Adolescent immigrant generation and stigmatizing attitudes toward drug addiction

This study examined differences in stigmatizing attitudes toward individuals addicted to drugs among three immigrant generations of youth, and the role of adolescent drug use and friends’ drug use on the association. Data were derived from the 2005 cycle of the Ontario Student Drug Use Survey administered to students in grades 7–12 in the province of Ontario, Canada. A sample of 4078 students completed questionnaires that included a measure of stigma toward drug addiction. Results indicated some immigrant generational differences in negative attitudes toward individuals addicted to drugs, but much of this difference was explained by adolescents’ individual drug use and friendships with individuals who use drugs. The difference between second-generation immigrant youth and their third- and later-generation counterparts was not fully explained. This study highlights the need for greater research on adolescent stigma toward drug addiction given that stigma may reduce drug usage but also may reduce help-seeking among individuals with an addiction.     

Meta-analyses of seven of the National Institute on Drug Abuse's principles of drug addiction treatment

Of the 13 principles of drug addiction treatment disseminated by the National Institute on Drug Abuse (NIDA), 7 were meta-analyzed as part of the Evidence-based Principles of Treatment (EPT) project. By averaging outcomes over the diverse programs included in the EPT, we found that 5 of the NIDA principles examined are supported: matching treatment to the client's needs, attending to the multiple needs of clients, behavioral counseling interventions, treatment plan reassessment, and counseling to reduce risk of HIV. Two of the NIDA principles are not supported: remaining in treatment for an adequate period and frequency of testing for drug use. These weak effects could be the result of the principles being stated too generally to apply to the diverse interventions and programs that exist or unmeasured moderator variables being confounded with the moderators that measured the principles. Meta-analysis should be a standard tool for developing principles of effective treatment for substance use disorders.     

Measuring internet use: comparisons of different assessments and with internet addiction

Background: The measurement of Internet use is an under-documented topic despite the worldwide growth of problematic Internet use and the recent debate in addiction research suggesting that heavy use over time should be suitable for population-based assessment. This study compared different measures of Internet use to identify the most relevant one, and tested whether Internet use was a good proxy of self-reported Internet addiction.

Methods: Data were collected in the ado@internet.ch study among 3054 Swiss 8th grade adolescents. Different assessments of Internet use (frequency, number of hours spent on Internet, quantity-frequency measure, latent score) were compared using rank invariance across instruments. We also examined associations of Internet use with health outcomes (Internet addiction, wellbeing, somatic health problems, and quantity of sleeping). Additionally, associations of Internet addiction with health outcomes were investigated.

Results: Quantity-frequency captured 82% of the variability of average quantity and 64% of the variability of frequency, whereas the latent score captured respectively 94% and 52%. Regression models showed that frequency displayed the lowest associations with Internet addiction (b?=?0.128) and wellbeing (b=?0.038). The associations of other Internet use measures were very similar. Associations of Internet addiction with wellbeing were higher than those of Internet use with wellbeing, whereas the other associations were similar.

Conclusions: The quantity-frequency appeared as the most reliable and straightforward measure of Internet use. However, Internet use seemed to be only one factor in Internet addiction. This study was a first step toward proposing a unique relevant tool of Internet use in epidemiological research.     

Perceived public stigma and stigmatization in explaining lifetime illicit drug use among emerging adults

Illicit drug use is often associated with adverse health and legal consequences, as well as stigma, or social disapproval. Stigma may be enacted as a preventive measure against drug use; however, research was needed to investigate its effects on use in an empirical manner. This cross-sectional study surveyed 1021 emerging adults (age 18–25) throughout Manhattan, New York. We investigated how two forms of stigma – perceived public stigma and personal stigmatization – along with religiosity and exposure to users, explained lifetime use of five drugs: marijuana, powder cocaine, ecstasy, and non-medical use of opioids and amphetamine. Odds ratios for lifetime use of each drug were estimated using age-adjusted stepwise logistic regression models. Results suggest that high levels of exposure to users increased the odds of lifetime use of each drug, and protective effects of religiosity and racial minority status often diminished when controlling for stigma. High levels of stigmatization toward users tended to decrease the odds of use, and perceived public stigma toward users did not explain use of any drug. In conclusion, although individuals who stigmatize users are protected from use, the perception of public stigma does not appear to be valuable in preventing use. Since stigma is associated with adverse psychological and social consequences in users, the efficacy of stigma as a public health tool against drug use is questionable. Public health efforts can deglamorize and discourage use while aiming to reduce stigma toward users by treating use as a health behavior and not a deviant or moral behavior.     

