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Scientific Reports Jun 2024It is well-recognized that individuals with alcohol-related disorders often use other psychoactive substances; however, systematic research on this topic remains...
It is well-recognized that individuals with alcohol-related disorders often use other psychoactive substances; however, systematic research on this topic remains limited. The primary objective was to determine the prevalence of lifetime psychoactive substance use and describe the dependence between concurrent use of alcohol and other drugs on psychiatric comorbidities in the analyzed group. The secondary aim was to try to assess the frequency of seeking psychiatric treatment between individuals declaring the concurrent use of alcohol with other drugs and those declaring the use only alcohol. The study was designed as a retrospective cross-sectional analysis based on discharge reports from psychiatric patients admitted to the Regional Psychiatric Hospital in Olsztyn, Poland. 1015 cases were included and analyzed in the study. Data for the study were collected in specially designed monitoring cards from discharge reports including data from psychiatric examinations, especially anamnesis. The percentage of people declaring lifetime use of psychoactive substances was 17.6%. 2.8% of them were diagnosed with substance-related disorders (F11-19 according to ICD-10). The most frequently declared use was cannabis, followed by amphetamine-type substances, benzodiazepines and new psychoactive substances. In the group of people declaring the lifetime use of psychoactive substances, 13.4% were additionally diagnosed with mental disorders. It was, consequently, 8% in the group of people denying the lifetime use of psychoactive substances. People declaring lifetime use of psychoactive substances were significantly more likely to seek psychiatric treatment, i.e. they were admitted significantly more often on an emergency admission than on an elective one, these people were significantly more likely to have undergone psychiatric treatment in the past and were more often hospitalized in our center during the research period. People who concurrently use alcohol with other drugs significantly more often have psychiatric comorbidity than people who deny the use of other drugs. That group also visibly more often seeks psychiatric treatment than patients who deny taking psychoactive substances.
Topics: Humans; Male; Female; Adult; Comorbidity; Substance-Related Disorders; Mental Disorders; Middle Aged; Cross-Sectional Studies; Retrospective Studies; Alcoholism; Poland; Patient Acceptance of Health Care; Prevalence; Psychotropic Drugs; Young Adult; Adolescent; Aged
PubMed: 38902395
DOI: 10.1038/s41598-024-65028-x -
JMIR Human Factors Jun 2024Young adults in the United States exhibit some of the highest rates of substance use compared to other age groups. Heavy and frequent substance use can be associated...
BACKGROUND
Young adults in the United States exhibit some of the highest rates of substance use compared to other age groups. Heavy and frequent substance use can be associated with a host of acute and chronic health and mental health concerns. Recent advances in ubiquitous technologies have prompted interest and innovation in using technology-based data collection instruments to understand substance use and associated harms. Existing methods for collecting granular, real-world data primarily rely on the use of smartphones to study and understand substance use in young adults. Wearable devices, such as smartwatches, show significant potential as platforms for data collection in this domain but remain underused.
OBJECTIVE
This study aims to describe the design and user evaluation of a smartwatch-based data collection app, which uses ecological momentary assessments to examine young adult substance use in daily life.
METHODS
This study used a 2-phase iterative design and acceptability evaluation process with young adults (aged 18-25 y) reporting recent alcohol or cannabis use. In phase 1, participants (8/15, 53%) used the data collection app for 14 days on their Apple Watches to report their substance use patterns, social contexts of substance use, and psychosocial risk factors (eg, affect). After this 14-day deployment, the participants completed a user experience survey and a semistructured interview to record their perspectives and experiences of using the app. Formative feedback from this phase informed feature modification and refinement of the app. In phase 2, an additional cohort (7/15, 47%) used the modified app for 14 days and provided feedback through surveys and interviews conducted after the app use period.
RESULTS
Analyses of overall app use patterns indicated high, consistent use of the app, with participants using the app for an average of 11.73 (SD 2.60) days out of 14 days of data collection. Participants reported 67 instances of substance use throughout the study, and our analysis indicates that participants were able to respond to ecological momentary assessment prompts in diverse temporal and situational contexts. Our findings from the user experience survey indicate that participants found the app usable and functional. Comparisons of app use metrics and user evaluation scores indicate that the iterative app design had a measurable and positive impact on users' experience. Qualitative data from the participant interviews highlighted the value of recording substance use patterns, low disruption to daily life, minimal overall burden, preference of platforms (smartphones vs smartwatches), and perspectives relating to privacy and app use in social contexts.
