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Q methodological studies often incorporate post-Q sort interviews to facilitate and enrich the interpretation of identified factors. This article describes a novel approach in which Q methodology and interviews comprise separate strands which are analyzed separately then converged for further analysis. The new approach is exemplified in a study exploring over-the-counter codeine misuse in Australia. The Q methodology and interview results are summarized, integrated and then discussed, including methodological challenges. This article contributes to scholarly literature by introducing and illustrating the applicability of using mixed methods integration to combine Q methodology and interviews; providing new insights into over-the-counter codeine misuse; and proposing 'unique contribution' as an alternative descriptor to the integration fit of 'silence'. [ABSTRACT FROM AUTHOR]

Background: Seventeen percent of individuals in the United States live with substance use disorder (SUD). Nursing curricula may not adequately address SUD, and stigma can impact care. Purpose: This project aimed to measure stigma toward people with SUD among nursing students. Methods: Surveys were administered to prelicensure nursing students. Stigma was measured using the Opening Minds Provider Attitudes Toward Opioid-Use Scale. Students were asked about personal experience with SUD and perceived adequacy of SUD-related curricula. Results: A total of 193 students participated. The mean stigma score was 31.35. Those with personal experience had lower stigma scores than those without ([95% CI 2.26-9.23]; P value = .0014). Most students (71.0%) desired to see content from individuals with lived experience incorporated into curriculum. Conclusion: Addressing stigma in SUD education is critical for improving future patient care. Nursing schools should consider incorporating stigma-reducing content, including perspectives from individuals with lived experiences, into SUD curricula. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance (AMR) is a complex global health threat driven by socio-demographic, economic, and systemic factors that contribute to drug misuse. In developing countries, inadequate healthcare, poor sanitation, and widespread poverty exacerbate this issue. Understanding these factors is crucial for designing targeted interventions. This study aims to (a) assess public awareness of AMR among residents of the Dodoma region, (b) identify common antimicrobial use practices, and (c) examine the influence of socio-economic factors on antimicrobial use and awareness. A cross-sectional study was conducted in the Dodoma region, where 450 participants from two districts were interviewed to collect data on AMR awareness and antimicrobial use practices. Chi-square tests were used to determine associations between categorical variables, while logistic regression was employed to identify factors influencing AMR awareness. Approximately 49% of the respondents were aware of AMR, and this variable was influenced by gender and education level, with females and respondents with higher education exhibiting greater knowledge of AMR. Drug misuse practices included sharing antimicrobials with family members (81.3%), self-medication (64.7%), and non-adherence to antimicrobial dosage (62.7%). Except for antimicrobial sharing, which was influenced by the level of income (with low income increasing the likelihood of sharing), the other antimicrobial use practices were not influenced by the socio-demographic and economic aspects of the respondents. The high rates of antimicrobial misuse practices suggest that increasing awareness of AMR and enhancing the availability of prompt healthcare services may play a crucial role in reducing these misuse behaviours. [ABSTRACT FROM AUTHOR]

Background: The increasing misuse of methamphetamine in South-eastern Nigeria has raised serious public health concerns. The study aimed to explore perceived devaluation, alienation, discrimination, and consequences of methamphetamine (Mkpurummiri) misuse among young people in South-eastern Nigeria. Methods: Using a cross-sectional study design, we purposively recruited 18 users of methamphetamine in the setting. Perceived devaluation, alienation, and discrimination were measured with the Illicit Drug Use Stigma Scale, while Substance misuse behaviors were measured using the Drug Abuse Screening Test. Results: Only 22.2% of study participants had ever received treatment for methamphetamine misuse. Perceived devaluation was prevalent, with 100% of study participants reporting that most people think someone who uses drugs is unreliable. For alienation, 94.4% of study participants reported avoiding people because they might be looked down upon for using drugs. Over half (58.8%) experienced discrimination in accessing medical care. The majority (72.2%) have experienced blackouts or flashbacks due to methamphetamine misuse. Conclusion: The rates of devaluation, alienation, and discrimination by young persons who misuse Mkpurummiri in southeastern Nigeria are high and with social and health consequences. Multilevel interventions must be utilized to mitigate stigma and discrimination and to provide treatment and rehabilitation for affected individuals. [ABSTRACT FROM AUTHOR]

