Showing papers in "Journal of Psychoactive Drugs in 2013"
TL;DR: The survey was completed by 953 participants from 31 countries, making this the largest international survey on a wide variety of users of cannabinoid-based medicine performed so far, and in general, herbal non-pharmaceutical CBMs received higher appreciation scores by participants than pharmaceutical products containing cannabinoids.
Abstract: Cannabinoids, including tetrahydrocannabinol and cannabidiol, are the most important active constituents of the cannabis plant. Over recent years, cannabinoid-based medicines (CBMs) have become increasingly available to patients in many countries, both as pharmaceutical products and as herbal cannabis (marijuana). While there seems to be a demand for multiple cannabinoid-based therapeutic products, specifically for symptomatic amelioration in chronic diseases, therapeutic effects of different CBMs have only been directly compared in a few clinical studies. The survey presented here was performed by the International Association for Cannabinoid Medicines (IACM), and is meant to contribute to the understanding of cannabinoid-based medicine by asking patients who used cannabis or cannabinoids detailed questions about their experiences with different methods of intake. The survey was completed by 953 participants from 31 countries, making this the largest international survey on a wide variety of users of cannabinoid-based medicine performed so far. In general, herbal non-pharmaceutical CBMs received higher appreciation scores by participants than pharmaceutical products containing cannabinoids. However, the number of patients who reported experience with pharmaceutical products was low, limiting conclusions on preferences. Nevertheless, the reported data may be useful for further development of safe and effective medications based on cannabis and single cannabinoids.
190 citations
TL;DR: There is a continued need for greater understanding of addiction as a disease, which would reduce stigma, especially in rural areas, as well as increase the prestige and earning potential of the substance abuse counseling occupation.
Abstract: Substance abuse counselors are vulnerable to burnout, which has negative repercussions for the counselor, employing organization, and clients. However, little is known about differences in counselor burnout from the counselors' perspective in rural versus urban treatment centers. In 2008, focus group data from 28 rural and urban counselors in a southern state were analyzed, revealing three burnout themes across all counselors: causes, consequences, and prevention. However, there were various differences between rural and urban counselors in subthemes, with only rural counselors citing office politics and low occupational prestige as causes of burnout. Only urban counselors reported responses endorsing the subthemes of role reversal, clients trying to choose their counselors, and changing jobs as consequences of burnout. All counselors cited coworker support, clinical supervision, and self-care as important strategies for managing burnout. In sum, context clearly matters as rural counselors cited ...
89 citations
TL;DR: An initial understanding is provided of what characterizes the experiences induced by MXE, one of the new “legal highs” sold on the Internet, which induced a heavily altered state of consciousness similar to classic hallucinogens and the dissociative ketamine.
Abstract: Methoxetamine (MXE), a ketamine analogue, is one of the new “legal highs” sold on the Internet. The aim of this qualitative study was to provide an initial understanding of what character- izes the ...
73 citations
TL;DR: Frequent cannabis use during adolescence may induce diminished ability to disengage the motivational circuit when no reward can be obtained, which could strengthen the search for reinforcements like drugs of abuse, even when facing the negative (non-rewarding) consequences.
Abstract: Adolescents' risk-taking behavior has been linked to a maturational imbalance between reward ("go") and inhibitory-control ("stop")-related brain circuitry. This may drive adolescent drug-taking, such as cannabis use. In this study, we assessed the non-acute effects of adolescent cannabis use on reward-related brain function. We performed a two-site (United States and Netherlands; pooled data) functional magnetic resonance imaging (fMRI) study with a cross-sectional design. Twenty-one abstinent but frequent cannabis-using boys were compared with 24 non-using peers on reward-related brain function, using a monetary incentive delay task with fMRI. Focus was on anticipatory and response stages of reward and brain areas critically involved in reward processing like the striatum. Performance in users was normal. Region-of-interest analysis indicated striatal hyperactivity during anticipatory stages of reward in users. Intriguingly, this effect was most pronounced during non-rewarding events. Striatal hyperactivity in adolescent cannabis users may signify an overly sensitive motivational brain circuitry. Frequent cannabis use during adolescence may induce diminished ability to disengage the motivational circuit when no reward can be obtained. This could strengthen the search for reinforcements like drugs of abuse, even when facing the negative (non-rewarding) consequences.
