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The American Journal of Geriatric... Nov 2016The authors assessed the prevalence of opioid and benzodiazepine prescription drug misuse in older adults, the risk factors associated with misuse, and age-appropriate... (Review)
Review
OBJECTIVE
The authors assessed the prevalence of opioid and benzodiazepine prescription drug misuse in older adults, the risk factors associated with misuse, and age-appropriate interventions.
METHODS
Following PRISMA guidelines, a literature search of PubMed, PsycINFO, and EMBASE for peer-reviewed journal articles in English through April 2014 with updates through November 2015 was conducted for reports on misuse of prescription benzodiazepines and opioids in older adults. Relevant publications were reviewed that included participants age ≥65 years. Reference lists were manually searched for key identified articles and geriatric journals through April 2016. Information on the study design, sample, intervention, comparators, outcome, time frame, and risk of bias were abstracted for each article.
RESULTS
Of 4,932 reviewed reports, 15 were included in this systematic review. Thirteen studies assessed the prevalence of prescription drug misuse and included studies related to opioid shopping behavior, assessment of morbidity and mortality associated with opioid and/or benzodiazepine use, frequency and characteristics of opioid prescribing, frequency of substance use disorders and nonprescription use of pain relievers, and health conditions and experiences of long-term benzodiazepine users. One study identified risk factors for misuse, and one study described the effects of provider education and an electronic support tool as an intervention.
CONCLUSION
There is a dearth of high quality research on prescription drug misuse in older adults. Existing studies are heterogeneous, making it difficult to draw broad conclusions. The need for further research specific to prescription drug misuse among older adults is discussed.
Topics: Aged; Benzodiazepines; Humans; Opioid-Related Disorders; Prescription Drug Misuse; Prevalence; Substance-Related Disorders
PubMed: 27567185
DOI: 10.1016/j.jagp.2016.06.003 -
Alcoholism, Clinical and Experimental... Sep 2015Emerging research suggests that some bariatric surgery patients are at a heightened risk for developing substance use problems, especially alcohol use problems. (Review)
Review
BACKGROUND
Emerging research suggests that some bariatric surgery patients are at a heightened risk for developing substance use problems, especially alcohol use problems.
METHODS
An exhaustive literature review was conducted in January 2015 to investigate all articles published that included data on postoperative alcohol use, alcohol use disorders, and illicit drug use among bariatric surgery patients.
RESULTS
Twenty-three studies reported on alcohol and/or substance use among bariatric patients. Six studies longitudinally assessed alcohol use behaviors; 3 of these studies found an increase in alcohol use following surgery. Six studies were cross-sectional, and 2 studies assessed medical records. Five studies investigated the prevalence of admissions to substance abuse treatment, and 3 studies combined alcohol and drug use data in a single index. Six studies reported on illicit drug use and reported low-postoperative use. The studies' samples were primarily non-Hispanic white females in their upper 40s, and only 11 of the 23 studies utilized validated assessment instruments.
CONCLUSIONS
Studies employing longitudinal designs and large sample sizes indicate that bariatric patients who had the gastric bypass procedure are at an elevated risk for alcohol use problems postoperatively. Research also indicates that bariatric surgery patients might be overrepresented in substance abuse treatment facilities. Risk factors for problematic postoperative alcohol use include regular or problematic alcohol use presurgery, male gender, younger age, tobacco use, and symptoms of attention deficient and hyperactivity disorder. As a whole, however, studies indicate bariatric surgery patients demonstrate a low prevalence of problematic alcohol use, and studies about gastric bypass patients are not entirely conclusive. Prospective, longitudinal studies are needed, utilizing standardized and validated alcohol assessment instruments that follow postoperative bariatric patients well beyond 2 years, and account for types of bariatric procedure. Finally, study samples with greater racial/ethnic diversity and wider age ranges are needed.
Topics: Alcohol Drinking; Alcohol-Related Disorders; Bariatric Surgery; Biomedical Research; Humans; Longitudinal Studies; Postoperative Care; Postoperative Complications; Prospective Studies; Retrospective Studies; Risk Factors; Substance-Related Disorders
PubMed: 26241357
DOI: 10.1111/acer.12805 -
Substance Abuse 2016Journalists' exposure to potentially traumatic events (PTEs), high levels of job stress, and anecdotal reports within the industry seem to suggest that journalists are... (Review)
Review
BACKGROUND
Journalists' exposure to potentially traumatic events (PTEs), high levels of job stress, and anecdotal reports within the industry seem to suggest that journalists are at greater risk than the general population to experience substance use disorders. The present systematic literature review (SLR) aims to provide a concise, comprehensive, and systematic review of the quantitative literature relating to journalists' experience of substance use.
METHODS
The systematic review method adopted within the present study was based on that prescribed by Fink in the 2010 book, Conducting systematic literature reviews: From the internet to paper, 3rd ed., which contains three main elements: sampling the literature, screening the literature, and extracting data.
