scholarly journals Chronic Pain among Individuals Experiencing Homelessness and Its Interdependence with Opioid and Other Substance Use and Mental Illness

2021 ◽  
Vol 19 (1) ◽  
pp. 5
Author(s):  
Marc Vogel ◽  
Fiona Choi ◽  
Jean N. Westenberg ◽  
Maurice Cabanis ◽  
Nooshin Nikoo ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Mental Illness ◽  
Substance Use ◽  
Homeless Persons ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Polysubstance Use ◽  
Specific Substance ◽  
Professional Treatment ◽  
To Receive

Chronic pain and substance use disorders are serious conditions that are prevalent among homeless populations. The aim of this study was to examine the association between chronic pain and substance use among individuals experiencing homelessness and mental illness. We analyzed cross-sectional data from two sites of the At Home/Chez Soi study (Vancouver and Toronto) using bivariate statistics and multivariate logistic regression. Substance use and chronic pain parameters were assessed with the Maudsley Addiction Profile and purpose-designed short instruments. The sample comprised 828 participants. Mean age was 42.4 years and 54% reported chronic pain. In bivariate analysis, chronic pain was significantly associated with use of opioids and stimulants, daily substance use, polysubstance use and injecting as route of administration. In multivariate analysis, only daily substance use (OR: 1.46, 95% CI: 1.02–2.09) and injecting (OR: 1.81, 95% CI: 1.08–3.05) remained as significant associated factors, whereas neither use of opioids nor use of stimulants specifically were significantly associated with chronic pain. Among participants with chronic pain, daily substance users (50% vs. 22%, p < 0.001) and injectors (66% vs. 24%, p < 0.001) were more likely to use non-prescribed medication for pain. Participants with daily substance use were less likely to receive professional treatment (52% vs. 64%, p = 0.017) and prescribed pain medication (42% vs. 54%, p = 0.023). Our findings suggest an association of chronic pain with patterns related to severity of substance use rather than to specific substance use in homeless persons with mental illness. Interventions aiming at prevention and treatment of chronic pain in this population should consider severity of substance use and associated risk behavior over use of specific substances.

scholarly journals Patients with stroke and psychiatric comorbidities have lower carotid revascularization rates

Neurology ◽  
2019 ◽  
Vol 92 (22) ◽  
pp. e2514-e2521 ◽  
Author(s):  
Diana M. Bongiorno ◽  
Gail L. Daumit ◽  
Rebecca F. Gottesman ◽  
Roland Faigle
Keyword(s):  
Mental Illness ◽  
Substance Use ◽  
Carotid Stenosis ◽  
Substance Use Disorders ◽  
Psychiatric Comorbidity ◽  
Cross Sectional ◽  
Psychiatric Comorbidities ◽  
Lower Odds ◽  
Carotid Revascularization ◽  
Psychiatric Conditions

ObjectiveWe investigated whether mental illness is associated with lower rates of carotid endarterectomy (CEA)/carotid artery stenting (CAS) after stroke due to carotid stenosis.MethodsIn this retrospective cross-sectional study, ischemic stroke cases due to carotid stenosis were identified in the 2007–2014 Nationwide (National) Inpatient Sample. Psychiatric conditions were identified by secondary ICD-9-CM diagnosis codes for schizophrenia/psychoses, bipolar disorder, depression, anxiety, or substance use disorders. Using logistic regression, we tested the association between psychiatric conditions and CEA/CAS, controlling for demographic, clinical, and hospital factors.ResultsAmong 37,474 included stroke cases, 6,922 (18.5%) had a psychiatric comorbidity. The presence of any psychiatric condition was associated with lower odds of CEA/CAS (adjusted odds ratio [OR] 0.84, 95% confidence interval [CI] 0.78–0.90). Schizophrenia/psychoses (OR 0.72, 95% CI 0.55–0.93), depression (OR 0.83, 95% CI 0.75–0.91), and substance use disorders (OR 0.73, 95% CI 0.65–0.83) were each associated with lower odds of CEA/CAS. The association of mental illness and CEA/CAS was dose-dependent: compared to patients without mental illness, patients with multiple psychiatric comorbidities (OR 0.74, 95% CI 0.62–0.87) had lower odds of CEA/CAS than those with only one psychiatric comorbidity (OR 0.86, 95% CI 0.79–0.92; p value for trend <0.001).ConclusionThe odds of carotid revascularization after stroke is lower in patients with mental illness, particularly those with schizophrenia/psychoses, depression, substance use disorders, and multiple psychiatric diagnoses.