65 citations
TL;DR: An overview of the risks and possible toxic effects of ayahuasca in humans is done, reviewing studies on the acute ayahuaco administration to humans, on the possible risks associated with long-term consumption by adults and adolescents, and on the possibly toxic effects on pregnant animals and in their offspring.
Abstract: Despite being relatively well studied from a botanical, chemical, and (acute) pharmacological perspective, little is known about the possible toxic effects of ayahuasca (an hallucinogenic brew used for magico-ritual purposes) in pregnant women and in their children, and the potential toxicity of long-term ayahuasca consumption. It is the main objective of the present text to do an overview of the risks and possible toxic effects of ayahuasca in humans, reviewing studies on the acute ayahuasca administration to humans, on the possible risks associated with long-term consumption by adults and adolescents, and on the possible toxic effects on pregnant animals and in their offspring. Acute ayahuasca administration, as well as long-term consumption of this beverage, does not seem to be seriously toxic to humans. Although some nonhuman developmental studies suggested possible toxic effects of ayahuasca or of some of its alkaloids, the limited human literature on adolescents exposed to ayahuasca as early as in the uterus reports no serious toxic effects of the ritual consumption of the brew. Researchers must take caution when extrapolating nonhuman data to humans and more data are needed in basic and human research before a definite opinion can be made regarding the possible toxic effects of ayahuasca in pregnant women and in their children.
63 citations
TL;DR: An agency self-assessment process that combines a trauma-informed assessment, a NIATx process of “walking-through” and use of the Institute of Healthcare Improvement's Plan-Do-Study-Act (PDSA) cycles, and a user-friendly format is described.
Abstract: Clients in substance abuse treatment need, in addition to evidence-based and sensitive treatment services in general, a system of care that takes into account the impact of trauma and violence in so many of their lives. In addition, services need to be delivered in a way that avoids triggering trauma memories or causing unintentional re-traumatization. To that end, this article describes an agency self-assessment process that combines a trauma-informed assessment, a NIATx process of "walking-through" and use of the Institute of Healthcare Improvement's Plan-Do-Study-Act (PDSA) cycles, and a user-friendly format. The trauma-informed assessment is designed to address issues of safety of clients and staff members, reduction of re-traumatization, consistency in practice, and client empowerment. It brings a non-judgmental, collaborative approach to process and practice improvement. The article describes how the assessment process can be--and has been--used to develop an Action Plan, including trainings and the identification of "trauma champions"; i.e., staff who will continue to spread trauma-informed changes and new evidence-based practices throughout the agency. As we enter a period of healthcare reform, addressing trauma as an integral part of addiction treatment also allows us to better deal with the totality of our clients' health problems.
55 citations
TL;DR: Male students and those in upper years of the MD program were more likely to have used pharmaceutical stimulants in the last year, and have favorable attitudes concerning use of cognitive-enhancing agents.
Abstract: Background: Cognitive enhancing agents are substances that may augment functions such as memory, attention, concentration, wakefulness, and intelligence. Methods: An anonymous, online survey containing a series of questions on the actual and hypothetical use of cognitive enhancers was sent via email to 647 medical students across all four years in one Canadian MD program. Results: The response rate was 50% (326/647). Overall, 49 (15%, 95% CI: 11% to19%) students admitted to non-medical and/or off-label use of one or more pharmaceutical stimulants, of whom 14 (4%, 95% CI: 2% to 6%) had used stimulants within the last year. Senior medical students reported recent use more often than junior students (8% vs. 2%, P = 0.04). Class seniority and male gender were both associated with positive attitudes towards use of these agents; favorable attitudes were associated with recent use of pharmaceutical stimulant and high-caffeine products. Conclusion: A substantial proportion of Canadian medical students ha...
49 citations
TL;DR: A retrospective review of Kratom exposure cases from the RPC toxic surveillance system found most cases in both groups had good prognostic outcome, and there was a baby with withdrawal symptoms who was delivered from a chronic Kratom-abusing mother, suggesting possible exposure via the transplacental route.