Stigma and drug use settings as correlates of self-reported,non-fatal overdose among people who use drugs in Baltimore,Maryland

BackgroundFatalities from opioid overdose quadrupled during the last 15 years as illicit opioid use increased. This study assesses how stigma and drug use settings are associated with non-fatal overdose to identify targets for overdose risk reduction interventions and inform overdose education and naloxone distribution programs.MethodsWe surveyed 444 people who used drugs in Baltimore, Maryland, USA, from 2009 to 2013 as part of a randomized clinical trial of a harm reduction intervention. Participants reported demographic characteristics, drug use, overdose history, use of a local syringe services program, involvement in the local drug economy, and whether they experienced discrimination from others (i.e., enacted stigma) or stigmatized themselves (i.e., internalized stigma) related to their drug use. We used multinomial logistic regression models to identify correlates of experiencing a non-fatal overdose within the past year or >1 year ago relative to participants who never experienced an overdose.ResultsStigma was positively associated with experiencing a non-fatal overdose in the past year (adjusted Odds Ratio [aOR]: 1.7, 95% Confidence Interval [CI]: 1.1–2.7) and >1 year ago (aOR [95% CI]: 1.5 [1.1–2.0]) after adjustment for demographic and substance use characteristics. The association of stigma with overdose was stronger for enacted versus internalized stigma. The number of public settings (shooting gallery, crack house, abandoned building, public bathroom, outside) where participants used drugs was also positively associated with experiencing an overdose.ConclusionsStigma related to drug use and using drugs in more settings may increase overdose risk. The effectiveness of overdose prevention and naloxone training may be improved by reducing discrimination against people who use drugs in community and medical settings and diversifying the settings in which overdose prevention trainings are delivered. These efforts may be enhanced by use of peer outreach approaches in which people who use drugs diffuse prevention messages through their social networks and within settings of drug consumption outside the medical setting.     

The relationship between drug use stigma and HIV injection risk behaviors among injection drug users in Chennai,India

Background

The purpose of this study was to examine the relationship between perceived drug use stigma, acquiescence response bias, and HIV injection risk behaviors among current injection drug users in Chennai, India.

Methods

The sample consists of 851 males in Chennai, India who reported having injected drugs in the last month and were recruited through street outreach.

Results

Results indicate a strong and consistent positive association between drug use stigma and HIV injection drug use risk behaviors. This association held across the injection behaviors of frequency of sharing needles, cookers, cotton filters, rinse water, pre-filled syringes and common drug solutions, even after controlling for acquiescence response bias, frequency of injection, and HIV/HCV serostatus.

Conclusions

These findings suggest that future HIV prevention and harm reduction programs for injection drug users and service providers should address drug use stigma.     

探析儿科不合理用药现状及合理用药原则

合理用药是现代医学必须遵守的一个最基本原则,现代药物机制的复杂性及疾病的多样性要求医生在诊疗过程中要仔细研究病情,科学合理用药。经过长期的发展,现代医学对疾病的认识以及治疗,建立了一套相对完善的理论体系,特别是在治疗对象上的细分,这为治疗的具体实施提供了便利。儿科作为一个重要的医学分支,在用药上有自己独特的特点,儿科的合理用药体现在给药过程的每一个环节(科学选择药物,合理使用药物及正确的剂量、用法等)。由于种种原因,实际诊疗过程中儿科用药存在一些不合理情况,不利于患儿疾病的康复。临床药师、医生应谨遵儿科用药特点及药物使用原则纠正这些不合理现象。     

The influence of acculturation on drug and alcohol use in a sample of adolescents

This article reports on the associations between acculturation and substance use among 198 ninth-grade Southern California adolescents (mean age=13.8 years). Substance use measures included 30-day (current) and lifetime use of alcohol and other drugs. Acculturation was measured using the Acculturation, Habits, and Interests Multicultural Scale for Adolescents (AHIMSA) acculturation scale, a multi-dimensional acculturation scale yielding four acculturation strategy scores. Linear regression analyses evaluated the association between acculturation on alcohol and drug use, adjusting for several covariates. Results revealed that the assimilation acculturation strategy was significantly, but negatively associated with current alcohol use, especially among males. The separation acculturation strategy was significantly and positively associated with current alcohol use, especially among females. Marginalization was associated with greater risk for lifetime alcohol and drug use, especially among males, and a greater risk of current drug use among females. The social influence covariates were predictive of both current and lifetime alcohol and drug use. Future studies should incorporate multidimensional acculturation scales in adolescent substance use to understand how different acculturation strategies impact different populations.     

