Simultaneous use of mephedrone and alcohol: A qualitative study of users' experiences

Mephedrone (4-methylmethcathinone) gained popularity across "recreational" drug scenes in the United Kingdom and Ireland during 2009. Although mephedrone was banned in both jurisdictions in 2010, the drug was subsequently sourced through street dealers. This qualitative study explores the simultaneous use of mephedrone and alcohol, among study participants who used mephedrone following legislative controls. Data were collected through semi-structured interviews with male and female respondents. The results suggest a three-tier classification system that describes users' experiences with simultaneous use of mephedrone and alcohol. Most participants engaged in "heavy" alcohol use immediately prior to consuming mephedrone, and then reduced alcohol consumption as the effects of mephedrone were experienced during the drug episode. Spontaneous use of mephedrone often was associated with larger amounts of alcohol being consumed just prior to the mephedrone episode. The findings have the potential for informing socioepidemiological surveys as well as peer interventions to reduce harm associated with
simultaneous drug use.

During pregnancy, recreational drug-using women stop taking ecstasy (3,4-methylenedioxy-N-methylamphetamine) and reduce alcohol consumption but continue to smoke tobacco and cannabis

While recreational drug use in UK women is prevalent, to date there is little prospective data on patterns of drug use in recreational drug-using women immediately before and during pregnancy. A total of 121 participants from a wide range of backgrounds were recruited to take part in the longitudinal Development and Infancy Study (DAISY) study of prenatal drug use and outcomes. Eighty-six of the women were interviewed prospectively while pregnant and/or soon after their infant was born. Participants reported on use immediately before and during pregnancy and on use over their lifetime. Levels of lifetime drug use of the women recruited were high, with women reporting having used at least four different illegal drugs over their lifetime. Most users of cocaine, 3,4-methylenedioxy-N-methylamphetamine (MDMA) and other stimulants stopped using these by the second trimester and levels of use were low. However, in pregnancy, 64% of the sample continued to use alcohol, 46% tobacco and 48% cannabis. While the level of alcohol use reduced substantially, average tobacco and cannabis levels tended to be sustained at pre-pregnancy levels even into the third trimester (50 cigarettes and/or 11 joints per week). In sum, while the use of ‘party drugs’ and alcohol seems to reduce, levels of tobacco and cannabis use are likely to be sustained throughout pregnancy. The data provide polydrug profiles that can form the basis for the development of more realistic animal models.

Alcohol and relatively pure cannabis use, but not schizotypy, are associated with cognitive attenuations

Elevated schizotypy relates to similar cognitive attenuations as seen in psychosis and cannabis/polydrug use. Also, in schizotypal populations cannabis and polydrug (including licit drug) use are enhanced.These cognitive attenuations may therefore either be a behavioral marker of psychotic (-like) symptoms or the consequence of enhanced drug use in schizotypal populations.To elucidate this, we investigated the link between cognitive attenuation and cannabis use in largely pure cannabis users (35) and non-using controls (48), accounting for the potential additional influence of both schizotypy and licit drug use (alcohol, nicotine). Cognitive attenuations commonly seen in psychosis were associated with cannabis and alcohol use, but not schizotypy. Future studies should therefore consider (i) non-excessive licit substance use (e.g., alcohol) in studies investigating the effect of cannabis use on cognition and (ii) both enhanced illicit and licit substance use in studies investigating cognition in schizotypal populations.