Abstract: Kratom (Mitragyna speciosa Korth), a native tree in Southeast Asia, is misused as an abuse drug and becomes legally widespread to several countries. Currently, it is available through the online market or by some shops. The clinical manifestations of Kratom's effects are not well-defined and the clinical studies are limited. This study was designed to identify the characteristics of Kratom poisoning and withdrawal cases from Kratom exposure cases in Ramathibodi Poison Center (RPC), Thailand, during a five-year period. We used a retrospective review of Kratom exposure cases from the RPC toxic surveillance system. A total of 52 Kratom exposure cases were identified. The trend of case consultations has been increasing. There were Kratom poisoning cases (76.9%) and withdrawal cases (23.1%). Common presenting symptoms in the poisoning group were palpitation (22.5%), followed by seizure (17.5%). For the withdrawal group, the common presenting symptoms were myalgia (33.3%), insomnia (16.67%), fatigue (16.67%), and chest discomfort (16.67%). There was a baby with withdrawal symptoms who was delivered from a chronic Kratom-abusing mother, suggesting possible exposure via the transplacental route. There were no deaths in either group. Kratom abuse can cause either poisoning or withdrawal. Most cases in both groups had good prognostic outcome.
47 citations
TL;DR: Extensive research is needed to clarify the range of acute and longer-term mental, behavioral, and physical effects induced by psychiatric drugs, both during and after consumption and withdrawal, to enable users and prescribers to exploit their psychoactive effects judiciously in a safe and more informed manner.
Abstract: The psychoactive effects of psychiatric medications have been obscured by the presumption that these medications have disease-specific actions. Exploiting the parallels with the psychoactive effects and uses of recreational substances helps to highlight the psychoactive properties of psychiatric medications and their impact on people with psychiatric problems. We discuss how psychoactive effects produced by different drugs prescribed in psychiatric practice might modify various disturbing and distressing symptoms, and we also consider the costs of these psychoactive effects on the mental well-being of the user. We examine the issue of dependence, and the need for support for people wishing to withdraw from psychiatric medication. We consider how the reality of psychoactive effects undermines the idea that psychiatric drugs work by targeting underlying disease processes, since psychoactive effects can themselves directly modify mental and behavioral symptoms and thus affect the results of placebo-controlled trials. These effects and their impact also raise questions about the validity and importance of modern diagnosis systems. Extensive research is needed to clarify the range of acute and longer-term mental, behavioral, and physical effects induced by psychiatric drugs, both during and after consumption and withdrawal, to enable users and prescribers to exploit their psychoactive effects judiciously in a safe and more informed manner.
46 citations
TL;DR: Findings underscore the need to facilitate parents' access to and involvement in treatment of adolescents and show an association between improved maternal mental health and greater parental warmth, as perceived by adolescents.
Abstract: Parental involvement in adolescents' substance abuse treatment is highly recommended, even though the mechanisms explaining how this favors youths' recovery are not well understood. The present study examines the association between (1) changes in adolescents' substance use and parenting practices, as measured by adolescent self-disclosure and parental warmth; (2) changes in mothers' mental health and their parenting practices, and (3) parental use of services offered by substance abuse treatment centres, parenting practices and adolescent substance use. In total, 147 adolescents and 69 mothers participated in this study. Participants were assessed upon adolescent admission into treatment, as well as at three- and six-month follow-up. Results show an association between improved maternal mental health and greater parental warmth, as perceived by adolescents. In addition, greater parental use of treatment services was found to be associated with greater adolescent self-disclosure and greater reduction of adolescent substance use. Finally, greater adolescent self-disclosure and parental warmth were both associated with lower adolescent substance use. These findings underscore the need to facilitate parents' access to and involvement in treatment of adolescents. The parent-adolescent relationship and the mental health of parents are essential aspects to consider for interventions.
44 citations
TL;DR: Risky cannabis use was significantly positively associated with alexithymia, multiple signs of frontal lobe dysfunction in everyday life, and impulsivity, and a broader pattern of dysfunction was indicated than for risky alcohol use in this sample.
