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Hospital Pediatrics Oct 2022The Child Abuse Prevention and Treatment Act's provisions concerning hospitalist and child protective services response to infants with prenatal substance exposure...
BACKGROUND
The Child Abuse Prevention and Treatment Act's provisions concerning hospitalist and child protective services response to infants with prenatal substance exposure (IPSE) were revised in 2016 to address the impact of the opioid epidemic. In 2019, Connecticut unveiled a statewide hospital reporting infrastructure to divert IPSE without safety concerns from CPS using a deidentified notification to CPS and a plan of safe care (POSC). Connecticut is the first state to implement a separate, deidentified notification system.
METHODS
We used notification and birth data to determine rates per 1000 births. We employed multinomial logistic regression to understand factors associated with 3 mutually exclusive outcomes: (1) diversion with POSC, (2) report with POSC, or (3) report without POSC.
RESULTS
During the first 28 months of policy implementation, hospitalists submitted over 4700 notifications (8% of total Connecticut births). Over three-quarters (79%) of notifications included marijuana exposure, and 21% included opioid exposure. Fewer than 3% included alcohol exposure. Black mothers were disproportionally overrepresented among notifications compared with the state population, and all other race groups underrepresented. Over half of identified IPSE were diverted. Type of substance exposure was the strongest predictor of outcome, controlling for maternal age and race group.
CONCLUSIONS
Connecticut Child Abuse Prevention and Treatment Act diverted IPSE without provider safety concerns away from child protective services. Substance exposure type was associated with the dyad's outcome at hospital discharge. Nonuniversal screening practices may contribute to racial disproportionality in implementation.
Topics: Analgesics, Opioid; Child; Child Protective Services; Female; Hospitalists; Humans; Infant; Policy; Pregnancy; Substance-Related Disorders
PubMed: 36093638
DOI: 10.1542/hpeds.2022-006562 -
Revista Brasileira de Enfermagem 2020to analyze the relationship between alcohol and other drug use, and mental distress among women.
OBJECTIVE
to analyze the relationship between alcohol and other drug use, and mental distress among women.
METHOD
an analytical cross-sectional study conducted with 369 women in Piauí State. Alcohol Use Disorders Identification Test, Non-Student Drugs Use Questionnaire and Self-Reporting Questionnaire and inferential statistics were used.
RESULTS
women with heavy alcohol consumption (zone IV - possible dependence) are 2.1 times more likely to have mental distress. Consuming tobacco increases the odds of distress 3.5%, tranquilizers 2.6 times and cannabis 4.5 times. There is a statistically significant and positive correlation between the Alcohol Use Disorders Identification Test score and the Self-Reporting Questionnaire (p = 0.000; r = 0.250).
CONCLUSION
alcohol, tobacco, tranquilizers and cannabis use is associated with mental distress. The more intense the alcohol consumption, the more intense the mental distress. Therefore, it is necessary to track alcohol and other drug consumption, and mental distress in the routine care of women.
Topics: Adult; Cross-Sectional Studies; Female; Humans; Middle Aged; Psychological Distress; Substance-Related Disorders; Surveys and Questionnaires; Women's Health
PubMed: 32130360
DOI: 10.1590/0034-7167-2018-0268 -
Fa Yi Xue Za Zhi Dec 2021Abuse of pharmaceutical drugs is a major public health and social problem worldwide. Mostly abused drugs mainly include opioids such as morphine, tramadol, methadone and...
Abuse of pharmaceutical drugs is a major public health and social problem worldwide. Mostly abused drugs mainly include opioids such as morphine, tramadol, methadone and fentanyl, sedative-hypnotics such as benzodiazepines and non-benzodiazepines, and central stimulants such as Ritalin (methylphenidate), Adderall (amphetamine and dextroamphetamine) and modafinil. Abuse of pharmaceutical drugs not only causes direct damage to multiple systems of the body, but also significantly increases risks of mental and physical diseases, imposing a heavy burden on individuals, families and society. Therefore, the prevention and control of pharmaceutical drug abuse are of vital importance. The Chinese government has taken strict administration measures for pharmaceutical drugs with abuse risk. However, confronting endless new drugs and changing abuse trends, it is necessary to further strengthen management and prevention of pharmaceutical drugs, monitor the trend of abuse, establish rapid response mechanisms, popularize relevant knowledge, and develop specific therapeutic drugs and intervention means, in order to promote prevention and treatment of pharmaceutical drug abuse.