The United States continues to suffer a drug overdose crisis that has resulted in over 100 000 deaths annually since 2021. Despite decades of attention, estimates of the prevalence of drug use at the spatiotemporal resolutions necessary for resource allocation and intervention evaluation are lacking. Current approaches for measuring the prevalence of drug use, such as population surveys, capture–recapture, and multiplier methods, have significant limitations. In a recent article, Santaella-Tenorio et al (Am J Epidemiol. 2024;193(7):959-967) used a novel joint bayesian spatiotemporal modeling approach to estimate the county-level prevalence of opioid misuse in New York State from 2007 to 2018 and identify significant intrastate variation. By leveraging 5 data sources and simultaneously modeling different opioid-related outcomes—such as numbers of deaths, emergency department visits, and treatment visits—they obtained policy-relevant insights into the prevalence of opioid misuse and opioid-related outcomes at high spatiotemporal resolutions. The study provides future researchers with a sophisticated modeling approach that will allow them to incorporate multiple data sources in a rigorous statistical framework. The limitations of the study reflect the constraints of the broader field and underscore the importance of enhancing current surveillance with better, newer, and more timely data that are both standardized and easily accessible to inform public health policies and interventions. This article is part of a Special Collection on Mental Health. [ABSTRACT FROM AUTHOR]

Purpose: Opioid misuse is increasingly recognized as a relevant problem among patients with cancer. However, the applicability of these concerns for patients with metastatic disease is complicated by shorter prognoses and greater symptom burden. This study aimed to investigate whether nonmedical opioid use (NMOU) was identified as contributing to opioid-related healthcare encounters among patients with metastatic cancer receiving long-term prescribing. Methods: The study included patients with stage IV cancer diagnosed from 2004–2017 in Alberta, Canada who 1) received long-term opioid prescribing and 2) experienced ≥ 1 hospitalization or emergency department visit relating to opioid overdose or use disorder. Records from visits to cancer centres and opioid-related hospital encounters were reviewed to identify any documentation of NMOU. Patient characteristics were compared between those with and without documented NMOU. Results: Charts of 46 patients were reviewed. Although NMOU contributed to opioid-related encounters, these events were often related to poorly controlled pain, declining functional status, and disease progression. NMOU behaviors were documented for 16 (35%) patients. The most common NMOU behaviour was overuse of prescribed medications, which was documented for 12 patients. For 7 patients, there were indications of use of opioids for psychological coping, including 3 encounters caused by intentional overdoses with suicidal intent. Patients with NMOU were significantly more likely to have a history of substance use and limited social support. Conclusion: Approximately 1-in-3 patients experiencing opioid-related hospitalizations/emergency department visits had indications of NMOU. Further psychosocial care and interdisciplinary pain management are warranted to improve safe prescribing for these patients. [ABSTRACT FROM AUTHOR]

