Correlates of sexual assault in a sample of male African American crack cocaine users

Although numerous studies have reported an association between substance use and sexual assault, little is known about the impact of sexual assault on male African American crack cocaine users. This study found that from a sample of 137 respondents from Houston, Texas, one-third reported having been sexually assaulted at least once during their lifetime. Respondents who reported sexual assault were using cocaine more often and were more likely to be physically dependent on drugs and to report greater numbers of physical health problems due to their drug use. However, no differences were identified in respect of reported mental health problems, or problems with family, friends or the workplace associated with drug use. The findings suggest further research as to the impact of sexual assault on male crack cocaine users is warranted and that clinical staff working with male substance users require some awareness of the impacts of sexual assault.

Harm reduction and decision making among recreational ecstasy users

Recent research indicates that 3,4-methylene-dioxymethamphetamine (MDMA), also known as ‘ecstasy’, is becoming increasingly popular as an illicit drug among young people. This study investigated risk and harm reduction practices among recreational ecstasy users. A semi-structured interview with 40 participants was designed to investigate how ecstasy users identify and manage the harms associated with their drug use, and the underlying decision-making process. Overall, the participants identified both positive and negative effects. The reported positive effects predominantly centred around enhanced psychological, physiological and social experiences. However, there were a number of factors that contributed to regulating ecstasy use. These included specific in-group and out-group practices executed within the peer group, preventative harm-reducing practices, shared decision making, and shared responsibility for harm prevention. Recommendations for promoting harm reduction strategies and suggestions for future research are discussed.

Dancing with death : the grey area between suicide related behavior, indifference and risk behaviors of heroin users

Suicide-related behavior (SRB) among heroin users is a complex and multifaceted continuum, including such fringe areas as indifference and "risky" behavior. The article investigates the nuances and intersections of SRB, using qualitative semi-structured interviews with 60 regular heroin users recruited primarily from syringe programs in Geelong, Australia. Twenty-eight percent of interviewees reported a previous suicide attempt and 45% reported serious consideration of it. Types of SRB reported included: Suicide attempts, instrumental suicide-related behaviors, suicidal ideation, indifference and risk-taking thoughts and behaviors. Heroin users engage in much behavior which inhabits a grey area of SRB. The use of a nomenclature which addresses the elements of lethality and intent improves the ability of research to properly define and categorize SRB in drug-using populations. But the categories should not be overinclusive; indifferent attitudes towards death and risk-taking behaviors can sometimes be a functional response to the risk environment of heroin users.

Risk and harm reduction among recreational ecstasy users

Ecstasy users' perceptions of risk, harm reduction and decision making practices were examined in 153 adults. Identified were a range of positive and negative effects attributed to using ecstasy. There was only a weak association between risk perception, other risk taking behaviours and high ecstasy use. However, the role of the peer group was found to be an important factor in the reducation of harm, and in particular, the decision making process.

Groin injecting in injectable opioid treatment service users in South London

Femoral (or groin) injecting is an emerging public health challenge to all drug-related services within the UK. Recent work in the area has proposed that groin injecting in the UK has moved from being a ‘risk boundary’ to an ‘acceptable behaviour’. This article uses data from 10 in-depth qualitative interviews with service users from a supervised injectable opiate treatment service in South London to report on pathways to, and reasons for, groin injecting. Our findings indicate that even though groin injecting constitutes a risk boundary for some injectors, the practice is no longer heavily stigmatised and is perceived by some to be an acceptable risk. Narratives also pointed to the importance of peers in the initiation of groin injecting. Interviewees described the groin as a site of ‘last resort’ in contrast to ‘convenience’ groin injectors described in some previous research. We conclude that it might be helpful to distinguish between convenience and last resort groin injectors and support the call for innovative interventions which aim to reduce modelling of groin injection and which promote social norms supportive of using peripheral injecting sites.

Harm reduction as anarchist practice : a user’s guide to capitalism and addiction in North America

In spite of its origins as an illegal, clandestine, grassroots activity that took place either outside or in defiant opposition to state and legal authority, there is growing evidence to suggest that harm reduction in North America has become sanitized and depoliticized in its institutionalization as public health policy. Harm reduction remains the most contested and controversial aspect of drug policy on both sides of the Canada–US border, yet the institutionalization of harm reduction in each national context demonstrates a series of stark contrasts. Drawing from regional case study examples in Canada and the US, this article historically traces and politically re-maps the uneasy relationship between the autonomous political origins of harm reduction, contemporary public health policy, and the adoption of the biomedical model for addiction research and treatment in North America. Situated within a broader theoretical interrogation of the etiology of addiction, this study culminates in a politically engaged critique of traditional addiction research and drug/service user autonomy. Arguing that the founding philosophy and spirit of the harm reduction movement represents a fundamentally anarchist-inspired form of practice, this article concludes by considering tactics for reclaiming and re-politicizing the future of harm reduction in North America.

