The importance of partnership factors and individual factors associated with absent or inconsistent condom use in heterosexuals: a cross-sectional study.

OBJECTIVES Decisions to use condoms are made within partnerships. We examined the associations between inconsistent or no condom use and individual and partnership characteristics. We also examined the relative importance of individual versus partnership factors. METHODS Cross-sectional study of heterosexual individuals enrolled from the sexually transmitted infections (STI) outpatient clinic in Amsterdam, the Netherlands, from May to August 2010. Participants completed a questionnaire about sexual behaviour with the last four partners in the preceding year. Participant and partnership factors associated with inconsistent or no condom use in steady and casual partnerships were identified. RESULTS 2144 individuals were included, reporting 6401 partnerships; 54.7% were female, the median age was 25 (IQR 22-30) years and 79.9% were Dutch. Inconsistent or no condom use occurred in 13.9% of 2387 steady partnerships and in 33.5% of 4014 casual partnerships. There was statistical evidence of associations between inconsistent condom use in steady partnerships and ethnic concordance, longer duration, higher number of sex acts, practising anal sex, and sex-related drug use. In casual partnerships, associations were found with having an older partner, ethnic concordance, longer duration, higher number of sex acts, anal sex, sex-related drug use, ongoing partnerships and concurrency. In multivariable models, partnership factors explained 50.9% of the variance in steady partnerships and 70.1% in casual partnerships compared with 10.5% and 15.4% respectively for individual factors. CONCLUSIONS Among heterosexual STI clinic attendees in Amsterdam, partnership factors are more important factors related with inconsistent condom use than characteristics of the individual.

Effect of calf purchase and other herd-level risk factors on mortality, unwanted early slaughter, and use of antimicrobial group treatments in Swiss veal calf operations.

The objective of this survey was to determine herd level risk factors for mortality, unwanted early slaughter, and metaphylactic application of antimicrobial group therapy in Swiss veal calves in 2013. A questionnaire regarding farm structure, farm management, mortality and antimicrobial use was sent to all farmers registered in a Swiss label program setting requirements for improved animal welfare and sustainability. Risk factors were determined by multivariable logistic regression. A total of 619 veal producers returned a useable questionnaire (response rate=28.5%), of which 40.9% only fattened their own calves (group O), 56.9% their own calves and additional purchased calves (group O&P), and 2.3% only purchased calves for fattening (group P). A total number of 19,077 calves entered the fattening units in 2013, of which 21.7%, 66.7%, and 11.6% belonged to groups O, O&P, and P, respectively. Mortality was 0% in 322 herds (52.0%), between 0% and 3% in 47 herds (7.6%), and ≥3% in 250 herds (40.4%). Significant risk factors for mortality were purchasing calves, herd size, higher incidence of BRD, and access to an outside pen. Metaphylaxis was used on 13.4% of the farms (7.9% only upon arrival, 4.4% only later in the fattening period, 1.1% upon arrival and later), in 3.2% of the herds of group O, 17.9% of those in group O&P, and 92.9% of those of group P. Application of metaphylaxis upon arrival was positively associated with purchase (OR=8.9) and herd size (OR=1.2 per 10 calves). Metaphylaxis later in the production cycle was positively associated with group size (OR=2.9) and risk of respiratory disease (OR=1.2 per 10% higher risk) and negatively with the use of individual antimicrobial treatment (OR=0.3). In many countries, purchase and a large herd size are inherently connected to veal production. The Swiss situation with large commercial but also smaller herds with little or no purchase of calves made it possible to investigate the effect of these factors on mortality and antimicrobial drug use. The results of this study show that a system where small farms raise the calves from their own herds has a substantial potential to improve animal health and reduce antimicrobial drug use.

Is dating violence associated with substance use and sexual risk behaviors among urban, minority, middle school youth

Background. One in 4 adolescents reports some form of dating violence each year. Dating violence among high school adolescents has been linked with several morbidity issues. However, the association between dating violence and sexual risk and/or substance use among young adolescents has rarely been studied.^ Methods. Research hypotheses were tested using a secondary data analysis from a HIV, STI, pregnancy prevention intervention study for urban middle school students.^ Results. At baseline, 21% of youth reported experiencing physical ADV victimization, 48.2% reported non-physical victimization, and 52.6% report any victimization. After adjusting for race/ethnicity, gender, and age ever having sex, alcohol use, and illicit drug use were significantly associated with several forms of ADV.^ Conclusions. Dating violence appears to be associated with early initiation of sexual behavior, as well as alcohol and drug use. Few interventions address ADV among middle school youth. Early interventions that prevent dating violence are needed. ^