Relationships among adolescent substance use, leisure boredom, and physical activity

This study was a secondary analysis of data drawn from the Youth Leisure Study. The purpose of the study was to: a) explore the relationships among physical activity, leisure boredom, and various substance use variables; b) determine if leisure boredom moderated the relationship among physical activity and substance use variables; and c) create a foundation of knowledge with which to educate adolescents and educators of the importance of adopting and maintaining a healthy lifestyle early in life (i.e., free from unhealthy behaviours such as substance use and physical inactivity). Studies examining relationships among physical activity and substance are limited and, in the past, have yielded inconsistent results. The interaction of leisure boredom with physical activity intensity variables, including both team and individual pursuits were tested using moderated hierarchical regression procedures. Six measures of physical activity were used as independent variables, including, frequency of high, medium, and low intensity individual and team physical activities. Various types of substance use, including, tobacco, marijuana, and alcohol use, binge drinking, and drunkenness were used as dependent variables. The results for this study indicated that frequency of physical activity intensity was a consistent, positive predictor of alcohol use and binge drinking, but not tobacco use, marijuana use, or drunkenness. Leisure boredom was found to be a highly significant predictor of tobacco use, however, it was not a moderator of relationships among physical activity intensity and substance use variables. The implications for the study findings, are discussed further, and suggestions for future research are presented.

Epidemiological study on antimicrobial use and non-compliance with withdrawal times in broiler farms in Vietnam

L’utilisation d’antimicrobiens chez les animaux de consommation est une source de préoccupation importante pour la santé publique à travers le monde en raison de ses impacts potentiels sur l’émergence de micro-organismes résistants aux antimicrobiens et sur la présence de résidus antimicrobiens néfastes dans la viande. Cependant, dans les pays en développement, peu de données sont disponibles sur les pratiques d’utilisation des antimicrobiens à la ferme. Par conséquent, une étude épidémiologique transversale a été menée de juin à août 2011 dans des élevages de poulets de chair situés dans le sud du Vietnam, ayant pour objectifs de décrire la prévalence d’utilisation des antimicrobiens ajoutés à l’eau de boisson ou aux aliments à la ferme, et de tester les associations entre les caractéristiques des fermes et la non-conformité avec les périodes de retrait recommandés sur l’étiquette des produits. Un échantillon d’accommodement de 70 fermes a été sélectionné. Les propriétaires des fermes ont été interrogés en personne afin de compléter un questionnaire sur les caractéristiques des fermes et les pratiques d’utilisation d’antimicrobiens. Au cours des 6 mois précédant les entrevues, il a été rapporté que la colistine, la tylosine, l’ampicilline, l’enrofloxacine, la doxycycline, l’amoxicilline, la diavéridine et la sulfadimidine ont été utilisés au moins une fois dans les fermes échantillonnées, avec une fréquence descendante (de 75.7% à 30.0%). D’après deux scénarios de risque basés sur la comparaison de la période de retrait recommandée sur l’étiquette du produit et celle pratiquée à la ferme, de 14.3% à 44.3% des propriétaires de ferme interrogés n’ont pas respecté la période de retrait recommandée sur l’étiquette au moins une fois au cours des 6 derniers mois, et ce pour au moins un antimicrobien. Les facteurs de risque associés (p<0.05) avec une non-conformité avec la période de retrait recommandée sur l’étiquette pour au moins un des deux scénarios sont les suivants : élever des oiseaux qui n’appartiennent pas tous à des races d’origine asiatique, vacciner contre la bronchite infectieuse, avoir utilisé plus de 6 différents antimicrobiens à la ferme au cours des 6 derniers mois, et utiliser un mélange d’aliments fait maison et commerciaux. Nos résultats soulignent l’importance d’utiliser les antimicrobiens de façon judicieuse et en respectant les temps de retrait officiels, afin de protéger le consommateur contre les risques pour la santé causés par une exposition à des niveaux nocifs de résidus antimicrobiens.

Drug control, human rights, and the right to the highest attainable standard of health: a reply to Saul Takahashi

A recent article in this journal challenged claims that a human rights framework should be applied to drug control. This article questions the author’s assertions and reframes them in the context of socio-legal drug scholarship, aiming to build on the discourse concerning human rights and drug use. It is submitted that a rights-based approach is a necessary, indeed obligatory, ethical and legal framework through which to address drug use and that international human rights law provides the proper scope for determining where interferences with individual human rights might be justified on certain, limited grounds.

