Tennessee’s Youth in Juvenile Justice Facilities: Mental Health and Substance Abuse Issues

In order to assess the prevalence of mental health and substance abuse among youth in one state’s juvenile justice facilities, a survey was conducted of 40 Tennessee facilities. A total of 1215 youth were being held on the “one day census” that was taken as part of the survey. The survey documented many mental health and substance abuse issues: 1) 53 percent of the youth in juvenile justice facilities were experiencing mental health problems; 2) 15 percent were taking some type of psychiatric medicine while in the juvenile justice facility; 3) 42 percent were known to have substance abuse problems; and 4) 30 percent had co-occurring mental health and substance use problems. Policy and program recommendations based on these findings are discussed

Impact of gastrointestinal physiology on drug absorption in special populations––An UNGAP review

The release and absorption profile of an oral medication is influenced by the physicochemical properties of the drug and its formulation, as well as by the anatomy and physiology of the gastrointestinal (GI) tract. During drug development the bioavailability of a new drug is typically assessed in early clinical studies in a healthy adult population. However, many disease conditions are associated with an alteration of the anatomy and/or physiology of the GI tract. The same holds true for some subpopulations, such as paediatric or elderly patients, or populations with different ethnicity. The variation in GI tract conditions compared to healthy adults can directly affect the kinetics of drug absorption, and thus, safety and efficacy of an oral medication. This review provides an overview of GI tract properties in special populations compared to healthy adults and discusses how drug absorption is affected by these conditions. Particular focus is directed towards non-disease dependent conditions (age, sex, ethnicity, genetic factors, obesity, pregnancy), GI diseases (ulcerative colitis and Crohn's disease, celiac disease, cancer in the GI tract, Roux-en-Y gastric bypass, lactose intolerance, Helicobacter pylori infection, and infectious diseases of the GI tract), as well as systemic diseases that change the GI tract conditions (cystic fibrosis, diabetes, Parkinson's disease, HIV enteropathy, and critical illness). The current knowledge about GI conditions in special populations and their impact on drug absorption is still limited. Further research is required to improve confidence in pharmacokinetic predictions and dosing recommendations in the targeted patient population, and thus to ensure safe and effective drug therapies