Abstract: Risky or problematic alcohol use by young adults has been found to be associated with factors such as alexithymia, frontal lobe dysfunction, reward sensitivity, and impulsivity. One interpretation is that these factors reflect inherent traits that predispose to risky substance use in general, a notion examined in the present study. Alexithymia, everyday frontal lobe functioning, sensitivity to reward and punishment, and impulsivity were examined in 138 young adult cannabis users who were divided into Low Risk (n = 99) and Risky (n = 39) users according to their Cannabis Use Disorder Identification Test (CUDIT) scores. Risky cannabis use was significantly positively associated with alexithymia, multiple signs of frontal lobe dysfunction in everyday life, and impulsivity. A broader pattern of dysfunction was indicated for risky cannabis use than for risky alcohol use in this sample. Findings are interpreted as likely reflecting not only inherent traits that predispose to risky substance use in general, but also perhaps residual effects of recent heavy cannabis use in the Risky user group. Longitudinal research is needed to disentangle these competing possibilities.
TL;DR: A Deleuzian theory, developed in this article, analyzes addictions as situational and interactional processes and suggests that a recovering body must increase its capacity to be affected and be capable of creating new biopsychosocial connections of desire.
Abstract: This theoretical article presents and applies the theories of the French philosopher Gilles Deleuze. The article takes as its starting point the observation that current biomedical, social and psychological research does not provide a coherent view of the nature of addiction and there is a great deal of controversy in the field. The material philosophy of Deleuze provides the opportunity to introduce new ideas and bridge the gaps between different theories and approaches. Deleuze's philosophy is especially useful since neurological research on addiction has developed rapidly. Deleuzian concepts have implications not only for the general theory of addiction, but also for different theories on treatment and recovery. A Deleuzian theory, developed in this article, analyzes addictions as situational and interactional processes. Alcohol and drugs are used because they are connected with situations and interactions that enable the production of desire. They change and alter the body. Addiction alters the production of desire and life itself begins to be reduced to alcohol, drugs or a specific mode of behavior. Recovery from addictions is connected with the changes in life that offer subjects an open future. A recovering body must increase its capacity to be affected and be capable of creating new biopsychosocial connections of desire.
TL;DR: A rare sample of 93 drug users with personal experience with 11 different illicit drugs that are widely used in the UK are identified, providing a useful insight into the opinions of experienced drug users on a subject about which they have a rare and intimate knowledge.
Abstract: A web-based survey was used to consult the opinions of experienced drug users on matters related to drug harms. We identified a rare sample of 93 drug users with personal experience with 11 different illicit drugs that are widely used in the UK. Asked to assess the relative harms of these drugs, they ranked alcohol and tobacco as the most harmful, and three "Class A" drugs (MDMA, LSD, and psilocybin) and one class B (cannabis) were ranked as the four least harmful drugs. When asked to assess the relative potential for benefit of the 11 drugs, MDMA, LSD, psilocybin, and cannabis were ranked in the top four; and when asked why these drugs are beneficial, rather than simply report hedonic properties, they referred to potential therapeutic applications (e.g., as tools to assist psychotherapy). These results provide a useful insight into the opinions of experienced drug users on a subject about which they have a rare and intimate knowledge.
TL;DR: A critical evaluation of reports associated with ayahuasca or some of its alkaloids with severe intoxications suggests that previous cardiac and hepatic pathologies and current use of serotonergic drugs/medications are contraindications to a...
Abstract: Ayahuasca is a botanical hallucinogenic preparation traditionally consumed by Northwestern Amazonian indigenous groups. Scientific evidence suggests good tolerability after acute administration of ayahuasca and also after years or even decades of its ritual consumption. Nevertheless, some scientific and media reports associate ayahuasca or some of its alkaloids with severe intoxications. The purpose of the present text is to do a critical evaluation of these reports. The evaluation of the cases highlights the fact that some lack accurate forensic/toxicological information, while others are not directly relevant to traditional ayahuasca preparations. These limitations reduce the possibility of an accurate risk assessment, which could indicate potential contraindications and susceptibilities for ayahuasca consumption. Nevertheless, even with these limitations, the cases suggest that previous cardiac and hepatic pathologies and current use of serotonergic drugs/medications are contraindications to ayahuasca use, and that caution should be taken when using different botanical species and extracted/synthetic alkaloids to prepare ayahuasca analogues.
TL;DR: Cannabis users require significantly more opioid rescue analgesia in the immediate postoperative period and further research is needed to elucidate the precise mechanism by which this occurs.
