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Trauma, Violence & Abuse Jul 2024Since the last two decades, the scientific community has made an effort to analyze drug-facilitated sexual assault (DFSA). However, a lack of understanding remains about... (Review)
Review
Since the last two decades, the scientific community has made an effort to analyze drug-facilitated sexual assault (DFSA). However, a lack of understanding remains about the DFSA problem, particularly concerning the opportunistic variant. Facing this situation, a systematic review of the term DFSA is carried out from its first appearance in the scientific databases consulted (Web of Science, Scopus, and PubMed) to the current day. The search resulted in 773 publications, reduced to a final study sample composed of 19 articles. Eligible studies for this review had to meet certain inclusion criteria, in addition to providing information on DFSA prevalence, DFSA victim profile, DFSA offender profile, involved drugs, or contextual information about the assault. The results demonstrated that the assailants are men, who mostly know victims before the assault. The victims are young women under 30 years old. Alcohol is the drug involved in most DFSA cases, prevailing a voluntary use. Most assaults occur in private spaces, particularly the aggressors' own homes. Furthermore, there is a detected need for a standard definition of DFSA to allow the different actors involved in dealing with sexual violence to work effectively together, and, at the same time, it is detected that the available studies overrepresent proactive DFSA and underestimate opportunism, the most common involved in DFSA cases.
Topics: Humans; Sex Offenses; Female; Crime Victims; Male; Adult; Substance-Related Disorders; Young Adult; Prevalence
PubMed: 37650508
DOI: 10.1177/15248380231195877 -
Sao Paulo Medical Journal = Revista... 2024Adolescence is characterized by complex and dynamic changes, often involving experimentation, including the use of psychotropic substances. Although it is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Adolescence is characterized by complex and dynamic changes, often involving experimentation, including the use of psychotropic substances. Although it is well-established that recreational psychotropic drugs are associated with suicide ideation in adults, evidence of this association in adolescents remains limited.
OBJECTIVE
To investigate the relationship between suicide ideation and psychotropic recreational drug use among adolescents.
DESIGN AND SETTING
Systematic review with meta-analysis developed at Universidade Federal de Uberlândia (UFU) and Universidade Estadual de Campinas (UNICAMP), Brazil.
METHODS
A search across eight electronic databases for observational studies, without language or publication year restrictions, was conducted. The Joanna Briggs Institute tool was used to assess the risk of bias. Random-effects meta-analyses and odds ratios were used to measure the effects.
RESULTS
The search yielded 19,732 studies, of which 78 were included in the qualitative synthesis and 32 in the meta-analysis. The findings indicated that suicidal ideation was 1.96 times more likely (95% confidence interval, CI = 1.47; 2.61) for adolescents who used some drug recurrently and 3.32 times more likely (95%CI = 1.86; 5.93) among those who abused drugs. Additionally, adolescents who used cannabis were 1.57 times more likely (95%CI = 1.34; 1.84) to experience suicide ideation compared with non-users, while cocaine users had 2.57 times higher odds (95%CI = 1.47; 4.50).
CONCLUSIONS
Psychotropic recreational drug use is associated with suicidal ideation among adolescents regardless of current or previous use, abuse, or type of substance used.
SYSTEMATIC REVIEW REGISTRATION
Registered in the PROSPERO database under the identification number CRD42021232360. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232360.
Topics: Humans; Suicidal Ideation; Adolescent; Psychotropic Drugs; Recreational Drug Use; Substance-Related Disorders; Risk Factors; Brazil; Illicit Drugs; Male; Female
PubMed: 38655989
DOI: 10.1590/1516-3180.2022.0641.R2.23012024 -
Journal of Psychoactive Drugs 2024Healthcare professionals are exposed to stressful situations that may favor substance use vulnerability. This systematic review aims to synthesize the risk and... (Review)
Review
Healthcare professionals are exposed to stressful situations that may favor substance use vulnerability. This systematic review aims to synthesize the risk and protective factors associated with use, abuse, and dependence of alcohol, tobacco, psychoactive drugs, and cannabis in healthcare professionals. Following PRISMA recommendations, a systematic search was performed in PsycINFO, Web of Science, PubMed/MEDLINE, Embase, Scopus, and Cochrane Library. The search yielded 1523 studies, of which 19 were selected. The identified risk factors were demographic factors (i.e. male gender, and single/divorced marital status), psychopathological factors, social factors, positive attitudes toward drugs, unhealthy lifestyle habits, the COVID-19 pandemic, and the coexistence of the use of several substances. The protective factors were demographic factors (i.e. ethnicity and having dependent children), healthy lifestyle habits, and workplace anti-drug policies (i.e. restriction of tobacco use). These findings highlight the need for preventive actions against drug use in healthcare professionals to improve their health and reduce the possible negative impact on their healthcare practice. Knowledge of modifiable risk and protective factors allows their incorporation as components in preventive actions, and non-modifiable factors (e.g. demographic variables) may contribute to the detection of groups of greater vulnerability to propose selective prevention actions in this population.
