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Critical Care Nursing Clinics of North... Jun 2024Substance abuse is a widespread problem in the United States and worldwide. This use within the pregnant population is thought to reflect a pattern similar to the...
Substance abuse is a widespread problem in the United States and worldwide. This use within the pregnant population is thought to reflect a pattern similar to the general population, with estimates of 10% to 15% of pregnant women experiencing substance abuse. Illicit substance use during pregnancy has increased substantially during the past decade in the United States. During the past decade, novel or atypical substances have emerged and become increasingly popular. Occurrences of toxicity and untoward fetal effects from designer drug use must be kept high on the watch list for all who practice in maternal-fetal, newborn, and emergency departments.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Analgesics, Opioid; Illicit Drugs; Pregnancy Complications; Psychotropic Drugs; Substance-Related Disorders; United States
PubMed: 38705689
DOI: 10.1016/j.cnc.2023.12.002 -
PeerJ 2024Thailand recently decriminalized ( legalized) cannabis use and sales. However, nationally representative data are scarce with regard to cannabis use behaviors and its...
BACKGROUND
Thailand recently decriminalized ( legalized) cannabis use and sales. However, nationally representative data are scarce with regard to cannabis use behaviors and its association with cannabis outlet density. The objectives of this study are: (1) to describe the prevalence of cannabis use behaviors and cannabis use disorder among the general adult population of Thailand; (2) to describe the extent that the density of cannabis outlets is associated with cannabis use behaviors, cannabis use disorder, and the amount of cannabis smoked per day.
METHODS
We conducted a community-based cross-sectional study in 11 provinces and the Bangkok Metropolitan Area. Participants were residents of sampled communities aged 20 years or older. We requested literate participants to self-administer the questionnaire and interviewed participants who could not read. We analyzed data using descriptive statistics with sampling weight adjustments and multivariate logistic regression analyses.
RESULTS
The prevalence of current cannabis use was 15 percent. At a 400-m radius, participants who reported three cannabis outlets had 4.2 times higher odds of being current users than participants who reported no outlet (Adjusted OR = 4.82; 95% CI [3.04-7.63]). We found no association between outlet density and hazardous cannabis use or cannabis use disorder, nor association with the amount of cannabis use among cannabis smokers.
DISCUSSION AND CONCLUSION
The patterns of association between outlet density and cannabis use behaviors were inconsistent. Furthermore, limitations regarding outlet density measurement and lack of temporality should be considered as caveats in the interpretation of the study findings.
Topics: Humans; Thailand; Male; Female; Adult; Cross-Sectional Studies; Prevalence; Middle Aged; Commerce; Marijuana Abuse; Young Adult; Cannabis; Surveys and Questionnaires; Marijuana Smoking; Marijuana Use
PubMed: 38699183
DOI: 10.7717/peerj.17317 -
Substance Abuse Treatment, Prevention,... Apr 2024Since 1996, an urban community-based organization whose primary mission is to serve diverse94 and emerging community health needs has provided screening, testing,...
BACKGROUND
Since 1996, an urban community-based organization whose primary mission is to serve diverse94 and emerging community health needs has provided screening, testing, overdose prevention and training, referrals, and access to treatment for substance use disorders (SUD) and communicable diseases such as HIV through its Life Points harm reduction program.
METHODS
As a partner in a State survey in 2021, the community organization recruited a convenience sample of people who use drugs to participate in a survey focused on their substance use, healthcare, and barriers to SUD services. Community health workers conducted outreach and used an encrypted identifier to collect data from a convenience sample of harm reduction participants regarding demographics, legal justice, engagement in harm reduction and access to healthcare. Evaluators entered paper surveys into Qualtrics for reporting and summative analysis.
RESULTS
A convenience sample of fifty-five people who use drugs were recruited and surveyed. The majority (86%, n = 47) were active participants in the agency Life Points (LP) harm reduction service. Participants' average age was 42.9 years (SD = 11.5). About half (51%, n = 28) were male, 48% (n = 26) were female, and 2% (n = 1) was transgender. About two-thirds (67%, n = 37) of participants were White/Caucasian, 13% (n = 7) were Black/African-American, 11% (n = 6) were Hispanic and 7% (n = 4) were Multi-Racial. Regarding current substance use, 98% (n = 54) reported use of heroin, 51% (n = 28) reported crack, 47% (n = 26) cocaine, 25% (n = 14) alcohol, 24% (n = 13) opioids, and 15% (n = 8) marijuana. The majority, 87% (n = 48) said they had health care insurance and over two-thirds (69%, n = 37) said they had been arrested for a felony. Almost three quarters (71%, n = 39) reported receiving services from the Department of Health & Human Services. A higher percentage of females compared to males (65% and 29% respectively) reported engagement in community mental health services and 69% of females (n = 18) compared to 15% (n = 4) of males reported needing to participate in sex to meet basic social needs. Participants described social determinants of health as barriers to services, including access to food, legal justice and transportation. About 44% (n = 24) said they would consider enrolling in a drug treatment program in the next 30 days.