Objectives: Widespread naloxone distribution is key to mitigating opioid-related morbidity, but stigma remains a barrier. Naloxone stigma among providers, emergency responders, and the public is well-documented and associated with treatment and policy preferences, but little is known about naloxone stigma among people who use drugs (PWUD), who may be overdose first responders. This study examines naloxone stigma, its correlates, and its association with stigma toward medication for opioid use disorder (MOUD) among PWUD. Methods: We recruited 293 individuals with a history of substance misuse from facilities that provide substance use and/or health care services (retained n = 195, 54% women, 75% White). Participants completed self-report measures, including the 5-item Naloxone-Related Risk Compensation Beliefs scale. Results: One in 5 respondents agreed with beliefs that access to naloxone leads to more opioid use and less treatment seeking and is "enabling." Those with nonopioid drug misuse, without prior overdose, and with fewer recovery attempts endorsed more naloxone stigma. Opioid misuse, prior overdose, and MOUD utilization were also inversely associated with MOUD stigma. There were no demographic differences in either stigma type. Naloxone stigma was positively associated with MOUD stigma in adjusted models. Conclusions: This is the first study to quantitatively examine naloxone stigma among PWUD. Findings emphasize the potential role of overdose education and naloxone distribution among those earlier in the substance use disorder course and who use nonopioid drugs. They support integrating MOUD stigma interventions into current overdose education and naloxone distribution targeted at PWUD to increase the acceptance and uptake of both medications. [ABSTRACT FROM AUTHOR]

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Abstract Antimicrobial resistance (AMR) is a complex global health threat driven by socio-demographic, economic, and systemic factors that contribute to drug misuse. In developing countries, inadequate healthcare, poor sanitation, and widespread poverty exacerbate this issue. Understanding these factors is crucial for designing targeted interventions. This study aims to (a) assess public awareness of AMR among residents of the Dodoma region, (b) identify common antimicrobial use practices, and (c) examine the influence of socio-economic factors on antimicrobial use and awareness. A cross-sectional study was conducted in the Dodoma region, where 450 participants from two districts were interviewed to collect data on AMR awareness and antimicrobial use practices. Chi-square tests were used to determine associations between categorical variables, while logistic regression was employed to identify factors influencing AMR awareness. Approximately 49% of the respondents were aware of AMR, and this variable was influenced by gender and education level, with females and respondents with higher education exhibiting greater knowledge of AMR. Drug misuse practices included sharing antimicrobials with family members (81.3%), self-medication (64.7%), and non-adherence to antimicrobial dosage (62.7%). Except for antimicrobial sharing, which was influenced by the level of income (with low income increasing the likelihood of sharing), the other antimicrobial use practices were not influenced by the socio-demographic and economic aspects of the respondents. The high rates of antimicrobial misuse practices suggest that increasing awareness of AMR and enhancing the availability of prompt healthcare services may play a crucial role in reducing these misuse behaviours.

OBJECTIVE: This paper aims to search for sociodemographic/ dental models predicting the self-care orientations in endodontic patients and to explore the effectiveness of the applied methods in relieving pain. MATERIALS AND METHOD: Patients with a history of endodontic pain presenting at the endodontic clinic of Gazi University were subjected to a survey. Their sociodemographic and clinical data were obtained. They were asked to select from a structured list whether they had used any self- or formal care methods. Pain relief was measured using a 5-point standard Likert scale. Statistical analyses were done using multivariate logistic regression, Wilcoxon and Kruskal-Wallis tests, and Benjamini-Hochberg correction. RESULTS: Among 356 patients, 90% applied self-care alone or in combination with formal care. Maximum pain level, age, and pattern of dental clinic attendance were the variables that predicted orientations to various subcategories of self-care behaviors, with the first two variables remaining statistically or marginally significant in all tested conditions (P < .05 or < .10). Among the home remedies, drinking or local application of alcohol and intraoral cold treatment by the patient provided significantly greater pain relief than the others (P = .001). Medication under the guidance of a professional was more effective than self-medication (P < .001; except for NSAIDs, which were similarly effective in both cases). CONCLUSION: Before applying to the dental school hospital, most of the patients used various self-care methods for relieving toothache. Maximum pain and age were the common covariates of various self-care orientations. Overall, formal care relieved pain better than self-care. Home remedies generally displayed little effectiveness.

