Prescription Drug Abuse among Ecstasy Users in Miami

This study examines the nature, extent and consequences of prescription drug abuse among 143 ecstasy users in Miami. Participants were recruited through nightclub and college campus outreach, and through respondent referrals. Instrumentation included the Risk Behavior Assessment, Substance Abuse Module and Center for Epidemiological Studies Depression Scale. Median age was 23, 42% were female and 50% Hispanic. An arrest history was reported by 44%, and 33% reported prior drug/alcohol treatment. Prescription drug abuse was reported by 87%; alprazolam (57%), oxycodone (36%), hydrocodone (32%) and diazepam (30%) were cited most often. Prescription drug abusers were more likely to report polydrug use, drug treatment histories, risky drug use behaviors, and symptoms of depression. They also reported numerous physical, psychological and social consequences of prescription drug abuse. Additional studies among larger samples are needed to understand the processes of prescription drug access and the extent of integration in club drug using cultures

Building global capacity for brain and nervous system disorders research.

The global burden of neurological, neuropsychiatric, substance-use and neurodevelopmental disorders in low- and middle-income countries is worsened, not only by the lack of targeted research funding, but also by the lack of relevant in-country research capacity. Such capacity, from the individual to the national level, is necessary to address the problems within a local context. As for many health issues in these countries, the ability to address this burden requires development of research infrastructure and a trained cadre of clinicians and scientists who can ask the right questions, and conduct, manage, apply and disseminate research for practice and policy. This Review describes some of the evolving issues, knowledge and programmes focused on building research capacity in low- and middle-income countries in general and for brain and nervous system disorders in particular

Sexual Behaviors among Club Drug Users: Prevalence and Reliability

Abstract HIV prevention efforts require a focus on reducing high risk sexual behavior. Because these are self-reported, assessments that reduce memory bias and improve elicitation of data are needed. As part of a multi-site psychometric study of club drug use, abuse, and dependence, data were collected with a test-retest design that measured the reliability of the Washington University Risk Behavior Assessment for Club Drugs (WU-RBA-CD). Reliability was assessed separately by sex via kappa coefficients and intraclass correlation coefficients (ICC); z tests compared coefficients by sex. A total of 603 participants were interviewed by independent assessors with 5 days in between interviews. Reliability for all 51 items of the sexual activity section of the WU-RBA-CD ranged from .23 to 1.00; 71% (n = 36) of items resulted in moderate to high reliability (.55-1.00). Number of lifetime sex partners was consistently reported for same-sex partners for both men and women and opposite-sex partners. Items with high reliability included reporting ever being under the influence of ecstasy (.87) or GHB (.87) while having sex. Items with lower reliability included those that queried the determinants of condom use (.45-.82) and about behaviors and attitudes experienced while using drugs (.23-.87). Very few sex differences were revealed in the reliability of reported sexual activities. Overall, the WU-RBA-CD performed with fairly high reliability rates. Assessing situations of when, how, and why individuals use condoms may offer the clearest evaluation of determinants of sexual behaviors, yet those items are not as reliable

Risk factors associated with Hepatitis C among female substance users enrolled in community-based HIV prevention studies

<p>Abstract</p> <p>Background</p> <p>Hepatitis C virus (HCV) infection is one of the most frequent chronic blood-borne infections in the United States. The epidemiology of HCV transmission is not completely understood, particularly in women and minorities.</p> <p>Findings</p> <p>We examined the HCV associated risk factors in substance abusing females involved in National Institute on Alcohol Abuse and Alcoholism (NIAAA) and National Institute on Drug Abuse (NIDA) funded HIV prevention studies of street recruited women. As a part of the 12 month follow-up, participants were interviewed about substance use and sexual risk behaviors, including drug implement sharing practices, tattoos, body piercing and blood transfusions and the sharing of personal hygiene equipment including tweezers, toothbrushes and razors. Urine and blood testing for HCV antibody (Ab), HIV and sexually transmitted diseases (STDs) was conducted at the time of assessment.</p> <p>Among 782 predominantly African American women, 162 (21%) tested positive for HCV Ab. Older age (p < 0.001), history of injection drug use (p < 0.001), lifetime crack cocaine use (p = 0.004) and having a tattoo (p = 0.01) were significantly associated with HCV Ab positivity. Other risk factors previously reported in association with HCV Ab positivity such as sexual risk behaviors were not significantly associated with the presence of a positive HCV Ab.</p> <p>Conclusions</p> <p>This large community based sample of predominantly African American substance abusing women showed high prevalence of HCV Ab positivity and low awareness of their HCV serostatus. Our study demonstrated that in addition to intravenous drug use (IDU), other factors were significantly associated with HCV Ab positivity such as having a tattoo and a lifetime history of crack use. Other potential routes of HCV transmission should be further studied among high risk female populations.</p

Prevalence of drug and alcohol use in urban Afghan istan: epidemiological data from the Afghanistan National Urban Drug Use Study (ANUDUS)

Background Previous attempts to assess the prevalence of drug use in Afghanistan have focused on subgroups that are not generalisable. In the Afghanistan National Urban Drug Use Study, we assessed risk factors and drug use in Afghanistan through self-report questionnaires that we validated with laboratory test confi rmation using analysis of hair, urine, and saliva. Methods The study took place between July 13, 2010, to April 25, 2012, in 11 Afghan provinces . 2187 randomly selected households completed a survey, representing 19 025 ho usehold members. We completed surveys with the female head of the household about past and current drug use among members of their household . We also obtained hair, urine, and saliva samples from 5236 people in these households and tested them for metabolites of 13 drugs. Find ings Of 2170 households with biological samples tested, 247 (11·4%) tested positive for any drug. Overall, opioids were the most prevale nt drug in the biological samples (5·6%), although prescription drugs (prescription pain pills, sedatives, and tranquilliser) were the most commonly reported in the past 30 days in the questionnaires (7·6%). Of individuals testing positive for at least one substance, opioids accounted for more than 50% of substance use in women and children, but only a third of substances in men, who predominantly tested positive for cannabinoids. After controlling for age with direct standardisation, individual prevalence of substance use (from laboratory tests) was 7·2% (95% CI 6·1–8·3) in men and 3·1% (2·5–3·7) in women—with a national prevalence of 5·1% (4·4–5·8) and a prevalence of 5·0% (4·1–5·8) in Kabul. Concordance between laboratory test results and self-reports was high. Interpretation These data suggest the female head of household to be a knowledgeable informant for household substance use. They also might provide insight into new avenues for targeted behavioural interventions and prevention messages