Drug Use as a Risk Factor of Moral Disengagement: A Study on Drug Traffickers and Offenders against Other Persons

This study investigates the moral-disengagement strategies and influence of drug use in adolescence on 49 offenders in Italian jails, 30 of which are drug traffickers and 19 of which are offenders against other persons. A semi-structured interview was conducted to collect data on family, social and medical histories and the manner in which the deviant act was carried out, and the Moral Disengagement Scale was used to identify specific moral disengagement mechanisms. The results show that the traffickers reported higher levels of general moral disengagement, dehumanization of victims, and advantageous comparison with respect to offenders against other persons. However, the offenders who used drugs in adolescence reported higher levels of advantageous comparison with respect to offenders who did not use drugs. Studying self-regulatory mechanisms is important for enriching the literature about risk factors connected with moral disengagement and deviant behaviour committed by offenders in order to implement the promotion of effective and targeted treatment and educational strategies.     

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.     

Autism spectrum disorder: Trends in research exploring etiopathogenesis

Autism spectrum disorder is a neurodevelopmental condition in which affected individuals have difficulties while interacting and communicating socially, and repetitive behaviors. It has a multifactorial etiology. Various risk factors, including genetic and environmental influences, have been explored while trying to understand its causation. As older evidence was suggestive of a high heritability, a majority of research focused on finding the underlying genetic causes of autism. Due to these efforts, there have been advances in the knowledge of some of the genetic factors associated with autism. But a recent trend also shows an increasing interest in exploration of various potential environmental triggers. These efforts have brought us closer to understanding the elusive disorder more so than ever before. The current review discusses the recent trends in research exploring the etiopathogenesis of autism spectrum disorder.     

Risk Indicators of Depressed Mood Among Sex-Trade Workers and Implications for HIV Risk Behaviour

Objectives:

To determine the prevalence of depressed mood among people who have traded sex for money in the Saskatoon Health Region (SHR), the adjusted risk factors for depressed mood among this sample, and if depressed mood was associated with decreased self-efficacy for safe sexual practices and injection drug use.

Methods:

Two-hundred ninety-nine people who have traded sex for money were surveyed with validated instruments for measuring risk behaviours, depressed mood, and self-efficacy for safe sexual practices.

Results:

The sample consisted primarily of low-income, poorly educated Aboriginal women, many of whom also indicated using injection drugs. Using the 16-point score cut-off for the Center for Epidemiologic Studies Depression Scale, 84.6% of participants had depressed mood. When the cut-off score was 23 points or higher, 65.9% had depressed mood. After multivariate analysis, covariates that had an independent association with depressed mood included injecting a drug in the past 4 weeks (OR 1.59; 95% CI 1.2 to 1.8), suffering the death or permanent separation from a parent before the age of 18 (OR 2.09; 95% CI 1.05 to 4.15), and physical assault or abuse by a partner in adult life (OR 2.79; 95% CI 1.38 to 5.64). Depressed mood was associated with lower self-efficacy scores for safe sexual behaviours.

Conclusions:

Our study suggests that high rates of depressed mood among people who have traded sex for money is associated with injection drug use and low self-efficacy for safe sexual health practices. These findings are important and may help explain the high rates of human immunodeficiency virus within the SHR.     

Socio-cultural Factors Associated with the Initiation of Opium Use in Darab, Iran

This study aimed to identify socio-cultural factors facilitating initiation of opium use among drug users in Darab, Iran. A qualitative study using in-depth interviews was conducted. The study began in June 2006 and included 76 drug users, aged 20–43, of whom 95% (72) were male, and 5% (4) were female. The five most common factors facilitating initiation of drug use were revealed to be: lack of hobbies, treatment of general medical problems, modeling, peer networks, and cultural norms. Partner pressure was a common complaint among women in this study. Cultural factors perceived to facilitate initiation of drug use revealed in this study have not been fully addressed by current prevention and rehabilitation programs. Programs can be targeted at social and family levels to alter drug use culture.     

Rational Use of Valproate: Indications and Drug Regimen in Epilepsy

Sodium valproate (Na VPA) is more often prescribed in European countries than valproic acid (VPA) in the United States for two reasons: Na VPA has been available for clinical use for a longer time, since it was first introduced in France in 1967 and VPA was not authorized for use in the United States until 1978; and in the United States indications for VPA (syrup and capsules) and very recently enteric-coated tablets of divalproex sodium include only absence seizures accompanied or not by other seizure types. In the majority of European countries, Na VPA (liquid forms and enteric-coated tablets) may be prescribed in all types of epilepsy. Before outlining the indications and drug regimens of Na VPA/VPA in epilepsy, we shall consider how this drug is presently used in a realistic situation and not in a highly specialized center.     