Risk factors for encephalitis and death from West Nile virus infection: An analysis of hospitalized cases in Houston, Texas from 2002--2008

We conducted a nested case-control study to determine the significant risk factors for developing encephalitis from West Nile virus (WNV) infection. The purpose of this research project was to expand the previously published Houston study of 2002–2004 patients to include data on Houston patients from four additional years (2005–2008) to determine if there were any differences in risk factors shown to be associated with developing the more severe outcomes of WNV infection, encephalitis and death, by having this larger sample size. A re-analysis of the risk factors for encephalitis and death was conducted on all of the patients from 2002–2008 and was the focus of this proposed research. This analysis allowed for the determination to be made that there are differences in the outcome in the risk factors for encephalitis and death with an increased sample size. Retrospective medical chart reviews were completed for the 265 confirmed WNV hospitalized patients; 153 patients had encephalitis (WNE), 112 had either viral syndrome with fever (WNF) or meningitis (WNM); a total of 22 patients died. Univariate logistic regression analyses on demographic, comorbidities, and social risk factors was conducted in a similar manner as in the previously conducted study to determine the risk factors for developing encephalitis from WNV. A multivariate model was developed by using model building strategies for the multivariate logistic regression analysis. The hypothesis of this study was that there would be additional risk factors shown to be significant with the increase in sample size of the dataset. This analysis with a greater sample size and increased power supports the hypothesis in that there were additional risk factors shown to be statistically associated with the more severe outcomes of WNV infection (WNE or death). Based on univariate logistic regression results, these data showed that even though age of 20–44 years was statistically significant as a protecting effect for developing WNE in the original study, the expanded sample lacked significance. This study showed a significant WNE risk factor to be chronic alcohol abuse, when it was not significant in the original analysis. Other WNE risk factors identified in this analysis that showed to be significant but were not significant in the original analysis were cancer not in remission > 5 years, history of stroke, and chronic renal disease. When comparing the two analyses with death as an outcome, two risk factors that were shown to be significant in the original analysis but not in the expanded dataset analysis were diabetes mellitus and immunosuppression. Three risk factors shown to be significant in this expanded analysis but were not significant in the original study were illicit drug use, heroin or opiate use, and injection drug use. However, with the multiple logistic regression models, the same independent risk factors for developing encephalitis of age and history of hypertension including drug induced hypertension were consistent in both studies.^

Investigating the epidemic of heroin use in Dar es Salaam, Tanzania: Recognizing the issues of heroin smokers

Since heroin was introduced to East Africa during the 1980s, heroin use practices have changed rapidly in response to various internal and external pressures. The aim of this study was to identify and describe the population of heroin users and locations of heroin use in Dar es Salaam, Tanzania, in order to understand recent contexts of heroin use. The study took place between June 30 and August 19, 2011, in all three districts (Kinondoni, Ilala, and Temeke) of Dar es Salaam. We mapped sites using a Global Positioning System device, counted numbers of heroin users, and conducted informal interviews with heroin users. The mixed-methods analyses of the data included quantifying the basic demographic and aggregate information about the sites and heroin users, as well as qualitative analysis and coding of fieldnotes from observations and responses to interviews which was used to identify themes and characteristics of heroin users. ^ We identified a total of 150 sites and counted a total of 1046 male and 46 female non-injecting drug users and 78 male and 9 female injecting drug users (IDUs) of heroin. We found that social organization existed at some of the sites, with 31% (n=47) of sites reporting having a leader and 44% (n=66) of sites reporting mutual aid between users frequenting the site. We had difficulty locating IDUs and female drug users, and the majority of users we encountered were heroin smokers of kokteli, a mixture of heroin, cannabis, and/or tobacco which is smoked like a cigarette. ^ This research highlighted heroin smokers’ desire for access to drug treatment services. The current methadone-based medication assisted treatment (MAT) program is funded and operates as an HIV prevention program for IDUs to reduce HIV infection in this population and slow or stop the spread of a second wave of HIV infection in the general population. However, smokers perceived MAT to be primarily a drug use prevention or cessation program and felt unjustly neglected from the intervention, leading to a tense relationship with IDUs. From a public health standpoint, future interventions should include heroin smokers to prevent HIV transmission. ^