CONCLUSION
This sample was reflective of increased participation by White participants that began to appear about a decade ago. The majority of participants reported having healthcare insurance, which may be reflective of engagement with community health workers to access appropriate services. Community organizations and healthcare professionals should continue to explore social determinants of health that can impact the health of people who use drugs, including overcoming barriers to health care access such as investing in mobile unit outreach.
Topics: Humans; Harm Reduction; Male; Female; Adult; Substance-Related Disorders; Middle Aged; Health Services Accessibility; Drug Users; Young Adult; Community Health Services
PubMed: 38689339
DOI: 10.1186/s13011-024-00601-1 -
BMJ Case Reports Apr 2024SummaryCannabis use is legalised in many countries. We present a patient in their 40s who complained of recurrent abdominal pain and associated nausea and vomiting. The...
SummaryCannabis use is legalised in many countries. We present a patient in their 40s who complained of recurrent abdominal pain and associated nausea and vomiting. The patient was previously seen in various hospitals, treated symptomatically, and discharged with a diagnosis of non-specific abdominal pain. The patient had a chronic history of smoking cannabis and nicotine and drinking alcohol. Abdominal examination revealed no masses, and abdominal X-ray was normal. Blood tests and gastroduodenoscopy revealed no obvious aetiology. Intravenous fluids, together with antiemetics and proton pump inhibitors, were administered. The patient also received counselling and was advised to stop cannabis use. At discharge, the patient was well and asked to come back for review in 2 weeks, and, thereafter monthly for a period of 6 months after stopping cannabis use. The patient reported no recurrent symptoms despite continued cigarette and alcohol use. A suspected cannabinoid hyperemesis syndrome (CHS) became a consideration. Awareness of cannabis-related disorders such as CHS may assist in avoiding costly hospital workups.
Topics: Humans; Vomiting; Adult; Abdominal Pain; Male; Cannabinoids; Syndrome; Nausea; Marijuana Abuse; Antiemetics; Cannabinoid Hyperemesis Syndrome
PubMed: 38688569
DOI: 10.1136/bcr-2023-256921 -
Indian Journal of Pharmacology Mar 2024Brain-derived neurotrophic factor (BDNF) has considerable relevance in neural growth and differentiation. It has been evaluated as a biomarker for individuals with... (Comparative Study)
Comparative Study Observational Study
Serum brain-derived neurotrophic factor level and its relation with cannabis use disorder and schizophrenia: A cross-sectional exploratory study in patients at a tertiary care hospital.
BACKGROUND
Brain-derived neurotrophic factor (BDNF) has considerable relevance in neural growth and differentiation. It has been evaluated as a biomarker for individuals with various psychiatric disorders such as substance-related disorders and psychotic disorders.
OBJECTIVE
The present study explored differences in the levels of BDNF (in serum) among subjects using cannabis (with and without schizophrenia).
METHODS
This cross-sectional observational study compared the serum BDNF level in male subjects aged 18-45 years. Four groups of 20 subjects each were included: individuals with tobacco use disorder only, patients having schizophrenia, patients with cannabis use disorder, and finally patients with comorbid cannabis use disorder and schizophrenia.
RESULTS
The BDNF levels were found to be significantly different across the four groups. The BDNF levels in subjects with concurrent schizophrenia and cannabis use disorder were higher than each of the other three groups (cannabis use disorder, schizophrenia, and tobacco use disorder only).
CONCLUSION
We find that BDNF may be higher when cannabis use disorder and schizophrenia co-occur, as compared to either of the conditions alone. The findings should be interpreted with caution due to the low sample size and potential confounders.
Topics: Adolescent; Adult; Humans; Male; Middle Aged; Young Adult; Biomarkers; Brain-Derived Neurotrophic Factor; Cross-Sectional Studies; Marijuana Abuse; Schizophrenia; Tertiary Care Centers; Tobacco Use Disorder
PubMed: 38687312
DOI: 10.4103/ijp.ijp_771_22 -
BJPsych Open Apr 2024In England in 2021, an estimated 274 000 people were homeless on a given night. It has long been recognised that physical and mental health of people who are homeless is...
BACKGROUND
In England in 2021, an estimated 274 000 people were homeless on a given night. It has long been recognised that physical and mental health of people who are homeless is poorer than for people who are housed. There are few peer-reviewed studies to inform health and social care for depression or anxiety among homeless adults in this setting.
AIMS
To measure the symptoms of depression and anxiety among adults who are homeless and who have difficulty accessing healthcare, and to describe distribution of symptoms across sociodemographic, social vulnerability and health-related characteristics.
