Prevalence and pattern of drug use amongst college students

This is a report on the study of the prevalence and pattern of the use of dependence-producing drugs on 1,192 postgraduate students from the faculties of Arts, Science and Commerce and final year undergraduate medical students. The overall prevalence rate of drug use was 50.08 % (65.22 % in medical and 34.85 % in non-medical students). The highest drug use (76.43 %) was among male medical students. Male students preferred to use alcohol and bhang while femala had a preference for meprobamate followed by alcohol. In the majority of cases, the age of initiation was in the “teens”. “Friends” were most responsible for suggesting drug use, although “more than one” influencing agents out-numbered all the single influencing agents. Parents were found to have a significantly “tolerant” attitude towards drug use by their off-spring. “Personal reasons” were not responsible for indulgence in or abstaining from drug use. L.S.D. users had the maximum number of after-effects. The effects experienced in respect of most drugs were generally unpleasant and sometimes contrary to the expectations of users. Most “non-users” and “infrequent users” did not favour self-decision for drug indulgence though some “moderate” and “frequent” users were in favour of giving this freedom for some substances. Stringent measum against drug use among students were advocated by all drug users. More males, particularly male medical students, than females reported drug experience. Among male users, religion, caste, earlier education, residence (both sexes), employment status, occupation of the father, parental education and family income (among females as well) were the variables found to be significantly associated with drug use.     

Substance use after bariatric surgery: A review

BackgroundPrevalence of obesity has increased dramatically. Obese individuals may undergo bariatric surgery to lose excessive body fat and mitigate obesity-related comorbidities. However, bariatric patients are particularly vulnerable to substance use problems. We conducted a review to examine the prevalence change and factors associated with substance use and determine the association between substance use and health status after weight loss among bariatric patients.MethodsWe searched peer-reviewed articles published between January 1990 and January 2015 in several databases (PubMed, PsycINFO, Cochrane Library, Google Scholar) using different keywords combinations. Studies that focused on pre-surgery substance use only or without reported effect measurements were excluded.ResultsOverall, 40 studies were included in the review. Preoperative history of substance use was a reliable correlate of postoperative substance use. The prevalence of postoperative alcohol use was higher among patients with preoperative history of alcohol use than those without. Postoperative prevalence of alcohol use ranged from 7.6% to 11.8%. No significant prevalence change in cigarette smoking from pre-to postoperative period was observed. Time effect was not observed on smoking or drug use prevalence, while an increase in alcohol consumption was inconsistent across studies. The proportion of new-onset substance users among bariatric patients after surgery ranged from 34.3% to 89.5%.ConclusionSubstance use is associated with poor health among bariatric patients. Preoperative assessment and postoperative follow-up should include interventions to reduce relapse among users and prevent substance use initiation.     

Internet use and addiction among Finnish Adolescents (15–19 years)

This study investigates Internet use among Finnish adolescents (n = 475) combining qualitative and quantitative research. Internet use was evaluated using the Internet Addiction Test (Young, 1998a, Young, 1998b). The data was divided into three parts according to the test scores: normal users (14.3%), mild over-users (61.5%), and moderate or serious over-users (24.2%). The most common reason for use was having fun. While half the students reported disadvantages associated with their use, further qualitative analysis revealed that students with serious overuse did not report any harm caused by using the Internet. As disadvantages of using the Internet, students reported that it is time-consuming and causes mental, social, and physical harm and poor school attendance. Four factors of Internet addiction were found, and for two of them, a statistical difference between females and males was found.     

MDMA (Ecstasy/Molly) Use Among African Americans: Patterns of Initiation

3,4-Methylenedioxymethamphetamine (MDMA; ecstasy/molly) use among African Americans has increased over the last two decades, yet there has been little examination into how African Americans initiate their use of the drug. This study aimed to fill this knowledge gap by exploring the initiation experiences of African Americans and their narrative accounts of the circumstances surrounding their MDMA onset. Audiotapes of in-depth interviews were transcribed, coded, and thematically analyzed. Analyses revealed the presence of initiation patterns that contrast somewhat with those found in other groups of MDMA users. This study adds to the limited research on African American MDMA use and sheds light on why some African Americans decide to start using the drug. The findings provide insights to prevention specialists, harm reduction workers, and treatment providers who work with African American drug users.     