Anabolic drugs consumption of high school students participating in school championships of physical education

This paper aims to analyse the use of anabolic drugs among Greek students participating in school championships of physical education (PE). In order to do it, a survey was conducted during the 2008 to 2009 academic year in suburban, urban and metropolitan areas in Greece. The sample was 2,535 high school students from the 10 to 12th grade, participating in the school physical education championships. The results showed that 9.6% of boys and 3.7% of girls reported that they had used anabolic drugs sometime in the past whereas 11.2% boys and 4.8% girls reported that they would intend to use them in the future. This confirms that anabolic steroids are an important problem among adolescents, and educational programs should increase their knowledge about these drugs. Information should come not only from the state, but also from coaches, teachers, trainers and parents.

Riesgo del consumo de cannabis para la práctica físico-deportiva

El consumo de cannabis es uno de los principales problemas de salud pública, especialmente entre los jóvenes, dadas sus prevalencias de consumo. Esta droga puede provocar alteraciones psicomotrices en el individuo, por ello, el presente trabajo de investigación tiene como objetivo principal comprobar si el consumo de cannabis supone un riesgo añadido a la práctica físico-deportiva. Para alcanzar dicho objetivo, se dividió el trabajo en dos estudios interrelacionados entre sí. En el primer estudio o Estudio 1, “Repercusión del consumo de cannabis en las clases de Educación Física”, se realizó un cuestionario autoadministrado, dirigido al profesorado de Educación Física de la Comunidad de Madrid, con el fin de recoger su opinión sobre la posible presencia de consumidores de cannabis en sus aulas. El segundo estudio o Estudio 2, “Influencia del cannabis en el equilibrio, la coordinación, el tiempo de respuesta y la percepción temporal”, consistió en la realización de una serie de pruebas por parte de un grupo control y un grupo de consumidores de cannabis, para así cuantificar y cualificar los efectos de la inhalación de esta droga en la condición motriz. La encuesta que se utilizó para el Estudio 1, “El cannabis, los adolescentes y la práctica físico-deportiva”, pasó primero por una fase de elaboración, corrección y validación, y después, utilizándose la técnica de muestreo aleatorio por conglomerados, fue distribuido por los centros públicos de enseñanzas secundarias de la Comunidad de Madrid seleccionados. Se obtuvo respuesta de 93 profesores de Educación Física pertenecientes a 76 centros, es decir el 22,35% de los centros de la comunidad. Por último, se procedió al análisis, discusión y difusión de los resultados. En el Estudio 2, primero se procedió al diseño de la batería de pruebas a realizar, compuesta por 7 tests con 16 variables que valoraron el equilibrio, la coordinación, el tiempo de respuesta y la percepción temporal de los sujetos. Después se procedió a la selección de la muestra, formada por dos grupos de voluntarios de entre 18 y 30 años: un grupo control de 52 participantes, y un grupo de consumidores de cannabis, de 28 participantes con un hábito de consumo diferente. Los sujetos del grupo de consumidores realizaron las pruebas 20 minutos después de la inhalación de cannabis. Tras la realización de las pruebas por parte de todos los sujetos se procedió al análisis de los resultados obtenidos, segmentándolos por sexo y apareando las variables para evitar posibles efectos confundidores. Los resultados del primer estudio indicaron que el 75,27% del profesorado ha pensado alguna vez que sus alumnos consumían cannabis antes del inicio de su clase, hecho asociado a alteraciones psicológicas (90,63%) y cognitivo-conductuales (68,75%); no siendo factores influyentes el sexo o la experiencia docente de los encuestados (p>0,05). El segundo estudio aportó como principal resultado el empeoramiento de la percepción temporal y la conducta motriz de los sujetos que consumieron cannabis, en especial de su equilibrio y su coordinación (p<0,05). También indicó que hubo ligeras diferencias en función del hábito de consumo de esta droga, si bien los resultados se vieron influenciados por el tamaño de la muestra. Las conclusiones extraídas mostraron que el profesorado de Educación Física percibe la presencia de consumidores de cannabis en sus aulas, utiliza el diálogo con el alumnado como herramienta de actuación, y conoce la influencia negativa que tiene el consumo de esta droga en el rendimiento motor. También demuestran que el cannabis supone un riesgo añadido a la práctica físico-deportiva, debido al empeoramiento de la conducta motriz, en especial de la coordinación y el equilibrio. Además, las diferencias surgidas en base al hábito de consumo no son concluyentes pero si apuntan a que el consumo esporádico puede conllevar un peor rendimiento motor que el consumo habitual. ABSTRACT Cannabis use is one of the most important concerns of public health, particularly among young people, given their use prevalence. This drug can produce psychomotor alterations in the subject; therefore, this research work has as main aim to check if cannabis use is an added risk for physical and sporting practices. In order to achieve the objectives pursued, work was divided in two interrelated studies. First study or Study 1, “Cannabis use impact in Physical Education lessons”, a self-managed questionnaire addressed to Physical Education teachers in Community of Madrid was carried out, in order to gather the opinion about the possible existence of Cannabis users in their classes. Second Study or Study 2, “Cannabis influence in balance, coordination, reaction time and temporal perception”, consisted in a series of tests performed by a control group and a cannabis users group, in order to quantify and qualify the effects of inhalation of this drug in the motor skills. The questionnaire used for Study 1, “Cannabis, teenagers, and physical and sporting practices”, firstly went through an elaboration y correction phase, and then, using cluster sampling technique, was distributed within selected Secondary Education Centres from Community of Madrid. Response from 93 Physical Education teachers from 76 High Schools were obtained, this is 22,35% of total High Schools in Madrid. Finally, analysis, discussion and dissemination of results were held. In Study 2, first of all design of tests to be made was done, consisting on 7 different test with 16 variables that measured balance, coordination, response time and temporal perception in subjects. After that, sample selection was performed, comprised of 2 volunteers groups of ages between 18-30 years: a control group of 52 participants, and a Cannabis Users Group of 28 participants with different consumption habits. Users group subjects carried out tests 20 minutes after cannabis inhalation. After tests were performed by all subjects, results were analyzed and segmented by sex and matching variables in order to avoid confusion effects. First study results brought out that 75,27% of teachers have ever thought that their pupils used cannabis before getting into class, this fact is linked to psychological alterations (90,63%) and cognitive-behavioral (68,75%); not being influencing factors sex or teaching experience of the surveyed (p>0,05). Second study provided as most significant result the worsening of temporal perception and motor tasks behavior in subjects that had used cannabis, especially in regards of their balance and coordination (p<0,05). Also resulted that there were slight differences in consumption habits, although results were influenced by the sample size. Conclusions drawn showed that Physical Education teachers notice the presence of cannabis users in lessons, use dialogue with pupils as an action tool and acknowledge the negative influence this drug has in motor tasks performance. Also, it is shown that cannabis is an additional risk for physical and sporting practices due to deteriorating in motor skills, particularly in coordination and balance. In addition, the differences that may arise depending on the consumption habits are not conclusive, but they suggest that the sporadic drug use may be related to a worse motor performance than usual consumption.