组胺对药物成瘾的调节作用及其机制

组胺能神经元胞体在中枢神经系统中仅存在于下丘脑乳头结节核,但其神经纤维在脑内广泛投射。许多研究表明,成瘾性药物会引发下丘脑、纹状体等部位内组胺水平的变化;组胺在药物成瘾过程中具有重要作用;组胺能系统与多巴胺能系统、NMDA受体系统、乙酰胆碱能系统和GABA能系统之间存在着相互作用,这些研究成果或许为药物成瘾的临床治疗提供了一条新思路。     

Reinforcements from the first drug experience can predict later drug habits and/or addiction: Results with coffee,cigarettes, alcohol,barbiturates, minor and major tranquilizers,stimulants, marijuana,hallucinogens, heroin,opiates and cocaine

The relationship between the reinforcing quality of the first drug experiences and eventual habits for a variety of drugs was studied in 42 male drug abusers who were predominantly opiate addicts. These subjects volunteered for drug studies carried out by the Addiction Research Center. The degree of reinforcement they derived from their first drug experience was related to their subsequent habit. This was true for alcohol, barbiturates, minor tranquilizers, cocaine, stimulants, marijuana, glue or solvents, hallucinogens, opiates other than heroin and heroin. Positive but non-significant correlations were found for coffee and major tranquilizers. The correlation for cigarettes was contrary to expectations. Of the components to the index of reinforcement, degree of liking of a drug on the first occasion was most related to the subsequent habit. The greatest initial reinforcement scores were found for heroin, cocaine and opiates other than heroin. Drugs which were not well liked on the first occasion included major tranquilizers, cigarettes, coffee, and glue.     

医疗机构药物滥用监测模式下药物成瘾性特征分析

目的： 了解医疗机构就诊患者麻醉、精神药品滥用/依赖情况和特征,为加强麻醉、精神药品管理提供依据。方法： 利用Excel表统计分析2018-2019年某院确诊为药物滥用或药物依赖患者的麻醉、精神药品使用情况,对确诊为麻醉、精神药品滥用/依赖者的人口学特征、药物使用情况进行描述性分析。结果： 该院就诊患者确诊药物依赖237例,未发现药物滥用患者。237例药物依赖者中,男性84例,占35.44%,女性153例,占64.56%;>60岁的药物依赖者161例,占67.93%;平均年龄（66.83±13.97）岁;依赖年限分布集中在1~3年,占56.119%,平均年限为（4.75±6.96）年;初中及以下文化程度者190例,占79.76%;已婚158例,占66.67%;离/退休人员140例,占59.07%。依赖的药物主要为苯二氮类,145例,占61.19%;药物获得渠道来自医疗机构占99.58%;使用药物原因为控制疾患的患者216例,占91.14%;监测上报人群中以医师、药师为主,占85.23%。结论： 在医疗机构药物滥用监测模式下能关注老年人麻醉、精神药品的合理使用,挖掘潜在的用药风险信号,提前预警与干预,降低药物成瘾性损害事件的发生。     

Volitional problems in carrying through a difficult decision: The case of drug addiction

Attempts by young drug addicts to decrease or quit drug consumption were studied by means of a series of interviews. Interest was focused on volitional problems arising due to difficulties in living up to commitments in the face of temptations and various types of emotional stress. It was found that relapses occurred mostly under the influence of emotional stress and that they were preceded by various forms of twisted reasoning, a finding similar to those for other types of addictive behaviors such as smoking and alcoholism. The techniques used by the drug addicts to fight temptations were similar to those reported by other patients. Knowledge of techniques seemed to be rather scarce. There was a correlation between knowledge of technique and success in quitting drug habits. Strong stimulus pull factors were evident in some cases and were apparently counteracted by more or less successful attempts by the patients to escape the tempting situation.     