Topics: Humans; Male; COVID-19; Health Personnel; Protective Factors; Risk Factors; Substance-Related Disorders; Female
PubMed: 37341709
DOI: 10.1080/02791072.2023.2227173 -
Current Psychiatry Reports Jun 2022To review the literature on the trends in substance use among youth during the coronavirus SARS-CoV-2 (COVID-19) pandemic. (Review)
Review
PURPOSE OF REVIEW
To review the literature on the trends in substance use among youth during the coronavirus SARS-CoV-2 (COVID-19) pandemic.
RECENT FINDINGS
The pandemic has given rise to concerns about the mental health and social well-being of youth, including its potential to increase or exacerbate substance use behaviors. This systematic review identified and included 49 studies of use across alcohol, cannabis, tobacco, e-cigarettes/vaping, and other drugs, and unspecified substances. The majority of studies across all categories of youth substance use reported reductions in prevalence, except in the case of other drugs and unspecified drug and substance use, which included three studies that reported an increase in use and three studies that reported decrease in use. Overall, the results of this review suggest that the prevalence of youth substance use has largely declined during the pandemic. Youth substance use in the post-pandemic years will require monitoring and continued surveillance.
Topics: Adolescent; COVID-19; Electronic Nicotine Delivery Systems; Humans; Pandemics; SARS-CoV-2; Substance-Related Disorders
PubMed: 35476186
DOI: 10.1007/s11920-022-01338-z -
Journal of Substance Abuse Treatment Dec 2021Stigma surrounding substance use disorders (SUDs) is a frequently cited barrier to treatment engagement. Research consistently demonstrates that healthcare... (Review)
Review
BACKGROUND
Stigma surrounding substance use disorders (SUDs) is a frequently cited barrier to treatment engagement. Research consistently demonstrates that healthcare professionals' attitudes towards patients with addiction problems are often negative and may adversely impact service delivery. The current study presents a systematic review of stigma interventions for providers who treat patients with SUDs, in order to evaluate the quality of existing studies and potential for implementation in clinical settings.
METHODS
This systematic literature review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases included PubMed, APA PsycInfo and the Cochrane Database of Systematic Reviews. Of the 1462 records identified between 2011 and 2019, 15 studies were eligible for inclusion. A narrative synthesis of stigma interventions summarized the change in stigmatizing attitudes held by providers.
RESULTS
Studies included heterogeneous and culturally diverse samples of providers (N = 1324), who varied by age, location, discipline, and experience, with the exception of primarily female providers (75%). Results delineated six types of provider stigma interventions with components including online education, in-person education, in-person contact with consumers in recovery, or some combination of these elements. The highest quality studies incorporated motivational interviewing or communication training interventions, and many interventions combined either in-person mentorship or contact with individuals in recovery. Positive effects on provider attitudes occurred at several levels of educational and consumer contact interventions. Interventions with consumer contact demonstrated long-term maintenance of attitudinal shifts. Despite significant methodological limitations and low-quality assessment ratings, several studies utilized real-world providers and patients, as well as practical, innovative, brief, and potentially cost-effective interventions, particularly in locations with limited technological resources.
CONCLUSIONS
Research on provider stigma interventions increased in recent years, indicating greater worldwide attention to the negative impact of stigma. While educational interventions alone can be helpful in attitudinal change, contact with individuals in recovery from SUDs is a vital component of provider stigma interventions, particularly for lasting effects. This review highlights the importance of including implementation outcomes, such as sustainability and cost-effectiveness, in the study of stigma interventions for providers of addiction treatment.
Topics: Attitude of Health Personnel; Female; Humans; Social Stigma; Substance-Related Disorders
PubMed: 34217033
DOI: 10.1016/j.jsat.2021.108486 -
Substance Abuse Treatment, Prevention,... Mar 2023Interest in the health and well-being of university students has increased in the UK and Ireland in the past two decades as their numbers have grown. Recent high-profile... (Review)
Review
BACKGROUND
Interest in the health and well-being of university students has increased in the UK and Ireland in the past two decades as their numbers have grown. Recent high-profile deaths of students after using illicit drugs have highlighted the importance of the topic for policy makers. This scoping review maps the state of the existing literature evaluating use of illicit drugs in university students in the UK and Ireland. It aims to highlight research gaps and inform policy.