Dando uma moral\' Moralidades, prazeres e poderes no caminho da adesão ao tratamento e da cura da tuberculose na população em situação de rua do município de São Paulo

A tuberculose entre pessoas em situação de rua é um grave problema de saúde pública, que carece de entendimentos e respostas melhor construídas. Questões envolvendo a dimensão coletiva do controle da doença, a dimensão individual do tratamento e o caminho para cura desta população são trazidos neste trabalho que tem como objetivo investigar os aspectos relacionados ao processo de gestão dos tratamentos e busca da cura nesta população. Para isto foram realizados estudos etnográficos junto as equipes de Consultório na Rua da cidade de São Paulo e no Hospital Leonor de Barros, em Campos do Jordão (SP), referência para internação deste grupo. A presença do uso de drogas, as co-infecções com o HIV, DSTs e as Hepatites Virais e o passado de tráfico e criminalidade são elementos presentes na história de vida dos internados, muitos dos quais já com passagem em presídios e alguns com problemas de saúde mental. Mesmo se sujeitando as regras do local em busca de um alento a seu estado de saúde, os pacientes buscam no uso de drogas escondido e no sexo discreto e não comentado, uma alternativa mediadora para suportarem as limitações a que estão expostos. A situação ainda revela uma dificuldade das instituições de internação no lidar com o tema a prática da estratégia de Redução de Danos ao uso de álcool e outras drogas, notando-se uma tendência a destacar práticas proibicionistas em qualquer ação desenvolvida. O entendimento do paciente frente à realidade encarada, revela-se principalmente pelas formas de resistência que eles desenvolvem para o período de reclusão que estarão submetidos durante o tratamento. Ao final se conclui que as diferenças sociais, oriundas de acessos dificultados, preconceitos, segregações e outros atos discriminatórios tem forte influência no processo de adesão do tratamento e cura. Além disto, percebeu-se a existência de vários enfoques de moralidades, envolvendo principalmente os profissionais de saúde e pacientes que refletem na gestão da atenção e cuidado e ainda a presença de uma diferenciação entre o conceito de ficar doente e ficar bom entre estes atores, criando um distanciamento de entendimentos e práticas.