CONCLUSIONS
This study demonstrated the acceptability of using a smartwatch-based app to collect intensive, longitudinal substance use data among young adults. The findings document the utility of smartwatches as a novel platform to understand sensitive and often-stigmatized behaviors such as substance use with minimal burden.
Topics: Humans; Male; Feasibility Studies; Mobile Applications; Female; Adult; Young Adult; Adolescent; Substance-Related Disorders; Ecological Momentary Assessment; Smartphone; United States
PubMed: 38901024
DOI: 10.2196/50795 -
PloS One 2024Cigarette smoking is a persistent public health problem as it is a risk factor for many diseases. Previous studies on the role of illegal drug use in cigarette smoking... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Cigarette smoking is a persistent public health problem as it is a risk factor for many diseases. Previous studies on the role of illegal drug use in cigarette smoking have yielded disparate and inconclusive results, hindering the development of effective intervention strategies to address this issue. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of cigarette smoking and its associated factors, with a specific focus on the influence of illegal drug use among students in Ethiopia.
METHODS
We conducted a comprehensive search of international databases, including PubMed, Cochrane Library, Science Direct, CINAHL, African Journals Online, HINARI, Global Health, and Google and Google Scholar. Grey literature was also identified from various university digital libraries. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA) guidelines. Due to the high heterogeneity among the included studies (I2 = 98.6%; p-value <0.001), we employed a random-effects model with a 95% confidence interval (CI) to estimate the pooled effect using STATA 14 software. The publication bias was assessed using a statistical Egger regression test.
RESULTS
A total of 22 studies involving 18,144 students met the eligibility criteria for this systematic review and meta-analysis. The pooled prevalence of lifetime and current cigarette smoking among students in Ethiopia was 13.8% (95% CI: 9.90-17.82) and 9.61% (95% CI: 7.19-12.03), respectively. Students who used illegal drugs were twenty-three times more likely to smoke cigarettes compared to their counterparts (OR = 23.57, 95% CI: 10.87-51.1). Living in urban settings (OR = 2.9; 95% CI: 1.15-7.28) and the habit of alcohol consumption (OR = 4.79; 95% CI: 1.57-14.64) were also identified as factors associated with cigarette smoking.
CONCLUSIONS
We found that more than one in eight students in Ethiopia have engaged in lifetime cigarette smoking. Notably, students who used illegal drugs exhibited a significantly higher likelihood of cigarette smoking. In light of these findings, it is imperative to implement comprehensive public health interventions that target illegal drug use, cigarette smoking, and alcohol consumption, with a particular emphasis on urban residents.
Topics: Ethiopia; Humans; Students; Cigarette Smoking; Substance-Related Disorders; Prevalence; Illicit Drugs; Male; Female; Risk Factors
PubMed: 38900812
DOI: 10.1371/journal.pone.0304948 -
JMIR Infodemiology Jun 2024Prenatal alcohol exposure represents a substantial public health concern as it may lead to detrimental outcomes, including pregnancy complications and fetal alcohol...
BACKGROUND
Prenatal alcohol exposure represents a substantial public health concern as it may lead to detrimental outcomes, including pregnancy complications and fetal alcohol spectrum disorder. Although UK national guidance recommends abstaining from alcohol if pregnant or planning a pregnancy, evidence suggests that confusion remains on this topic among members of the public, and little is known about what questions people have about consumption of alcohol in pregnancy outside of health care settings.
OBJECTIVE
This study aims to assess what questions and topics are raised on alcohol in pregnancy on a web-based UK-based parenting forum and how these correspond to official public health guidelines with respect to 2 critical events: the implementation of the revised UK Chief Medical Officers' (CMO) low-risk drinking guidelines (2016) and the first COVID-19 pandemic lockdown (2020).
METHODS
All thread starts mentioning alcohol in the "Pregnancy" forum were collected from Mumsnet for the period 2002 to 2022 and analyzed using qualitative content analysis. Descriptive statistics were used to characterize the number and proportion of thread starts for each topic over the whole study period and for the periods corresponding to the change in CMO guidance and the COVID-19 pandemic.
RESULTS
A total of 395 thread starts were analyzed, and key topics included "Asking for advice on whether it is safe to consume alcohol" or on "safe limits" and concerns about having consumed alcohol before being aware of a pregnancy. In addition, the Mumsnet thread starts included discussions and information seeking on "Research, guidelines, and official information about alcohol in pregnancy." Topics discussed on Mumsnet regarding alcohol in pregnancy remained broadly similar between 2002 and 2022, although thread starts disclosing prenatal alcohol use were more common before the introduction of the revised CMO guidance than in later periods.
