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Mathers, Bradley M.; Degenhardt, Louisa; Bucello, Chiara; Lemon, James; Wiessing, Lucas; Hickman, Mathew |
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Mortality among people who inject drugs : a systematic review and meta-analysis |
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2013 |
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Bulletin of the World Health Organization |
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91 |
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2; 02/2013 |
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102-123 |
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AOD user; intravenous drug user; risk; AODR mortality; AOD overdose mortality; viral disease; communicable disease; HIV infection; Aids; statistical data; meta-analysis; international area |
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Objective To systematically review cohort studies of mortality among people who inject drugs, examine mortality rates and causes of death in this group, and identify participant- and study-level variables associated with a higher risk of death. Methods Tailored search strings were used to search EMBASE, Medline and PsycINFO. The grey literature was identified through online grey literature databases. Experts were consulted to obtain additional studies and data. Random effects meta-analyses were performed to estimate pooled crude mortality rates (CMRs) and standardized mortality ratios (SMRs). Findings Sixty-seven cohorts of people who inject drugs were identified, 14 of them from low- and middle-income countries. The pooled CMR was 2.35 deaths per 100 person–years (95% confidence interval, CI: 2.12–2.58). SMRs were reported for 32 cohorts; the pooled SMR was 14.68 (95% CI: 13.01–16.35). Comparison of CMRs and the calculation of CMR ratios revealed mortality to be higher in low- and middle-income country cohorts, males and people who injected drugs that were positive for human immunodeficiency virus (HIV). It was also higher during off-treatment periods. Drug overdose and acquired immunodeficiency syndrome (AIDS) were the primary causes of death across cohorts. Conclusion Compared with the general population, people who inject drugs have an elevated risk of death, although mortality rates vary across different settings. Any comprehensive approach to improving health outcomes in this group must include efforts to reduce HIV infection as well as other causes of death, particularly drug overdose. |
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0042-9686; 1564-0604 |
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Conclusions in Arabic, Chinese, French, Russian, Spanish |
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50-12926 |
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60000 |
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Gahr, Maximilian; Freudenmann, Roland W.; Hiemke, Christoph; Gunst, Ingo M.; Connemann, Bernhard J.; Schönfeldt-Lecuona, Carlos |
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Desomophine goes “Crocodile” |
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2012 |
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Journal of addictive diseases |
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31 |
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4; 10/2012 |
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407-412 |
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AOD use, abuse, and dependence; addiction; chemical addiction; opioids in any form; designer drug; research chemical; codeine; morphine; epidemiology; AODR mortality; AOD effects and AODR problems; AOD induced risk; AODR disability; international area; Russia; Germany |
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A systematic review was conducted to identify the available data for the term Krokodil, which is a jargon expression for an allegedly new drug. Krokodil seems to be a mixture of several substances and was first used in Russia in 2003, with a tremendous increase in the number of addicted individuals since then. The psychoactive core agent of Krokodil is desomorphine, an opioid-analogon that can be manufactured by boiling tablets containing codeine and other ingredients. The procedure results in a suspension that is used intravenously and regularly causes complications such as abscess, thrombophlebitis, and gangrene. |
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1055-0887 (print); 1545-0848 (online) |
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50-12872 |
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59998 |
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Battistella, Giovanni; Fornari, Eleonora; Thomas, Aurélien; Mall, Jean-Frédéric; Chtioui, Haithem; Appenzeller, Monique; Annoni, Jean-Marie; Favrat, Bernard; Maeder, Philippe; Giroud, Christian |
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Weed or Wheel! fMRI, behavioural, and toxicological investigations of how cannabis smoking affects skills necessary for driving |
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2013 |
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Plos One |
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8 |
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1; 02.01.2013 |
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15 |
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chemical addiction; illicit drug; marijuana in any form; cannabis; tetrahydrocannabinol; AOD intoxication; AOD effects and consequences; AOD use and driving; research; brain; neuroscience (field); laws and regulations |
