Use of and Attitudes Toward Club Drugs by Medical Students

ABSTRACT

This study assesses medical students' use of and attitudes towards club drugs, classified as “Generation I” (i.e., cocaine and lysergic acid diethylamide), and “Generation II” (ie, methylenedioxymethamphetamine [MDMA], ketamine, gamma hydroxybutyrate, methamphetamine, rohypnol, dextromethorphan) club drugs based on their initial widespread use in club settings. An anonymous questionnaire was administered to 340 medical students. The prevalence of any club drug use was 16.8%, with MDMA (11.8%) and cocaine (5.9%) the most commonly used. Results discussed also include the relationship of age and gender to having ever used club drugs and to their attitudes regarding use. Additionally, the study identifies differences in patterns of use and attitudes toward Generation I versus Generation II club drugs based on age, gender, and participants' prior club drug use. Findings are compared to those of earlier studies about medical students and those in a similar age group in the general population.     

How Do Students Source and Supply Drugs? Characteristics of the University Illegal Drug Trade

Background: It is widely known that a proportion of university students use drugs. However, much less is known about how they source and supply their drugs. Objectives: In this article, we investigate student drug trading activity, including how they obtained their drugs, whether they sold drugs, and the extent to which their drug trading might be described as a form of “social supply”. Methods: A survey was conducted of all students across seven of the nine universities of Wales. In total, 7855 students submitted a questionnaire and 1877 of these reported drug use in the current academic year. All students who reported using one or more illegal drugs in the current academic year were asked how they obtained their drugs, how they funded their drug use, whether they had sold, traded or given away illegal drugs, along with their motives for drug trading. Results: The results showed that about half of users obtained drugs solely from friends and associates and one-fifth obtained them solely from external dealers. One-quarter used friends and associates as well as external markets. In many cases, supplying drugs amounted to sharing them or giving them away. However, over one-third of students said that they had sold drugs. Conclusions: Overall, the methods of sourcing and supplying drug among university students shares features of both “social supply” and “traditional” drug markets. We conclude that the student drug market investigated is best described as a “hybrid” combination of both.     

Drug Use and Abuse: Some Culture-Crossing Questions

Abstract

The relationships between authoritarian ideology and attitudes and beliefs about illegal drugs, the War on Drugs, and prevention strategies were investigated among 353 university faculty, administrators, and students. A confidential mail survey assessed five variables: right-wing authoritarianism, attitude toward drug legalization, attitude toward drug decriminalization, belief regarding the controlled use of illegal drugs, and the tendency to endorse a “just say no” approach to substance abuse prevention. Multivariate analyses revealed that highly authoritarian participants were significantly more opposed to both drug legalization and drug decriminalization than less authoritarian participants. Only nonauthoritarian participants favored decriminalization, though they did not favor legalization. Compared to those scoring lower on authoritarianism, higher-scoring authoritarian participants held significantly more dichotomous beliefs about illegal drugs (i.e., that abstinence or compulsive drug abuse are the only possibilities related to involvement with illegal drugs). They were also less likely to recommend to potential drug users that they consider following guidelines for their use that may potentially function as protective factors against drug abuse, preferring instead to endorse the slogan “just say no to drugs.” Comparisons between groups revealed that students scored significantly higher on authoritari anism and demonstrated significantly greater opposition to drug decriminalization than did faculty and administrators.     

Use of the Inhalant Langa by Brazilian Medical Students

In a recent epidemiological survey of more than 700 Brazilian medical students, we found new evidence on a previously reported pattern of the “lanca perfume” inhalant drug use. With multiple logistic regression used to hold constant an array of suspected correlates, we found a moderately strong association between the use of marijuana and the use of lanca (adjusted odds ratio, OR = 5.6; p <. 01). We also found that lanca is almost never used by students who have never consumed alcoholic beverages. This pattern of associations can be used to guide the planning of programs to reduce the occurrence of illicit use of pharmaceutical compounds by medical students in Brazil.     

The relationship between alcohol use and other drug use among New York State college students

A questionnaire dealing with alcohol and drug use was administered to a representative sample of 7723 New York State undergraduate students. Those students who were heavy drinkers were also more likely to use tobacco, marijuana, and other drugs. Factor analysis revealed patterns of use of four distinct types of drugs: “party” drugs, medical sedatives, inhalants, and psychedelic drugs. Users of party drugs were typically male, white and Americanborn. Sedative users were typically female, white and older students. Inhalant users were typically male, while psychedelic drug users tended to be white Americans of either sex.     