Mediated addiction: The drug discourses of Hong Kong youth

This paper examines the ways young people in Hong Kong at different stages of involvement with illegal drugs respond to government produced anti-drug television commercials through a methodology which provided them with the technical skills and equipment to make their own short videos about drugs. An analysis of the videos they produced and their interaction while producing them reveals that participants with different drug-taking experiences have very different and often multiple ways of talking about drugs, and that these different ‘discourses’ and the ways they are deployed in different contexts affect how ‘at-risk’ they are for new or continued drug use and how they respond to anti-drug messages designed to mitigate this risk.

A randomized and controlled trial about the use of oral isotretinoin for photoaging

Topical retinoids are used to treat photoaging; oral isotretinoin is gold standard for acne; off label indications, including photoaging, have been reported with insufficient evidence of efficacy. This is a randomized controlled phase II trial with clinical and histological assessment to evaluate efficacy and safety of oral isotretinoin for photoaging. Study population was comprised of 32 menopausal or sterilized women, aged 40-55, divided in 2 groups: A (21) received 20mg isotretinoin, 3 times per week, nightly moisturizer, and daily sunscreen, for three months; B (11) just moisturizer/sunscreen. Main outcome measures were: overall clinical assessment; profilometry, corneometer and elasticity tests in periocular regions and left forearm; before/after biopsies from left forearm in patients of B and in 10 randomly selected of A. Microscopic blinded evaluation of epidermal thickness, dermal elastosis, new collagen, p53 epidermal expression was performed by quantitative digital image analysis. All data were submitted to statistical analysis. Clinical evaluation showed slight improvement; profilometry, corneometer and skin elasticity tests presented significant difference in pre/post values (P = 0.001 to 0.028), but no differences between A/B. Histological findings and p53 expression were comparable between groups before treatment (P > 0.1); microscopic analysis showed no differences between groups for most variables, after treatment. Slight but significant difference between A/B for p53 with major reduction post isotretinoin [0.66±0.31 vs. 0.94±0.34 respectively (P = 0.04) was observed. There were minor side effects and no significant laboratory test alterations. We concluded that no significant clinical, microscopic changes but p53 epidermal expression reduction were observed. The role of ultra-violet induced p53 mutation in skin carcinogenesis reinforces retinoids chemoprevention. Oral isotretinoin seemed safe but not effective to treat photoaging. Caution should be considered for women prone to pregnancy. Further controlled studies are necessary. © 2010 The International Society of Dermatology.

Risk factors that may signify a propensity to the use of drugs in students at a public university

Introduction: We sought to evaluate the risk factors that may increase the propensity to use licit and illicit drugs among students at a public university. Methods: The project involved students (n = 268) enrolled in the first and fourth years of courses in the areas of the social and biological sciences at a public university. Data collection was conducted by means of self-administered, semistructured questionnaires, based on such standardized assessment instruments as Audit, Assist, Cage and Duse. Collected data were analyzed quantitatively by calculating the percentages and evaluating the data in terms of categories of risk, classifying them by age, gender, religion, schooling, use (before or after entering university) and contexts of use. By means of this survey the researchers were able to correlate the use of drugs to the risk factors that might increase the students’ propensity to use these substances. Results: The results revealed a high proportion of current drug-using students, but showed no significant differences between the first and fourth year students as regards contexts of use. However, 67% of students regarded the university environment as encouraging the use of drugs. Students pointed to such major risk factors as friends’ and fellow-students’ influence, university parties, excessive curiosity and desire to experiment. Conclusion: Due to the high rate of drug use among university students, by the determination of the risk factors related to the university environment and also knowing that the process of addiction is one of growing chemical dependence, the importance of the development and implementation of public health policies at all levels, especially in terms of approaches and specific interventions addressing this population, should be noted.