Survey on Drug Use Among People Living with HIV in Hong Kong

This study investigated the prevalence of drug use and the drug use behavior among people living with HIV in Hong Kong. In this cross-sectional survey, subjects were recruited by convenience sampling from the out-patient clinic of a HIV treatment center. A total of 500 subjects completed the questionnaire between January and May 2017. About one third (31.4%, n?=?157) participants reported drug use behavior. Common substances used included methamphetamine (65%), rush poppers (59.2%), gamma-hydroxybutyrate (56.7%), ketamine (49%), ecstasy (45.9%), cannabis (34.4%), cocaine (18.5%), cough medicine (15.3%), and heroin (7%). Polydrug use was common (51%). Younger age, men who have sex with men, history of sexually transmitted infections, and smoking were independently associated with drug use. About 34.4% drug users had co-existing mental illnesses. Most drug users (91.1%) had never received any form of drug treatment services. Linking HIV-infected drug users to drug addiction treatment services is needed.     

Immigrants from Russia, Ukraine and the Caucasus Region: Differential Drug Use, Infectious Disease, and Related Outcomes

This study examined drug use patterns, HIV/AIDS, and related outcomes among former Soviet Union (FSU) immigrants from Russia, Ukraine and the Caucasus mountain region in Israel who reported heroin use. A total of 253 FSU heroin users were interviewed from 2002 to 2007 as part of a large drug use surveillance study in Israel. Individuals were sampled at drug treatment facilities in an urban population center of the Negev region of Israel. Participants were assessed using the Addiction Severity Index, fifth edition. First, immigrants from Russia and Ukraine were compared; then, as a group, compared to those from the Caucasus region. Overall, ASI composite scores suggested comparable levels of addiction severity between the Russian and Ukrainian groups. However, Kavkaz immigrants are older, less likely to be employed, and have more severe scores on many of the drug use measures as compared to the other two nationalities. This study shows different drug use patterns exist among FSU immigrants. Such differences may be, in part, due to socioeconomic, geographic and other sociodemographic factors. Injection drug use, regardless of country/region of origin is a critical public health problem, especially given the link between injection drug use and infectious disease.     

Substance initiation sequences among Taiwanese adolescents using methamphetamine

The aim of this study was to examine substance initiation sequences in Taiwanese adolescent methamphetamine (MAMP) users. Three hundred adolescent MAMP users were questioned about their use of cigarettes, alcohol, areca quid, benzodiazepine, glue, marijuana, MAMP and heroin. The sequences of substance use before MAMP use were determined in every subject according to their age at substance initiation. The sequences of substance initiation were compared between genders and between early-onset and late-onset MAMP users. The results revealed that the adolescents had used cigarettes, alcohol and areca quid before MAMP, and very few (4%) adolescents had started using MAMP before using other substances. Female MAMP users were more likely to use MAMP as their first substance and were less likely to use areca quid than males. Male early-onset MAMP users were more likely to drink alcohol and chew areca quid before MAMP use than were late-onset users. This study found that the sequences of substance initiation were different between genders and between the early-onset and late-onset MAMP users. There are several findings that are different from those in Western studies on the sequence of substance initiation in the adolescent population.     

Excessive Internet use and self-esteem among Internet users in Egypt

Several psychological comorbidities are thought to be associated with excessive Internet use. This study aimed to assess the relation between excessive Internet use and self-esteem among Internet users in Egypt. In this cross-sectional study, a Google form questionnaire, composed of three sections, was used to assess participants’ sociodemographic characteristics and daily Internet use. Self-esteem was evaluated using the Arabic version of the Rosenberg Self-Esteem Scale. Only people ≥18?years who reported having a stable Internet access and were residing in Egypt were included. Our results indicated that 25.3% of the 407 participants reported excessive Internet use (>4?h/day) and 29.5% had low self-esteem. Logistic regression showed that age ≤ 25?years and being unmarried were risk factors of excessive Internet use; (OR 2.85, 95% CI: 1.44–5.66; p value = 0.003) and (OR 2.64, 95% CI: 1.20–5.80; p value = 0.015), respectively. Low self-esteem associated with excessive Internet use by the univariate analysis (OR 1.68, 95% CI: 1.05–2.69; p value = 0.022), yet after adjustment for other covariates, the association attenuated (OR 1.44, 95% CI: 0.86–2.41; p value = 0.162). In participants ≤ 25?years, the association between self-esteem and excessive Internet use remained significant after adjustment for the covariates (Before: OR 2.04, 95% CI: 1.08–3.85; p value = 0.020 vs. After: OR 2.12, 95% CI: 1.11–4.08; p value = 0.015). In conclusion, excessive Internet use is a common finding among Internet users in Egypt. Young and unmarried people are more susceptible to use the Internet excessively. Low self-esteem in young people is associated with excessive Internet use.     

