Patterns of substance use and abuse in inner-city adolescent medical patients

Distinct patterns of use and abuse of alcohol and illicit drugs are described in a sample of 2,415 teenage patients using primary health clinics over a two-year period. The sample was obtained in the course of a large-scale study to evaluate the effectiveness of consolidated medical programs directed to predominantly inner-city, minority-group adolescents. Information was obtained in personal interviews using a structured format and professional interviewers. Analysis of data proceeded in two steps. First, the rates of progression from abstention or light use of alcohol and drugs to regular use or abuse, and the reverse of this pattern (i.e., remission) were examined. The second step in the analysis was to examine the degree to which certain psychosocial variables characterized temporal patterns of heavy use. Regular tobacco use had a substantial influence on the progression to substance abuse in male and female patients. The results indicate that about 20 percent of the patients attending these clinics were in some phase of either increasing or decreasing their substance use, and another 20 percent engaged in regular use continuously over the two-year period, while the remaining 60 percent of patients stayed at low risk over this same period. These subgroups were rather easy to differentiate on the basis of concurrent behavioral and lifestyle problems.     

Public health: Youth substance use and abuse: challenges and strategies for identification and intervention

Public health initiatives to distribute nicotine replacement therapy free of charge as a means of promoting smoking cessation are ongoing. Are there enough smokers interested in using nicotine replacement therapy to have a substantial impact on the prevalence of smoking if this aid were distributed free to all interested smokers? We conducted a telephone survey of 825 randomly selected daily smokers aged 18 years or older who had smoked at least 10 cigarettes per day at some point in their lives. Overall, 58.9% of the respondents said they would be interested in nicotine replacement therapy if it were offered for free. Of those interested, almost all (93.8%) said that they would use the nicotine replacement therapy to help them quit for good. There were differences in the levels of interest: smokers who intended to quit were more interested in using the nicotine replacement therapy than those who planned to reduce or maintain their smoking.Nicotine replacement therapy significantly increases a smoker''s chances of quitting.¹ It is widely available in Canada and can be obtained over the counter, usually at a cost to the consumer. Several public health initiatives have explored the advantages of free distribution of nicotine replacement therapy as a means of promoting smoking cessation.^2,3 Based on the popularity of these mass distribution efforts, it has been suggested that giving free nicotine replacement therapy to all interested smokers could have an important impact on the prevalence of smoking.²This statement assumes that a substantial proportion of smokers would actually be interested in receiving free nicotine replacement therapy and would use it in an attempt to quit. Previous studies^4,5 have reported a high level of interest among smokers; however, their results may reflect a response bias rather than a true intention to use nicotine replacement therapy. Health care professionals need to know how receptive smokers are to using nicotine replacement therapy. We sought to evaluate smokers'' attitudes by asking novel questions about their interest in receiving free nicotine replacement therapy and what they would do if they received it.     

Role of opioid antagonists in treating intravenous cocaine abuse

Intravenous cocaine abuse is a major probel in opioid abusers including those treated in methadone maintenance. Studying 138 opioid addicts, we found that speedballing by combining opioid agonists with cocaine may be blocked by opioid antagonists such as naltrexone and by partial antagonists such as buprenorphine. With both these treatments cocaine abuse was five to eight times less than with methadone treatment.     

Weight loss maintenance in a population-based sample of German adults

The objective of this study was to investigate the prevalence of weight loss maintenance in a population-based sample of the German adult population. German adults were recruited based on the random digital-dialing methodology. Using computer-assisted telephone interviewing, weight loss maintenance was assessed, defined as having intentionally lost at least 10% from maximum weight and having maintained it for at least 1 year at the time of the survey. A total of 2,095 noninstitutionalized adults were randomly selected from all parts of Germany and the data of 957 respondents were included into the analysis. Of those who were at least overweight (BMI >or= 25 kg/m(2)) at their maximum weight, 17.7% reported having maintained a current weight loss of >or=10% of their maximum weight for at least 1 year. Among participants who reported a maximum weight in the obese range (BMI >or= 30 kg/m(2)), 29.7% reported successful 1-year weight loss maintenance. Among at least overweight participants, being younger and female, and having a higher maximum BMI were significant predictors of successful 1-year weight loss maintenance. The results suggest that successful weight loss maintenance is not uncommon in the general population, particularly in formerly obese participants. More should be learned about the strategies that successful weight maintainers use to avoid regaining weight.     

Biosocial correlates of asthma in a national sample of young adults

As the participants in the 1958 National Child Development Study cohort enter adulthood most of the social factors associated with onset of asthma are no longer relevant, but many of the biological factors continue to be important. There is a continuing association at age 23 between eczema, hayfever and similar allergic reactions and continuing asthma, while the earlier associated social factors including non-manual occupations, home ownership, and lack of crowding within the home or sharing of the bedroom with others in the household cease to have significant effects. Smoking patterns in this age group diverge sharply from what might be expected in those with a serious respiratory affliction: significantly more asthmatics smoke than would be expected at random.     