Introduction: Although psychoactive medicines (PMed) are needed in several psychiatric conditions, their use and misuse bear risks. We aimed at estimating the prevalence of PMed use and misuse. Methods: Data on all PMed prescribed in 2017 and dispensed in community pharmacies of the Lisbon and Tagus Valley region of Portugal (ARSLVT) were extracted from ARSLVT medicines' dispensing database. For 21 PMed among prescription opioids, benzodiazepines and z-drugs (BZDR), antidepressants (AD) and anticonvulsants (AC), we estimated the number of users of each PMed, and assessed PMed misuse by a set of proxy indicators for studying this practice: chronic use (use of ≥180 DDD during the study period) of PMed intended for short-term treatments, concomitant use of several PMed, in particular if involving long-term (≥ 30 days) opioid analgesic (OA) use, and doctor shopping (patients consulting several physicians in order to have access to a quantity higher than intended by each prescriber). Data were analysed using descriptive statistics and hypothesis testing, and multivariate logistic regression was used to explore potential factors affecting long-term concomitant treatment of chronic OA with other PMed. Results: PMed use prevalence was 21.7%: 6.6% for OA, 12.7% for benzodiazepines (BZD), 5.3% for AD and 2.8% for AC. BZDR were mainly prescribed in primary care and OA in hospital outpatients. Chronic use of PMed was observed in 25%, especially with sertraline and buprenorphine for opioid use disorder (long-term treatment), and lorazepam (short-term treatment). About 56.6% of OA chronic users were long-term concurrent users with other PMed, mainly BZDR. Risk of abuse was low for BZDR, whilst four opioids had meaningful doctor shopping indicators – fentanyl, opioid use disorder buprenorphine, morphine and hydromorphone. Conclusions: BZD are the main PMed used in ARSLVT, often chronically, especially lorazepam. Prevalence of OA use is low, although with higher risk of misuse than BZDR. Concomitant use of several PMed is frequent. [ABSTRACT FROM AUTHOR]

Background: Methylphenidate (MPH), a central nervous system stimulant primarily prescribed for attention-deficit/hyperactivity disorder (ADHD), has seen increasing rates of misuse and abuse, particularly in patients with dual diagnosis (co-occurring psychiatric disorders and substance use disorders/SUDs). The heightened risk of dependence and adverse effects in these vulnerable populations warrants a systematic review to assess the prevalence and pattern of abuse/misuse of MPH among patients within this population and to understand potential risk factors, patterns of misuse, and outcomes, including the impact on psychiatric symptoms and overall mental health, the effects on SUD (e.g., exacerbation or mitigation of symptoms), and the incidence of adverse events and complications (e.g., cardiovascular issues, psychological effects). Methodology: A systematic review was conducted in August-September 2024 using both PubMed and Scopus databases. The following search strategy was used: TITLE-ABS-KEY (methylphenidate OR Ritalin OR Concerta) AND TITLE-ABS-KEY (abuse OR misuse OR dependency OR addiction) AND TITLE-ABS-KEY (dual diagnosis OR comorbid psychiatric disorder OR psychiatric disorder AND substance use disorder). The systematic review was structured in accordance with the PRISMA guidelines and identified studies were assessed by title/abstract and full text screening against eligibility criteria. Results: A total of 12 studies were selected for analysis after screening for relevance, quality, and adherence to inclusion criteria. Findings indicated that individuals with psychiatric disorders, particularly conduct disorder (N=593/1551 individuals), mood disorder (N=90/1551 individuals), anxiety disorder (N=66/1551 individuals), personality disorder (N=44/1551 individuals) and major depression disorder (N=40/1551 individuals), were more likely to misuse MPH. Co-occurring SUD, especially involving Alcohol Use Disorder (N=475/1551 individuals), Cannabis Use Disorder (N=371/1551 individuals), Nicotine Use Disorder (N=343/1551 individuals), Cocaine Use Disorder (N=68/1551 individuals), significantly elevated the risk. Misuse often involved higher doses than prescribed (N=84/1551 individuals) or using non-oral routes of administration (N=20/1551 individuals; e.g., snorting). Adverse outcomes included heightened risk of gastrointestinal events (N=201/1551 individuals), cardiovascular events (N=108/1551 individuals), psychosis (N=69/1551 individuals), and exacerbation of psychiatric symptoms (N=1082/1551 individuals). Conclusion: MPH misuse and abuse are significant concerns in patients with psychiatric disorders and SUD. Risk factors include impulsivity, history of substance abuse, and access to prescription stimulants. Integrated therapeutic approaches and stricter prescription monitoring are recommended to mitigate misuse risks. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024576724. [ABSTRACT FROM AUTHOR]