Symptoms of depression,suicidal behaviour and use of substances in Greece: a nationwide general population survey

This study aimed at investigating the relationship between the use of unprescribed licit and illicit drugs and problematic drinking with reported depressive symptoms and suicidal behaviour in a nationwide general population sample of 4291 respondents aged 12 to 64. Depressive symptoms were detected by the use of the Center for Epidemiological Studies Depression Scale (CES-D). A higher proportion of respondents who have reported illicit drug use in their lifetime were found to be depressed with a > 16 score in the CES-D in all age groups and both sexes, than of the other categories of substance use. A multiple range test revealed 3 groups of substance users. The more frequent illicit drug users together with the problematic drinkers exhibited the higher average depressive symptoms scores. The 12-month prevalence of suicidal ideation and suicide attempts was found to be in accordance with the severity and frequency of substance consumption.     

Upregulation of microglia in drug users with and without pre-symptomatic HIV infection

It is generally thought that infection of the central nervous system (CNS) by HIV-1 can occur early, even around the time of seroconversion, and evidence from animal studies supports this. However, the mode and timing of viral entry remain poorly understood since there have been comparatively few studies of the early neuropathology of HIV infection. In this study, samples of frontal and temporal lobes, and basal ganglia, were selected from 12 HIV-positive drug users who had been infected for 4-130 months before death, 10 HIV-negative drug users and 10 non-drug using controls, all age and sex matched. Routine and immunocytochemical staining showed that leptomeningeal and perivascular lymphocytic infiltrate was upregulated in HIV-infected cases compared with the two control groups, and choroid plexitis was confined to the HIV-positive subjects, suggesting an association with viral infection. In contrast, CD68-positive microglia were enhanced in both HIV- positive and HIV-negative drug users, considerably above the baseline seen in normal controls. However, there was no statistical difference between the three groups in relation to astrocytes. Screening and competitive polymerase chain reaction (PCR) undertaken on multiple samples including brain tissue, choroid plexus and leptomeninges from four of the HIV-positive subjects and one control case showed that the pro-viral burden was never more than 13 copies/microg DNA and was negative in multiple samples from one HIV-positive case and one control case. All the basal ganglia samples were PCR-negative. This study has not revealed any t spots' of viral load in brain tissue, choroid plexus or meninges, either early or late in the course of pre-symptomatic HIV infection. Drug use alone is associated with significant upregulation of microglia and this may predispose to HIV infection of the nervous system in drug users.     

The differential impact of risk factors on illicit drug involvement in females

AbstractBackground Initiation of drug use and progression to abuse/dependence involve complex pathways. Potential risk factors may correlate with initiation or progression or both. Are there risk factors that associate with illicit drug use or illicit drug abuse/dependence? Is the magnitude of the association the same for use and abuse/dependence? Does this pattern of association differ across categories of drugs?Methods We used data from female-female adult twins to assess the association of 26 putative risk factors with use and abuse/dependence of six illicit psychoactive drugs. Drug involvement was represented by independent dichotomous outcomes and by a single ordinal variable. Odds ratios were obtained by logistic regression and a continuation ratio was used to test the magnitude of association.Results Factors associate in similar patterns with different drug categories. Some associated factors interact only with initiation while others relate with both stages. There is a stronger association of significant socio-demographic factors with drug use while the psychiatric diagnoses are more strongly associated with progression to abuse/dependence.Conclusions Risk factors may be use-specific, abuse/dependence-specific or common to use and abuse/dependence. The trend of associations is similar across different illicit drugs. This suggests complex, interacting pathways that determine drug habits in individuals. These results are hypothesis-generating and future studies of causal relationships may draw from the outcomes presented in these analyses.     