METHOD
We conducted a systematic search of papers related to psychoactive drug use in university students in the UK and Ireland published before August 2021. The 18 extracted study characteristics included author(s); year of publication; journal; location of data collection; study design; delivery method (e.g., online survey, in-person, postal survey); number of participants; response rate; participant course of study, year of study, degree level (i.e., undergraduate, postgraduate), gender and age; time-period assessed (e.g., lifetime, current use, past 12 months); primary aim; primary outcome; ethical approval; and funding source.
RESULTS
The PRISMA-guided search strategy identified 1583 papers for abstract review; of 110 papers retained for full-text review, 54 studies met criteria for inclusion for this paper. Primary outcomes were coded into five groups: prevalence and patterns of drug use; factors associated with drug use; attitudes and knowledge about, and motivation for, drug use; supply of drugs; consequences of drug use. The results show that there is no coherent body of research in this area. The prevalence of reported drug use has crept up and the range of substances reported has broadened over time, and attitudes to drugs on average have normalised. However, there are significant methodological limitations that limit the utility of these findings. There was little evidence of published work on prevention of, or intervention to reduce, drug-related harms.
CONCLUSION
The domains identified offer a framework for university administrators, researchers and policy makers to understand the potential response to drug use in university students in the UK and Ireland. Recommendations are made to fill the gaps in the research evidence base.
Topics: Humans; Ireland; Universities; Students; Substance-Related Disorders; Illicit Drugs; United Kingdom
PubMed: 36915093
DOI: 10.1186/s13011-023-00526-1 -
International Journal of Mental Health... Dec 2022Mental and substance use disorders are leading contributing factors for the Australian non-fatal burden of disease. These disorders frequently co-occur in the mental... (Review)
Review
Mental and substance use disorders are leading contributing factors for the Australian non-fatal burden of disease. These disorders frequently co-occur in the mental health population, and mental health nurses are the largest group of professionals treating dual diagnosis. A comprehensive understanding of mental health nurses' attitudes and perceptions is required to inform future implementation of dual diagnosis training programs. A systematic literature review of sources derived from electronic databases including Medline, CINAHL, SCOPUS review, and PsychINFO, along with Connected Papers. Selection criteria included a focus on mental health nurses' attitudes towards dual diagnosis of mental illness and substance use. Extracted data was qualitatively synthesized. Of the 5232 articles retrieved initially, 12 were included in the review. Four themes emerged from the synthesis: drug and alcohol use among mental health consumers (seven studies), caring for dual diagnosis consumers (eight studies), role perception (six studies), and treatment optimism (five studies). Salient beliefs included substance use as a self-inflicted choice (71%) or a form of 'self-medication' (29%); a lack of willingness to provide care (75%), or a strong commitment to care (25%); greater comfort with screening and acute medical management rather than ongoing management (83%); and pessimism about treatment effectiveness (100%). Mental health nurses' beliefs and attitudes towards dual diagnosis were often negative, which is likely to result in poor quality care and treatment outcomes. However, the lack of recent studies in this research area indicates the need for up-to-date knowledge that can inform the development of training programs.
Topics: Humans; Mental Health; Australia; Psychiatric Nursing; Substance-Related Disorders; Attitude of Health Personnel
PubMed: 35909095
DOI: 10.1111/inm.13043 -
Public Health Aug 2023To determine the effect of recreational cannabis legalization (RCL) and/or recreational cannabis commercialization (RCC) on emergency department (ED) visits,... (Review)
Review
OBJECTIVE
To determine the effect of recreational cannabis legalization (RCL) and/or recreational cannabis commercialization (RCC) on emergency department (ED) visits, hospitalizations, and deaths due to substance use, injury, and mental health among those aged 11 years and older.
METHODS
A systematic review of six electronic databases up to February 1, 2023. Original, peer-reviewed articles with interrupted time series or before and after designs were included. Four independent reviewers screened articles and assessed risk of bias. Outcomes with 'critical' risk of bias were excluded. Protocol registered on PROSPERO (# CRD42021265183).
RESULTS
After screening and risk of bias assessment, 29 studies were included which examined ED visits or hospitalizations for cannabis use or alcohol (N = 10), opioid mortality (N = 3), motor vehicle fatalities or injury (N = 11), and intentional injury/mental health (N = 5). Rates or number of cannabis-related hospitalizations increased after RCL in Canada and the USA. Immediate increases in rates of cannabis-related ED visits were found after both RCL and RCC in Canada. Rates of traffic fatalities increased after RCL and RCC in certain jurisdictions in the USA.
CONCLUSIONS
RCL was associated with increased rates of cannabis-related hospitalizations. RCL and/or RCC was associated with increased rates of cannabis-related ED visits, consistently shown across sex and age groups. The effect on fatal motor vehicle incidents was mixed, with observed increases found after RCL and/or RCC. The effect of RCL or RCC on opioids, alcohol, intentional injury, and mental health is not clear. These results inform population health initiatives and international jurisdictions considering RCL implementation.
