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Background: Historically, drug abuse described the negative consequences of drug use as a proxy measure of maladaptive behavior that manifests within the addiction process. Negative consequences can span multiple domains including physical (e.g., blacking out), psychological (e.g., mood shifts), interpersonal (e.g., relationship problems), social (e.g., drinking and driving), and economic (e.g., job loss) problems. Objective: In determining the appropriate terminology to describe the phenomenon under investigation, researchers should consider (1) the theoretical objective (i.e., substance use construct under investigation) and (2) the research methodology being employed. Results: Problem substance use is appropriate for describing the outcome of interest when conducting cross-sectional, or pre-post, designs where investigators are interested in a snapshot of problems associated with substance use behavior. Conversely, substance misuse reflects a pattern of negative consequences over time and is appropriate when conducting longitudinal research with three or more time points. Here, substance misuse captures a pattern of substance use problems over time that may be indicative of a substance use disorder. These terms should be distinguished from studies investigating the frequency (how often) and quantity (how much) of a substance is being used where risky substance use is appropriate for cross-sectional studies and heavy substance use is appropriate for longitudinal studies. Conclusion: This framework is intended to describe the phenomena being investigated (i.e., the variable) and not the person or people experiencing a substance use problem. We should continue the dialogue of semantics in science realizing that our choice of words has important "real world" ramifications for the populations we serve. [ABSTRACT FROM AUTHOR]

During the last decade, drug abuse rates, particularly prescription drugs, have increased. Simultaneously, music consumption has dramatically increased, and the leading genre is currently rap music. While the casual relationship is debated, musical preference is related to substance misuse and other risky behaviors. There is a lack of studies examining rap music and references to specific types and forms of drugs. Objective: The present study seeks to broaden the understanding of the messages related to substance misuse within rap music over time. Method: A lyrical content evaluation of the top 25 most popular rap songs between 2006 and 2018 (n = 325) identifying references to alcohol, illicit, and prescription drug misuse. Results: 72% (n = 233) of popular rap songs contain references to one or more substances, with 947 references, which resulted in 63 references to drugs or alcohol after just one hour of listening. Further, 50% of songs included illicit drug references, including marijuana (38%), manufacturing or selling drugs (19%), cocaine or crack (17%), and MDMA (6%). Prescription drug misuse occurred in 20% of songs, including; prescription cold medication (13%), other types of opioids (4%), and various other prescriptions (e.g. Xanax & Adderall) (10%). Yearly trends indicate that alcohol lyrics are declining, illicit drug lyrics remain stable, and prescription drug lyrics increase. Conclusions/Importance: The rise in music consumption with rap music leading in popularity and 72% of songs celebrating drug usage is a concerning trend, especially as prescription drug misuse is rising in popularity within rap music. [ABSTRACT FROM AUTHOR]

Both clinical and street-based encounters with people who misuse drugs have led the authors to examine the relationship between misuse of drugs and narcissism. Widely accepted criteria for diagnosing Substance Use Disorder (SUD) suggest parallels between narcissistic traits (e.g. invulnerability to consequences and lack of empathy for others) and the characteristics of drug abusers. Because narcissism as a concept has a long and somewhat confusing history, we first reviewed its origins in the psychoanalytic tradition of psychiatry and its exegesis into current clinical concepts in order to arrive at a set of attributes that may be useful when applied to problems of drug abuse. This process required extensive review of the literature on narcissism and its interactions with the literature on drug abuse. This process led to an understanding that positive self-concept may exemplify a variety of socially beneficial narcissism, but that at the other end of narcissism's continuum of traits may be found exploitative and non-empathetic traits. Furthermore, the negative traits of narcissism, as they may arise in adolescence along with drug use, can support an individual's ongoing dependence on drugs, especially if narcissism and drug use persist into adulthood. Our investigation of narcissism and drug use revealed, through in-depth interviewing, that some drug users employ drugs and alcohol to feed their self-concepts of superiority over other people. Our findings suggest that treatment for drug abuse cannot proceed assuming that drug users have low self-concepts. Rather, their continued use of drugs may emanate from a narcissistic sense of superiority. [ABSTRACT FROM AUTHOR]