Topics: Analgesics, Opioid; Central Nervous System Stimulants; Humans; Illicit Drugs; Substance-Related Disorders
PubMed: 35243843
DOI: 10.12116/j.issn.1004-5619.2021.310403 -
Addiction (Abingdon, England) Apr 2022Up to 95% of pregnant women seeking treatment for alcohol and other drug (AOD) use smoke tobacco. Previous reviews indicate few effective smoking cessation treatments... (Review)
Review
BACKGROUND AND AIMS
Up to 95% of pregnant women seeking treatment for alcohol and other drug (AOD) use smoke tobacco. Previous reviews indicate few effective smoking cessation treatments for this group. This updated review aimed to identify and measure the efficacy of smoking cessation interventions trialled among pregnant women in AOD treatment settings who smoke tobacco.
METHODS
A narrative synthesis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies involving psychological, behavioural or pharmacological interventions used to treat tobacco use, including electronic nicotine delivery systems, for pregnant women of any age, who smoked tobacco and were seeking/receiving treatment, or in post-treatment recovery for AOD concerns, were reviewed. MEDLINE, PsycINFO, CINAHL, EMBASE and ProQuest databases, grey literature and reference lists were searched, and field experts were contacted for unpublished study data. The Effective Public Health Practice Project tool assessed study quality. The review was pre-registered with PROSPERO no. CRD42018108777.
RESULTS
Seven interventions (two randomised controlled trials, two single-arm pilot studies, two program evaluations and one causal comparative study) treating 875 women were identified. All were United States (US)-based and targeted women with drug dependence, but not alcohol dependence. Three interventions used contingency management, five provided behavioural counselling, and one offered nicotine replacement therapy. All reported reductions in cigarette consumption; one contingency management-based study demonstrated higher abstinence rates compared with controls at treatment-end that were not maintained at follow-up. Four of six studies were rated as methodologically weak and one unpublished study was not rated.
CONCLUSIONS
Conclusions about the efficacy of smoking interventions for pregnant women with alcohol and other drug concerns who also smoke tobacco are hindered by the paucity of available data and poor methodological quality of included studies.
Topics: Alcoholism; Behavior Therapy; Female; Humans; Male; Pregnancy; Pregnant Women; Randomized Controlled Trials as Topic; Smoking Cessation; Substance-Related Disorders; Tobacco Use Cessation Devices; United States
PubMed: 34374145
DOI: 10.1111/add.15663 -
The International Journal on Drug Policy Oct 2022In the context of changing cannabis and other drug policy and regulation, concerns may arise regarding drug treatment access and use. We assessed...
BACKGROUND
In the context of changing cannabis and other drug policy and regulation, concerns may arise regarding drug treatment access and use. We assessed cannabis/cocaine-related dependence and treatment in Argentina, Chile, and Uruguay.
METHODS
Nationally representative cross-sectional household surveys of people ages 15-64 in Argentina (4 surveys, 2006-2017), Chile (7 surveys, 2006-2018), and Uruguay (4 surveys, 2006-2018) were harmonized. We estimated weighted prevalences of cannabis or cocaine-related (cocaine or cocaine paste) dependence, based on meeting 3+ past-year ICD-10 dependence criteria. We estimated weighted prevalences of past-year alcohol/drug treatment use (Argentina, Chile) or use/seeking (Uruguay) among people with past-year cannabis/cocaine-related dependence. We tested model-based prevalence trends over time and described individual-level treatment correlates by country.
