International Journal of Environmental Research and Public Health

Research

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243 KiB

Open AccessArticle

Impact of Co-Occurring Psychiatric Disorders on Retention in a Methadone Maintenance Program: An 18-Month Follow-Up Study

by Mònica Astals, Laura Díaz, Antònia Domingo-Salvany, Rocío Martín-Santos, Antoni Bulbena and Marta Torrens

Int. J. Environ. Res. Public Health 2009, 6(11), 2822-2832; https://doi.org/10.3390/ijerph6112822 - 12 Nov 2009

Cited by 35 | Viewed by 11120

Abstract

We assess the influence of co-occurring psychiatric disorders on retention in 189 opioid dependent patients in a methadone maintenance treatment (MMT) and determine the incidence of psychiatric co-morbidity during an 18-month follow-up period. About 68.5 % were retained in the MMT. Neither co-occurring [...] Read more.

We assess the influence of co-occurring psychiatric disorders on retention in 189 opioid dependent patients in a methadone maintenance treatment (MMT) and determine the incidence of psychiatric co-morbidity during an 18-month follow-up period. About 68.5 % were retained in the MMT. Neither co-occurring mental disorders (chi-square = 0.303, df = 1, p = 0.622) nor methadone doses [85 (88.9) vs. 79.2 (85) mg/day, p = 0.672] were related to retention. In the follow-up period 19 new diagnoses were made, mainly major depression and antisocial and borderline personality disorders. Co-occurring psychiatric disorders should be assessed during MMT follow-up. Full article

(This article belongs to the Special Issue Drug Abuse and Addiction)

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177 KiB

Open AccessArticle

The Relationship between Concurrent Substance Use Disorders and Eating Disorders with Personality Disorders

by Christine Courbasson and Jacqueline M. Brunshaw

Int. J. Environ. Res. Public Health 2009, 6(7), 2076-2089; https://doi.org/10.3390/ijerph6072076 - 23 Jul 2009

Cited by 17 | Viewed by 13126

Abstract

Objective: The current pilot study investigated whether patients with concurrent substance use disorders and eating disorders (SUD and ED) who experienced a reduction in SUD and ED symptoms following treatment for SUD and ED also experienced a reduction in personality disorder (PD) symptoms. [...] Read more.

Objective: The current pilot study investigated whether patients with concurrent substance use disorders and eating disorders (SUD and ED) who experienced a reduction in SUD and ED symptoms following treatment for SUD and ED also experienced a reduction in personality disorder (PD) symptoms. Method: Twenty patients with SUD and ED and PD were assessed pre and post treatment using clinical interviews, self-report questionnaires, and a therapist questionnaire on DSM-IV-TR symptoms for PD. Results: Symptoms for the personality disorders were reduced following treatment. This reduction was correlated with a decrease in the number of symptoms of ED at post treatment. Discussion: Chronic concurrent SUD and ED may make it difficult to separate PD symptoms from co-occurring disorders. Many features attributed to PDs may be reduced when problematic substance use and disordered eating are addressed, a fact that may increase clinician and patients’optimism about therapeutic change. Full article

(This article belongs to the Special Issue Drug Abuse and Addiction)

124 KiB

Open AccessArticle

Sexual Orientation, Drug Use Preference during Sex, and HIV Risk Practices and Preferences among Men Who Specifically Seek Unprotected Sex Partners via the Internet

by Hugh Klein

Int. J. Environ. Res. Public Health 2009, 6(5), 1620-1632; https://doi.org/10.3390/ijerph6051620 - 11 May 2009

Cited by 15 | Viewed by 9377

Abstract

The present study entailed conducting a content analysis of 1,434 ads/profiles posted on one of the most popular “Men who have Sex with Men” (MSM) websites that specifically fosters unprotected sex. Ads/profiles were selected randomly based on the American ZIP code of residence [...] Read more.