RESULTS
Alcohol consumption is the most widely studied substance in journalist samples and is discussed in relation to quantity, level of risk, and potential alcoholism. The review also considers journalists' use of substances, including cigarettes, cannabis, and other illicit substances. In particular, comparisons are made between journalistic roles and gender.
CONCLUSIONS
The research is piecemeal in nature, in that more recent research does not build upon the research that has come before it. Much of what has been reported does not reflect the progress that has taken place in recent years within the alcohol consumption and substance use field in terms of theory, assessment, scale development, practice, and interventions with those who use or are addicted to various substances. This SLR raises a number of methodological and theoretical issues to be explored and addressed in future research.
Topics: Humans; Journalism; Substance-Related Disorders
PubMed: 26453337
DOI: 10.1080/08897077.2015.1101732 -
CNS Drugs Jan 2016Several case reports and epidemiological studies have raised concern about the abuse potential of pregabalin, the use of which has increased substantially over the last... (Review)
Review
BACKGROUND
Several case reports and epidemiological studies have raised concern about the abuse potential of pregabalin, the use of which has increased substantially over the last decade. Pregabalin is, in some cases, used for recreational purposes and it has incurred attention among drug abusers for causing euphoric and dissociative effects when taken in doses exceeding normal therapeutic dosages or used by alternative routes of administration, such as nasal insufflation or venous injection. The magnitude of the abuse potential and the mechanism behind it are not fully known.
OBJECTIVE
The aim of this study was to present a systematic review of the data concerning the abuse potential of pregabalin.
METHODS
We performed a systematic literature search and reviewed the preclinical, clinical and epidemiological data on the abuse potential of pregabalin.
RESULTS
We included preclinical (n = 17), clinical (n = 19) and epidemiological (n = 13) studies addressing the abuse potential of pregabalin. We also reviewed case reports (n = 9) concerning abuse of pregabalin. The preclinical studies indicated that pregabalin possesses modulatory effects on the GABA and glutamate systems, leaving room for an abuse potential. Further, clinical studies reported euphoria as a frequent side effect in patients treated with pregabalin. The majority of case reports concerning abuse of pregabalin involved patients with a history of substance abuse and, similarly, epidemiological studies found evidence of abuse, especially among opiate abusers.
CONCLUSIONS
Overall, the available literature suggests an important clinical abuse potential of pregabalin and prescribers should pay attention to signs of abuse, especially in patients with a history of substance abuse.
Topics: Animals; Clinical Trials as Topic; Drug Evaluation, Preclinical; Euphoria; Humans; Illicit Drugs; Pregabalin; Prescription Drug Misuse; Substance-Related Disorders
PubMed: 26767525
DOI: 10.1007/s40263-015-0303-6 -
BMJ Open Nov 2015Most female street-based sex workers (SSWs) are drug users and this group experience particularly poor outcomes in achieving and maintaining abstinence. In 2010 the UK... (Review)
Review
OBJECTIVES
Most female street-based sex workers (SSWs) are drug users and this group experience particularly poor outcomes in achieving and maintaining abstinence. In 2010 the UK adopted a recovery-orientated Drug Strategy. This strategy did not specifically highlight the complex drug treatment needs of SSWs. Therefore we sought to synthesise and critically appraise existing evidence of interventions to reduce illicit drug use in this group, in order to guide service change toward better provision for the drug treatment needs of SSWs.
METHODS
A systematic review of evidence on the effectiveness of interventions to reduce illicit drug use in female SSWs. Following the PRISMA guidelines, a structured search strategy was used. Searches included databases, organisational and government websites to identify published and grey literature, as well as contacting experts in the field, and hand-searching reference lists and journals.
RESULTS
Six studies, one experimental and five observational, were identified which met review inclusion criteria. Intervention approaches evaluated included substitute prescribing, educational sessions and motivational interviewing. All studies reported a positive intervention effect but the five observational studies were all subject to a relatively high risk of bias. By contrast, the experimental study provided little or no evidence of positive effect (OR for reduction of illicit drug in intervention compared to controls 1.17 95%CI 0.84-1.66 at 3 months and 1.14 (95% CI 0.8 to 1.61) at 6 months follow-up). All six studies described challenges and solutions to study recruitment, retention and follow-up, which were influenced by issues affecting SSWs' health and social stability.
CONCLUSIONS
There is currently no strong evidence for effectiveness of interventions to reduce illicit drug use in female SSWs with problematic drug use. Thus, the development and robust evaluation of effective interventions should be a priority if recovery-orientated goals are to become more achievable for this group.