Psychedelics as an emerging novel intervention in the treatment of substance use disorder: a review

Molecular Biology Reports - Classical psychedelics are a group of drugs characterized by their activation of the serotonin-2A (5-hydroxytryptamine-2A; 5-HT2A) receptor and the unique hallucinogenic...     

Prenatal substance use in a Western urban community.

To assess the extent of prenatal substance use in a predominantly white population in an urban area of the western United States and to develop a risk profile for this population, a cross-sectional prevalence study was done. Prenatal clinics (10 public and 10 private) anonymously recorded demographic information about and collected aliquots of routinely obtained urine specimens from women during prenatal visits. Urine specimens were screened by enzyme immunoassay for amphetamines, marijuana, cocaine, opiates, and ethanol. Of the 935 women screened, 92 (9.8%) had urine specimens positive for one or more of these substances. Urine screens were positive in 56 (10.0%) of 562 women attending private clinics and 36 (9.6%) of 373 women attending public clinics. Only 7 of the 935 women (0.7%) had screens positive for cocaine. Ethanol was the most frequently detected substance in the private clinic group (6.4%), whereas marijuana was most common among women attending public clinics (5.1%). Although substance use in this group of pregnant women occurs at a lower rate and a different pattern from those found in other more densely populated areas, the rate is high enough to be of concern to all prenatal care professionals, who should incorporate substance use history taking and selective urine drug screening into their routine prenatal practices.     

Comparison of three oxidative stress biomarkers in a sample of healthy adults

Oxidative stress is a potentially important aetiological factor for many chronic diseases, including cardiovascular disease, neurodegenerative disease and cancer, yet studies often find inconsistent results. The associations between three of the most widely used biomarkers of oxidative stress, i.e. F₂-isoprostanes for lipid peroxidation and 8-oxo-7,8-dihydro-2’-deoxyguanosine (8-oxo-dG) and the comet assay with FPG for oxidative DNA damage, were compared in a sample of 135 healthy African-American and white adults. Modest associations were observed between F₂-isoprostanes and the comet assay (r?=?0.22, p?=?0.01), but there were no significant correlations between 8-oxo-dG and the comet assay (r?=??0.09) or F₂-IsoP (r?=??0.04). These results are informative for researchers seeking to compare results pertaining to oxidative stress across studies and/or assessment methods in healthy disease-free populations. The development and use of oxidative stress biomarkers is a promising field; however, additional validation studies are necessary to establish accuracy and comparability across oxidative stress biomarkers.     

Dynamic carbon budget of a large shallow lake assessed by a mass balance approach

To study the role of large and shallow hemiboreal lakes in carbon processing, we calculated a 3-year carbon mass balance for Lake Võrtsjärv (Estonia) based on in situ measurements. This balance took into account hydrological and biogeochemical processes affecting dissolved inorganic (DIC), dissolved organic (DOC) and particulate organic (POC) carbon species. Accumulation varied greatly on a seasonal and yearly basis. The lake exported carbon during most of the year except during spring floods and in late autumn. In-lake processes were responsible for exporting POC and storing DOC while DIC switched between storage and export. The carbon cycle was alternatively dominated in 2009 by biogeochemical processes and in 2011 by riverine fluxes, whereas in 2010 the two process types were of the same magnitude. These results suggest that the role of large shallow lakes like Võrtsjärv in the global C cycle is equally driven by hydrological factors, in particular seasonal water level changes, and by biogeochemical in-lake reactions.     

From heroin epidemics to methamphetamine epidemics: Modelling substance abuse in a South African province

The global rise in the use of methamphetamine has been documented to have reached epidemic proportions. Researchers have focussed on the social implications of the epidemic. A typical drug use cycle consists of concealed drugs use after initiation, addiction, treatment-recovery-relapse cycle, whose dynamics are not well understood. The model by White and Comiskey [41], on heroin epidemics, treatment and ODE modelling, is modified to model the dynamics of methamphetamine use in a South African province. The analysis of the model is presented in terms of the methamphetamine epidemic threshold R₀. It is shown that the model has multiple equilibria and using the center manifold theory, the model exhibits the phenomenon of backward bifurcation where a stable drug free equilibrium co-exists with a stable drug persistent equilibrium for a certain defined range of R₀. The stabilities of the model equilibria are ascertained and persistence conditions established. Furthermore, numerical simulations are performed; these include fitting the model to the available data on the number of patients with methamphetamine problems. The implications of the results to drug policy, treatment and prevention are discussed.