CONCLUSIONS
Web-based discussions within a UK parenting forum indicated that users were often unclear on guidance and risks associated with prenatal alcohol use and that they used this platform to seek information and reassurance from peers.
Topics: Humans; Pregnancy; Female; Alcohol Drinking; United Kingdom; COVID-19; Internet; Qualitative Research; Fetal Alcohol Spectrum Disorders; SARS-CoV-2; Social Media
PubMed: 38900536
DOI: 10.2196/58056 -
Addiction Biology Jun 2024A growing body of evidence indicates the existence of abnormal local and long-range functional connection patterns in patients with alcohol use disorder (AUD). However,...
A growing body of evidence indicates the existence of abnormal local and long-range functional connection patterns in patients with alcohol use disorder (AUD). However, it has yet to be established whether AUD is associated with abnormal interhemispheric and intrahemispheric functional connection patterns. In the present study, we analysed resting-state functional magnetic resonance imaging data from 55 individuals with AUD and 32 healthy nonalcohol users. For each subject, whole-brain functional connectivity density (FCD) was decomposed into ipsilateral and contralateral parts. Correlation analysis was performed between abnormal FCD and a range of clinical measurements in the AUD group. Compared with healthy controls, the AUD group exhibited a reduced global FCD in the anterior and middle cingulate gyri, prefrontal cortex and thalamus, along with an enhanced global FCD in the temporal, parietal and occipital cortices. Abnormal interhemispheric and intrahemispheric FCD patterns were also detected in the AUD group. Furthermore, abnormal global, contralateral and ipsilateral FCD data were correlated with the mean amount of pure alcohol and the severity of alcohol addiction in the AUD group. Collectively, our findings indicate that global, interhemispheric and intrahemispheric FCD may represent a robust method to detect abnormal functional connection patterns in AUD; this may help us to identify the neural substrates and therapeutic targets of AUD.
Topics: Humans; Male; Alcoholism; Magnetic Resonance Imaging; Adult; Brain; Middle Aged; Prefrontal Cortex; Thalamus; Case-Control Studies; Gyrus Cinguli; Brain Mapping; Young Adult
PubMed: 38899438
DOI: 10.1111/adb.13398 -
Addiction Biology Jun 2024The association of impaired dopaminergic neurotransmission with the development and maintenance of alcohol use disorder is well known. More specifically, reduced...
Correlation of striatal dopamine D2/3 receptor availability with GABA level in the anterior cingulate cortex in healthy controls but not in alcohol-dependent subjects and individuals at high risk: A multimodal magnetic resonance spectroscopy and positron emission tomography study.
BACKGROUND
The association of impaired dopaminergic neurotransmission with the development and maintenance of alcohol use disorder is well known. More specifically, reduced dopamine D2/3 receptors in the striatum of subjects with alcohol dependence (AD) compared to healthy controls have been found in previous studies. Furthermore, alterations of gamma-aminobutyric acid (GABA) and glutamate (Glu) levels in the anterior cingulate cortex (ACC) of AD subjects have been documented in several studies. However, the interaction between cortical Glu levels and striatal dopamine D2/3 receptors has not been investigated in AD thus far.
METHODS
This study investigated dopamine D2/3 receptor availability via 18F-fallypride positron emission tomography (PET) and GABA as well as Glu levels via magnetic resonance spectroscopy (MRS) in 19 detoxified AD subjects, 18 healthy controls (low risk, LR) controls and 19 individuals at high risk (HR) for developing AD, carefully matched for sex, age and smoking status.
RESULTS
We found a significant negative correlation between GABA levels in the ACC and dopamine D2/3 receptor availability in the associative striatum of LR but not in AD or HR individuals. Contrary to our expectations, we did not observe a correlation between Glu concentrations in the ACC and striatal D2/3 receptor availability.
CONCLUSIONS
The results may reflect potential regulatory cortical mechanisms on mesolimbic dopamine receptors and their disruption in AD and individuals at high risk, mirroring complex neurotransmitter interactions associated with the pathogenesis of addiction. This is the first study combining 18F-fallypride PET and MRS in AD subjects and individuals at high risk.
