49 research outputs found
Utilisation non mĂ©dicale des mĂ©dicaments dâordonnance chez les adolescents utilisant des drogues au QuĂ©bec
Abstract : OBJECTIVE: To determine the prevalence and factors associated with nonmedical use of prescription medication (NMUPM) among adolescents who use drugs (ages 12 to 17 years) in Quebec.
METHOD: Secondary data analyses were carried out with data from a 6-month study, namely, the 2010-2011 Quebec Health Survey of High School Students-a large-scale survey that sought to gain a better understanding of the health and well-being of young Quebecers in high school. Bivariate and multivariate logistic regression analyses were conducted to study NMUPM among adolescents who use drugs, according to sociodemographic characteristics, peer characteristics, health indicators (anxiety, depression, or attention-deficit disorder [ADD] with or without hyperactivity), self-competency, family environment, and substance use (alcohol and drug use) factors.
RESULTS: Among adolescents who had used drugs in the previous 12 months, 5.4% (95% CI 4.9% to 6.0%) reported NMUPM. Based on multivariate analyses, having an ADD (adjusted odds ratio [AOR] 1.47; 95% CI 1.13 to 1.91), anxiety disorder (AOR 2.14; 95% CI 1.57 to 2.92), low self-esteem (AOR 1.62; 95% CI 1.26 to 2.08), low self-control (AOR 1.95; 95% CI 1.55 to 2.45), low parental supervision (AOR 1.43; 95% CI 1.11 to 1.83), regular alcohol use (AOR 1.72; 95% CI 1.36 to 2.16), and polysubstance use (AOR 4.09; 95% CI 3.06 to 5.48) were associated with increased odds of reporting NMUPM.
CONCLUSIONS: The observed prevalence of NMUPM was lower than expected. However, the associations noted with certain mental health disorders and regular or heavy use of other psychoactive substances are troubling. Clinical implications are discussed.OBJECTIF: DĂ©terminer la prĂ©valence de lâutilisation non mĂ©dicale des mĂ©dicaments
dâordonnance (UNMMO) et les facteurs qui y sont associĂ©s chez les adolescents (de 12 Ă 17 ans) qui utilisent des drogues au QuĂ©bec.
MĂTHODE: Des analyses de donnĂ©es secondaires ont Ă©tĂ© exĂ©cutĂ©es avec les donnĂ©es dâune Ă©tude de 6 mois, lâEnquĂȘte quĂ©bĂ©coise sur la santĂ© des jeunes du secondaire 2010-2011, une enquĂȘte de grande envergure visant Ă obtenir une meilleure comprĂ©hension de la santĂ© et du bien-ĂȘtre des jeunes quĂ©bĂ©cois du secondaire. Des analyses de rĂ©gression logistique bivariĂ©e et multivariĂ©e ont Ă©tĂ© menĂ©es pour Ă©tudier lâUNMMO chez les adolescents qui utilisent des drogues, selon les facteurs des caractĂ©ristiques sociodĂ©mographiques, des caractĂ©ristiques des pairs, des indicateurs de la santĂ© (anxiĂ©tĂ©, dĂ©pression, ou trouble de dĂ©ficit de lâattention [TDA] avec ou sans hyperactivitĂ©), de lâautoefficacitĂ©, de lâenvironnement familial, et de lâutilisation de substances (utilisation dâalcool et de drogues).
RĂSULTATS: Parmi les adolescents qui avaient utilisĂ© des drogues dans les 12 mois
prĂ©cĂ©dents, 5,4 % (IC Ă 95 % 4,9 % Ă 6,0 %) dĂ©claraient une UNMMO. Selon les analyses multivariĂ©es, un TDA (ratio de cotes ajustĂ© [RCC] 1,47; IC Ă 95 % 1,13 Ă 1,91), un trouble anxieux (RCC 2,14; IC Ă 95 % 1,57 Ă 2,92), une faible estime de soi (RCC 1,62; IC Ă 95 % 1,26 Ă 2,08), un faible autocontrĂŽle (RCC 1,95; IC Ă 95 % 1,55 Ă 2,45), une faible supervision parentale (RCC 1,43; IC Ă 95 % 1,11 Ă 1,83), une utilisation dâalcool rĂ©guliĂšre (RCC 1,72; IC Ă 95 % 1,36 Ă 2,16), et une utilisation de polysubstances (RCC 4,09; IC Ă 95 % 3,06 Ă 5,48) Ă©taient associĂ©s Ă des probabilitĂ©s accrues de dĂ©clarer une UNMMO.