Influences on prescribing: the perceptions of general practitioners in two primary care trusts

We describe results from a postal questionnaire sent to all GPs (general practitioners) in two East London primary care trusts investigating perceived influences of prescribing and their attitudes towards the local formulary The strongest influencing factors on prescribing are: “the drug is recommended by a specialist or peer”, “guidelines”‘ and “GP's own previous experience of the drug” The weakest influencing factors are: “visits from drug representatives”, “advertisements in journals and magazines” and “internet information” GPs need, agree and comply with local formularies but they do not use them much; still, GPs are influenced by local formularies but the influence of pharmaceutical advisers remains uncertain The more we know about what influences prescribing, the better we can design steering interventions so that drugs are being prescribed wisely and cost effectively     

我院75例“特殊使用级”抗菌药物使用情况调查分析

抗菌药物合理应用是卫生部医院质量管理的一项重要内容。现调查分析了我院75例"特殊使用级"抗菌药物实际的使用情况。调查结果表明:全部病例中,使用一种药物的有40例,两种的有28例,三种的有6例,三种以上的有1例。其中,进行病原学检查的有51例,未进行病原学检查的有23例。通过对"特殊使用级"抗菌药物的管理,其使用合理性正逐步提高,为抗菌药物的管理提供依据。     

CONTROLLING AND POLICING SUBSTANCE USE(RS)*

Controlling drug use—a dynamic, global, politicalized process—is reviewed in terms of selected types of drugs, “natural levels” of drug demand and use, drug markets and the drug market environment, types of traffickers, illicit drug trade profits, approaches to drug control (“War on Drugs”, “Zero Tolerance” programs and policies, “normalizing” and legalizing selected drugs), including UN's then relatively recent “Balanced Approach” and facets of drug law enforcement (drug prices and purity levels and values of drug seizures), including various rarely noted benefits to intervention programs and control agents. Unresolved issues and needed “tools” are noted while considering the implications of the first UN's World Drug Report data.     

Toward a new paradigm for the efficient in vitro–in vivo extrapolation of metabolic clearance in humans from hepatocyte data

The objective of this study was to follow up a previous study on a comparative analysis of diverse in vitro–in vivo extrapolation (IVIVE) methods used for predicting hepatic metabolic clearance (CL) of drugs from intrinsic clearance (CL_int) data determined in microsomal incubations, but using hepatocyte data instead. Six IVIVE methods were compared: the “conventional and conventional bias‐corrected methods,” the “regression equation method,” the “direct scaling method,” the “Berezhkovskiy's method,” and the “novel IVIVE method of Poulin et al.” offering a new paradigm. A large and diverse dataset of 49 drugs were collected from the literature for hepatocyte data in human. Based on all statistical parameters, this study confirms that the novel IVIVE method of Poulin et al. shows the greatest prediction performance among the IVIVE methods tested by using hepatocyte data. The superior prediction performance of this novel IVIVE method is again most pronounced for (a) drugs highly bound in blood, (b) drugs bound to albumin, and (c) low CL drugs. Because the novel IVIVE method has been developed particularly to improve the prediction accuracy for drugs with such properties, this study confirms its utility. Furthermore, the results of the current comparative analysis performed using hepatocyte data confirm the findings of a previous analysis made with microsomal data. Overall, the proposed novel IVIVE method offers a new paradigm for the prediction of hepatic metabolic CL particularly for drugs, which have the aforementioned properties, and, hence, this would contribute to a more accurate CL prediction for small molecules in drug discovery and development, interspecies scaling, and can potentially be used for the optimization of driving factors of CL in an attempt to facilitate the simulation of drug disposition by using the physiologically based pharmacokinetics (PBPK) model. © 2013 Wiley Periodicals, Inc. and the American Pharmacists Association J Pharm Sci 102:3239–3251, 2013     

Pharmacist-physician co-operation at a regional level

In the Dutch region of “Betuwe” the hospital pharmacists and community pharmacists together provide short drug letters about new drugs, which are sent bimonthly to all the practising general practitioners (n=83) and medical specialists (n=50) in this region. A survey was conducted among these physicians in order to investigate their opinion about and reported use of the drug letters in comparison with other drug-information sources. The majority of the responding physicians (response rate 68%) was found to read the drug letter frequently and evaluated the drug letter as a useful source of information about drugs, especially its section about the advantages and disadvantages of the new drug compared to other drugs. With respect to the different stages of the drug-adoption process, the drug letter was found to be the most frequently used information source at the decision stage. At the introduction stage the pharmaceutical industry representative seems to be the most frequently used source of information, while at the information stage it is the “Geneesmiddelenbulletin” (Drug Bulletin). The majority of the responding general practitioners reported to participate in local group meetings with pharmacists. However, in only 20% of these group meetings attention is given to the drug letter. Since it is known that written information has only a limited influence on the physician's behaviour, the influence of the “Betuwe Circulaire” may increase when attention is paid to it in the local contacts between pharmacists and physicians.     

How Do We Know Whether a Primary Prevention Program on Drug Abuse Works or Does Not Work?

Primary prevention of drug abuse is defined as a systematic effort through which curiosity-oriented drug experimenters are kept from becoming regular drug users. Following this definition, a model program entitled Ombudsman is evaluated. The hypothesis tested is: The proportion of students who no longer use drugs will be greater among those who have participated in the Ombudsman program than among those who have not. Some of the findings are: (1) the program is most effective with regard to “hard” drugs (p <. 001), but not with “social” drugs; (2) the program impact is most effective among younger students (p <. 01).     