Abstract: Background: Anecdotal reports suggest that cannabis users require increased postoperative analgesia but there is insufficient supporting data. Methods: A prospective randomized study was carried out in 73 patients undergoing elective operations. Postoperatively, all patients were assessed by a blinded investigator, who recorded pain intensity, sedation levels, mood, and hourly analgesia requirements. We calculated the mean pain intensity difference at the first postoperative hour (MPID1) and the sum of pain intensity differences (SPID1). The following end points were compared between cannabis users and non-users using SPSS 16: MPID1; SPID; patient mood; supplemental analgesia requirements and global assessment scores. Results: There were 42 cannabis users and 31 non-users. Cannabis users had significantly higher supplemental pethidine requirements (82.7 mg, SD = 3.4 vs. 51.6 mg, SD = 42.7, p = 0.003) and significantly greater MPID1 scores (1.88, SD = 1.09 vs. 1.35, SD = 1.12, p = 0.001) compared ...
TL;DR: Findings help identify areas to target educational campaigns, such as prevention of sexually transmitted infections, risk behaviors specifically associated with prescription drug misuse warrant further study.
Abstract: Prescription drug misuse among young adults, especially opioids, is a substantial public health problem in the United States. Although risks associated with injection of illicit drugs are well established, injection and sexual risks associated with misuse of prescription drugs are under-studied. Forty young injection drug users aged 16 to 25 who reported injection of a prescription drug were recruited in 2008–09 in Los Angeles and New York City. Descriptive quantitative and qualitative data were analyzed to illustrate risky injection and sexual behaviors reported in this sample. Over half of participants engaged in risky injection behavior, three-quarters engaged in risky sexual behavior, nearly half reported both risky behaviors, and five did not report either risk behavior while misusing a prescription drug. Prescription opioids, tranquilizers, and stimulants were misused in the context of risky sexual behaviors while only opioids were misused in the context of injection risk behaviors. Access ...
TL;DR: The need for women-specific services and a comprehensive network of service linkages for all patients in drug treatment is critical, as Georgian women are twice stigmatized, once by a society that views them as fulfilling only a limited purposeful role and again by their male drug-using counterparts.
Abstract: This study examined attitudes and perspectives of 34 health service providers through in-depth interviews in the Republic of Georgia who encountered an injection drug-using woman at least once in the past two months. Most participants' concept of drug dependence treatment was detoxification, as medication-assisted therapy was considered part of harm reduction, although it was thought to have relatively better treatment outcomes compared to detoxification. Respondents reported that drug dependence in women is much more severe than in men. They also expresSed less tolerance towards drug-using women, as most providers view such women as failuresas a good mother, wife, or child. Georgian women are twice stigmatized, once by a society that views them as fulfilling only a limited purposeful role and again by their male drug-using counterparts. Further, the vast majority of respondents were unaware of the availability of specific types of drug-treatment services in their city, and even more did not seek connections with other service providers, indicating a lack of linkages between drug-related and other services. The need for women-specific services and a comprehensive network of service linkages for all patients in drug treatment is critical. These public health issues require immediate consideration by policy makers, and swift action to address them.
TL;DR: It is found that the association between alcohol abuse and mental illness was stronger among females than males, and the presence of alcohol abuse/dependence and the nonmedical use of prescription drugs to be associated with relatively serious mental illness and with lack of health care.
Abstract: The present study examined whether and how collegians' misuse of prescription drugs and alcohol abuse are associated with mental illness and with a lack of mental health care. Nationally representative data were derived from 5,241 full-time American college students who completed the 2010 National Survey on Drug Use and Health. We observed the presence of alcohol abuse/dependence and the nonmedical use of prescription drugs to be associated with relatively serious mental illness and with lack of health care. In pursuing gender-specific results, we found that the association between alcohol abuse and mental illness was stronger among females than males.
TL;DR: Findings indicate a variety of factors including age, gender, types of drug, Addiction Severity Index Medical and Psychiatric scores, and readiness to change could be incorporated into pretreatment assessments, so that programs can initiate preventive measures to decrease attrition and improve treatment outcomes.