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Marijuana is the most widely used illicit drug, however its effects on cognitive functions underling safe driving remain mostly unexplored. Our goal was to evaluate the impact of cannabis on the driving ability of occasional smokers, by investigating changes in the brain network involved in a tracking task. The subject characteristics, the percentage of D9-Tetrahydrocannabinol in the joint, and the inhaled dose were in accordance with real-life conditions. Thirty-one male volunteers were enrolled in this study that includes clinical and toxicological aspects together with functional magnetic resonance imaging of the brain and measurements of psychomotor skills. The fMRI paradigm was based on a visuo-motor tracking task, alternating active tracking blocks with passive tracking viewing and rest condition. We show that cannabis smoking, even at low D9-Tetrahydrocannabinol blood concentrations, decreases psychomotor skills and alters the activity of the brain networks involved in cognition. The relative decrease of Blood Oxygen Level Dependent response (BOLD) after cannabis smoking in the anterior insula, dorsomedial thalamus, and striatum compared to placebo smoking suggests an alteration of the network involved in saliency detection. In addition, the decrease of BOLD response in the right superior parietal cortex and in the dorsolateral prefrontal cortex indicates the involvement of the Control Executive network known to operate once the saliencies are identified. Furthermore, cannabis increases activity in the rostral anterior cingulate cortex and ventromedial prefrontal cortices, suggesting an increase in self-oriented mental activity. Subjects are more attracted by intrapersonal stimuli (“self”) and fail to attend to task performance, leading to an insufficient allocation of task-orientedre sources and to sub-optimal performance. These effects correlate with the subjective feeling of confusion rather than with the blood level of D9-Tetrahydrocannabinol. These findings bolster the zero-tolerance policy adopted in several countries that prohibits the presence of any amount of drugs in blood while driving. |
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1932-6203 |
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50-12783 |
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59993 |
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Thomas, Kevin V.; Bijlsma, Lubertus; Castiglioni, Sara; Covaci, Adrian; Emke, Erik; Grabic, Roman; Félix Hernández, Félix; Karolak, Sara; Kasprzyk-Hordern, Barbara; Lindberg, Richard H.; Lopez de Alda, Miren; Meierjohann, Axel; Ort, Christoph; Pico, Yolanda; Quintana, José B.; Reid, Malcolm; Rieckermann, Jörg; Terzic, Senka; van Nuijs, Alexander L.N.; de Voogt, Pim |
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Comparing illicit drug use in 19 European cities through sewage analysis |
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2012 |
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Science of the Total Environment |
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432 |
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432-439 |
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AOD use; illicit drug; ecstasy; MDMA; cocaine; cannabis; amphetamines; research; study; water pollution; international differences; international area; statistical data; Europe; journal article |
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The analysis of sewage for urinary biomarkers of illicit drugs is a promising and complementary approach for estimating the use of these substances in the general population. For the first time, this approach was simultaneously applied in 19 European cities, making it possible to directly compare illicit drug loads in Europe over a 1-week period. An inter-laboratory comparison study was performed to evaluate the analytical performance of the participating laboratories. Raw 24-hour composite sewage samples were collected from 19 European cities during a single week in March 2011 and analyzed for the urinary biomarkers of cocaine, amphetamine, ecstasy, methamphetamine and cannabis using in-house optimized and validated analytical methods. The load of each substance used in each city was back-calculated from the measured concentrations. The data show distinct temporal and spatial patterns in drug use across Europe. Cocaine use was higher in Western and Central Europe and lower in Northern and Eastern Europe. The extrapolated total daily use of cocaine in Europe during the study period was equivalent to 356 kg/day. High per capita ecstasy loads were observed in Dutch cities, as well as in Antwerp and London. In general, cocaine and ecstasy loads were significantly elevated during the weekend compared to weekdays. Per-capita loads of methamphetamine were highest in Helsinki and Turku, Oslo and Budweis, while the per capita loads of cannabis were similar throughout Europe. This study shows that a standardized analysis for illicit drug urinary biomarkers in sewage can be applied to estimate and compare the use of these substances at local and international scales. This approach has the potential to deliver important information on drug markets (supply indicator). |
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50-12720 |
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59990 |
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Kuntsche, Emmanuel; Labhart, Florian |
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Investigating the drinking patterns of young people over the course of the evening at weekends |
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2012 |
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Drug and alcohol Dependence |
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124 |
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3 |
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319-324 |