Drug Use Among College Undergraduates: Current Use and 10-Year Trends

A random sample of 10% of the undergraduate student body at a rural New England university were surveyed as to their use of drugs in 1987. Over 87% of the surveyed students returned questionnaires. Results indicated that alcohol is clearly the “drug of choice” on the campus, and the second most used drug is marijuana. The 1987 survey findings were also compared to similar studies conducted on the campus in 1977 and 1983. Over the decade there has been a decrease in daily, weekly, and monthly use of marijuana. Cocaine use was greatest in the 1983 survey, but the 1987 figures were still somewhat higher than those of 1977. Hallucinogen use has remained low across all three observation points. Students indicating they had substance-dependent parents showed more use of cocaine, “ecstasy,” and sedative-hypnotic drugs than their fellow students.     

Injection drug users’ involvement in drug dealing in the downtown eastside of Vancouver: Social organization and systemic violence

BackgroundIllicit drug markets are a key component of the risk environment surrounding injection drug use. However, relatively few studies have explored how injection drug users’ (IDUs) involvement in drug dealing shapes their experiences of drug market-related harm. This exploratory qualitative study aims to understand IDUs’ dealing activities and roles, as well as the perceived benefits and risks related to participation in illicit drug markets, including experiences of drug market violence.MethodsTen IDUs with extensive involvement in drug dealing activities were recruited from the Vancouver Injection Drug User Study (VIDUS) and participated in semi-structured qualitative interviews, which elicited discussion of experiences dealing drugs, perceived benefits and hazards related to dealing, and understandings of drug market violence.ResultsParticipant's involvement in drug market activities included corporate sales, freelance or independent sales, and opportunistic sales termed “middling” as well as drug market-related hustles entailing selling bogus drugs and robbing dealers. Participants primarily dealt drugs to support their own illicit drug use, and we found that arrest and criminal justice involvement, hazards stemming from drug debts, and drug market-related violence were key risks related to dealing activities.ConclusionThe challenges of managing personal consumption while selling drugs exacerbates the hazards associated with drug dealing. Efforts to address drug dealing among IDUs should consider both drug dependency and the material conditions that propel drug users towards dealing activities. Interventions should explore the potential of combining enhanced drug treatment programs with low threshold employment and alternative income generation opportunities.     

“I’m not afraid of those ones just ‘cause they’ve been prescribed”: Perceptions of risk among illicit users of pharmaceutical opioids

BackgroundThere has been a rise in the illicit use of pharmaceutical opioids (“pain pills”) in the United States. Conducted with young adult non-medical users of pharmaceutical opioids, this study uses qualitative methods and cultural consensus analysis to describe risk perceptions associated with pharmaceutical opioids and to determine patterns of cultural sharing and intra-cultural variation of these views.MethodsThe qualitative sub-sample (n = 47) was selected from a larger sample of 396 young adults (18–23 years old), who were participating in a natural history study of illicit pharmaceutical opioid use. Qualitative life history interviews, drug ranking task, and cultural consensus analysis were used to elicit participant views about risks and harms associated with pain pills and other drugs, as well as alcohol and tobacco.ResultsCultural consensus analysis revealed that the participants shared a single cultural model of drug risks, but the level of agreement decreased with the increasing range of drugs ever used. Further, those with more extensive drug use histories differed from less “experienced” users in their views about OxyContin and some other drugs. Overall, pain pills were viewed as addicting and potentially deadly substances, but these properties were linked to the patterns and methods of use, as well as characteristics of an individual user. Further, risks associated with pharmaceutical opioids were further curtailed because they “came from the doctor,” and thus had a legitimate aspect to their use.ConclusionsThis study highlights potential problems with universal approaches to substance use prevention and intervention among young people since such approaches ignore the fact that substance use education messages may be experienced differently depending on an individual's drug use history and his/her perceptions of drug risks. Findings reported here may be useful in the development of prevention and intervention programs aimed at reducing the harm associated with illicit use of pain pills.     

Pharmacy students' perceptions of their profession relative to other health care professions

Objectives (1) To investigate pharmacy students' perceptions of 10 occupations within the medical and allied professions: community pharmacists, dentists, dietitians, general medical practitioners (GPs), hospital pharmacists, medical specialists, nurses, occupational therapists, physiotherapists and social workers. (2) To explore students' perceptions of community and hospital pharmacists at different stages of a four‐year undergraduate programme and at the year of pre‐registration training. Method A 90‐item questionnaire was administered to 543 pharmacy undergraduates and 95 graduates undergoing their pre‐registration year training in 2001. Setting Faculty of Pharmacy, The University of Sydney, Australia. Key findings Students perceived the health care professions along three major dimensions, relating to “empathy”, “potency” and “expertise”. On an empathy dimension, students rated community pharmacists the highest and medical specialists the lowest. On a potency dimension, students rated medical specialists the most powerful, community and hospital pharmacists significantly lower, and nurses the lowest. On an expertise dimension, students rated medical specialists the highest and dietitians the lowest. A significant pattern of differences was noted in students' perceptions and a possible decline was identified in the potency rating of pharmacists at different stages of the pharmacy programme. Conclusion These differences may be attributed to the differences in the students' value systems, skills and experiences, the influence of reference groups and the content and structure of the educational and training programme in each year.