Topics: Bias; Female; Humans; Illicit Drugs; Motivational Interviewing; Outcome Assessment, Health Care; Randomized Controlled Trials as Topic; Sex Workers; Substance-Related Disorders; United Kingdom
PubMed: 26582403
DOI: 10.1136/bmjopen-2015-009238 -
Neuromodulation : Journal of the... Feb 2022Substance addiction encompasses the incapacity to discontinue urgent drug use; many severely disabled patients might be considered appropriate candidates for surgery due... (Review)
Review
BACKGROUND
Substance addiction encompasses the incapacity to discontinue urgent drug use; many severely disabled patients might be considered appropriate candidates for surgery due to the high rates of relapse despite conservative treatment. A crucial finding in the brain of these patients is increased extracellular concentrations of dopamine in the nucleus accumbens (NAcc).
OBJECTIVES
To determine the efficacy and safety of NAcc surgery for the treatment of substance dependence.
MATERIALS AND METHODS
Adhering to PRISMA guidelines, we performed a systematic review to identify all original studies in which NAcc surgery was performed to treat relapsing drug addiction with a minimum follow-up of six months. From database inception to April 10, 2020, we searched PubMed, Scopus, and LILACS. Two reviewers independently selected studies and extracted data. The main outcome was the relapse rate. The GRADE methods were applied to evaluate the quality of evidence. This study was registered with PROSPERO CRD42020177054.
RESULTS
Fifteen studies involving 359 participants met inclusion criteria; eight (56%) included NAcc deep brain stimulation (DBS) in 13 patients with addiction for alcohol (N = 6, 46.1%), opioid (N = 4, 30.7%), and nicotine (N = 3, 15.3%); seven studies (N = 346, 44%) performed NAcc radiofrequency (RF) ablation for opioid (N = 334) and alcohol (N = 12) dependence. Relapse rates were 38.4% for DBS and 39% for RF ablation.
CONCLUSIONS
Despite available studies reporting a benefit in the treatment of drug addictions with NAcc surgery, this systematic review stresses the need for carefully planned prospective studies in order to further address the efficacy and indications.
Topics: Deep Brain Stimulation; Feasibility Studies; Humans; Nucleus Accumbens; Prospective Studies; Substance-Related Disorders
PubMed: 35125136
DOI: 10.1111/ner.13348 -
Drug and Alcohol Dependence May 2018In response to calls to reassess and reform international drug policy, we estimated the prevalence of drug use among students in China from 2004 to 2013 through a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
In response to calls to reassess and reform international drug policy, we estimated the prevalence of drug use among students in China from 2004 to 2013 through a systematic review and meta-analysis.
METHODS
We systemically identified and reviewed published studies on illicit drug use and abuse of sedative-hypnotics among students in China. We estimated the prevalence of drug use among students using a meta-regression model. The trends in drug use and any geographic differences were assessed using multilevel models, and the association between drug use and sedative-hypnotics abuse was also examined.
RESULTS
The pooled prevalence of illicit drug use and sedative-hypnotics abuse in students was 2.10% (95% CI: 1.80-2.50) and 6.10% (95% CI: 5.10-7.20). A significant decrease in the prevalence of illicit drug use was observed in 2009-2013 (OR = 0.28, 95% CI: 0.25-0.32). Students in higher grades showed a higher prevalence of both illicit drug use and sedative-hypnotics abuse than those in lower grades. Provincial differences in illicit drug use (OR = 2.66, 95% CI: 1.24-5.73) and sedative-hypnotics abuse (OR = 1.37, 95% CI: 1.05-1.79) were identified. The geographical area of illicit drug use was observed to be expanding.
CONCLUSION
Prevalence of drug use among students is twice as high as in the general population of adults in China, indicating that drug use is becoming an urgent public health issue among the younger population. Further investigation among school students is needed.
Topics: Adolescent; China; Female; Humans; Hypnotics and Sedatives; Male; Prevalence; Schools; Students; Substance-Related Disorders; Young Adult
PubMed: 29605569
DOI: 10.1016/j.drugalcdep.2017.12.047 -
Addiction (Abingdon, England) Jul 2016Since its market release, gabapentin has been presumed to have no abuse potential and subsequently has been prescribed widely off-label, despite increasing reports of... (Review)
Review
BACKGROUND AND AIMS
Since its market release, gabapentin has been presumed to have no abuse potential and subsequently has been prescribed widely off-label, despite increasing reports of gabapentin misuse. This review estimates and describes the prevalence and effects of, motivations behind and risk factors for gabapentin misuse, abuse and diversion.
METHODS
Databases were searched for peer-reviewed papers demonstrating gabapentin misuse, characterized by taking a larger dosage than prescribed or taking gabapentin without a prescription, and diversion. All types of studies were considered; grey literature was excluded. Thirty-three papers met inclusion criteria, consisting of 23 case studies and 11 epidemiological reports. Published reports came from the United States, the United Kingdom, Germany, Finland, India, South Africa and France, and two analyzed websites not specific to a particular country.