Drug addictions and sexual violence in childhood and adolescence: analyzing life stories

The sexual abuse suffered in childhood and adolescence, in addition to damage to physical and psychological health of the victim, is considered as an important risk factor for alcohol and drugs addiction, development of psychopathology and psychosocial damage in adulthood. In addition to the pain and humiliation that are submitted by the abuse, children and adolescents also experience shame and guilt which require them to adopt coping strategies to endure those feelings. The use of psychoactive substances is a recognized way of dealing with the pains of living. This work, which is of narrative style, analyses and discusses, through five case reports, chemical dependency as a result of sexual abuse suffered in childhood and/or adolescence. The eight subjects in this study are male and have suffered sexual violence in this age period of life. Their ages range from 23 years to 39 years, and all are admitted to a therapeutic community in a city in the interior of Sao Paulo state, in Brazil, for treatment of chemical dependency, being met by the Department of Psychology. The reasons for the choice of the participants for treatment modality for patients are: difficult to stop using drugs, even unwilling to take it, they have easy access to it; the feeling of losing control over their lives; by successive losses as a result of drug use, and for fear that their lives had a tragic ending. With the exception of two participants, the others do not classify that as a child suffered sexual violence. However, all attribute that facilitated their entry into the world of drugs. Seven participants experienced such violence in childhood (between 7 years and 9 years) and adolescence (age 14). The attackers were people closed to the victims—in the case of two victims, their families, with the exception of one participant who was raped by a stranger. Six participants declared themselves as homosexual. Another participant does not claim to be homosexual, but presents difficulties in terms of sexuality. Two participants are HIV positive. The start of psychoactive substances use occurred during adolescence (12 years to 17 years). The participants see drugs as an anesthetic to the pain of the soul, a way to get pleasure, but they get charged expensively, as it increases the feeling of emptiness, guilt, helplessness, worthlessness and hopelessness. Although participants have sought help to deal with addiction, it is noted that throughout the life course the issue of sexual violence was not treated. It was noted that the patients have a double stigma in society: the issue of drugs addiction and the orientation of sexual desire, because the majority of participants are homosexual. The results reinforce the need for effective action geared to accommodate the victims of sexual violence and effective preventive measures to prevent children and adolescents from being abused.

Causes for the underreporting of adverse drug events by health professionals: a systematic review

Objective: Identifying the main causes for underreporting of Adverse Drug Reaction (ADR) by health professionals. Method: A systematic review carried out in the following databases: LILACS, PAHO, SciELO, EMBASE and PubMed in the period between 1992 and 2012. Descriptors were used in the search for articles, and the identified causes of underreporting were analyzed according to the classification of Inman. Results: In total, were identified 149 articles, among which 29 were selected. Most studies were carried out in hospitals (24/29) for physicians (22/29), and pharmacists (10/29). The main causes related to underreporting were ignorance (24/29), insecurity (24/29) and indifference (23/29). Conclusion: The data show the eighth sin in underreporting, which is the lack of training in pharmacovigilance. Therefore, continuing education can increase adherence of professionals to the service and improve knowledge and communication of risks due to drug use.

Causes for the underreporting of adverse drug events by health professionals: a systematic review

Objective: Identifying the main causes for underreporting of Adverse Drug Reaction (ADR) by health professionals. Method: A systematic review carried out in the following databases: LILACS, PAHO, SciELO, EMBASE and PubMed in the period between 1992 and 2012. Descriptors were used in the search for articles, and the identified causes of underreporting were analyzed according to the classification of Inman. Results: In total, were identified 149 articles, among which 29 were selected. Most studies were carried out in hospitals (24/29) for physicians (22/29), and pharmacists (10/29). The main causes related to underreporting were ignorance (24/29), insecurity (24/29) and indifference (23/29). Conclusion: The data show the eighth sin in underreporting, which is the lack of training in pharmacovigilance. Therefore, continuing education can increase adherence of professionals to the service and improve knowledge and communication of risks due to drug use.