Introduction: Evidence suggests an increasing misuse of veterinary medicines by humans. This study aims to analyse Adverse Events (AEs) associated with selected veterinary products using the Food and Drug Administration Adverse Events Reporting System (FAERS). Methods: A descriptive pharmacovigilance analysis was conducted on AEs related to 21 drugs approved for human and/or animal use. Results: A total of 38,756 AEs, including 9566 fatalities, were identified. The United States reported the highest number of cases (13,532), followed by Canada (2869) and the United Kingdom (1400). Among the eight drugs licenced exclusively for animals, levamisole, pentobarbital, and xylazine were most frequently reported. Reports predominantly involved males (57%) from the 18–64 age group, with incidents related mainly to overdose, dependence, and multi-agent toxicities. Unmasking techniques revealed 'intentional overdose' as the primary reaction. Polysubstance use was evident in 90% of the drugs, with benzodiazepines/Z-drugs and opioids as common co-used classes. Conclusions: Veterinary medications are increasingly infiltrating the illicit drug market due to their pharmacological properties. This trend highlights the need for heightened vigilance and awareness to prevent further public health risks associated with the adulteration of illicit substances with veterinary products like xylazine and pentobarbital. [ABSTRACT FROM AUTHOR]

Background: illegal drugs significantly contribute to global health issues, with health complications often occurring not only in regular users with Substance Use Disorders (SUDs) but also in first-time and occasional users. Methods: this study examines five clinical cases from a public hospital in Ibiza, Spain, where patients presented with acute psychiatric symptoms due to recreational drug use. Results: Contrary to previous studies on SUDs, our patients typically had higher education levels and stable employment. Most of them used multiple substances, with cannabis, cocaine, and alcohol being the most frequently used. There was also a common occurrence of consuming drugs with uncertain contents. Upon admission, typical symptoms included aggression, hallucinations, mood swings, and disorientation in time and space. Conclusions: Our findings underscore the significant mental health risks posed by illicit drugs, even for individuals with no prior psychiatric history. Factors like the drug's potency, frequency and amount of use, past mental health issues, personality traits, and previous traumatic experiences might influence the onset of these symptoms. [ABSTRACT FROM AUTHOR]

Background: Piperazines, synthetic compounds known for their stimulant and hallucinogenic effects, have gained prominence among novel psychoactive substances (NPS) and are frequently associated with adverse psychiatric outcomes, including psychosis. Methods: A systematic review of the literature available up to 23 May 2024 was conducted, using the PubMed, Scopus, and Web of Science databases, in addition to the related gray literature, utilizing the following search strategy: “piperazines” AND (“psychosis” OR “hallucination” OR “delusion” OR “schizophrenia” OR “delusional” OR “schizoaffective”) NOT review NOT animal. Data collection adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research methods were registered with PROSPERO (CRD42024549204). Results: Out of a total of 4547 articles identified, 4 met the inclusion criteria. We observed an important relationship between piperazine abuse and the onset of acute psychotic episodes, marked by symptoms such as paranoia, auditory, and visual hallucinations. Conclusion: The complex polyreceptor action mechanism of piperazines may explain these psychopathological effects, similar to those observed with other NPS. Although studies confirm a link between piperazine use and psychosis, data on long-term outcomes are limited. Recovery is common following cessation and treatment. Further research into the effects of piperazine abuse and the development of specific treatment protocols for substance-induced psychosis is necessary.