CONCLUSIONS: La prĂ©valence observĂ©e de lâUNMMO Ă©tait plus faible que prĂ©vu. Cependant, les associations notĂ©es entre certains troubles de santĂ© mentale et lâutilisation rĂ©guliĂšre ou intensive dâautres substances psychoactives sont inquiĂ©tantes. Les implications cliniques sont discutĂ©es
Access to pain treatment as a human right
<p>Abstract</p> <p>Background</p> <p>Almost five decades ago, governments around the world adopted the 1961 Single Convention on Narcotic Drugs which, in addition to addressing the control of illicit narcotics, obligated countries to work towards universal access to the narcotic drugs necessary to alleviate pain and suffering. Yet, despite the existence of inexpensive and effective pain relief medicines, tens of millions of people around the world continue to suffer from moderate to severe pain each year without treatment.</p> <p>Discussion</p> <p>Significant barriers to effective pain treatment include: the failure of many governments to put in place functioning drug supply systems; the failure to enact policies on pain treatment and palliative care; poor training of healthcare workers; the existence of unnecessarily restrictive drug control regulations and practices; fear among healthcare workers of legal sanctions for legitimate medical practice; and the inflated cost of pain treatment. These barriers can be understood not only as a failure to provide essential medicines and relieve suffering but also as human rights abuses.</p> <p>Summary</p> <p>According to international human rights law, countries have to provide pain treatment medications as part of their core obligations under the right to health; failure to take reasonable steps to ensure that people who suffer pain have access to adequate pain treatment may result in the violation of the obligation to protect against cruel, inhuman and degrading treatment.</p
Psychodynamik medikalisierter Beziehungen
Konsensuskonferenzen in der Medizin tragen das zu einem bestimmten Zeitpunkt verfĂŒgbare Wissen ĂŒber eine Krankheit zusammen, um Empfehlungen zu formulieren, wie sie erfolgreich diagnostiziert und therapiert werden kann. FĂŒr die Aufmerksamkeits und/oder HyperaktivitĂ€tsstörung bei Kindern und Jugendlichen haben entsprechende BemĂŒhungen dazu gefĂŒhrt, einen aufwendigen Diagnoseprozess zu verlangen, der die gesamte Lebenswelt der auffĂ€lligen Kinder und Jugendlichen in die Beobachtung einbezieht und Vorsicht walten lĂ€sst, um Unaufmerksamkeit, ImpulsivitĂ€t und HyperaktivitĂ€t nicht vorschnell als Symptome einer psychischen Störung zu beurteilen (Remschmidt, 2005). Ein solcher Aufwand ist nicht zuletzt deshalb notwendig, weil die Symptomdiagnose einer AD(H)S auf Urteilen sozialer Wahrnehmung beruht, die immer NormalitĂ€tsvorstellungen enthalten, die unterschiedlich ausfallen können. Eine andere Möglichkeit der Objektivierung gibt es nicht. Was die Therapie der AD(H)S betrifft, so gilt es inzwischen als Behandlungsstandard, sich nicht auf die Verordnung von Medikamenten zu beschrĂ€nken, weil eine solche BeschrĂ€nkung die Ătiologie der Symptome ignoriert. Wenn eine Medikation nach sorgfĂ€ltiger PrĂŒfung indiziert erscheint, sollte sie gegebenenfalls von psychotherapeutischen, psychoedukativen, ergotherapeutischen, logopĂ€dischen, pĂ€dagogischen oder anderen geeigneten nichtmedikamentösen UnterstĂŒtzungen flankiert werden. Ohne eine solche Flankierung wird den Betroffenen die Entwicklung eines angemessenen SelbstverstĂ€ndnisses vorenthalten
Drug policy and the public good: A summary of the second edition
The second edition of Drug Policy and the Public Good presents up-to-date evidence relating to the development of drug policy at local, national, and international levels. The book explores both illicit drug use and nonmedical use of prescription medications from a public health perspective. The core of the book is a critical review of the scientific evidence in five areas of drug policy: 1) primary prevention programs in schools and other settings; 2) treatment interventions and harm reduction approaches; 3) attempts to control the supply of illicit drugs, including drug interdiction and law enforcement; 4) penal approaches, decriminalization and other alternatives; and 5) control of the legal market through prescription drug regimes. It also discusses the trend toward legalization of some psychoactive substances in some countries and the need for a new approach to drug policy that is evidence-based, realistic, and coordinated. The accumulated evidence provides important information about effective and ineffective policies. Shifting the emphasis toward a public health approach should reduce the extent of illicit drug use, prevent the escalation of new epidemics, and avoid the unintended consequences arising from the marginalization of drug users through severe criminal penalties