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alcohol; AOD use; young adult; study; research; journal article |
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Memory deficits lead to distortion when long recall periods are used to assess alcohol consumption. We used the recently developed Internet-based cell phone-optimised assessment technique (ICAT) to describe the drinkingpatterns of youngpeopleover the course of Thursday, Friday and Saturday evenings and to compare the amounts reported during the drinking sessions in question with those in the retrospective baseline assessment. Methods Using hyperlinks in text messages sent to their cell phones over five weeks, 183 young adults in French-speaking Switzerland completed a total of 8646 questionnaires at 8 pm, 9 pm, 10 pm, 11 pm, midnight and 11 am the next morning over 1441 evenings. Findings Participants consumed an average of three drinks on Thursday evenings, four on Friday evenings and five and a half on Saturday evenings. The multi-group and multi-level latent growth curves showed that while the difference was minimal at the beginning of the evening, consumption decreased over the course of the evening on Thursdays, remained about stable on Fridays and increased on Saturdays between both genders. The amounts indicated in the evening assessments were up to twice as high as those indicated retrospectively. Conclusions Using participants’ cell phones, ICAT appears to be a convenient method for collecting alcohol-related data throughout the evening. Due to the significant impact of eveningdrinkingpatterns on the total amount consumed and related consequences, it is important to prevent the average increase of drinking that is likely to occur on Saturday evenings among youngpeople. |
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50-12660 |
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59987 |
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Thane, Katja; Stöver, Heino |
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Health needs of drug dependent prisoners in four countries (Estonia, Hungary, Lithuania, Poland) = Die gesundheitlichen Bedürfnisse drogenabhängiger Inhaftierter in vier Ländern (Estland, Ungarn, Litauen, Polen) |
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2011 |
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Acceptance-oriented drug work = Akzeptanzorientierte Drogenarbeit |
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8 |
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24.08.2011 |
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23-43 |
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AOD dependence; AOD associated consequences; health and disease; addiction; prison-based health service; prison-based prevention; prevention; prevention directed at groups; international area; Estonia; Hungary; Lithuania; Poland |
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The majority of people held in European prisons have severe problems associated with drug use, together with related health and social disadvantages. Those categorised as problematic drug users (PDUs) constitute a substantial proportion of prison populations in Europe. Recent figures indicate that a third to a half of prisoners having illicit drug use experience before imprisonment. Acknowledging the existence of a drug problem within prison walls often remains a taboo for prisoners, staff, management and politicians. Moreover, lack of continuity of care and support throughout the criminal justice system (CJS), from the moment of arrest to release from prison into the community, contributes to failures in reintegration, drives the “revolving door effect”, with drug users routinely caught in the criminal justice system and does not allow for the full implementation of the principle of equivalence of health services in prison comparable to those available in the community. Most of the countries, who joined the European Union (EU) most recently have, to varying degrees, im-plemented effective treatment programmes and harm reduction projects outside of the prison system. However, effective drug treatment and blood-borne virus (BBV) prevention programmes within the prison walls and follow up services for released inmates with problematic drug use still have, in most New Member States, to be developed. Overall, prison policies and practices, in particular in dealing with drug users and related (infectious) diseases, remain an important EU concern. In few of the New Member States the public health imperative of a healthy prison system receives the political attention it deserves |
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1861-0110 |
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50-12349 |
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59972 |
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Newman, Robert G. |
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Opioid maintenance treatment: a glass half full but also half empty!; = Opioid-Erhaltungs-Behandlung: ein halbvolles, aber auch halbleeres Glas |
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2011 |
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Akzeptanzorientierte Drogenarbeit = Acceptance-oriented drug work |
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8 |
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04.07.2011 |
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14-22 |
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opioids in any form; treatment and maintenance; heroin-assisted treatment; harm reduction; methadone |
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50-12296 |
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59971 |