RESULTS
Cannabis/cocaine dependence prevalence increased in the region starting in 2010-2011, driven by cannabis dependence. Adjusted cannabis dependence prevalence increased from 0.7% in 2010 to 1.5% in 2017 in Argentina (aPD=0.8, 95% CI= 0.3, 1.2), from 0.8% in 2010 to 2.8% in 2018 in Chile (aPD=2.0, 95% CI= 1.4, 2.6), and from 1.4% in 2011 to 2.4% in 2018 in Uruguay (aPD=0.9, 95% CI= 0.2, 1.6). Cocaine-related dependence increased in Uruguay, decreased in Argentina, and remained stable in Chile. Among people with past-year cannabis/cocaine dependence, average alcohol/drug treatment use prevalence was 15.3% in Argentina and 6.0% in Chile, while treatment use/seeking was 14.7% in Uruguay. Alcohol/drug treatment prevalence was lower among people with cannabis dependence than cocaine-related dependence. Treatment correlates included older ages in all countries and male sex in Argentina only.
CONCLUSION
Alcohol/drug treatment use among people with cannabis/cocaine-related dependence remained low, signaling an ongoing treatment gap in the context of growing cannabis dependence prevalence in the region. Additional resources may be needed to increase treatment access and uptake. Future studies should assess contributors of low treatment use, including perceived need, stigma, and service availability.
Topics: Adolescent; Adult; Argentina; Cannabis; Chile; Cocaine; Cocaine-Related Disorders; Cross-Sectional Studies; Ethanol; Hallucinogens; Humans; Male; Marijuana Abuse; Middle Aged; Substance-Related Disorders; Uruguay; Young Adult
PubMed: 35939947
DOI: 10.1016/j.drugpo.2022.103810 -
International Journal of Molecular... Jan 2022Drug addiction causes constant serious health, social, and economic burden within the human society. The current drug dependence pharmacotherapies, particularly relapse... (Review)
Review
Drug addiction causes constant serious health, social, and economic burden within the human society. The current drug dependence pharmacotherapies, particularly relapse prevention, remain limited, unsatisfactory, unreliable for opioids and tobacco, and even symptomatic for stimulants and cannabinoids, thus, new more effective treatment strategies are researched. The antagonism of the growth hormone secretagogue receptor type A (GHS-R1A) has been recently proposed as a novel alcohol addiction treatment strategy, and it has been intensively studied in experimental models of other addictive drugs, such as nicotine, stimulants, opioids and cannabinoids. The role of ghrelin signaling in these drugs effects has also been investigated. The present review aims to provide a comprehensive overview of preclinical and clinical studies focused on ghrelin's/GHS-R1A possible involvement in these nonalcohol addictive drugs reinforcing effects and addiction. Although the investigation is still in its early stage, majority of the existing reviewed experimental results from rodents with the addition of few human studies, that searched correlations between the genetic variations of the ghrelin signaling or the ghrelin blood content with the addictive drugs effects, have indicated the importance of the ghrelin's/GHS-R1As involvement in the nonalcohol abused drugs pro-addictive effects. Further research is necessary to elucidate the exact involved mechanisms and to verify the future potential utilization and safety of the GHS-R1A antagonism use for these drug addiction therapies, particularly for reducing the risk of relapse.
Topics: Animals; Biomarkers; Central Nervous System Stimulants; Clinical Studies as Topic; Disease Models, Animal; Disease Susceptibility; Genetic Predisposition to Disease; Ghrelin; Humans; Nicotine; Receptors, Ghrelin; Reinforcement, Psychology; Signal Transduction; Substance-Related Disorders; Tobacco Use
PubMed: 35054944
DOI: 10.3390/ijms23020761 -
Addiction Science & Clinical Practice Sep 2023Youth, 18 to 24 years, experiencing homelessness (YEH) are recognized as having developmental challenges dissimilar to older adults. Yet, research on efforts to end... (Review)
Review
BACKGROUND
Youth, 18 to 24 years, experiencing homelessness (YEH) are recognized as having developmental challenges dissimilar to older adults. Yet, research on efforts to end homelessness and prevent or intervene in drug use and mental health problems among youth have lagged behind that of adults. The Housing First (HF) Model which underlies Permanent Supportive Housing (PSH) and Rapid Re-Housing (RRH) has become preferred over treatment-first models.