This study aimed to understand how social determinants-the economic and social factors that affect health and well-being-are associated with self-reported and biological alcohol and other drug misuse in South Africa among women living with HIV. Logistic regression analyses were performed using baseline data from an implementation science trial conducted from 2015 to 2018 with 480 Black and Coloured women who were living with HIV and reported recent alcohol or other drug misuse. Educational attainment, type of housing, access to running water, food insecurity, and housing instability were examined. Women with higher education had reduced odds of any drug misuse-both biological (aOR: 0.53; 95% CI: 0.33-0.84) and self-reported (aOR: 0.37; 95% CI: 0.22-0.64). Women living in formal housing had increased odds of a positive alcohol screening test (aOR: 1.92; 95% CI: 1.16-3.18) and women with housing instability had increased odds of self-reported alcohol misuse-daily (aOR: 1.99; 95% CI: 1.18-3.35) and weekly (aOR:1.91; 95% CI: 1.19-3.07). Food insecurity was associated with reduced odds of self-reported alcohol misuse (aOR: 0.40; 95% CI: 0.25-0.64) and increased odds of self-reported drug misuse (aOR: 2.05; 95% CI: 1.16-3.61). These findings indicate the complexity of the relationship between social determinants and alcohol and other drug misuse, and may have implications for addressing social and structural determinants as part of multilevel interventions focused on reducing alcohol and other drug misuse among key populations of women in South Africa.

The COVID-19 pandemic has contributed to significant societal challenges, including increased substance misuse. The COVID stress syndrome is a constellation of interrelated processes that occur in response to pandemics, including danger/contamination fears, fears concerning economic consequences, xenophobia, compulsive checking/reassurance-seeking, and pandemic-related traumatic stress symptoms. In the present study, using a sample of 812 adults collected during the early stages of the COVID-19 pandemic in May 2020, we examined the relations between identified profiles of the COVID Stress Scales (CSS) and behavioral and cognitive aspects of substance misuse. Using profile analysis via multidimensional scaling (PAMS), we identified two core profiles of the CSS, which explained 60 % of the variance in participant responding: 1) High compulsive checking & Low xenophobia and 2) High xenophobia & Low danger/contamination. The first profile is consistent with the COVID stress syndrome, while the second profile aligns with the COVID disregard syndrome, which is a constellation of interrelated processes distinguished by a denial or downplaying of the seriousness of the COVID-19 pandemic and lack of perceived vulnerability to disease. Both profiles demonstrated significant positive correlations with drug and alcohol misuse, respectively. However, only the High xenophobia & Low danger/contamination profile demonstrated relations with cognitive aspects of substance misuse via positive and negative correlations with positive and negative expectancies of alcohol use, respectively. These findings provide further support for the relationship between the COVID stress syndrome and substance misuse and offer insight into how unique profiles of this syndrome may impact pandemic-related mental and public health interventions. • COVID stress syndrome is a set of processes occurring in response to pandemics. • The COVID stress scales (CSS) was developed to measure the COVID stress syndrome. • Two distinct profiles were identified characterizing participant responding on CSS. • Both profiles were related to substance abuse-related outcomes. • Relationship between COVID stress syndrome and substance use warrants more research. [ABSTRACT FROM AUTHOR]