The influence of methylphenidate on the power spectrum of ADHD children â an MEG study
BACKGROUND: The present study was dedicated to investigate the influence of Methylphenidate (MPH) on cortical processing of children who were diagnosed with different subtypes of Attention Deficit Hyperactivity Disorder (ADHD). As all of the previous studies investigating power differences in different frequency bands have been using EEG, mostly with a relatively small number of electrodes our aim was to obtain new aspects using high density magnetoencephalography (MEG). METHODS: 35 children (6 female, 29 male) participated in this study. Mean age was 11.7 years (± 1.92 years). 17 children were diagnosed of having an Attention-Deficit/Hyperactivity Disorder of the combined type (ADHDcom, DSM IV code 314.01); the other 18 were diagnosed for ADHD of the predominantly inattentive type (ADHDin, DSM IV code 314.0). We measured the MEG during a 5 minute resting period with a 148-channel magnetometer system (MAGNESâą 2500 WH, 4D Neuroimaging, San Diego, USA). Power values were averaged for 5 bands: Delta (D, 1.5â3.5 Hz), Theta (T, 3.5â7.5 Hz), Alpha (A, 7.5â12.5 Hz), Beta (B, 12.5â25 Hz) and Global (GL, 1.5â25 Hz).). Additionally, attention was measured behaviourally using the D2 test of attention with and without medication. RESULTS: The global power of the frequency band from 1.5 to 25 Hz increased with MPH. Relative Theta was found to be higher in the left hemisphere after administration of MPH than before. A positive correlation was found between D2 test improvement and MPH-induced power changes in the Theta band over the left frontal region. A linear regression was computed and confirmed that the larger the improvement in D2 test performance, the larger the increase in Theta after MPH application. CONCLUSION: Main effects induced by medication were found in frontal regions. Theta band activity increased over the left hemisphere after MPH application. This finding contradicts EEG results of several groups who found lower levels of Theta power after MPH application. As relative Theta correlates with D2 test improvement we conclude that MEG provide complementary and therefore important new insights to ADHD
Evaluation of the Effectiveness of Workshops on the Availability and Rational Use of Opioids in Latin America
Factors associated with heroin addiction among male adults in Lahore, Pakistan
The objective of this matched case control study was to evaluate the factors associated with heroin addiction among male heroin addicts of age 15 to 35 years in Lahore. A total of 233 heroin addicts, matched on neighborhood controls, were enrolled at a case control ratio of 1:2. Multivariate conditional logistic regression analysis was carried out to study the independent relationship of hypothesized factors with heroin addiction. The factors associated with heroin addiction were parental disharmony (i.e. occasional fights versus no fights: adjusted matched odds ratio (adj. mOR) = 4.3, 95% CI: 2.4-7.8; frequent fights versus no fights: adj. mOR = 6.0, 95% CI: 2.8-16.6), drug using peers (adj. mOR = 5.6, 95% CI, 2.6-12.1), alcohol use (adj. mOR = 4.2, 95% CI, 2.3-7.6). use of over the counter available drugs (adj. mOR = 4.1, 95% CI, 1.8-10.6), father\u27s absence (adj. mOR = 2.9, 95% CI, 1.6-5.5), non-formal schooling of the mother (adj. mOR = 2.8, 95% CI, 1.7-4.7), non-formal schooling of the respondent (adj. mOR = 2.4, 95% CI, 1.5-3.8), and the presence of a drug user among similar age group family members (adj. mOR = 2.4, 95% CI, 1.3-4.8). It is recommended that public health strategies be formulated based on various facets of the problem revealed by this and previous research to prevent illicit drug use