RESULTS
Prevalence of gabapentin misuse in the general population was reported to be 1%, 40-65% among individuals with prescriptions and between 15 and 22% within populations of people who abuse opioids. An array of subjective experiences reminiscent of opioids, benzodiazepines and psychedelics were reported over a range of doses, including those within clinical recommendations. Gabapentin was misused primarily for recreational purposes, self-medication or intentional self-harm and was misused alone or in combination with other substances, especially opioids, benzodiazepines and/or alcohol. Individuals with histories of drug abuse were most often involved in its misuse.
CONCLUSIONS
Epidemiological and case report evidence suggests that the anti-epileptic and analgesic medication gabapentin is being misused internationally, with substance abuse populations at special risk for misuse/abuse.
Topics: Amines; Analgesics; Cyclohexanecarboxylic Acids; Gabapentin; Humans; Prescription Drug Diversion; Prescription Drug Misuse; Prevalence; Substance-Related Disorders; gamma-Aminobutyric Acid
PubMed: 27265421
DOI: 10.1111/add.13324 -
Journal of Psychoactive Drugs 2023Renewed interest in psychedelic substances in the 21 century has seen the exploration of psychedelic treatments for various psychiatric disorders including substance use... (Review)
Review
Renewed interest in psychedelic substances in the 21 century has seen the exploration of psychedelic treatments for various psychiatric disorders including substance use disorder (SUD). This review aimed to assess the effectiveness of psychedelic treatments for people with SUD and those falling below diagnostic thresholds (i.e. substance misuse). We systematically searched 11 databases, trial registries, and psychedelic organization websites for empirical studies examining adults undergoing psychedelic treatment for SUD or substance misuse, published in the English language, between 2000 and 2021. Seven studies investigating treatment using psilocybin, ibogaine, and ayahuasca, alone or adjunct with psychotherapy reported across 10 papers were included. Measures of abstinence, substance use, psychological and psychosocial outcomes, craving, and withdrawal reported positive results, however, this data was scarce among studies examining a wide range of addictions including opioid, nicotine, alcohol, cocaine and unspecified substance. The qualitative synthesis from three studies described subjective experience of psychedelic-assisted treatments enhanced self-awareness, insight, and confidence. At present, there is no sufficient research evidence to suggest effectiveness of any of the psychedelics on any specific substance use disorder or substance misuse. Further research using rigorous effectiveness evaluation methods with larger sample sizes and longer-term follow-up is required.
Topics: Adult; Humans; Hallucinogens; Psilocybin; Substance-Related Disorders; Psychotherapy; Ibogaine; Lysergic Acid Diethylamide
PubMed: 36933948
DOI: 10.1080/02791072.2023.2190319 -
European Addiction Research 2022Places where people deal and/or use drugs publicly are known as open drug scenes (ODSs). Drug-related community impacts (DRCIs) refer to drug-related issues that...
INTRODUCTION
Places where people deal and/or use drugs publicly are known as open drug scenes (ODSs). Drug-related community impacts (DRCIs) refer to drug-related issues that negatively influence public and individual health, communities, businesses, and recreational and public space enjoyment. There are no well-established criteria for identification of DRCIs. We therefore performed a scoping review of literature to determine DRCIs indicators associated with ODSs.
METHODS
The review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScP). We searched English articles in PubMed, Scopus, Web of Science, and EMBASE databases from 1990 to 2021. The keywords were drug-related crime, drug-related offense, misconduct, social marginalization, homeless drug users, open drug scene, drug-related street disorder, public nuisance, and community impact.
RESULTS
Sixty-four studies were identified. Twenty-five studies were included. Two studies (8%) were about drug-related public nuisance, 1 (4%) considered drug-related social problems, 2 (8%) focused on drug-related social disorder, and 18 studies (72%) discussed indicators of community impacts such as crime, drug-related litter, safety, noise, and drug use in public. Two studies (8%) included the frequency of drug use in ODSs.
DISCUSSION
DRCI indicators are heterogenic, and various factors affect the indicators. The factors include social mores, political discourse, and historical approaches to dealing with and using drugs. Some societies do not tolerate the existence of ODSs. In contrast, many countries have adopted harm reduction programs to manage DRCIs. Identified DRCI indicators were drug using and dealing in public, drug-related litter, crime, drug-related loitering, street-based income generation activities, noise, and unsafety feelings in inhabitants. To solve the problems associated with DRCIs and to make a major change in ODSs, it is necessary to pay attention to the improvement of the economic conditions (e.g., employment opportunities), amendment (e.g., determine the limits of criminalization in drug use), and adoption of social policies (e.g., providing low-threshold and supportive services for homeless drug users).
Topics: Harm Reduction; Humans; Substance-Related Disorders
PubMed: 34794145
DOI: 10.1159/000519886