Background: Work-related musculoskeletal disorders (WRMDs) are frequently observed among market vendors, and engaging in health risk behaviors can exacerbate these issues, leading to various health problems. Common health risk behaviors among market vendors include alcohol consumption and insufficient physical activity. However, there is currently a lack of research examining the prevalence of WRMDs and health risk behaviors among market vendors in Bangkok. Furthermore, the emerging trend of drug misuse within this group remains poorly understood. This study aims to explore the prevalence of muscle pain and flexibility issues and assess health risk behaviors, including alcohol consumption, inadequate exercise, and drug misuse, among market vendors. Methods: A mixed-method study was undertaken among 213 market vendors in Bangkok. Data collection utilized direct observation techniques, questionnaires, and muscle flexibility tests. Qualitative data were elucidated and showcased through textual descriptions and quotations. Quantitative data were analyzed using descriptive statistics to present numerical and percentage values. Results: Qualitative findings revealed that market vendors often engage in static muscular work and maintain awkward postures due to their job characteristics and workstation setups. Quantitatively, the right arm was the most common pain region (34.7%), followed by the left leg (31.0%), right leg (30.0%), and left arm (28.6%). Additionally, 64.3% of participants showed poor muscle flexibility. The study also found that 35% of market vendors resorted to alcohol and 11.7% to drug misuse to cope with fatigue and prevent adverse symptoms. Moreover, 68.5% of participants reported no regular exercise due to lack of time. Conclusion: The study highlights the prevalence of musculoskeletal issues among market vendors, largely attributed to static muscular work and awkward postures dictated by their job roles and workstation arrangements. The right arm emerged as the most commonly affected area, followed by the left leg, right leg, and left arm, with significant rates of reported pain. The research also points to a notable lack of muscle flexibility in a majority of vendors and a concerning tendency towards alcohol and drug misuse as coping mechanisms for fatigue and symptom management. Furthermore, a significant portion of the vendors do not participate in regular exercise, primarily due to time constraints. These findings can be used to implement health prevention programs within the market vendor group. [ABSTRACT FROM AUTHOR]

Drug misuse and overdoses (DMO) continue to rise in the United States and around the world. As the COVID-19 pandemic lockdown brought America to a standstill, the drug overdose epidemic took a sharp turn for the worse. Poorly built environments have been said to pose greater risks for substance use. The inequitable race and socioeconomic status distribution of the built environment might be tipping drug overdose and deaths toward minority populations. This review examined the contribution of the built environment to drug misuse and overdose to identify further research and policy needs. Databases like PubMed and Google Scholar were searched for peer-reviewed empirical studies in the English language published from 2010 to March 2021. MeSH search terms were built environment, overdose, drug, and drug overdose. Using the PRISMA flow diagram of article selection, title, and abstract screening plus text narrative synthesis of included articles were done. The built environment features making it more conducive to initiating and maintaining DMO included disinvestment, geographical context (urban versus rural), spatial characteristics of the built environment, easy access to drugs, low access to interventions, and built-environmentassociated environmental and social stressors. Built environment features play some roles in drug misuse problems. Policies and programs are needed that place the built environment at the centre of health, drug overdose prevention, and harm reduction, provide increased treatment facilities for addicted persons, ensure stricter opioid prescription measures, and address poverty as well as hopelessness due to disinvestment. [ABSTRACT FROM AUTHOR]