Adolescent addictive internet use and drug abuse in Wuhan,China

Background: Drug use (DU) and addictive internet use (AIU) are two increasing risk behaviors among youth in China. However, little information is available on the relationship between addictive internet use and DU. Therefore, we investigate the role of AIU on DU behavior and its impact on the variables such as pro-drug attitude (PDA), anti-drug attitude (ADA), social norm of drugs and intentions on DU.

Method: A total of 3018 students (47% boys, 53% girls), who were from 15 secondary schools (five middle schools, five academic high schools, and five vocational high schools) and one university in Wuhan, China, completed paper-and-pencil questionnaires during class-time. A conceptual model was developed based on Reasoned Behavior Theory. Structural equation modeling (SEM) was used to test the proposed model.

Results: The prevalence rate of internet addiction and DU are 5 and 4%, respectively. In the SEM model (GFI = 0.920, AGFI = 0.907, RMSEA = 0.047), adolescent DU and intention of DU were significantly predicted by AIU, which is mediated by PDA, ADA, and perceived social norm of DU.

Conclusions: These findings contribute to the theoretical and managerial understanding of the role of AIU behaviors on adolescent DU. It suggests that prevention education of DU should be strengthened among young internet users.     

Physical and relational aggression as predictors of drug use: gender differences among high school students

The present study investigated the longitudinal relationships between physical and relational aggression and later drug use, as moderated by gender. Self-reported data were gathered from 2064 high school students at pretest and 1-year post-test to test the hypotheses that (1) males would engage in more physical aggression than females, whereas females would engage in more relational aggression than males; and (2) physical aggression would be a stronger drug use predictor for males and relational aggression a stronger predictor for females. Results indicated that males reported engaging in more physical aggression than females at baseline; however, females and males reported engaging in similar rates of relational aggression. After controlling for relational aggression, baseline drug use, and demographic variables, physical aggression at baseline was found to predict alcohol use 1-year later for males but not for females. After controlling for physical aggression, baseline drug use, and demographic variables, relational aggression was found to predict cigarette use and marijuana use for females but not for males. However, relational aggression was found to predict later alcohol and hard drug equally across gender. These findings suggest that both physical and relational aggression are predictive of subsequent drug use and have important implications for violence and drug use prevention intervention efforts.     

临床不合理使用药物剂型分析

目的明确合理使用药物剂型的重要性。方法运用药剂学、药理学原理对临床常见几种药物剂型不合理使用的做法进行分析,呈明其弊端,并提出合理使用剂型的意见、建议。结果不合理使用药物剂型不仅影响药物治疗效果延误病情,还可增加不良反应。结论加强对药物剂型的掌握,合理使用药物剂型是临床医师、药师的共同责任;同时研制更多新剂型特别是更适于儿童的新剂型,供临床选择应用,以保证患者安全,合理、方便用药,应引起充分的重视。     

Stigma towards people who use drugs: A case vignette study in methadone maintenance treatment clinics in China

BackgroundDrug use stigma among service providers has been recognized as a barrier to improving the accessibility and outcomes of addiction treatment. This study examined the stigmatizing attitudes towards people who use drugs (PWUD) among service providers in methadone maintenance treatment (MMT) clinics in China and its associated factors.MethodsThe cross-sectional study used the baseline data of a randomized intervention trial conducted in China, and the data were collected from January 2012 to August 2013. A total of 418 MMT service providers were included in the study. Stigma towards PWUD was measured via a 10-item scale embedded in two case vignettes (PWUD and non-PWUD). The Wilcoxon signed-rank test was performed to evaluate the vignette difference for each item of the scale. The linear mixed model was used to identify the adjusted association between drug use stigma and other interested variables including demographics, professional background, and MMT knowledge of the service providers.ResultsThe Wilcoxon signed-rank tests showed that the participants had a higher level of stigmatizing attitudes towards PWUD than non-PWUD (p-value<0.001 for all items of the stigma scale). The linear mixed model identified that the reception of national MMT training was associated with a lower degree of drug use stigma (estimate=−1.79; 95% CI: −3.13, −0.45; p-value = 0.009).ConclusionThe findings of the study provide evidence of the existence of drug use stigma among MMT providers in China. The expansion of national-level training and the development of stigma reduction interventions are needed to address this issue.