METHOD
We completed structured questionnaires with 311 adults who were homeless and who had difficulty accessing healthcare in London, UK, between August and December 2021. We measured anxiety and depression symptoms using the 4-item Patient Health Questionnaire (PHQ-4) score. We compared median PHQ-4 scores across strata of the sociodemographic, social vulnerability and health-related characteristics, and tested for associations using the Kruskal-Wallis test.
RESULTS
The median PHQ-4 score was 8 out of 12, and 40.2% had scores suggesting high clinical need. Although PHQ-4 scores were consistently high across a range of socioeconomic, social vulnerability and health-related characteristics, they were positively associated with: young age; food insecurity; recent and historic abuse; joint, bone or muscle problems; and frequency of marijuana use. The most common (60%) barrier to accessing healthcare related to transportation.
CONCLUSIONS
Adults who are homeless and have difficulty accessing healthcare have high levels of depression and anxiety symptoms. Our findings support consideration of population-level, multisectoral intervention.
PubMed: 38686447
DOI: 10.1192/bjo.2024.34 -
The International Journal on Drug Policy Jun 2024Most violent crimes (52 %) are committed by adults aged 18-34, who account for 23 % of the US population and have the highest prevalence of cannabis use and cannabis use...
BACKGROUND
Most violent crimes (52 %) are committed by adults aged 18-34, who account for 23 % of the US population and have the highest prevalence of cannabis use and cannabis use disorder (CUD). We examined whether and how associations of cannabis use, use frequency, and CUD with violent behavior (i.e., attacking someone with the intent to harm seriously) vary by sex in U.S. young adults.
METHODS
Data were from 113,454 participants aged 18-34 in the 2015-2019 US National Surveys on Drug Use and Health, providing nationally representative data on cannabis use, CUD (using DSM-IV criteria), and violent behavior. Descriptive analyses and bivariate and multivariable logistic regression analyses were conducted.
RESULTS
Among U.S. adults aged 18-34, 28.9 % (95 % CI = 28.5-29.2 %) reported past-year cannabis use (with/without CUD), including 20.5 % (95 % CI = 20.2-20.8 %) with non-daily cannabis without CUD, 4.7 % (95 % CI = 4.5-4.8 %) with daily cannabis use without CUD, 2.1 % (95 % CI = 1.9-2.2 %) with non-daily cannabis use and CUD, and 1.7 % (95 % CI = 1.5-1.8 %) with daily cannabis use and CUD. Past-year adjusted prevalence of violent behavior was higher among males with daily cannabis use but without CUD (2.9 %, 95 % CI = 2.4-2.7 %; adjusted prevalence ratio (PR) = 1.7, 95 % CI = 1.3-2.2) and males with daily cannabis use and CUD (3.1 %, 95 % CI = 2.3-4.0 %; adjusted PR = 1.8, 95 % CI = 1.3-2.4) than males without past-year cannabis use (1.7 %, 95 % CI = 1.6-1.9 %). Adjusted prevalence of violent behavior was higher among females with cannabis use regardless of daily cannabis use/CUD status (adjusted prevalence = 1.6-2.4 %, 95 % CIs = 0.9-3.2 %; adjusted PRs = 1.6-2.4, 95 % CI = 1.3-3.2) than females without past-year cannabis use (1.0 %, 95 % CI = 0.9-1.1 %).
CONCLUSIONS
Research is needed to ascertain the directionality of the associations between cannabis use and violent behavior and underlying sex-specific mechanism(s). Our results point to complex sex-specific relationships between cannabis use frequency, CUD, and violent behavior and highlight the importance of early screening for and treatment of CUD and of preventive interventions addressing cannabis misuse.
Topics: Humans; Male; Female; Adult; United States; Young Adult; Adolescent; Marijuana Abuse; Violence; Prevalence; Marijuana Use; Sex Factors; Health Surveys; Marijuana Smoking
PubMed: 38677161
DOI: 10.1016/j.drugpo.2024.104431 -
BMC Women's Health Apr 2024Intimate Partner Violence (IPV) is the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by a current or former...
BACKGROUND
Intimate Partner Violence (IPV) is the range of sexually, psychologically and physically coercive acts used against adult and adolescent women by a current or former male partner. It is a major public health problem globally. This study determined the prevalence, patterns and predictors of IPV amongst female undergraduates in Abia State.
METHODS
A cross-sectional study was conducted from January - February 2022 amongst 306 female undergraduates in Abia State. A mixed method of an online structured questionnaire created on Google forms & onsite self-administered questionnaire were deployed for data collection. Descriptive, bivariate and multivariate analyses were done using IBM SPSS Version 26.0. The level of significance was set at 5%.