Abstract: A significant number of individuals with co-occurring substance abuse and mental health disorders do not engage, stay, and/or complete residential treatment The purpose of this study is to identify factors during the initial phase of treatment which predict retention in private residential treatment for individuals with co-occurring substance use and mental health disorders The participants were 1,317 individuals with co-occurring substance abuse and mental health disorders receiving treatment at three residential treatment centers located in Memphis, TN, Malibu, CA, and Palm Springs, CA Bivariate analysis and logistic regression were utilized to identify factors that predict treatment retention at 30 days The findings indicate a variety of factors including age, gender, types of drug, Addiction Severity Index Medical and Psychiatric scores, and readiness to change These identified factors could be incorporated into pretreatment assessments, so that programs can initiate preventive measures
TL;DR: Those who reported BZ dependence had 2.5 times greater odds of using a healthcare source to obtain BZs than those who did not meet criteria for dependence, and those with higher incomes had higher odds of utilizing healthcare diversion sources.
Abstract: Benzodiazepines (BZ) are often diverted from legal sources to illicit markets at various points in the distribution process beginning with a pharmaceutical manufacturer, followed by healthcare providers, and finally, to the intended users. Little is known about the extent of BZ diversion involving distribution points directly related to healthcare sources versus points further down the distribution chain. The present study examines the scope of BZ diversion, and the association between BZ dependence and the direct utilization of particular healthcare-related diversion sources among a diverse sample of prescription drug abusers in South Florida. Cross-sectional data were collected from five different groups of drug users: methadone-maintenance clients (n = 247), street drug users (n = 238), public-pay treatment clients (n = 245), private-pay treatment clients (n = 228), and stimulant-using men who have sex with men (MSM; n = 249). Findings suggest that those who are ages 26 to 35 years old, non-Hispanic White participants, private-pay treatment clients, those who are insured, and those with higher incomes had higher odds of utilizing healthcare diversion sources. Those who reported BZ dependence had 2.5 times greater odds of using a healthcare source to obtain BZs than those who did not meet criteria for dependence.
TL;DR: Overall, health and criminal outcomes varied based on type and combination of substances used, and these differences should be considered when planning treatment strategies.
Abstract: This study examines health and legal problems associated with use of commonly reported substances and combinations of substances in a sample of adults with long histories of methamphetamine (meth) use. Data are from a 2009–11 eight-year follow-up interview in an intensive natural history study (N = 373). Respondents who had not used illicit substances in the year preceding the follow-up interview (38%) were compared to users of marijuana-only (16%), meth-only (7%), and poly-drug users who used meth + marijuana but not heroin or cocaine (19%), and poly-drug users who used heroin and/or cocaine (20%). Multinomial regression results indicate that compared to drug-abstinent individuals, greater depressive symptomatology was reported for poly-drug users of meth + marijuana (p = .001), and arrest rates were higher for poly-drug users who used heroin/cocaine (p = .006); no differences in health, mental health, or criminal involvement were observed for meth-only users compared to abstinent individuals. U...
TL;DR: This study finds distinct alcohol trajectories among monoracial and biracial/ethnic Blacks with all groups showing a cross-over or catch-up effect, and shows gender, socioeconomic status, and household structure differences in impact on alcohol use among mon oracial andBiracial/ ethnic Blacks.
Abstract: Objective: The present study investigates developmental trajectories of alcohol use from early adolescence to adulthood by age and race/ethnicity among White, Black, Black-American Indian, Black-Hispanic, and Black-White individuals and associated sociodemograhphic correlates. Method: We used a subsample of nationally representative data obtained from the National Longitudinal Study of Adolescent Health (Add Health). The analytic sample consisted of 15,278 individuals in Wave 1 (ages 11 to 21 years). The sample consists of adolescents who were in Grades 7–12 at wave one and who were followed across four waves of data collection into adulthood. Respondents could report more than one race/ethnicity. Results: We find distinct alcohol trajectories among monoracial and biracial/ethnic Blacks with all groups showing a cross-over or catch-up effect. Black-White adults demonstrated a cross-over effect by surpassing the alcohol drinking rates of Whites in adulthood, Black-American Indians showed a within-...
TL;DR: Findings suggest that participants who self-report two races/ethnicities have prevalence rates that are intermediate to those of the two corresponding monoracial/ethnic rates.