The present study entailed conducting a content analysis of 1,434 ads/profiles posted on one of the most popular “Men who have Sex with Men” (MSM) websites that specifically fosters unprotected sex. Ads/profiles were selected randomly based on the American ZIP code of residence (n = 1,316), with a randomly-drawn oversampling of profiles of men who self-identified as heterosexual or “curious” rather than gay or bisexual (n = 118). Data were collected between September 2006 and September 2007. The purpose of the present paper is to examine the conjoint effects of self-identified sexual orientation and preference for having/not having sex while high, on men’s sought-after sexual risk. Analytical comparisons of the four groups showed that, on most measures, the combination of sexual orientation and drug use preference during sex differentiated the men. Generally speaking, gay/bisexual men who advertised online for partners with whom they could have sex while high expressed the greatest interest in risky sexual behaviors (e.g., felching, unprotected oral sex, unprotected anal sex) and various risk-related preferences (e.g., multiple partner sex, anonymous sex, eroticizing ejaculatory fluids). This is especially true when they are compared to their heterosexual/“curious” counterparts whose online profiles were not as likely to indicate a desire for having sex while high. Full article

(This article belongs to the Special Issue Drug Abuse and Addiction)

93 KiB

Open AccessArticle

Latinos and Latinas in Communal Settings: A Grounded Theory of Recovery

by Josefina Alvarez, Leonard A. Jason, Margaret I. Davis, Bradley D. Olson and Joseph R. Ferrari

Int. J. Environ. Res. Public Health 2009, 6(4), 1317-1334; https://doi.org/10.3390/ijerph6041317 - 31 Mar 2009

Cited by 13 | Viewed by 9566

Abstract

Semi-structured interviews were conducted with 12 Latino/a residents of a mutual help residential recovery program (Oxford House) in order to elicit their experiences of the program’s therapeutic elements. A model of recovery emerged from the analysis including several themes supported by existing literature: [...] Read more.

Semi-structured interviews were conducted with 12 Latino/a residents of a mutual help residential recovery program (Oxford House) in order to elicit their experiences of the program’s therapeutic elements. A model of recovery emerged from the analysis including several themes supported by existing literature: personal motivation and readiness to change, mutual help, sober environment, social support, and accountability. Consistent with a broad conceptualization of recovery, outcomes included abstinence, new life skills, and increased self-esteem/sense of purpose. Most participants were the only Latino/a in their Houses; however, cultural differences did not emerge as salient issues. The study’s findings highlight potential therapeutic aspects of mutual-help communal recovery programs and suggest that English-speaking, bicultural Latinos/as have positive experiences and may benefit from participating in these programs. Full article

(This article belongs to the Special Issue Drug Abuse and Addiction)

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169 KiB

Open AccessArticle

Antecedents and Covariates of Alcohol Consumption among Swiss Male Conscripts

by Mario Mueller, Ingo Kipke, Franz Frey, Wulf Rossler, Gianpiero Lupi and Stefan Vetter

Int. J. Environ. Res. Public Health 2009, 6(3), 958-970; https://doi.org/10.3390/ijerph6030958 - 2 Mar 2009

Cited by 4 | Viewed by 8286

Abstract

This study aimed to investigate prevalence and correlates of alcohol consumption frequency in a sample of Swiss conscripts (n=25,611) in order to identify factors that predispose for frequent consumption. A self-report of drinking frequencies, as well as socio-demographic and psychosocial variables, was collected [...] Read more.

This study aimed to investigate prevalence and correlates of alcohol consumption frequency in a sample of Swiss conscripts (n=25,611) in order to identify factors that predispose for frequent consumption. A self-report of drinking frequencies, as well as socio-demographic and psychosocial variables, was collected at psychiatric baseline screening. Based on univariate analyses, relevant variables were included in a multivariate multinomial logistic regression model. Six percent were abstainers, 15% reported rarely drinking, 53% occasional drinking, 24% regular drinking and 2% daily drinking. Except for substance use, most associations followed a “J”-shaped curve across the categories of alcohol frequency. Abstinence and frequent drinking can be perceived as deviations from the social norm. Both behaviors are associated with more psychosocial stressors and might be therefore special targets for further studies and new prevention programs. Full article

(This article belongs to the Special Issue Drug Abuse and Addiction)

183 KiB

Open AccessArticle

Attitudes toward Methadone among Out-of-Treatment Minority Injection Drug Users: Implications for Health Disparities

by Nickolas D. Zaller, Alexander R. Bazazi, Lavinia Velazquez and Josiah D. Rich

Int. J. Environ. Res. Public Health 2009, 6(2), 787-797; https://doi.org/10.3390/ijerph6020787 - 23 Feb 2009

Cited by 63 | Viewed by 17523

Abstract

Injection drug use (IDU) continues to be a significant public health issue in the U.S. and internationally, and there is evidence to suggest that the burden of injection drug use and associatedmorbidity and mortality falls disproportionately on minority communities. IDU is responsible for [...] Read more.

