Substance use & misuse
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Substance use & misuse · Jan 2018
Racial/Ethnic Differences in Prevalence Trends for Heroin use and Non-Medical use of Prescription Opioids Among Entrants to Opioid Treatment Programs, 2005-2016.
Recent data suggest an increase in use of heroin and non-medical use of prescription opioids (POs) in the United States, but it is unclear if these trends are consistent across racial/ethnic groups. In a nationwide prevalence study, 69,140 patients newly admitted to an opioid treatment program (OTP) completed a brief self-administered survey of past month heroin use and PO misuse from January 2005 through September 2016. We calculated heroin use and PO misuse prevalence rates, and prevalence rate ratios of Black and Latino OTP entrants compared to White entrants over time. ⋯ Among OTP entrants, racially/ethnically disparate rates of heroin use, and to a lesser extent, of PO misuse have become more similar over time. These trends were stronger when analysis was restricted to OTP entrants who either had no previous OTP history or were younger. To understand potential impacts of interventions to deter PO misuse and to maximize the effectiveness of OTPs it is important to consider potential changes in opioid use across racial/ethnic groups.
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Substance use & misuse · Dec 2017
Opioid Misuse Trends in Treatment Seeking Populations: Revised Prescription Opioid Policy and Temporally Corresponding Changes.
Over the last two decades, U.S. rates of prescription opioid (PO) misuse have risen drastically. In response, federal and state governments have begun to implement new PO policies. Recent legislative changes warrant up-to-date assessments of today's misuse rates. ⋯ Relative to the pre-policy cohort, a greater percentage of the post-policy cohort reported recent misuse, daily use, and intravenous administration of POs. IO use was also more frequently reported post-policy. Non-opioid drug use prevalence did not significantly differ between cohorts. Among the opioid-using subsample, equivalent percentages of the pre- and post-policy cohorts reported the use of POs without IOs, IOs without POs, and POs/IOs concurrently. Conclusions/Importance: Florida's PO policy amendments were temporally accompanied by a higher prevalence of PO misuse and IO use among treatment-seekers assessed in this study. Whether our data reflect increased awareness of and treatment seeking for opioid use disorders or insufficient efficacy of new policies to reduce opioid misuse remains in question. Regardless, findings suggest the need for enhanced emphasis on mitigating hazardous PO-use behaviors (e.g., IV use).
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Substance use & misuse · Dec 2017
The Curious (Dis)Connection between the Opioid Epidemic and Crime.
Drug epidemics often bring with them an accompanying rise in crime. The heroin wave of the 1970's and crack crisis of the 1980's were each accompanied by major gun violence, including large numbers of murders and violent property crimes. The current United States opioid epidemic, however, has not been associated with either a rise in homicide or in property crime. ⋯ While the drugs-crime connection has always been far more nuanced than the way it is typically portrayed, there wasn't such a glaring disconnect between reality and mythology during the drug epidemics of the 1970's and 1980's. The mystery of the missing opioid crime explosion offers unique insight into the myths and realities of drug addiction. To explore this issue further, this commentary briefly summarizes the drugs-crime connection, contrasts the current opioid crisis with drug epidemics of the past, and provides possible explanations for the absence of an opioid-fueled crime wave.
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Substance use & misuse · Jul 2017
Attitudes Toward Medical Cannabis Legalization Among Serbian Medical Students.
Currently, medical cannabis polices are experiencing rapid changes, and an increasing number of nations around the world legalize medical cannabis for certain groups of patients, including those in Serbia. ⋯ Overall, 63.4% students supported medical cannabis legalization, and only 20.8% supported its legalization for recreational use. Students who previously used marijuana (p <.001) and alcohol (p =.004) were significantly more in favor of medical cannabis legalization compared with students who never used them. Support for marijuana recreational use was also related to prior marijuana (p <.001) and alcohol consumption (p =.006). Only cancer (90.4%) and chronic pain (74.2%) were correctly reported approved medical indications by more than half the students. Students who supported medical cannabis legalization showed better knowledge about indications, in contrast to opponents for legalization who showed better knowledge about side effects. Beliefs that using medical cannabis is safe and has health benefits were correlated with support for legalization, and previous marijuana and alcohol use, while beliefs that medical cannabis poses health risks correlated most strongly with previous marijuana use. Conclusions/Importance: The medical students' attitudes toward medical cannabis legalization were significantly correlated with previous use of marijuana and alcohol, knowledge about medical indications and side effects, and their beliefs regarding medical cannabis health benefits and risks.
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Substance use & misuse · Jul 2017
People Who Inject Drugs and Have Mood Disorders-A Brief Assessment of Health Risk Behaviors.
People who inject drugs have a greater risk of infectious disease and mortality than other substance abusers and nondrug users. Variation in risk behavior among people who inject drugs is likely associated with comorbid mental health disorders. ⋯ While there were no differences between groups in frequency of drug use, people who inject drugs who report a history of mood disorders reported more injection risk behaviors, drug overdoses, sex exchanges, and multiple partners than those with no history of mental illness. Adjusting the comparison for demographic characteristics and current depressive symptoms had little impact on these findings. Variation in risk between depression and bipolar disorder groups was minimal. Conclusions/Importance: People who inject drugs and have mood disorders have unique and significant social, clinical, and risk reduction needs. Despite the limited validity of self-reported mental health history, simply asking about a history of mood disorder may be effective for identifying a particularly vulnerable population of people who inject drugs.