Topics: Humans; Positron-Emission Tomography; Gyrus Cinguli; Male; Alcoholism; Receptors, Dopamine D2; Adult; Female; Receptors, Dopamine D3; gamma-Aminobutyric Acid; Magnetic Resonance Spectroscopy; Middle Aged; Corpus Striatum; Case-Control Studies; Glutamic Acid; Benzamides
PubMed: 38899357
DOI: 10.1111/adb.13424 -
Frontiers in Public Health 2024American Indian/Alaska Native (AI/AN) communities are more likely to suffer negative consequences related to substance misuse. The COVID-19 pandemic exacerbated the...
INTRODUCTION
American Indian/Alaska Native (AI/AN) communities are more likely to suffer negative consequences related to substance misuse. The COVID-19 pandemic exacerbated the opioid poisoning crisis, in combination with ongoing treatment barriers resulting from settler-colonialism, systemic oppression and racial discrimination. AI/AN adults are at greatest risk of COVID-19 related serious illness and death. In collaboration with an Indigenous community advisory board and Tribal leadership, this study explored AI/AN treatment provider perceptions of client-relatives' (i.e., SUD treatment recipients) experiences during the pandemic from 2020 to 2022.
METHODS
Providers who underwent screening and were eligible to participate ( = 25) represented 6 programs and organizations serving rural and urban areas in Washington, Utah, and Minnesota. Participants engaged in audio-recorded 60-90 min semi-structured individual interviews conducted virtually via Zoom. The interview guide included 15 questions covering regulatory changes, guidance for telemedicine, policy and procedures, staff communication, and client-relatives' reactions to implemented changes, service utilization, changes in treatment modality, and perceptions of impact on their roles and practice. Interview recordings were transcribed and de-identified. Members of the research team independently reviewed transcripts before reaching consensus. Coding was completed in Dedoose, followed by analyses informed by a qualitative descriptive approach.
RESULTS
Five main domains were identified related to client-relative experiences during the COVID-19 pandemic, as observed by providers: (1) accessibility, (2) co-occurring mental health, (3) social determinants of health, (4) substance use, coping, and harm reduction strategies, and (5) community strengths. Providers reported the distinctive experiences of AI/AN communities, highlighting the impact on client-relatives, who faced challenges such as reduced income, heightened grief and loss, and elevated rates of substance use and opioid-related poisonings. Community and culturally informed programming promoting resilience and healing are outlined.
CONCLUSION
Findings underscore the impact on SUD among AI/AN communities during the COVID-19 pandemic. Identifying treatment barriers and mental health impacts on client-relatives during a global pandemic can inform ongoing and future culturally responsive SUD prevention and treatment strategies. Elevating collective voice to strengthen Indigenous informed systems of care to address the gap in culturally-and community-based services, can bolster holistic approaches and long-term service needs to promote SUD prevention efforts beyond emergency response efforts.
Topics: Humans; COVID-19; Alaska Natives; Opioid-Related Disorders; Adult; Female; Male; Substance-Related Disorders; Indians, North American; American Indian or Alaska Native; SARS-CoV-2; Middle Aged; United States; Qualitative Research
PubMed: 38898893
DOI: 10.3389/fpubh.2024.1356033 -
BMC Public Health Jun 2024In Canada, substance-related accidental acute toxicity deaths (AATDs) continue to rise at the national and sub-national levels. However, it is unknown if, where, when,...
OBJECTIVES
In Canada, substance-related accidental acute toxicity deaths (AATDs) continue to rise at the national and sub-national levels. However, it is unknown if, where, when, and to what degree AATDs cluster in space, time, and space-time across the country. The objectives of this study were to 1) assess for clusters of AATDs that occurred in Canada during 2016 and 2017 at the national and provincial/territorial (P/T) levels, and 2) examine the substance types detected in AATD cases within each cluster.
METHODS
Two years of person-level data on AATDs were abstracted from coroner and medical examiner files using a standardized data collection tool, including the decedent's postal code and municipality information on the places of residence, acute toxicity (AT) event, and death, and the substances detected in the death. Data were combined with Canadian census information to create choropleth maps depicting AATD rates by census division. Spatial scan statistics were used to build Poisson models to identify clusters of high rates (p < 0.05) of AATDs at the national and P/T levels in space, time, and space-time over the study period. AATD cases within clusters were further examined for substance types most present in each cluster.