Abstract: This study estimates the prevalence of cigarette, alcohol, and marijuana use in a nationally representative sample of monoracial/ethnic and biracial/ethnic youth and young adults. The authors consider 16 racial/ethnic categories and used four waves of data from the National Longitudinal Study of Adolescent Health. The analysis sample consists of 20,745 individuals in Wave 1. The primary statistical methodology used in the present study is logistic regression with sample weights. Findings suggest that participants who self-report two races/ethnicities have prevalence rates that are intermediate to those of the two corresponding monoracial/ethnic rates. For example, Black-American Indians reported cigarette smoking rates that were significantly lower than rates reported by American Indians but significantly higher than rates reported by Blacks. Groups with the highest prevalence of cigarette smoking at Wave 1 were American Indian, White-American Indian, White, and Multiracial (people reporting thre...
TL;DR: Overall, concordance between friends’ binge drinking and marijuana use appears to help some elements of friendship quality and harm others.
Abstract: While it is commonly understood that the substance use of peers influences an individual's substance use, much less is understood about the interplay between substance use and friendship quality. Using a sample of 2,148 emerging adults nested within 1,074 dyadic friendships, this study separately investigates how concordance and discordance in binge drinking and marijuana use between friends is related to each friend's perceptions of friendship quality. Because “friendship quality” is a complex construct, we employ a measure containing five sub-elements – companionship, a lack of conflict, willingness to help a friend, relationship security, and closeness. Results for both binge drinking and marijuana use reveal that individuals in friendship pairs who are concordant in their substance use perceive significantly higher perceptions of friendship quality than individuals in dyads who are dissimilar in substance use. Specifically, concordant binge drinkers estimate significantly higher levels of com...
TL;DR: Analysis of reports published on a recreational web site by drug users who ingested seeds of plants belonging to the Convolvulaceae family reveals the reoccurrence of recreational use of I. tricolor and violacea (morning glory), which had not been reported in medical literature since 1968.
Abstract: Recently, there are important changes in recreational drug use. The aim of the present study was to analyse reports published on a recreational web site by drug users who ingested seeds of plants belonging to the Convolvulaceae family and to compare them with available medical case reports. We have also included reports describing the effects induced by “druids fantasy,” which is a new drug allegedly containing the same alkaloid as the seeds of A. nervosa. Our search reveals the reoccurrence of recreational use of I. tricolor and violacea (morning glory), which had not been reported in medical literature since 1968. We have also found that drug users are experimenting with other species, such as I. purpurea, whose psychoactive properties are unknown. Symptoms and doses reported by drug users were comparable with the few available medical case reports. The most worrying symptom was suicidal ideation reported by two subjects who ingested A. nervosa and Ipomoea seeds. Effects induced by druids fanta...
TL;DR: Stigmatization towards users more than doubled the odds of reporting that addiction is a choice, and more than tripled the odds for reporting that marijuana and heroin are equally dangerous; Stigmatization, however, lowered the chances of reported that drugs would be okay to use if legal.
Abstract: Stigma can be harmful to drug users, particularly those in need of treatment. Beliefs and opinions about drug use may influence how individuals view or treat drug users, so research was needed to examine whether specific beliefs and opinions are related to stigma towards users. A sample of 531 adults was assessed to examine how stigmatization relates to specific beliefs and opinions about drug use. Eighty percent of the sample reported lifetime use of an illicit drug. While controlling for demographic characteristics, lifetime drug use and exposure to users, stigmatization towards users more than doubled the odds of reporting that addiction is a choice, and more than tripled the odds for reporting that marijuana and heroin are equally dangerous. Stigmatization, however, lowered the odds of reporting that drugs would be okay to use if legal. Individuals who stigmatize drug users may be under-educated about drug use; however, such individuals appear to be at low risk for use. Beliefs and opinions guided by misinformation may negatively affect users, so public health efforts are needed to educate individuals about drug use and addiction in an objective manner, and treat use as more of a health behavior and less of a moral behavior.
TL;DR: Overall, it is found that SS can be effectively conducted for comorbid PTSD and PG, with improvements in numerous domains and high acceptability.