RESULTS
A total of 306 respondents participated in the survey. The overall prevalence of IPV amongst female undergraduates was 51.2% (95% CI: 44.8-57.6%). Emotional abuse was the most common form of abuse 78.9%, followed by Physical abuse 42.0% and Sexual abuse 30.8%. Predictors of IPV reported include female earning/receiving more than their partner monthly (aOR = 2.30; 95% CI: 1.20-4.41); male (partner) alcohol consumption (aOR = 5.17; 95% CI: 2.46-10.88), being a smoker of cigarette/marijuana (aOR = 11.01; 95% CI: 1.26-96.25) and having witnessed domestic violence as a child (aOR = 3.55; 95% CI: I.56-8.07). Adverse effects such as unwanted pregnancies (12%), miscarriages (10%), eating/sleeping disorders (21%) and bruises (23%) amongst others were noted in some of the victims.
CONCLUSION
Over half of all female undergraduates in Abia State have experienced IPV with emotional abuse being the commonest. Some Individual and relationship factors were identified as predictors of IPV. We recommend intensifying primary prevention campaigns against risk factors identified like smoking and alcohol consumption.
Topics: Humans; Female; Intimate Partner Violence; Nigeria; Cross-Sectional Studies; Prevalence; Young Adult; Students; Adult; Adolescent; Surveys and Questionnaires; Universities; Risk Factors; Sexual Partners; Public Health; Alcohol Drinking; Male; Emotional Abuse; Sex Offenses
PubMed: 38664690
DOI: 10.1186/s12905-024-03088-x -
Substance Use & Misuse 2024With increases in cannabis use and potency, there is a need to improve our understanding of the impact of use on cognitive function. Previous research indicates...
BACKGROUND
With increases in cannabis use and potency, there is a need to improve our understanding of the impact of use on cognitive function. Previous research indicates long-term cannabis use may have a negative effect on executive function. Few studies have examined persistence of it in protracted abstinence, and there is limited evidence of predictors of worse cognitive function in current and former users. In this study, we aim to evaluate the associations between cannabis use status (current, former, and never use) and self-report cognition. Further, we investigate if cannabis use characteristics predict self-report cognitive function.
METHODS
Cross-sectional cannabis use data from the National Epidemiological Survey on Alcohol and Related Conditions-III (NESARC-III), a national survey ( = 36,309) conducted in the USA between 2012 and 2013 were used alongside the Executive Function Index scales. The data were analyzed by using Ordinary Least Squares regression.
RESULTS
Current ( = 3,681, Female = 37.7%) and former users ( = 7,448, Female = 45.4%) reported poorer cognition than never users ( = 24,956, Female = 56.6%). Self-reported cognition of former users was in-between that of current and never users. Several cannabis use characteristics were associated with self-reported cognition in current and former users.
CONCLUSION
While prospective studies are required to confirm, findings suggest cannabis use is linked to worse cognition. There may be some limited recovery of cognition in former users and some cannabis use characteristics predict impairment. These findings add to our understanding of the cognitive impact of cannabis use. As worse cognitive function may impact relapse, findings have implications for personalization of cannabis use disorder treatment.
Topics: Humans; Male; Female; Self Report; Adult; United States; Cross-Sectional Studies; Cognition; Middle Aged; Young Adult; Adolescent; Executive Function; Marijuana Use; Marijuana Abuse; Marijuana Smoking
PubMed: 38664196
DOI: 10.1080/10826084.2024.2340975 -
Journal of Studies on Alcohol and Drugs Apr 2024Theories suggest that experiences of negative and positive affect are important precursors to alcohol and illicit substance use. Research utilizing ecological momentary...
BACKGROUND
Theories suggest that experiences of negative and positive affect are important precursors to alcohol and illicit substance use. Research utilizing ecological momentary assessments (EMA) has generally supported the relation between momentary experiences of positive affect, but not negative affect, and subsequent substance use. Unfortunately, most of these studies have focused on alcohol use and not other substance use. The goal of this paper was to further explore the relation between momentary affect and use of both alcohol and illicit substances within a population of individuals with a history of substance use. Additionally, this study aimed to understand whether the relations between affect and substance use would vary depending on the timing of EMA assessments of affect prior to substance use.
METHOD
Participants with a history of heavy substance use ( = 59) completed EMA's measuring affect and substance use using random prompts 4 times a day for 14 days.
RESULTS
We found that positive affect was significantly related to later engagement in drinking, illicit substance use, and marijuana use. Moreover, timing of the affect was important. When affect was assessed in the last hour prior to substance use, relative to 7 hours prior, the relation between positive affect and illicit substance use was stronger. Negative affect was related to a lower likelihood of subsequent marijuana use, but more so when it was measured a few hours versus several hours before the use.
CONCLUSION
This study further supported the relation between positive affect and both alcohol and illicit substance use.
PubMed: 38662516
DOI: 10.15288/jsad.23-00067