents in Cannabis sativa, with the latter being linked to an increased risk of psychosis. We describe a clinical case of a male patient diagnosed with schizophrenia, combined personality disorder, CUD and cocaine use disorder. Over the course of 8 years, he was hospitalized 30 times due to psychotic relapses and continued substance use. Consequently, CBD cigarettes with a low THC content (<1%) were used as adjunctive therapy. Additionally, we established off-label treatment with methylphenidate to support abstinence. The patient reported to feel significantly less need to consume illegal cannabis with a high THC content. He stopped to use cocaine, for the time being, and has not been hospitalized since. This case report demonstrates the potential of smoked CBD as a substitute for severe and chronic CUD.

scholarly journals Impact of COVID-19 on People with Disabilities

2021 ◽  
Vol 3 (2) ◽  
pp. 1-6
Author(s):  
Smriti Pant ◽  
Saugat Koirala ◽  
Madhusudan Subedi
Keyword(s):  
Online News ◽  
The Body ◽  
Narrative Review ◽  
The Poor ◽  
Increased Risk ◽  
The World ◽  
People With Disability ◽  
The Disabled ◽  
Mainstream Society ◽  
The Impact

Any condition of the body or mind that makes it more difficult for the person with the condition to do certain activities and interact with the world around them is known as a disability. Despite the various efforts being done to ensure their rights and equity of the disabled, they still suffer more during various crises like conflicts, natural disasters and pandemics. The purpose of this narrative review is to access the impact that the COVID-19 pandemic has had on People with disability (PWD). For writing this narrative review, Google, Google Scholar, Pub Med and online news portals were searched by using various combination of the following terminologies; “Disability”, “Differently “Disabled”, “Disable”, “People with Disability”, “PWD” “Impact”, “COVID-19”, “Corona Pandemic”, “Challenges”, “Issues”, “Policies”, “Social”, and “increased risk”. The pandemic has created many challenges for people with disability. They not have greater risk of contracting COVID-19, but also have problems accessing health services. It has also had various social impacts like problems related to education, employment as well as discrimination. The COVID pandemic has exposed gaps in the health system that make the poor, marginalized and disabled population more vulnerable to neglect and mistreatment. Proper implementation and monitoring of policies should be done to ensure that PWD feel included and respected. It is important to continually integrate PWD into the mainstream society while minimizing their risks of contracting COVID-19. The caretakers should use the necessary PPE when attending to their needs.

P6476Surgery does not appear to improve survival in patients with endocarditis and substance use disorder

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Abdollah ◽  
S B Brogly ◽  
D Payne ◽  
K Lajkosz ◽  
N S Coverdale ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Early Death ◽  
Population Based ◽  
Hospital Death ◽  
Term Survival ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Increased Risk ◽  
One Year

Abstract Background Cohort studies of surgery compared with medical treatment (MT) on endocarditis mortality are conflicting. We conducted a population-based study to estimate associations between treatment and mortality. Methods 1,381 patients with substance use disorder (SUD) and 5,053 without (NSUD) hospitalized for endocarditis were included. Treatment was modeled as a time-dependent variable: patients who underwent surgery after admission were classified as MT until surgery occurred and surgically treated thereafter. Patients without surgery were classified as MT. Adjusted hazard ratios (aHR) between treatment and death (in-hospital, 30 days, one, two, five years) by SUD status were estimated. Results Among SUD patients, there was a trend towards reduction in in-hospital death with surgery vs. MT (aHR 0.61 [95% CI: 0.35–1.04]), but no difference at 30 days (aHR 0.79 [95% CI: 0.42–1.48]). Mortality was higher in SUD patients who underwent surgery compared with MT at one (aHR 1.30 [95% CI: 0.95–1.76]), two (aHR 1.27 [95% CI: 0.97–1.65]), and five years (aHR 1.37 [95% CI: 1.09–1.72]). In NSUD patients, in-hospital mortality (aHR 0.93 [95% CI 0.76–1.16]) did not differ, but 30 day mortality (aHR 1.36 [95% CI 1.04–1.77]) was higher with surgery versus MT, and lower at one (aHR 0.87 [95% CI: 0.73–1.03]), two (aHR 0.75 [95% CI: 0.64–0.88]), and five years (aHR 0.70 [95% CI: 0.61–0.81]). Kaplan-Meier Survival Curves of Patients Interpretation Surgery compared with MT conferred no long-term survival benefit in SUD patients. In NSUD patients, surgery was associated with an initial increased risk of early death followed by a lower risk after one year. Acknowledgement/Funding Grant from Department of Surgery, Queen's University

scholarly journals Cigarette Smoking Is Associated With Increased Risk of Substance Use Disorder Relapse

2017 ◽  
Vol 78 (02) ◽  
pp. e152-e160 ◽  
Author(s):  
Andrea H. Weinberger ◽  
Jonathan Platt ◽  
Hannah Esan ◽  
Sandro Galea ◽  
Debra Erlich ◽  
...  
Keyword(s):  
Substance Use ◽  
Cigarette Smoking ◽  
Substance Use Disorder ◽  
Increased Risk

Brain Activation, Response Inhibition, and Increased Risk for Substance Use Disorder

2008 ◽  
Vol 32 (3) ◽  
pp. 405-413 ◽  
Author(s):  
Rebecca L. McNamee ◽  
Kathryn L. Dunfee ◽  
Beatriz Luna ◽  
Duncan B. Clark ◽  
William F. Eddy ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
Response Inhibition ◽  
Brain Activation ◽  
Increased Risk ◽  
Activation Response