Injection drug use (IDU) continues to be a significant public health issue in the U.S. and internationally, and there is evidence to suggest that the burden of injection drug use and associatedmorbidity and mortality falls disproportionately on minority communities. IDU is responsible for a significant portion of new and existing HIV/AIDS cases in many parts of the world. In the U.S., the prevalence of HIV and hepatitis C virus is higher among populations of African-American and Latino injection drug users (IDUs) than among white IDUs. Methadone maintenance therapy (MMT) has been demonstrated to effectively reduce opiate use, HIV risk behaviors and transmission, general mortality and criminal behavior, but opiate-dependent minorities are less likely to access MMT than whites. A better understanding of the obstacles minority IDUs face accessing treatment is needed to engage racial and ethnic disparities in IDU as well as drug-related morbidity and mortality. In this study, we explore knowledge, attitudes and beliefs about methadone among 53 out-of-treatment Latino and African-American IDUs in Providence, RI. Our findings suggest that negative perceptions of methadone persist among racial and ethnic minority IDUs in Providence, including beliefs that methadone is detrimental to health and that people should attempt to discontinue methadone treatment. Additional potential obstacles to entering methadone therapy include cost and the difficulty of regularly attending a methadone clinic as well as the belief that an individual on MMT is not abstinent from drugs. Substance use researchers and treatment professionals should engage minority communities, particularly Latino communities, in order to better understand the treatment needs of a diverse population, develop culturally appropriate MMT programs, and raise awareness of the benefits of MMT. Full article

(This article belongs to the Special Issue Drug Abuse and Addiction)

Review

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184 KiB

Open AccessReview

Bloodborne Viral Hepatitis Infections among Drug Users: The Role of Vaccination

by Fabio Lugoboni, Gianluca Quaglio, Paolo Civitelli and Paolo Mezzelani

Int. J. Environ. Res. Public Health 2009, 6(1), 400-413; https://doi.org/10.3390/ijerph6010400 - 22 Jan 2009

Cited by 16 | Viewed by 9230

Abstract

Drug use is a prevalent world-wide phenomenon and hepatitis virus infections are traditionally a major health problem among drug users (DUs). HBV and HCV, and to a lesser extent HAV, are easily transmitted through exposure to infected blood and body fluids. Viral hepatitis [...] Read more.

Drug use is a prevalent world-wide phenomenon and hepatitis virus infections are traditionally a major health problem among drug users (DUs). HBV and HCV, and to a lesser extent HAV, are easily transmitted through exposure to infected blood and body fluids. Viral hepatitis is not inevitable for DUs. Licensed vaccines are available for hepatitis A and hepatitis B. The purpose of this overview is to show some epidemiological data about HBV and the other blood-borne viral hepatitis among DUs and to summarize and discuss use of hepatitis vaccinations in this population. Successful vaccination campaigns among DUs are feasible and well described. We try to focus on the most significant results achieved in successful vaccination programs as reported in scientific literature. Vaccination campaigns among DUs represent a highly effective form of health education and they are cost-saving. Full article

(This article belongs to the Special Issue Drug Abuse and Addiction)

219 KiB

Open AccessReview

A Multivariate Approach to a Meta-Analytic Review of the Effectiveness of the D.A.R.E. Program

by Wei Pan and Haiyan Bai

Int. J. Environ. Res. Public Health 2009, 6(1), 267-277; https://doi.org/10.3390/ijerph6010267 - 13 Jan 2009

Cited by 59 | Viewed by 30066

Abstract

The Drug Abuse Resistance Education (D.A.R.E.) program is a widespread but controversial school-based drug prevention program in the United States as well as in many other countries. The present multivariate meta-analysis reviewed 20 studies that assessed the effectiveness of the D.A.R.E. program in [...] Read more.

The Drug Abuse Resistance Education (D.A.R.E.) program is a widespread but controversial school-based drug prevention program in the United States as well as in many other countries. The present multivariate meta-analysis reviewed 20 studies that assessed the effectiveness of the D.A.R.E. program in the United States. The results showed that the effects of the D.A.R.E. program on drug use did not vary across the studies with a less than small overall effect while the effects on psychosocial behavior varied with still a less than small overall effect. In addition, the characteristics of the studies significantly explained the variation of the heterogeneous effects on psychosocial behavior, which provides empirical evidence for improving the school-based drug prevention program. Full article

(This article belongs to the Special Issue Drug Abuse and Addiction)

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