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Krul, Jan; Blankers, Matthijs; Girbes, Armand R. J. |
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Substance-related health problems during rave parties in the Netherlands (1997-2008) |
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2011 |
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PLoS ONE |
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6 |
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12; 12/2011 |
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e29620 |
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AOD use; AOD use pattern; nightlife; gamma-hydroxybutyric acid; ecstasy; alcohol; cannabis; amphetamines; cocaine; risk assessment; harm reduction; study; Netherlands |
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The objective of this study was to describe a 12-year (1997–2008) observation of substance-related incidents occurring at rave parties in the Netherlands, including length of visits to first-aid stations, substances used, and severity of the incidents. During rave parties, specifically trained medical and paramedical personnel staffed first aid stations. Visitors were diagnosed and treated, and their data were recorded using standardized methods. During the 12-year period with 249 rave parties involving about 3,800,000 visitors, 27,897 people visited a first aid station, of whom 10,100 reported having a substancerelated problem. The mean age of these people was 22.3+/25.4 years; 52.4% of them were male. Most (66.7%) substancerelated problems were associated with ecstasy or alcohol use or both. Among 10,100 substance-related cases, 515 required professional medical care, and 16 of these cases were life threatening. People with a substance-related problem stayed 20 min at the first aid station, which was significantly longer than the 5 min that those without a substance-related health problem stayed. These unique data from the Netherlands identify a variety of acute health problems related to the use of alcohol, amphetamines, cannabis, cocaine, ecstasy, and GHB. Although most problems were minor, people using GHB more often required professional medical care those using the other substances. We recommended adherence to harm and risk reduction policy, and the use of first aid stations with specially trained staff for both minor and serious incidents. |
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50-12290 |
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59970 |
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Pierre, Joseph M. |
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Cannabis, synthetic cannabinoids, and psychosis risk : What the evidence says |
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2011 |
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Current Psychiatry |
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10 |
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9 |
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49-57 |
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risk factors; schizophrenia; etiology; cannabis; study |
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Over the past 50 years, anecdotal reports linking cannabis sativa (marijuana) and psychosis have been steadily accumulating, giving rise to the notion of “cannabis psychosis.” Despite this historic connection, marijuana often is regarded as a “soft drug” with few harmful effects. However, this benign view is now being revised, along with mounting research demonstrating a clear association between cannabis and psychosis. In this article, I review evidence on marijuana’s impact on the risk of developing psychotic disorders, as well as the potential contributions of “medical” marijuana and other legally available products containing synthetic cannabinoids to psychosis risk. |
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50-12112 |
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59954 |
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Haefeli, Joerg; Lischer, Suzanne; Schwarz, Juerg |
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Early detection items and responsible gambling features for online gambling |
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2011 |
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International Gambling Studies |
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01.08.2011 |
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1-16 |
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gambling; harm reduction; early identification; statistical data; study; Switzerland |
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Early detection is an effective building block for the prevention of problem gambling. This study aims to identify communication-based indicators for gambling-related problems in the setting of online gambling. In the framework of a semi-structured interview, customer service employees of three online gambling operators were surveyed, to identify indicators in customer correspondence could be used as a predictor for gambling-related problems. In a confirmatory part of the study, we investigated to what degree these indicators are able to predict problem gambling in a prospective empirical design. An optimally parsimonious log-linear model, was able to correctly predict 76.6% of the cases. Discussed in the light of this evidence, communication-based indicators could constitute an effective component of early detection. Due to the fact that the internet offers optimal conditions for consistent monitoring and objective analysis, the suggested predictive model could be combined with other models, relying on the analysis of gambling behaviour. |
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59952 |
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