Trends in depression and anxiety: men and women

Recent reports from four longitudinal studies indicate that the epidemiology of depression and anxiety in general populations may have changed over the third quarter of this century. In each of two studies in the United States, one in Canada, and one in Sweden, more women than men at mid-century were found to have experienced depression and/or anxiety. By the end of the quarter, women and men in a few to several age groups were more equal in this regard than they had been earlier. In each study, interpretation was offered to the effect that social and historical changes may have contributed to these epidemiologic trends. The four studies are reviewed, and it is suggested that the findings deserve attention as generating hypotheses for further research.     

Associations of health insurance coverage,mental health problems,and drug use with mental health service use in US adults: an analysis of 2013 National Survey on Drug Use and Health

Objective: To estimate the prevalence of mental health service use among US adults, examine the associations of mental health service use with health insurance coverage, mental health problems and drug use, and detect health disparities.

Methods: This was a cross-sectional study with 5,434 adults receiving mental health service out of 37,424 adult respondents from the 2013 National Survey on Drug Use and Health. Weighted univariate and multiple logistic regression analyses were used to estimate the associations of potential factors with mental health service use.

Results: The overall prevalence of mental health services use was 14.7%. Our results showed that being female, aging, having a major depressive episode, serious psychological distress, and illicit drug or alcohol abuse/dependence were positively associated with mental health service use; whereas being African American, Asian or Hispanic ethnicity, married, and having any form of insurance were negatively associated with mental health service use . Stratified analysis by insurance types showed that Medicaid/CHIP, CHAMPUS, and other insurance were positively associated with mental health service use.

Conclusions: Health insurance coverage, mental health problems, and drug abuse or dependence were associated with mental health service use in US adults. Furthermore, adults with different insurances had disparities in access of mental health service.     

Initiation of Intrathecal Drug Delivery Dramatically Reduces Systemic Opioid Use in Patients With Advanced Cancer

ObjectivesPain is common in cancer, affecting more than 70% of patients with advanced disease. Intrathecal drug delivery systems (IDDS) are a well-established treatment for patients with refractory cancer pain, improving pain control and reducing associated side effects. To date, details of systemic opioid use before and after IDDS implant have not been reported.Materials and MethodsWe conducted a retrospective review of patients at Huntsman Cancer Institute-University of Utah treated with IDDS for cancer pain from May 2014 to May 2018. Oral, transdermal, and parenteral opioid use before IDDS implant was compared to use 30 days postoperatively.ResultsA total of 173 patients were included, 93% with stage IV disease. The pre-implant median daily oral morphine equivalent (OME) was 240 mg (interquartile range 130–390, range 0–2616 mg). OME doses >200 mg/day were required by 57% of patients, and >500 mg OME by 19% of patients. The post-implant median OME was 0 mg (interquartile range 0–0, range 0–480 mg) and 82.6% of patients discontinued systemic opioids completely. 11.0% of patients used <100 mg OME, and only 1.7% of patients used >200 mg OME. Mean OME decreased by 94% following IDDS implant (p < 0.0001) and all patients who continued to use systemic opioids required a lower OME compared to pre-implant.ConclusionsIn the largest cohort of patients with advanced cancer and refractory pain treated with IDDS, implantation was associated with a dramatic reduction in systemic opioid use 30 days postoperatively, with a large majority of patients discontinuing systemic opioids. Those patients that continued systemic opioids utilized significantly lower doses as compared to their pre-implant dose.     

Conducting Genetic Epidemiology Studies of Autism Spectrum Disorders: Issues in Matching

The objective of this review is to clarify the role of matching in family genetic studies of autism as a way of defining endophenotypes for linkage analysis. The concept of a confounding variable is reviewed and the importance of considering these in family studies of three endophenotypes in autism are considered: cognitive/language impairments, psychiatric disorders, and autistic-like traits. The importance of matching in infant sibling studies of autism is also addressed. Matching as a way of dealing with confounding variables has an important impact on understanding the extent to which these phenotypes are associated with the genes that confer susceptibility to autism and to the early detection of the disorder. Matching continues to be an important issue in the planning and conduct of family-genetic studies of the autism spectrum disorders, particularly as the search for autism susceptibility genes enters the next generation of studies.