scholarly journals Is unhealthy substance use associated with failure to receive cancer screening and flu vaccination? A retrospective cross-sectional study

BMJ Open ◽  
2011 ◽  
Vol 1 (1) ◽  
pp. e000046-e000046 ◽  
Author(s):  
K. E. Lasser ◽  
T. W. Kim ◽  
D. P. Alford ◽  
H. Cabral ◽  
R. Saitz ◽  
...  
Keyword(s):  
Substance Use ◽  
Cancer Screening ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Flu Vaccination ◽  
To Receive

scholarly journals Acute pain and self-directed discharge among hospitalized patients with opioid-related diagnoses: a cohort study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Peggy Compton ◽  
Shoshana V. Aronowitz ◽  
Heather Klusaritz ◽  
Evan Anderson
Keyword(s):  
Chronic Pain ◽  
Substance Use ◽  
Acute Pain ◽  
Primary Diagnosis ◽  
Opioid Use ◽  
Treatment Interventions ◽  
Polysubstance Use ◽  
Discharge Rates ◽  
Discharge Outcomes ◽  
Icd 10

Abstract Background Patients with substance use disorders are more likely than those without to have a self-directed hospital discharge, putting them at risk for poor health outcomes including progressing illness, readmissions, and death. Inadequate pain management has been identified as a potential motivator of self-directed discharge in this patient population. The objective of this study was to describe the association between acute pain and self-directed discharges among persons with opioid-related conditions; the presence of chronic pain in self-directed discharges was likewise considered. Methods We employed a large database of all hospitalizations at acute care hospitals during 2017 in the city of Philadelphia to identify adults with opioid-related conditions and compare the characteristics of admissions ending with routine discharge versus those ending in self-directed discharge. We examined all adult discharges with an ICD-10 diagnoses related to opioid use or poisoning and inspected the diagnostic data to systematically identify acute pain for the listed primary diagnosis and explore patterning in chronic pain diagnoses with respect to discharge outcomes. Results Sixteen percent of the 7972 admissions involving opioid-related conditions culminated in self-directed discharge, which was more than five times higher than in the general population. Self-directed discharge rates were positively associated with polysubstance use, nicotine dependence, depression, and homelessness. Among the 955 patients with at least one self-directed discharge, 15.4% had up to 16 additional self-directed discharges during the 12-month observation period. Those admitted with an acutely painful diagnosis were almost twice as likely to complete a self-directed discharge, and for patients with multiple admissions, rates of acutely painful diagnoses increased with each admission coinciding with a cascading pattern of worsening infectious morbidity over time. Chronic pain diagnoses were inconsistent for those patients with multiple admissions, appearing, for the same patient, in one admission but not others; those with inconsistent documentation of chronic pain were substantially more likely to self-discharge. Conclusions These findings underscore the importance of pain care in disrupting a process of self-directed discharge, intensifying harm, and preventable financial cost and suffering. Each admission represents a potential opportunity to provide harm reduction and treatment interventions addressing both substance use and pain.

scholarly journals Stigmatising attitudes towards persons with mental illness: a survey of medical students and interns from Southern Nigeria

2012 ◽  
Vol 4 (1) ◽  
pp. 32-34 ◽  
Author(s):  
Bawo Onesirosan James ◽  
Joyce Ohiole Omoaregba ◽  
Esther Osemudiamen Okogbenin
Keyword(s):  
Mental Illness ◽  
Substance Use ◽  
Medical Students ◽  
Substance Use Disorders ◽  
Health Professionals ◽  
Medical Doctors ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medical Graduates ◽  
Item Level