Background: Alcohol and drug misuse present significant public health concerns due to their high prevalence and deleterious outcomes. A growing body of research provides support for the role of difficulties regulating positive emotions in alcohol and drug misuse. However, research is needed to better understand for whom difficulties regulating positive emotions are most strongly associated with alcohol and drug misuse to inform assessment and treatment efforts. Objectives: The goal of the present study was to examine potential sociodemographic moderators (i.e. age, gender, ethnicity, race, income, and educational attainment) in the relations between difficulties regulating positive emotions and alcohol and drug misuse. Methods: Participants were 373 trauma-exposed adults (57.1% female, 75.8% White) recruited from the community. Results: Significant differences were identified across sociodemographic groups regarding difficulties regulating positive emotions (i.e. gender, ethnicity, race, and income) and alcohol use (i.e. gender). Moderation analyses revealed a significant interaction between difficulties regulating positive emotions and gender on drug misuse (b = 0.08, p <.001), such that the association was significant for females (b = 0.11, p <.001) but not males (b =.03, p =.05). Conclusions: Results suggest the importance of developing gender-sensitive recommendations for the assessment and treatment of substance misuse, and of incorporating techniques focused on addressing difficulties regulating positive emotions. [ABSTRACT FROM AUTHOR]

Background: Traumatic injury is one of the most common causes of mortality worldwide. Previous research suggests that alcohol and drug misuse can increase the risk of experiencing these injuries. Method: Data on all hospital admissions due to traumatic injury in the Detroit metropolitan area between 2006 and 2014 were obtained from the Michigan State Inpatient Database. Patients with no recorded substance misuse comorbidity were compared with those who had (a) alcohol misuse comorbidity only, (b) drug misuse comorbidity only, and (c) both alcohol and drug misuse comorbidities. Outcomes examined included in-hospital mortality, length of stay, and total cost of care. Results: Generalized linear modeling was used to examine the relationship between substance misuse comorbidities and each of the three outcomes. Lower mortality was related to drug and drug/alcohol misuse. Longer length of stay was related to alcohol, drug, and alcohol/drug misuse. Total costs were higher for patients with comorbid alcohol misuse, but lower for those with comorbid drug misuse. These patterns of results were not changed after controlling for differences in background demographics and injury characteristics. Discussion: Alcohol and drug misuse were highly prevalent in trauma patients, in comparison to estimate for the US population as a whole. The relationship between substance misuse comorbidity and outcomes among trauma patient is not straightforward. Substance misuse of all types was related to longer hospitalization, but its association with cost and mortality was mixed. Assessment of substance misuse background at intake may help optimize care for trauma patients. [ABSTRACT FROM AUTHOR]

Background: Positive emotions, such as gratitude has been found to be beneficial to both physical and mental well-being but so far, drug misuse research has yet to identify important emotive predictors related to drug use. Objectives: This study aimed to examine the relationship between gratitude and drug use among a group of drug misusers. It was hypothesized that greater dispositional gratitude was associated with lesser drug use through greater use of adaptive coping methods and lesser use of maladaptive coping methods. Methods: This study utilized a cross-sectional design to examine the relationship between gratitude, coping, and drug use among a sample of drug misusers (N = 105) at a drug rehabilitation center. Participants completed the gratitude questionnaire (GQ-6), the joy subscale of the Dispositional Positive Emotion Scale (DPES), the Brief COPE, and a questionnaire on their drug use. Data were collected in 2015. Results: Mediation analysis supported the hypothesis and found that adaptive coping mediated the relationship between gratitude and drug use. However, mediation was not found for maladaptive coping. Additional analysis found that adaptive coping as a mediator was not found for joy. Conclusion: Results suggested that gratitude has utility in reducing drug use through the use of more adaptive coping strategies and this relationship was not simply due to positive affect. Interventions targeting drug use behavior could consider introducing gratitude to increase adaptive coping abilities to reduce drug use. [ABSTRACT FROM AUTHOR]