Abstract: This pilot study evaluated Seeking Safety (SS) therapy for seven outpatients with current comorbid pathological gambling (PG) and posttraumatic stress disorder (PTSD). This represents the first treatment outcome study of this population, and included both genders and 29% minorities. We found significant improvements in: PTSD/trauma (the PTSD Checklist criterion B symptoms; the Trauma Symptom Inventory overall mean and subscales anxiety, dissociation, sexual abuse trauma index, sex problems; and the World Assumptions Scale benevolence subscale); gambling (the Gamblers Beliefs Questionnaire overall mean and subscales illusion of control); functioning (the Basis-32 overall mean and depression/anxiety subscale); psychopathology (the Brief Symptom Inventory overall mean and subscales anxiety and depression; and the Addiction Severity Index, ASI, psychiatric composite score); self-compassion (the Self-Compassion Scale overall mean and subscales isolation, overidentified, and self-judgment); and helping alliance (the Helping Alliance Questionnaire overall mean). One variable indicated worsening (employment composite subscale on the ASI), possibly reflecting measurement issues. SS attendance was excellent. PTSD onset occurred prior to PG onset for most of the sample, and most believed the two disorders were related. Overall, we found that SS can be effectively conducted for comorbid PTSD and PG, with improvements in numerous domains and high acceptability. Limitations are discussed.
TL;DR: A novel text messaging intervention for use as an adjunct to cognitive behavioral group therapy for methamphetamine users is developed and tested, with high ratings of ease of use and functionality, and is ready for testing in randomized clinical trials.
Abstract: Psychosocial treatments for methamphetamine dependence are of limited effectiveness. Thus, a significant need exists for add-on therapy for this substance user disorder. The aim of this study was to develop and test a novel text messaging intervention for use as an adjunct to cognitive behavioral group therapy for methamphetamine users. Text messaging has the potential to support patients in real-time, around the clock. We convened two meetings of an expert panel, held three focus groups in current and former users, and conducted 15 semi-structured interviews with in-treatment users in order to develop a fully automated, cognitive behavioral therapy-based text messaging intervention. We then conducted a randomized, crossover pre-test in five users seeking treatment. Participants’ ratings of ease of use and functionality of the system were high. During the pre-test, we performed real-time assessments via text messaging on daily methamphetamine use, craving levels, and the perceived usefulness of m...
TL;DR: Depression and anxiety contribute significantly to variation in HRQoL over and above the effects of disease variables, indicating that effective depression and anxiety treatment may result in improved overall functioning.
Abstract: Objective: Intravenous drug use (IDU) remains a prominent pathway of HIV transmission in the United States, though little is known about modifiable factors influencing quality of life among IDUs. The goal of this study was to evaluate the influence of psychological variables (e.g., depression and anxiety) on health-related quality of life among HIV-positive individuals with a history of IDU who were enrolled in outpatient treatment for opioid dependence. Method: 108 HIV-positive individuals with a history of IDU and participating in current outpatient treatment for opiate dependence who were screened for participation in a depression and adherence study reported sociodemographic data, depressive and anxiety symptoms, and health-related quality of life (HRQoL; Multidimensional Health Assessment using the ACTG-SF 21). Results: Multiple regression models controlling for disease stage and background characteristics identified significant negative relationships between General Health Perception and Fu...
TL;DR: A phenomenologically grounded ethnographic study of the experiences of ecstasy users in the Sydney, Australia, area is outlined, suggesting that a context-specific approach that is phenomenologically attuned to user's experiences with ecstasy can contribute to the growing body of literature undertaken in the Australian and international research community.
Abstract: Ecstasy (MDMA) has attracted widespread attention with its association as a "recreational substance" that is concentrated in club and rave settings. This paper outlines a phenomenologically grounded ethnographic study of the experiences of ecstasy users in the Sydney, Australia, area. I espouse phenomenology as a framework for describing and understanding these experiences. A number of excerpts are presented from my primary corpus of ethnographic material. For the purposes of this paper I assemble user's reports into nine thematic areas: (1) initial reactions and peaking; (2) the rush; (3) plateau; (4) coming down/scattering; (5) love; (6) peace, love, understanding, and respect; (7) connections on ecstasy; (8) unificatory experiences; (9) returning to baseline. The typical experiences presented in these reports confirm and extend interdisciplinary approaches to understanding ecstasy. I suggest that a context-specific approach that is phenomenologically attuned to user's experiences with ecstasy can contribute to the growing body of literature undertaken in the Australian and international research community.