Patterns of Ecstasy Use and Associated Harm: Results of a Brazilian Online Survey

The aim of this study was to gather information about ecstasy users in Brazil, particularly on issues related to risks associated to the use of the drug, so as to offer a basis to prevention projects. A total of 1,140 Brazilian ecstasy users answered an online questionnaire from August 2004 to February 2005. Participants were predominantly young single heterosexual well-educated males from upper economical classes. A categorical regression with optimal scaling (CATREG) was performed to identify the risks associated with ecstasy use. ""Pills taken in life"" had a significant correlation with every investigated risk, particularly ecstasy dependence, unsafe sex, and polydrug use. ""Gender,"" ""sexual orientation,"" and ""socioeconomic class"" were not predictive of risk behavior. The Internet proved to be a useful tool for data collection. Given the recent increase in ecstasy availability in Brazil, a first prevention campaign directed toward the drug is urgent. At least in a preliminary Brazilian intervention, the campaign must be conducted at night leisure places, mainly frequented by youngsters from upper socioeconomic classes. The results do not call for information material with specific targets, such as gender or sexual orientation. The study`s limitations have been noted.

The association between low alcohol use and traffic risk behaviors among Brazilian college students

Although there are a large number of studies focused on binge drinking and traffic risk behaviors (TRB), little is known regarding low levels of alcohol consumption and its association to TRB. The aim of this cross-sectional study is to examine the association of low to moderate alcohol intake pattern and TRB in college students in Brazil. 7037 students from a National representative sample were selected under rigorous inclusion criteria. All study participants voluntarily fulfilled a structured, anonymous, and self-questionnaire regarding alcohol and drug use, social-demographic data, and TRB. Alcohol was assessed according to the average number of alcoholic units consumed on standard occasions over the past 12 months. The associations between alcohol intake and TRB were summarized with odds ratio and their confidence interval obtained from logistic regression. Compared with abstainers students who consumed only one alcohol unit had the risk of being a passenger in a car driven by a drunk driver increased by almost four times, students who reported using five or more units were increased by almost five times the risk of being involved in a car crash. Compared with students who consumed one alcohol unit, the risk of driving under the influence of alcohol increased four times in students using three alcohol units. Age group, use of illicit drugs, employment status, gender, and marital status significantly influenced occurrence of TRB among college students. Our study highlights the potential detrimental effects of low and moderate pattern of alcohol consumption and its relation to riding with an intoxicated driver and other TRB. These data suggest that targeted interventions should be implemented in order to prevent negative consequences due to alcohol use in this population. (C) 2012 Elsevier Inc. All rights reserved,

Prescribed use of methylphenidate hydrochloride and its correlates among Brazilian college students

Background: The prevalence of prescribed use of methylphenidate (MPH) and its correlates are not well-known in Brazil. Objective: To estimate the prevalence of prescribed use of MPH and its correlates in a sample of Brazilian college students. Methods: Twelve-thousand seven hundred and eleven college students filled out a drug use questionnaire. They were divided into two groups based on the lifetime use of MPH: MPH users (MPHU) and MPH non-users (MPHNU). Quasi-binomial regression models were carried out in order to evaluate the correlation among MPHU and other variables. Results: A lifetime use of MPH was reported from 0.9% of college students (MPHU). Being from the Midwest (PR = 4.8, p < 0.01) and South (PR = 5.2, p < 0.05), living in students housing (PR = 5.8, p < 0.001), prescribed use of amphetamines (PR = 8.9, p < 0.001) and benzodiazepines (< 3 weeks: PR = 4.4, p < 0.001; >= 3 weeks: PR = 6.7, p < 0.001), and harmful use of alcohol (PR = 4.0, p < 0.05) were correlated with MPHU. Discussion: The association of alcohol and drug use with prescribed use of MPH among college students suggests the importance of screening drinking patterns and use of other drugs among students with ADHD symptoms. Cesar ELR, et al. / Rev Psiq Clin. 2012; 39(6):183-8