RESULTS
Eight clusters in five regions of Canada at the national level and 24 clusters in 15 regions at the P/T level were identified, highlighting where AATDs occurred at far higher rates than the rest of the country. The risk ratios of identified clusters ranged from 1.28 to 9.62. Substances detected in clusters varied by region and time, however, opioids, stimulants, and alcohol were typically the most commonly detected substances within clusters.
CONCLUSION
Our findings are the first in Canada to reveal the geographic disparities in AATDs at national and P/T levels using spatial scan statistics. Rates associated with substance types within each cluster highlight which substance types were most detected in the identified regions. Findings may be used to guide intervention/program planning and provide a picture of the 2016 and 2017 context that can be used for comparisons of the geographic distribution of AATDs and substances with different time periods.
Topics: Humans; Canada; Female; Male; Adult; Spatio-Temporal Analysis; Middle Aged; Adolescent; Young Adult; Substance-Related Disorders; Cluster Analysis; Aged
PubMed: 38898445
DOI: 10.1186/s12889-024-18883-2 -
BMC Public Health Jun 2024Drug use disorders (DUDs) have emerged as one of the most significant public health crises, exerting a substantial influence on both community health and socio-economic...
BACKGROUND
Drug use disorders (DUDs) have emerged as one of the most significant public health crises, exerting a substantial influence on both community health and socio-economic progress. The United States (US) also suffers a heavy burden, it is necessary to figure out the situation from multiple perspectives and take effective measures to deal with it. Therefore, using the data from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2021, we evaluated this topic.
METHODS
Annual data on DUDs-related burden were collected from the GBD study 2021. We calculated the indicator of estimated annual percentage change (EAPC) to evaluate the changing trend of burden. The Bayesian model for age-period-cohort was introduced to forecast the burden.
RESULTS
In 2021, the number and age-standardized rate of prevalence were particularly prominent, with 12,146.95 thousand and 3821.43 per 100,000, respectively. Higher burden was also observed in males, 15-45 years old populations, and opioid use disorders subtype. From 1990 to 2021, the DUDs-related burden increased in the US and all states, especially in West Virginia; and the national death-related burden with the highest increase (EAPC = 7.96). Other significant inverse associations were seen between EAPC, age-standardized rates, and socio-demographic index (SDI). Moreover, in the next 14 years, the projected DUDs burden remains exigent.
CONCLUSIONS
The burden of DUDs in the US is heavy and has been enlarging. This study proposes that greater attention should be paid to the strategies in males, the younger population, opioid use disorders, and low-SDI states implemented by decision-makers to achieve goals such as reducing burden.
Topics: Humans; United States; Male; Middle Aged; Adult; Female; Adolescent; Young Adult; Substance-Related Disorders; Bayes Theorem; Aged; Cost of Illness; Global Burden of Disease; Forecasting; Prevalence
PubMed: 38898398
DOI: 10.1186/s12889-024-19142-0 -
Nature Communications Jun 2024Methaqualone, a quinazolinone marketed commercially as Quaalude, is a central nervous system depressant that was used clinically as a sedative-hypnotic, then became a...
Methaqualone, a quinazolinone marketed commercially as Quaalude, is a central nervous system depressant that was used clinically as a sedative-hypnotic, then became a notorious recreational drug in the 1960s-80s. Due to its high abuse potential, medical use of methaqualone was eventually prohibited, yet it persists as a globally abused substance. Methaqualone principally targets GABA receptors, which are the major inhibitory neurotransmitter-gated ion channels in the brain. The restricted status and limited accessibility of methaqualone have contributed to its pharmacology being understudied. Here, we use cryo-EM to localize the GABA receptor binding sites of methaqualone and its more potent derivative, PPTQ, to the same intersubunit transmembrane sites targeted by the general anesthetics propofol and etomidate. Both methaqualone and PPTQ insert more deeply into subunit interfaces than the previously-characterized modulators. Binding of quinazolinones to this site results in widening of the extracellular half of the ion-conducting pore, following a trend among positive allosteric modulators in destabilizing the hydrophobic activation gate in the pore as a mechanism for receptor potentiation. These insights shed light on the underexplored pharmacology of quinazolinones and further elucidate the molecular mechanisms of allosteric GABA receptor modulation through transmembrane binding sites.
Topics: Receptors, GABA-A; Binding Sites; Cryoelectron Microscopy; Humans; Animals; Etomidate; Propofol; Quinazolinones; Allosteric Regulation; HEK293 Cells; Hypnotics and Sedatives
PubMed: 38898000
DOI: 10.1038/s41467-024-49471-y