Stigmatising attitudes towards persons with mental illness are commonly reported among health professionals. Familiarity with mental illness has been reported to improve these attitudes. Very few studies have compared future medical doctors' attitudes toward types of mental illness, substance use disorders and physical illness. A cross-sectional survey of 5th and 6th year medical students as well as recently graduated medical doctors was conducted in April 2011. The 12-item level of contact report and the Attitude towards Mental Illness Questionnaire were administered. Partici -pants endorsed stigmatising attitudes towards mental illness; with attitudes more adverse for schizophrenia compared to depression. Stigmatising attitudes were similarly endorsed for substance use disorders. Paradoxically, attitudes towards HIV/AIDS were positive and similar to diabetes mellitus. Increasing familiarity with mental illness was weakly associated with better attitudes towards depression and schizophrenia. Stigmatising attitudes towards depression and schizophrenia are common among future doctors. Efforts to combat stigma are urgently needed and should be promoted among medical students and recent medical graduates.

Prevalence and Sociodemographic Determinants of Substance Use in Turkey

2021 ◽  
pp. 1-10
Author(s):  
Hüseyin Ünübol ◽  
Gökben Hızlı Sayar
Keyword(s):  
Substance Use ◽  
Emerging Adults ◽  
Large Scale ◽  
Public Health Problem ◽  
Multinomial Regression ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Polysubstance Use ◽  
Single Substance ◽  
Sociodemographic Determinants

<b><i>Background:</i></b> Substance use disorder is a serious public health problem. It is essential to know who is prone to substance use in order to adopt appropriate measures. <b><i>Objectives:</i></b> This study aims to determine the use prevalence ratios of substance use (tobacco, alcohol, cannabis, cocaine, synthetic cannabinoids, ecstasy, and others) in a large-scale sample of a general population. It also intends to examine related sociodemographic factors. <b><i>Methods:</i></b> This study is based on a cross-sectional survey conducted with a nationally representative sample of 24,494 individuals in face-to-face interviews conducted by a trained team of 125 clinical psychologists. <b><i>Results:</i></b> Lifetime prevalence of single substance use and polysubstance use are 4.5 and 2.6%, respectively (nicotine and alcohol excluded). Age, gender, education level, and marital status are important sociodemographic determinants for other substance use. Similarly, smoking and alcohol consumption are important determinants for other substance use. The multinomial regression analysis results showed that compared with adults aged 39 years and older, early-emerging adults (aged 18–23 years), late-emerging adults (aged 24–29 years), and young adults (aged 30–39 years) are more likely to turn to single substance use and polysubstance use. <b><i>Conclusion:</i></b> Tobacco, alcohol, and other substance use are serious health concerns in Turkey. Sociodemographic status is an important determinant of several aspects of tobacco, alcohol, and other substance use and, therefore, should be examined thoroughly to be able to develop effective protective and preventive strategies.

scholarly journals Prevalence and Characteristics of Borderline Intellectual Functioning in a Cohort of Patients With Polysubstance Use Disorder

2021 ◽  
Vol 12 ◽  
Author(s):  
Jens Hetland ◽  
Kirsten J. Braatveit ◽  
Egon Hagen ◽  
Astri J. Lundervold ◽  
Aleksander H. Erga
Keyword(s):  
Substance Use ◽  
Work Experience ◽  
Satisfaction With Life ◽  
Age Of Onset ◽  
Intellectual Functioning ◽  
University Hospital ◽  
Satisfaction With Life Scale ◽  
Cross Sectional ◽  
Borderline Intellectual Functioning ◽  
Polysubstance Use

Objective: To determine the prevalence and associated demographic and clinical features of borderline intellectual functioning (BIF) among individuals with polysubstance use disorder (pSUD).Methods: We applied a cross-sectional analytical design to data from the Norwegian STAYER study (n = 162), a cohort study of patients with a pSUD from the Stavanger University hospital catchment area. We used Wechsler Abbreviated Scale of Intelligence Full Scale IQ (FSIQ) to define BIF (FSIQ = 70–85) and non-BIF (FSIQ = &gt;85) and collected demographic and clinical data using semi-structured interviews and self-reports on the Symptom Checklist 90-Revised (SCL-90-R) and the Satisfaction With Life Scale (SWLS).Results: The prevalence of BIF was 18% in the present study. The presence of BIF was associated with higher SCL-90-R GSI scores than in the non-BIF group. There were no significant differences between the BIF and non-BIF groups regarding age, gender, participation in meaningful daily activity, years of work experience, years of education, satisfaction with life, level of care, treatment attempts, age at substance-use onset, years of substance use, history of injecting drugs, or age of onset of injecting drugs.Conclusion: The present study confirmed a higher prevalence of BIF among patients with pSUD than expected from the distribution of IQ scores in a general population. Elevated SCL-90-R GSI scores suggested that BIF is associated with increased psychological distress in patients receiving treatment for pSUD. Further studies on this association, and its effect on treatment procedure and outcomes are strongly warranted.