Evaluación del programa de prevención de drogas "Barbacana"

El presente trabajo es parte de una evaluación más amplia del programa de prevención de drogas Barbacana, enfocado a alumnos de secundaria con un doble objetivo: 1. Evaluar las herramientas del programa y del proceso de implantación: conocer cómo se han desarrollado las actividades programadas. 2. Evaluar los resultados: describir los efectos del programa en los destinatarios del mismo y el grado de cumplimiento de los objetivos marcados. Para la consecución del primer objetivo hemos aplicado una metodología cualitativa basada en entrevistas semiestructuradas a los profesores encargados de llevar a cabo el programa en distintos centros de la Comunidad Valenciana. De la información resultante podemos comprobar que tanto los materiales como el proceso han sido calificados de positivo o muy positivo, tanto entre los aplicadores como entre los receptores. Para el segundo objetivo, optamos por un diseño cuasiexperimental con grupo de comparación no equivalente, en un mismo momento temporal que nos permite medir las diferencias y equivalencias entre ambos, confirmando nuestra hipótesis causal de partida: "las diferencias entre los alumnos del grupo experimental y de control en cuanto a información y niveles de consumo hacia las drogas, se deben básicamente a la aplicación del programa Barbacana".

Predictors and Consequences of Simultaneous Alcohol and Cannabis Use in Adolescents

Background/Aims: The simultaneous use of alcohol and cannabis is common among adolescents, but has been little studied. In this study, we examine predictors and consequences of this behavior in a population-based sample of high school students. Method: Self-reports were obtained from students in Quebec (Canada) followed throughout high school (N=6589). Logistic regressions were used to test the association between individual, family, and peerrelated predictors in grades 7–8 and simultaneous alcohol and cannabis use in grade 10, as well as between simultaneous alcohol and cannabis use in grade 10 and experiencing 3 or more substance-related problems of various types (legal, physical, etc.) in grade 11. Results: Most predictors in grades 7–8 were associated with simultaneous alcohol and cannabis use in grade 10. Only variables reflecting early-onset substance use involvement — alcohol intoxication, cannabis use, and drug use by close friend(s) — remained predictive in a multivariate model. Simultaneous alcohol and cannabis use was associated with increased substance-related problems in grade 11, above and beyond baseline problems and the concurrent use of the two substances in separate episodes in grade 10. Conclusions: Simultaneous alcohol and cannabis use 1) is anticipated by multiple psychosocial risk factors which come together with individual and peer substance use in early high school and 2) is independently predictive of subsequent substance-related problems. Providing adolescents with adequate information regarding the potential harm of simultaneous use may be a useful prevention strategy.

Prospective associations between meth/amphetamine (speed) and MDMA (ecstasy) use and depressive symptoms in secondary school students

Background Research has raised significant concern regarding the affective consequences of synthetic drug use. However, little evidence from well-controlled longitudinal studies exists on these consequences. The aim of this study was to determine whether use of meth/amphetamine (speed) and 63,4- methylenedioxymethamphetamine (MDMA, ecstasy) is independently predictive of subsequent depressive symptoms in adolescents. Methods A sample of 3880 adolescents from secondary schools in disadvantaged areas of Quebec, Canada, were followed over time (2003e2008). Logistic regression was used to test the association between meth/ amphetamine and MDMA use in grade 10 (ages 15e16 years) and elevated depressive symptoms on an abridged Center for Epidemiologic Studies-Depression scale in grade 11, controlling for pre-existing individual and contextual characteristics. Results After adjustment, both MDMA use (OR 1.7, 95% CI 1.1 to 2.6) and meth/amphetamine use (OR 1.6, 95% CI 1.1 to 2.3) in grade 10 significantly increased the odds of elevated depressive symptoms in grade 11. These relationships did not vary by gender or pre-existing depressive symptoms. Increased risk was particularly observed in concurrent usage (OR 1.9, 95% CI 1.2 to 2.9). Conclusions Adolescent use of meth/amphetamine and MDMA (particularly concurrent use) is independently associated with subsequent depressive symptoms. Further enquiry must determine whether these associations reflect drug-induced neurotoxicity and whether adolescence is a period of increased vulnerability to the hazards of synthetic drug exposure.