Comorbid depression among untreated illicit opiate users: results from a multisite Canadian study.

OBJECTIVES: This study aimed to describe patterns of major depression (MDD) in a cohort of untreated illicit opiate users recruited from 5 Canadian urban centres, identify sociodemographic characteristics of opiate users that predict MDD, and determine whether opiate users suffering from depression exhibit different drug use patterns than do participants without depression. METHOD: Baseline data were collected from 679 untreated opiate users in Vancouver, Edmonton, Toronto, Montreal, and Quebec City. Using the Composite International Diagnostic Interview Short Form for Major Depression, we assessed sociodemographics, drug use, health status, health service use, and depression. We examined depression rates across study sites; logistic regression analyses predicted MDD from demographic information and city. Chi-square analyses were used to compare injection drug use and cocaine or crack use among participants with and without depression. RESULTS: Almost one-half (49.3%) of the sample met the cut-off score for MDD. Being female, white, and living outside Vancouver independently predicted MDD. Opiate users suffering from depression were more likely than users without depression to share injection equipment and paraphernalia and were also more likely to use cocaine (Ps < 0.05). CONCLUSIONS: Comorbid depression is common among untreated opiate users across Canada; targeted interventions are needed for this population.     

Adolescent Initiation of Drug Use: Effects of Prenatal Cocaine Exposure

ObjectiveTo investigate the direct effects of prenatal cocaine exposure (PCE) on adolescent drug use, while controlling for other predictors of adolescent use.MethodData are from a longitudinal study of PCE in which women and their offspring were assessed throughout childhood. Adolescents were interviewed at 15 years about their age at initiation of alcohol, marijuana, and tobacco. The sample consisted of 214 adolescents and their caregivers: 50% was of white ethnicity, and 50% African American.ResultsFirst trimester cocaine exposure significantly predicted earlier adolescent marijuana and alcohol initiation. The hazard of marijuana and alcohol initiation among exposed adolescents was almost two times greater than among nonexposed adolescents, adjusting for other significant factors. There were no differences in tobacco initiation. Other significant predictors of adolescent drug use were family history of alcohol problems, exposure to violence, and childhood maltreatment.ConclusionsCocaine exposure during early pregnancy was associated with initiation of marijuana and alcohol use. Exposure to violence, childhood maltreatment, and familial factors also predicted adolescent initiation, but did not mitigate the effects of PCE. The combination of these risk factors has significant implications for the development of later substance use, social, and psychiatric problems.     

Influence of depressed mood on neuropsychologic performance in HIV-seropositive drug users

Some studies point out that depression affects the performance of HIV patients in neuropsychological tasks, but at present this effect is not clear. The purpose of the present paper was to study whether the presence of symptoms of depression affects the neuropsychologic performance of seropositive drug users in tasks of attention/concentration, learning and memory, language, construction and visuospatial function, speed of motor performance, cognitive flexibility, manual skill and concept formation and reasoning. In order to carry out this research a sample consisting of 127 male volunteer subjects was used. These subjects were distributed in four groups: one group consisted of HIV-seropositive drug users with symptoms of depression (n = 33); the second group consisted of HIV-seropositive drug users without symptoms of depression (n = 47); the third group was formed by HIV-seronegative drug users with symptoms of depression (n = 15) and the fourth group was formed by HIV-seronegative drug users without symptoms of depression (n = 32). The results reveal the effect of symptoms of depression (evaluated by the Beck Depression Inventory) on the neuropsychologic performance of seropositive drug users. This effect, however, was not observed in the seronegative group. These findings lead us to suggest that symptoms of depression constitute a risk factor for presenting neuropsychologic disturbances in seropositive subjects, which could well be acting as a factor that foments the neuropsychological effects of HIV.     