scholarly journals Substance Use and Mental Illness among Women Admitted in a Rehabilitation Center in Jos, Nigeria: A 5-Year Profile

2021 ◽  
Vol 4 (2) ◽  
pp. 19-26
Author(s):  
CN Nwoga ◽  
DD Dapap ◽  
AY Armiya'u ◽  
MD Audu ◽  
SG Goar ◽  
...  
Keyword(s):  
Mental Illness ◽  
Substance Use ◽  
Substance Use Disorder ◽  
Cross Sectional Study ◽  
Economic Consequences ◽  
Main Diagnosis ◽  
Rehabilitation Center ◽  
Cross Sectional ◽  
Multiple Substance ◽  
Significant Health

Substance use disorder are among the most common public health problems caused by using legal and/or illegal substances. Therefore, this study is aimed at reviewing a five-year profile of women admitted at a rehabilitation center in Jos, Nigeria for substance use and mental illness. This is a retrospective cross-sectional study carried out on 183 females admitted between 2012 and 2017 at a rehabilitation center in Jos, Nigeria. Data collection was carried out from documents note of these female participants. Data were analyzed using SPSS version 22. The mean age of the participants was 38.515.3 years. Almost half of the participants were within the age bracket of 20 – 29 years and married (45.9%). Depressive disorder (36.1%) was the commonest mental disorder in the studied participants. Among those abusing substances, multiple substance use (12.6%) was the most prevalent with alcohol use disorder (9.3%) the main diagnosis among those with substance use disorder. According to the result almost half of the studied participants were young, married and educated females. Depression and multiple substance abuse with alcohol the main drug of abuse was a cause for concern in this population. This portrays significant health and economic consequences and the need for urgent action.

scholarly journals Suicidal ideation in patients with mental illness and concurrent substance use: analyses of national census data in Norway

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Helle Wessel Andersson ◽  
Solfrid E. Lilleeng ◽  
Torleif Ruud ◽  
Solveig Osborg Ose
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Substance Use ◽  
Suicidal Ideation ◽  
Mental Health Services ◽  
Health Services ◽  
Census Data ◽  
Current Treatment ◽  
Cross Sectional ◽  
Specialized Mental Health

Abstract Background Suicidal ideation may signal potential risk for future suicidal behaviors and death. We examined the prevalence of recent suicidal ideation in patients with mental illness and concurrent substance use and explored the clinical and sociodemographic factors associated with suicidal ideation in this patient subgroup, which represents a particular risk group for adverse psychiatric outcomes. Methods We used national cross-sectional census data in Norway collected from 25,525 patients in specialized mental health services. The analytic sample comprised 3,842 patients with concurrent substance use, defined as having a co-morbid substance use disorder or who reported recent regular alcohol use/occasional illicit drug use. Data included suicidal ideation measured in relation to the current treatment episode, sociodemographic characteristics and ICD-10 diagnoses. Bivariate and multivariate analyses were used to examine differential characteristics between patients with and without suicidal ideation. Results The prevalence of suicidal ideation was 25.8%. The suicidal ideation rates were particularly high for those with personality disorders, posttraumatic stress disorder, and depression, and for alcohol and sedatives compared with other substances. Patients with suicidal ideation were characterized by being younger, having single marital status, and having poorly perceived social relationships with family and friends. Conclusion Suicidal ideation in patients with mental illness and concurrent substance use was associated with a number of distinct characteristics. These results might help contribute to an increased focus on a subgroup of individuals at particular risk for suicidality and support suicide prevention efforts in specialized mental health services.

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