Background: Community pharmacists frequently encounter patients at risk of medication misuse, diversion, and intentional overdose. However, few studies have examined the perspective of the pharmacist on the identification and management of these patients. Objective: To understand the perspective of community pharmacists on the dispensing of select medications commonly associated with misuse, diversion, and overdose. Methods: An online survey was disseminated by electronic mail to community pharmacists listed in the College of Pharmacists of Manitoba directory. The survey was open from July to September 2014. Descriptive statistics were used to describe demographic information of the pharmacist and practice setting, and pharmacists' perceptions on the dispensing of select medications. Results: A total of 82 community pharmacists completed the survey. Most pharmacists considered a one-month supply appropriate for a psychotropic agent; but a 7–10 day-supply was considered appropriate for an opioid for acute pain. Factors that aid pharmacist decisions on providing select medications to patients include familiarity with the patient, ease of access to medical history information, and ease of access to the prescribing physician. Only 10.3%, 16.2%, and 32.4% felt they have received adequate training on the management of patients at risk for suicide, drug diversion, and medication misuse, respectively. Conclusion: Findings from this study demonstrated a need for improved systems for managing patients at risk for medication misuse, diversion, and overdose. Strategies that warrant further attention for limiting the means of medication misuse include increased access to electronic medical records and providing additional continuing education support for community pharmacists. [ABSTRACT FROM AUTHOR]

Aims: The aim of the research was to identify the types of drugs currently being used by university students, their involvement in multiple drug misuse and drug combinations, and the consequences of drug misuse in terms of associated harms. Methods: The research was based on an email survey of all first- and second-year students registered as undergraduates at a university in south Wales during October 2012. Results: The results of the research showed that drug misuse on the university campus studied was widespread in terms of the types and patterns of drug misuse. The most troublesome findings concern the high levels of multiple drug use, the use of some of the most dangerous drugs (including crack and powder cocaine and heroin, as well as ketamine), and the list of recorded harms experienced as a result of drug misuse. Conclusions: The article concludes that little attention has been paid outside of the United States to drug use among university students or to interventions designed to prevent it. However, there are signs that government policy in the United Kingdom is beginning to pay attention to the specific problems of drug misuse among university students. [ABSTRACT FROM AUTHOR]

Anabolic-androgenic steroids (AAS) are used to enhance performance and appearance. The aim of this research was to assess the knowledge of AAS among Brazilian bodybuilders. The sample was comprised of 123 male participants between the ages of 18 and 50 years. Questionnaires were administered to bodybuilders from gyms in the district capital and in the rural area of Pernambuco, state of northeast of Brazil, in 2008. We analyzed the use and abuse of AAS from several different perspectives among the bodybuilders. For the participants in our study, enhanced appearance justifies the misuse of AAS. The study's limitations are noted. [ABSTRACT FROM AUTHOR]

Analyses were conducted to compare rates of employment before, during, and after employment at the therapeutic workplace, which is a novel employment-based treatment for drug misuse. Participants in two clinical trials attended the therapeutic workplace at higher rates than they worked before intake and six months after discharge. These data suggest that unemployed chronic drug misusers will attend work at higher rates at the therapeutic workplace than in the community when paid modest wages, and that the failure of chronic drug misusers to obtain employment in the community may not result from lack of interest in work. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate abuse/misuse of prescription and nonprescription drugs in community pharmacies in Jordan by random distribution of a structured questionnaire to 405 pharmacies (November 2005–January 2006). Data were analyzed using SPSS for windows (version 14.0). Most respondents (94.1%) suspected that some level of abuse/misuse occurred in their pharmacy, which was highest for decongestants, cough/cold preparations, benzodiazepines, and antibiotics. Abuse/misuse of prescription and nonprescription drugs is present in Jordan, but current methods for controlling the problem are ineffective, and better methods should be developed. The study's limitations are noted.. [ABSTRACT FROM AUTHOR]

Increase in recreational ketamine use may be a cause for concern. We aimed here at assessing, in a sample of ketamine misusers, concordance between the typical near-death experience (NDE) features and the on-drug psychoactive effects the subjects experienced. In 2003–2005, a sample of previous ketamine misusers recollecting a ketamine-related NDE were recruited through snowballing and screened with the means of the Greyson NDE Scale; 125 participants made an initial contact with the researcher and 50 reported a minimum score of seven at the “Greyson NDE Scale”. Interviewees were in the range 21–66 years old; 27 participants (54%) were educated at BA level, 18 (36%) had an MSc, and 5 (10%) a PhD. Eight (16%) interviewees had a definite religious background. An average lifetime ketamine intake of 140 occasions was reported by the interviewees, who typically presented with a polydrug, including cannabis and MDMA/ecstasy, misuse history. In 45 (90%) cases, the NDE occurred during the first few occasions of intake. Most frequent features of reported NDE states included: altered perception of time (90%), strong sense of detaching from own physical body (88%), and a sense of peace/joy (76% of subjects). Although results here described were elicited from a self-selected, nonrandomized, limited size sample of misusers, we suggest that recreational ketamine intake may be associated with occurrence of near-death related states. [ABSTRACT FROM AUTHOR]