Incident diabetes associated with antipsychotic use in the United Kingdom general practice research database

BACKGROUND: Recent reports suggest an association between antipsychotic use and development or exacerbation of diabetes. This study evaluated the risk of incident diabetes associated with the use of atypical and conventional antipsychotics. METHOD: This nested case-control study included all patients in the U.K. General Practice Research Database treated with antipsychotic drugs between January 1994 and December 1998. The main outcome measures were the odds ratios of current (within prior 6 months) or recent (7 to 12 months) antipsychotic exposure among those with (N = 424) compared with those without incident diabetes (N = 1522). RESULTS: The adjusted odds ratio for current use of any antipsychotic drug compared with no use in the past year among those with diabetes was 1.7 (95% confidence interval [CI] = 1.3 to 2.3). The adjusted odds ratio for current use of atypical and conventional antipsychotic drugs compared with no use in the past year among those with diabetes was 4.7 (95% CI = 1.5 to 14.9) and 1.7 (95% CI = 1.2 to 2.3), respectively. The adjusted odds ratio for recent use of conventional antipsychotic drugs compared with no use in the past year among those with diabetes was 1.0 (95% CI = 0.6 to 1.6). The odds ratio for recent atypical antipsychotic drug use could not be calculated because no study subjects had this exposure. CONCLUSION: This study showed an increased risk of incident diabetes among current users of atypical and conventional antipsychotic medications. These results were independent of other established risk factors. The larger association observed for atypical antipsychotic users should be regarded as preliminary given the small number of incident diabetes cases in this group.     

Dependence symptoms in young cannabis users? A prospective epidemiological study

AIM: To examine prospectively over a period of 4 years the profile of cannabis dependence and the risk of specific dependence criteria in a community sample of adolescents. METHODS: A representative community sample of 2446 young adults aged 14-24 years at baseline was followed up over a period of 4 years. Frequency of use measures and of criteria for DSM-IV dependence were assessed by standardized diagnostic interview measures (CIDI). To explore the nature of this association, frequency of use and concomitant use of other psychoactive substances was considered. RESULTS: 30% of the sample were cannabis users. Among all users 35% met at least one dependence criterion. Most frequently reported dependence criteria among all users were withdrawal (17%), tolerance (15%), loss of control (14%) and continued use despite a health problem (13%). Even without concomitant use of other illicit drugs, 22% of low frequency users and 81% of high frequency users met at least one dependence criterion. Symptom patterns were similar in high and low frequency users. The occurrence of a dependence syndrome or of specific dependence criteria could not be attributed to the use of other illicit drugs or to comorbid nicotine and alcohol dependence. CONCLUSIONS: Regular cannabis use in adolescence is associated with the development of a dependence syndrome. This association cannot be explained by the concomitant use of other illicit substances or by comorbid nicotine and alcohol dependence.     

Drug-use initiation and conduct disorder among adolescents in drug treatment

This study investigated effects of drug-use initiation and conduct disorder (CD) among 1031 adolescents who participated in the Drug Abuse Treatment Outcomes Studies for Adolescents (DATOS-A) sponsored by the National Institute on Drug Abuse (NIDA). The mean age of first drug use was 12.7 (S.D.=2.2), 57% met DSM-III-R criteria for CD, and earlier initiators were more likely to have CD. About 78% of the adolescents with CD reported that their first CD symptom occurred prior to drug-use initiation. The proportions of adolescents who had prior treatment were similar (about 28%) across all groups, but earlier initiators reported a greater number of treatment episodes and younger ages at their first treatment. Conduct disordered adolescents revealed greater problems prior to DATOS-A treatment, but they appeared to be more motivated and ready for treatment. Although adolescents with CD still showed worse outcomes after treatment, the impact of CD appeared to lessen when pretreatment differences were controlled. To a lesser extent, adolescents who began using drugs at earlier ages had greater alcohol and drug use and other problems at intake, but their treatment outcomes appeared to be similar to later initiators. There were few significant interaction effects of initiation and CD. Findings from this study highlight the importance of better understanding the progression of drug use, treatment utilization, and psychiatric comorbidity among adolescents with substance abuse problems.     

Factors associated with low cognitive performance in general practice

Summary In the preparatory phase of a randomised controlled trial data were collected to assess the magnitude of changes on cognitive functions in 1628 volunteers (age range 45–75 years) that were recruited from general practitioners' patient population. Subjects were administered a short neuropsychological battery of tests including three paper-and-pencil tests, which assessed immediate recall, delayed memory, and attention. Being on antihypertensive medication was associated with low results for all three tests in every age group, and in all strata according to blood pressure levels. Psychotropic drug use was correlated with low results for all three tests. Differences between psychotropic drug users and nonusers increased with age. Antihypertensive treatment and psychotropic drug use seem to be important to consider in longitudinal studies of cognitive decline in aging.