METHODS AND RESULTS
We provide an overview of PSH and RRH studies to date and summarize our current understanding of their utility for use with YEH. Finally, we review our team's current and past randomized trials testing RRH with YEH, providing lessons learned and recommendations.
CONCLUSION
Current research efforts to guide best practices are hampered by a lack of fidelity to HF principles, lack of randomized design, and lack of focus on youth. Lessons learned and recommendations from our work are offered to facilitate the future work of those who seek to end homelessness and address drug use and mental health problems among youth.
Topics: Humans; Adolescent; Aged; Housing; Ill-Housed Persons; Substance-Related Disorders
PubMed: 37775777
DOI: 10.1186/s13722-023-00413-x -
Soins; La Revue de Reference Infirmiere 2022High levels of substance-related disorders among incarcerated people have been documented and there is a lot of drug users in French prisons. Several health and social...
High levels of substance-related disorders among incarcerated people have been documented and there is a lot of drug users in French prisons. Several health and social workers are involved in the management of people dealing with addictions in prison. The coordination between substance use and mental health services in correctional settings and in the community is fundamental to ensure treatment continuity for these people.
Topics: Humans; Prisons; Prisoners; Substance-Related Disorders; Behavior, Addictive
PubMed: 36681507
DOI: 10.1016/j.soin.2022.11.011 -
International Journal of Offender... Aug 2022Research regarding mental illness and drug addiction among inmates in Morocco requires increased knowledge; previous literature reported that prisoners suffer from...
Research regarding mental illness and drug addiction among inmates in Morocco requires increased knowledge; previous literature reported that prisoners suffer from severe psychological distress. The present study aimed to provide information about Moroccan prisoners' psychological distress and define the differences in psychological distress levels among inmates with and without drug-dependence. A sample of 177 male inmates completed a set of surveys, including the Drug Use Disorders Identification Test (DUDIT) and the Brief Symptom Inventory (BSI). The "Drug dependence" group scored significantly higher psychological distress levels in each of the BSI domains. The strongest differences were measured in the General Severity Index (GSI), hostility, and depression scales. Moroccan prison inmates have high psychological distress, and those with drug-dependence have even higher. There is a need of psychiatric assessment, selection, and care possibilities in prison inmate populations.
Topics: Anxiety; Humans; Male; Prisoners; Psychological Distress; Substance-Related Disorders; Surveys and Questionnaires
PubMed: 33882747
DOI: 10.1177/0306624X211010286 -
Sensors (Basel, Switzerland) Nov 2022Substance use disorder (SUD) is a dangerous epidemic that develops out of recurrent use of alcohol and/or drugs and has the capability to severely damage one's brain and...
Substance use disorder (SUD) is a dangerous epidemic that develops out of recurrent use of alcohol and/or drugs and has the capability to severely damage one's brain and behaviour. Stress is an established risk factor in SUD's development of addiction and in reinstating drug seeking. Despite this expanding epidemic and the potential for its grave consequences, there are limited options available for management and treatment, as well as pharmacotherapies and psychosocial treatments. To this end, there is a need for new and improved devices dedicated to the detection, management, and treatment of SUD. In this paper, the negative effects of SUD-related stress were discussed, and based on that, a few significant biomarkers were selected from a set of eight features collected by a chest-worn device, RespiBAN Professional, on fifteen individuals. We used three machine learning classifiers on these optimal biomarkers to detect stress. Based on the accuracies, the best biomarkers to detect stress and those considered as features for classification were determined to be electrodermal activity (EDA), body temperature, and a chest-worn accelerometer. Additionally, the differences between mental stress and physical stress, as well as different administrations of meditation during the study, were identified and analysed. Challenges, implications, and applications were also discussed. In the near future, we aim to replicate the proposed methods in individuals with SUD.
Topics: Humans; Substance-Related Disorders; Stress, Psychological; Machine Learning; Behavior, Addictive; Biomarkers
PubMed: 36433299
DOI: 10.3390/s22228703