The etiology of behavioral precursors to substance misuse and aggression is viewed from the perspective of a developmental, multifactorial model of complex disorders. Beginning at conception, genetic and environmental interactions have potential to produce a sequence of behavioral phenotypes during development that bias the trajectory toward high-risk outcomes. One pathway is theorized to emanate from a deviation in neurological development that predisposes children to affective and cognitive delays or impairments that, in turn, generate dysregulatory behaviors. The plasticity of these neurobiological systems is highly relevant to the prevention sciences; their functions are reliant upon environmental inputs and can be altered, for better or for worse, contingent upon the nature of the inputs. Thus, social contextual factors confer significant influence on the development of this neural network and behavioral outcomes by increasing risk for, or protecting1 against, dysregulatory outcomes. A well-designed intervention can exploit the brain's plasticity by targeting biological and social factors at sensitive time points to positively influence emergent neurobiological functions and related behaviors. Accordingly, prevention research is beginning to focus on perturbations in developmental neural plasticity during childhood that increase the likelihood of risky behaviors and may also moderate intervention effects on behavior. Given that the more complex features of neurobiological functions underlying drug misuse and aggression (e.g., executive cognitive function, coping skills, affect regulation) do not coalesce until early adulthood when prefrontal-limbic brain networks consolidate, it is critical that mechanisms underlying developmental risk factors are identified. An empirically driven prevention approach, thus, may benefit from consideration of (i) the type, effect, and developmental timing of the environmental impact on the brain, and (ii) the type and effect on brain function, and developmental timing of the intervention. This translational approach promises to eventually offer some direction for the design of effective interventions to prevent drug misuse and concomitant aggression. [ABSTRACT FROM AUTHOR]

The goal of the article is to provide information about polydrug abuse1 and drug misuse patterns in Sweden among women and men. The data has been taken from a 1998 national survey of “Heavy”/severe drug misuse in Sweden, project “MAX-98” (Olsson, Adamsson-Wahren, & Byqvist, 2001). The drug misusers were reported by various government agencies, including health services, social services, police, and correctional treatment facilities on a special form. One of the significant gender differences that emerged was that a greater percent of the women in the survey used and injected amphetamines, injected opiates, and used tranquilizers/sedatives, while a greater percent of the men smoked cannabis, smoked heroin, and misused alcohol. Furthermore, the most common combinations for both genders was amphetamines + cannabis, followed by amphetamines + heroin + cannabis. Alcohol played a large role for the narcotics users. Heroin as a primary drug has grown in the age groups under 35. The trends document that the use of ecstasy as well as chemical CNS-stimulating/hallucinogenic drugs has grown, that polydrug use has increased compared with earlier surveys, and that the methods of ingestion have changed. It is therefore more precise today to speak of different types of polydrug users than about users of exclusively one drug. 1The journal's style utilizes the category substance abuse as a diagnostic category. Substances are used or misused; living organisms are and can be abused. Editor's note. [ABSTRACT FROM AUTHOR]

Data are reported from drug diversion cases involving health care workers who were investigated by the Cincinnati Police Division Pharmaceutical Diversion Squad over an 11-year period. This type of information is rarely available because few U.S. police jurisdictions dedicate resources to prescription drug diversion surveillance. Data from 1992 through 2002 show that opioids were the drugs most commonly diverted by health care workers, followed by benzodiazepines. Nurses, nursing assistants, and medical assistants were involved in almost three quarters of all cases. Hospitals were the most common sources of complaint to police, followed by pharmacies. Health care professional associations are advised to promote greater awareness of drug misuse and dependence concerns among their memberships, and health care facilities that stock pharmaceuticals liable for misuse and diversion are advised to increase the security of their supplies. [ABSTRACT FROM AUTHOR]