Patterns of memory dysfunction in current and 2-year abstinent MDMA users

The popular recreational drug MDMA or “ecstasy” is a selective serotonin neurotoxin in many species and has been found to be associated with memory dysfunction in human beings. Recent studies suggest that this impairment persists after cessation of use for periods up to at least one year. However, there is no clear indication as yet concerning which stage of memory processing is impaired as a result of MDMA use. In the current study, 31 current MDMA users and 30 MDMA users who had been abstinent for more than two years were compared with 30 controls on the WMS-III. The results suggest that MDMA use is associated with memory dysfunction and that this dysfunction persists for up to two years after cessation of use. Importantly, the findings suggest that this memory dysfunction may be due to interference at the encoding stage of memory processing.

Modifying the risk associated with an impulsive temperament: a prospective study of drug dependence treatment

The evidence linking the personality trait of impulsivity and substance misuse is well established. Importantly, impulsivity not only predicts substance misuse problems but has an association with duration in treatment, likelihood of completing treatment and time to relapse. Treatment that focuses on increasing awareness and acceptance of thoughts and emotions may potentially address impulsive behaviour and in this respect improve treatment outcomes for substance misuse. The current paper investigated the relationship between the facet of impulsivity that taps into poor inhibitory control and treatment outcome. In addition, there was a specific focus on ascertaining the impact of an increase in awareness and attentional control measured in 144 adult substance users receiving treatment in a residential therapeutic community. Impulsivity predicted poorer treatment outcome (measured as drug use severity). Increases in awareness and acceptance of emotions and thoughts during treatment were related to better outcome although this was not associated with baseline levels of impulsivity. Clinical and theoretical implications are discussed.

'Wide-awake drunkenness'? Investigating the association between alcohol intoxication and stimulant use in the night-time economy

Aims: We tested whether patrons of the night-time economy who had co-consumed energy drinks or illicit stimulants with alcohol had higher blood alcohol concentration (BAC) levels than patrons who had consumed only alcohol. Design: Street intercept surveys (n=4227) were undertaken between 9 p.m. and 5 a.m. over a period of 7 months. Setting: Interviews were undertaken with patrons walking through entertainment precincts, queuing to enter venues or exiting venues in five Australian cities. Participants: The response rate was 92.1%; more than half the study sample was male (60.2%) and the median age was 23 years (range 18-72). Measurements: Data were collected on demographics, length of drinking session, venue types visited, types and quantity of alcohol consumed and other substance use. A BAC reading was recorded and a subsample of participants was tested for other drug use. Findings: Compared with the total sample (0.068%), illicit stimulant consumers (0.080%; P=0.004) and energy drink consumers (0.074%; P<0.001) had a significantly higher median BAC reading, and were more likely to engage in pre-drinking (65.6, 82.1 and 77.6%, respectively, P<0.001) and longer drinking sessions (4, 5 and 4.5 hours, respectively, P<0.001). However, stimulant use was not associated independently with higher BAC in the final multivariable model (illicit stimulants P=0.198; energy drinks P=0.112). Interaction analyses showed that stimulant users had a higher BAC in the initial stages of the drinking session, but not after 4-6 hours. Conclusions: While stimulant use does not predict BAC in and of itself, stimulants users are more likely to engage in prolonged sessions of heavy alcohol consumption and a range of risk-taking behaviours on a night out, which may explain higher levels of BAC among stimulants users, at least in the initial stages of the drinking session.

Street intercept method : an innovative approach to recruiting young adult high-risk drinkers

Many young adults are risky drinkers who are often missed by general population surveys. The aim of the present study was to assess factors affecting participation rates in a street intercept approach to recruiting young adult bar-goers for an online survey.

Drug use in Australian nightlife settings: estimation of prevalence and validity of self-report

AIMS: This study aimed to 1) estimate the prevalence of illicit drug use in night-time entertainment districts across five major cities in Australia; and 2) validate self-reported drug use using biochemical marker oral swabs. DESIGN: Street intercept surveys and oral drug swabs conducted over a seven-month period during 2011-2012. SETTING: The night-time entertainment districts of three metropolitan cities (Sydney, Melbourne and Perth) and two regional cities (Wollongong and Geelong) in Australia, between the hours of 10 pm and 5 am. PARTICIPANTS: 7,340 individuals agreed to participate in the survey (a 93% response rate). More than half (62%) of the sample was male, with a median age of 22 years (range 18-73). MEASUREMENTS: Patrons were approached in thoroughfares, and while entering and leaving licensed venues. Data collected included demographics and current session alcohol and other substance use. Drug swabs (n = 401) were performed with a sub-sample of participants. FINDINGS: Approximately 9% (95% CI, 7% to 12%) of participants self-reported consumption of illicit or non-prescribed pharmaceutical drugs prior to interview; of those, 81% identified psychostimulants as the drug used. One in five drug swabs returned a positive result, with psychostimulants the most commonly detected drugs (15%; 95% CI, 12%-19%). Kappa statistics indicate agreement between self-report of any illicit drug and a positive drug swab is in the slight range (κ = 0.12 (95% CI, .05 to .20) p = .000). CONCLUSIONS: Self-report findings suggest drug use in the nightlife in Australia is common, though still very much a minority past-time. Drug swabs indicate a higher prevalence of use (20%) than self-report (9%), which suggests that self-reported drug use may not be reliable in this context. This article is protected by copyright. All rights reserved.

Neuroimaging of the human brain in adolescent substance users

Included among the topics: Cognitive development, learning, and drug use. Neurobiology of the action of drugs of abuse. Findings in adolescents with substance dependence based on neuroimaging tests.