Substance use Disorder in the Offspring of Antenatally Depressed Mothers in the Northern Finland 1966 Birth Cohort: Relationship to Parental History of Severe Mental Disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. s246-s246
Author(s):  
P. Mäki ◽  
T. Taka-Eilola ◽  
J. Veijola
Keyword(s):  
Substance Use ◽  
Mental Disorder ◽  
Maternal Depression ◽  
Birth Cohort ◽  
Substance Use Disorder ◽  
Antenatal Depression ◽  
Severe Mental Disorder ◽  
Parental History ◽  
Increased Risk ◽  
Depressed Mothers

IntroductionMaternal depression during pregnancy is common. However, reports of the adult offspring with maternal antenatal depression are scarce.ObjectivesOur aim was to study whether offspring of antenatally depressed mothers have increased risk for substance use disorder when taking account parental mental disorder.MethodsIn the Northern Finland 1966 Birth Cohort, the mothers of 12,058 children were asked at the antenatal clinic if they felt depressed. The offspring were followed for over 40 years. Substance use disorders were detected using the Finnish Care Register for Health Care, which was also used for identifying severe mental disorders in the parents till 1984.ResultsOf the mothers, 14% had rated themselves as depressed during pregnancy. Of the parents, 10% had had a hospital-treated mental disorder. The risk for substance use disorder was slightly increased in the offspring of antenatally depressed mothers (crude OR 1.6; 95% CI 1.2–2.1), when compared with the cohort members without maternal antenatal depression. The risk for substance use disorder was higher in the offspring with both maternal antenatal depression and parental mental disorder (2.8; 1.7–4.7) than in those with maternal depression but without parental mental disorder (1.4; 1.1–2.0) or those without maternal depression and with parental mental disorder (1.5; 1.1–2.2). The reference group was cohort members without maternal antenatal depression and without parental mental disorder. The association remained significant after adjustment [1].ConclusionsOffspring with both maternal depression during pregnancy and parental severe mental disorder have elevated risk for substance use disorder.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Driving Access to Care: Use of Mobile Units for Urine Specimen Collection During the Coronavirus Disease-19 (COVID-19) Pandemic

2020 ◽  
Vol 7 ◽  
pp. 237428952095355
Author(s):  
Jill S. Warrington ◽  
Alexa Brett ◽  
Heather Foster ◽  
Jamie Brandon ◽  
Samuel Francis-Fath ◽  
...  
Keyword(s):  
Substance Use ◽  
Access To Care ◽  
Substance Use Disorder ◽  
Drug Testing ◽  
Geographic Region ◽  
Urine Specimen ◽  
Mobile Unit ◽  
Increased Risk ◽  
Urine Drug Testing ◽  
Urine Drug

Patients with substance use disorders (SUD) are at increased risk of both coronavirus disease-19 complications as well as exacerbations of their current conditions due to social distancing and isolation. Innovations that provide increased access to support substance use disorder patients may mitigate long-term sequelae associated with continued or renewed drug use. To improve patient access during the coronavirus disease-19 pandemic, we deployed a mobile unit to enable access to urine drug testing where needed for patients suffering from substance use disorder. Over a 3-week pilot program, 54 patients received urine drug testing across 5 providers and 8 zip codes. The mobile unit was cost-effective, demonstrating a volume-dependent 19% lower cost compared to pre-coronavirus disease-19 patient service centers in a similar geographic region. The mobile unit was well-received by patients and providers with an average of 9 out of 10 satisfaction scores and allowed for access to urine drug testing for 67% patients who would not have received testing during this time frame. No statistically significant differences were found in substance use positivity rates in comparison to pre-coronavirus disease findings; however, some shifts in use included higher rates of fentanyl and opioid positivity and reductions in tetrahydrocannabinol and cocaine use in the mobile collections setting. Deployment of mobile collection services during the coronavirus disease-19 pandemic has shown to be an effective mechanism for supporting patients suffering from substance use disorder, allowing for access to care of this often stigmatized, vulnerable population.

scholarly journals Pancreas as an Occult Source of Recurrent Salmonella enteritidis Bacteremia in an Immunocompromised Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Don Bambino Geno Tai ◽  
Laxmi Upadhyay ◽  
Ruchika Jain ◽  
Robert Goldstein
Keyword(s):  
Lupus Erythematosus ◽  
Rare Case ◽  
Salmonella Enteritidis ◽  
Immunocompromised Patient ◽  
The Body ◽  
Oral Antibiotics ◽  
Risk Of Infection ◽  
Organ Systems ◽  
Increased Risk ◽  
Almost All

Salmonella infection usually presents as gastroenteritis and enteric fever. Some cases of bacteremia can lead to invasion of different organ systems and become occult sources for recurrence. Almost all organs of the body can be affected and have been reported in the literature. We report a rare case of repeated Salmonella enteritidis infection in a patient with systemic lupus erythematosus. She was treated with intravenous and oral antibiotics but still had recurrence of fevers and bacteremia. After a thorough workup, pancreatic abscesses were identified and drained with abscess culture revealing Salmonella enteritidis. She was then treated with a prolonged course of antibiotics and finally cleared the infection. This case demonstrates that nontyphoid Salmonella can be invasive and cause persistent infection. This is particularly pertinent in immunocompromised patients who are at an increased risk of infection. An aggressive workup and prolonged antibiotic course might be beneficial for this subset of patients.

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