The study investigates associations between attachment cognitions and depression symptoms in 71 15–25-year-olds, 26 of whom have eating disorders, and 20 of whom are drug misusers. Attachment cognitions were measured with the CaMir Q-sort, which provides indexes for secure, avoidant, and preoccupied attachment, as well as scores on 13 dimensions. The BDI-13 was used to measure depressive symptomatology. Consistent with the literature, BDI scores were associated with cognitions of preoccupied attachment. They were also related to cognitions of avoidant attachment, confirming Bowlby's theory on defensive exclusion. For participants with eating disorders, depressive symptomatology was related to preoccupation and parental interference, whereas for drug misusers, it was negatively related to security, preoccupation, parental support, and lack of parental concern. These findings help understand how attachment cognitions may participate in depressive symptomatology, namely in youth whose behavior problems may be associated with specific attachment experiences. [ABSTRACT FROM AUTHOR]

This article introduces the scope of the Special Issue. A variety of scientific disciplines are brought together to establish theoretical integration of the arenas of drug use, misuse, "abuse," and drug misuse prevention. Transdisciplinary scientific collaboration (TDSC) is utilized as a process of integration. Introductory comments regarding the strengths and limitations of TDSC are presented. Then, the relevance of genetics to substance misuse and substance misuse prevention is presented. Next, the relevance of cognition for prevention is discussed. Specifically, neurologically plausible distinctions in cognition and implicit cognition and their relevance for prevention are discussed. At a relatively molar social-level of analysis, social network theory, systems dynamic models, geographic information systems models, cultural psychology, and political science approaches to drug misuse and its prevention are introduced. The uses of both quantitative and qualitative statistical approaches to prevention are mentioned next. Finally, targeted prevention, bridging the efficacy-effectiveness gap, and a statement on over- coming disbalance round out the Special Issue. The bridges created will serve to propel drug misuse "prevention science" forward in the years to come. Advances in understanding etiological issues, translation to programs, and ecological fit of programming are desired results. [ABSTRACT FROM AUTHOR]

“Drug abuse” provides many unique challenges to the research community. Some of these involve fundamental epidemiologic issues, such as measuring the extent of the problem, identifying and assessing changes in patterns and trends, detecting emerging “drugs of abuse”, characterizing vulnerable populations and determining health and social consequences. A number of research methods are employed to address these issues. This paper describes one of these—a model in which ongoing surveillance of “drug abuse” is maintained through a network of community-based researchers, local officials, academics, and other interested and qualified members of the community. Timely, accurate, and cost-effective data can be generated through systematic collection and analysis of indirect indicators of “drug abuse” that are often routinely produced by a variety of community sources. This information, in turn, can be used to make informed public health policy decisions. The community-based network model has been implemented at the city, state, national, regional, and international levels, and a case is made that this type of program could be useful, as well, in understanding the dynamics of “drug abuse” in rural areas of the country. [Translations are provided in the International Abstracts Section of this issue.] [ABSTRACT FROM AUTHOR]

The present study sought to determine whether gender-specific differences existed in the perception of drug user treatment services delivered at a residential substance misuse treatment program operated by a large youth correctional agency in the western United States. Hypothesized gender differences in perceptions of treatment services and treatment-related needs were confirmed in a number of areas such as treatment engagement, counseling needs, and post-release concerns. Findings of this exploratory study underscore the need to consider gender-specific issues in correctional substance misuse treatment for young offenders. [ABSTRACT FROM AUTHOR]

In this article we describe the development and psychometric properties of a self-administered instrument for assessing drug-user treatment counselors' therapeutic approaches such as psychodynamic or interpersonal, cognitive-behavioral, family systems or dynamics, 12-step, and case management. We generated an initial pool of items corresponding to these five approaches and modified them based on expert ratings. We developed three sets of items. The first concerned the beliefs underlying each therapeutic approach. The second and third concerned the practices of each applicable approach within individual and group counseling, respectively. With the exception of case management, an approach that originated within social work and which is only applicable to individual counseling, the other four approaches are applicable, at least theoretically, to both individual and group counseling. Additionally, we included items that describe techniques used exclusively with groups (i.e., group techniques). Finally, we included some items that are not associated with any of the traditional approaches but which reflect the practical approach that drug-user treatment programs often take to both individual and group counseling (i.e., practical counseling). The initial instrument consisted of 17 subscales with a total of 76 items. This instrument was administered to 226 counselors from 45 drug-user treatment programs in Los Angeles County. Based on this data, we further refined these scales using confirmatory factor analysis to ensure both construct validity and discriminant validity. The final instrument consisted of 14 subscales with a total of 48 items. [ABSTRACT FROM AUTHOR]