Topics: Humans; Cannabis; Mental Health; Carcinoma, Renal Cell; Substance-Related Disorders; Analgesics, Opioid; Legislation, Drug; Ethanol; Kidney Neoplasms
PubMed: 37429043
DOI: 10.1016/j.puhe.2023.06.012 -
BMC Psychiatry Feb 2024Systemic therapy (ST) is a psychotherapeutic intervention in complex human systems (both psychological and interpersonal). Cognitive behavioural therapy (CBT) is an... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Systemic therapy (ST) is a psychotherapeutic intervention in complex human systems (both psychological and interpersonal). Cognitive behavioural therapy (CBT) is an established treatment for children and adolescents with mental disorders. As methodologically rigorous systematic reviews on ST in this population are lacking, we conducted a systematic review and meta-analysis to compare the benefit and harm of ST (and ST as an add-on to CBT) with CBT in children and adolescents with mental disorders.
METHODS
We searched MEDLINE, Embase, PsycINFO and other sources for randomised controlled trials in 14 mental disorder classes for the above comparisons in respect of effects on patient-relevant outcomes (search date: 7/2022). Where possible, meta-analyses were performed and results were graded into 3 different evidence categories: "proof", "indication", or "hint" (or none of these categories). PRISMA standards were followed.
RESULTS
Fifteen studies in 5 mental disorder classes with usable data were identified. 2079 patients (mean age: 10 to 19 years) were analysed. 12/15 studies and 29/30 outcomes showed a high risk of bias. In 2 classes, statistically significant and clinically relevant effects in favour of ST were found, supporting the conclusion of a hint of greater benefit of ST for mental and behavioural disorders due to psychoactive substance use and of ST as an add-on to CBT for obsessive-compulsive disorders. In 2 other classes (eating disorders; hyperkinetic disorders), there was no evidence of greater benefit or harm of ST. For affective disorders, a statistically significant effect to the disadvantage of ST was found for 1 outcome, supporting the conclusion of a hint of lesser benefit of ST.
CONCLUSIONS
Our results show a hint of greater benefit of ST (or ST as an add-on to CBT) compared with CBT for 2 mental disorder classes in children and adolescents (mental and behavioural disorders due to psychoactive substance use, obsessive compulsive disorders). Given the importance of CBT as a control intervention, ST can therefore be considered a beneficial treatment option for children and adolescents with certain mental disorders. Limitations include an overall high risk of bias of studies and outcomes and a lack of data for several disorders.
Topics: Child; Humans; Adolescent; Young Adult; Adult; Psychotherapy; Cognitive Behavioral Therapy; Obsessive-Compulsive Disorder; Treatment Outcome; Substance-Related Disorders
PubMed: 38355466
DOI: 10.1186/s12888-024-05556-y -
Drug and Alcohol Dependence Jun 2021Substance use-related stigma is a significant barrier to care among persons who use drugs (PWUD). Less is known regarding how intersectional identities, like gender,... (Review)
Review
BACKGROUND
Substance use-related stigma is a significant barrier to care among persons who use drugs (PWUD). Less is known regarding how intersectional identities, like gender, shape experiences of substance use-related stigma. We sought to answer the following question: Do men or women PWUD experience more drug use stigma?
METHODS
Data were drawn from a systematic review of the global, peer-reviewed scientific literature on substance use-related stigma conducted through 2017 and guided by the Stigma and Substance Use Process Model and PRISMA guidelines. Articles were included in the present analysis if they either qualitatively illustrated themes related to the gendered nature of drug use-related stigma, or quantitatively tested the moderating effect of gender on drug use-related stigma.
RESULTS
Of the 75 studies included, 40 (53 %) were quantitative and 35 (47 %) were qualitative. Of the quantitative articles, 22 (55 %) found no association between gender and drug use-related stigma, 4 (10 %) identified women who use drugs (WWUD) were more stigmatized, and 2 (5 %) determined men who use drugs (MWUD) were more stigmatized. In contrast, nearly all (34; 97 %) of the qualitative articles demonstrated WWUD experienced greater levels of drug use-related stigma.
CONCLUSION
The quantitative literature is equivocal regarding the influence of gender on drug use-related stigma, but the qualitative literature more clearly demonstrates WWUD experience greater levels of stigma. The use of validated drug use-related stigma measures and the tailoring of stigma scales to WWUD are needed to understand the role of stigma in heightening the disproportionate harms experienced by WWUD.
Topics: Female; Gender Identity; Humans; Male; Pharmaceutical Preparations; Social Stigma; Substance-Related Disorders
PubMed: 33901753
DOI: 10.1016/j.drugalcdep.2021.108706