The Arms Trade Treaty and the Control of Dual-Use Goods and Technologies. IES WORKING PAPER 1/2013

This paper seeks to delineate some preliminary factors and working methods that could work in favour of establishing a workable international export control regime for dual-use goods and technologies. Drawing on the work initiated by various United Nations initiatives and the Wassenaar Agreement, but specifically looking at the European Union export regime model, this working paper asks if and how a similar model could be adopted at the international level. Far from suggesting that the EU regime should of could be adopted on a global basis or that the regime is full-proof, the authors acknowledge that EU regulations are seen as among the most stringent of frameworks on dual-use goods and technologies available. Accordingly, this paper asks what elements of the EU’s control regime could be of international benefit after the ATT negotiations and how it could be adopted on a more international basis. Indeed, any future ATT control mechanism for dual-use items will have to draw on existing arms transfers and control regimes. It does this through an analysis of the ATT and the current discourse on dual-use goods and technologies in the negotiations, an stocktaking of the strengths and weaknesses of the EU’s export control regime and by asking what elements of the EU’s regime could be utilised for international control mechanisms after a future ATT is negotiated.

Predictors and Consequences of Simultaneous Alcohol and Cannabis Use in Adolescents

Background/Aims: The simultaneous use of alcohol and cannabis is common among adolescents, but has been little studied. In this study, we examine predictors and consequences of this behavior in a population-based sample of high school students. Method: Self-reports were obtained from students in Quebec (Canada) followed throughout high school (N=6589). Logistic regressions were used to test the association between individual, family, and peerrelated predictors in grades 7–8 and simultaneous alcohol and cannabis use in grade 10, as well as between simultaneous alcohol and cannabis use in grade 10 and experiencing 3 or more substance-related problems of various types (legal, physical, etc.) in grade 11. Results: Most predictors in grades 7–8 were associated with simultaneous alcohol and cannabis use in grade 10. Only variables reflecting early-onset substance use involvement — alcohol intoxication, cannabis use, and drug use by close friend(s) — remained predictive in a multivariate model. Simultaneous alcohol and cannabis use was associated with increased substance-related problems in grade 11, above and beyond baseline problems and the concurrent use of the two substances in separate episodes in grade 10. Conclusions: Simultaneous alcohol and cannabis use 1) is anticipated by multiple psychosocial risk factors which come together with individual and peer substance use in early high school and 2) is independently predictive of subsequent substance-related problems. Providing adolescents with adequate information regarding the potential harm of simultaneous use may be a useful prevention strategy.

Prospective associations between meth/amphetamine (speed) and MDMA (ecstasy) use and depressive symptoms in secondary school students

Background Research has raised significant concern regarding the affective consequences of synthetic drug use. However, little evidence from well-controlled longitudinal studies exists on these consequences. The aim of this study was to determine whether use of meth/amphetamine (speed) and 63,4- methylenedioxymethamphetamine (MDMA, ecstasy) is independently predictive of subsequent depressive symptoms in adolescents. Methods A sample of 3880 adolescents from secondary schools in disadvantaged areas of Quebec, Canada, were followed over time (2003e2008). Logistic regression was used to test the association between meth/ amphetamine and MDMA use in grade 10 (ages 15e16 years) and elevated depressive symptoms on an abridged Center for Epidemiologic Studies-Depression scale in grade 11, controlling for pre-existing individual and contextual characteristics. Results After adjustment, both MDMA use (OR 1.7, 95% CI 1.1 to 2.6) and meth/amphetamine use (OR 1.6, 95% CI 1.1 to 2.3) in grade 10 significantly increased the odds of elevated depressive symptoms in grade 11. These relationships did not vary by gender or pre-existing depressive symptoms. Increased risk was particularly observed in concurrent usage (OR 1.9, 95% CI 1.2 to 2.9). Conclusions Adolescent use of meth/amphetamine and MDMA (particularly concurrent use) is independently associated with subsequent depressive symptoms. Further enquiry must determine whether these associations reflect drug-induced neurotoxicity and whether adolescence is a period of increased vulnerability to the hazards of synthetic drug exposure.

Marijuana, other drugs and their relation to highway safety: a report to the Congress.

Mode of access: Internet.