BackgroundMethylphenidate (MPH), a central nervous system stimulant primarily prescribed for attention-deficit/hyperactivity disorder (ADHD), has seen increasing rates of misuse and abuse, particularly in patients with dual diagnosis (co-occurring psychiatric disorders and substance use disorders/SUDs). The heightened risk of dependence and adverse effects in these vulnerable populations warrants a systematic review to assess the prevalence and pattern of abuse/misuse of MPH among patients within this population and to understand potential risk factors, patterns of misuse, and outcomes, including the impact on psychiatric symptoms and overall mental health, the effects on SUD (e.g., exacerbation or mitigation of symptoms), and the incidence of adverse events and complications (e.g., cardiovascular issues, psychological effects).MethodologyA systematic review was conducted in August-September 2024 using both PubMed and Scopus databases. The following search strategy was used: TITLE-ABS-KEY (methylphenidate OR Ritalin OR Concerta) AND TITLE-ABS-KEY (abuse OR misuse OR dependency OR addiction) AND TITLE-ABS-KEY (dual diagnosis OR comorbid psychiatric disorder OR psychiatric disorder AND substance use disorder). The systematic review was structured in accordance with the PRISMA guidelines and identified studies were assessed by title/abstract and full text screening against eligibility criteria.ResultsA total of 12 studies were selected for analysis after screening for relevance, quality, and adherence to inclusion criteria. Findings indicated that individuals with psychiatric disorders, particularly conduct disorder (N=593/1551 individuals), mood disorder (N=90/1551 individuals), anxiety disorder (N=66/1551 individuals), personality disorder (N=44/1551 individuals) and major depression disorder (N=40/1551 individuals), were more likely to misuse MPH. Co-occurring SUD, especially involving Alcohol Use Disorder (N=475/1551 individuals), Cannabis Use Disorder (N=371/1551 individuals), Nicotine Use Disorder (N=343/1551 individuals), Cocaine Use Disorder (N=68/1551 individuals), significantly elevated the risk. Misuse often involved higher doses than prescribed (N=84/1551 individuals) or using non-oral routes of administration (N=20/1551 individuals; e.g., snorting). Adverse outcomes included heightened risk of gastrointestinal events (N=201/1551 individuals), cardiovascular events (N=108/1551 individuals), psychosis (N=69/1551 individuals), and exacerbation of psychiatric symptoms (N=1082/1551 individuals).ConclusionMPH misuse and abuse are significant concerns in patients with psychiatric disorders and SUD. Risk factors include impulsivity, history of substance abuse, and access to prescription stimulants. Integrated therapeutic approaches and stricter prescription monitoring are recommended to mitigate misuse risks.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024576724.

Prescription opioid misuse has become one of the most frequent types of drug consumption among adolescents. Our objective was to report the prevalence, gender differences, and factors associated with prescription opioid misuse in school-aged adolescents. An observational study was conducted. We used the Spanish State Survey on Drug Use in Secondary Education 2018–2019, which covers drug use among students aged 14–18 years. Based on logistic multivariate regression models, we estimated the independent effect of each variable on prescription opioid misuse. Prescription opioid misuse was reported by 554 adolescents, with a greater prevalence in boys than girls (OR = 2.72). Misuse of tranquilizers, sedatives, sleeping pills, and other illicit psychoactive drugs (AOR = 9.32) are risk factors for prescription opioid misuse in both genders. Use of cannabis (AOR = 3.23) and cocaine (AOR = 2.28) is the predictor of prescription opioid misuse in females. There are differences in risk factors for prescription opioid misuse by gender. [ABSTRACT FROM AUTHOR]

Opioid medication is an integral part of pain management in palliative care. However, opioid therapy poses a risk of misuse and abuse of these drugs. Identifying this problem can be difficult due to the specificity of the patient population, as well as the complexity of the potential causes. One strategy to prevent this phenomenon is the early identification of patients at risk. Several tools exist to assess the risk of abnormalities during opioid therapy. Structured use of these tools in combination with careful clinical examination, regular medical visits, and laboratory tests can further reduce risk and increase the safety and efficacy of opioid treatment. In this article, we have presented the current state of knowledge on inappropriate use of opioid medications in palliative care, risk factors, and outcomes. In addition, we have provided examples of tools and solutions that should be implemented to minimise the risk of opioid medication inadequacies. [ABSTRACT FROM AUTHOR]

ObjectiveIncreased medication misuse over the last two decades has prompted extensive discussion about the lack of evidence-based and evidence-informed prevention education programs targeting the topic. As older adults are high utilizers of medications, this is an important population to reach with such educational programming. This study was designed to assess the change in knowledge and behavioral intentions of older adult participants after attending an educational session focused on safe medication use utilizing the Generation Rx Older Adult Toolkit (GROAT) resources.MethodsThe Generation Rx team at The Ohio State University College of Pharmacy (OSU COP) partnered with The Ohio State University Extension offices (OSU Extension) across the state of Ohio to provide GROAT educational programming in their communities. OSU Extension Educators were trained via the standardized virtual training program, Generation Rx Ambassadors. Program participants were surveyed immediately before and after the educational events. Pre- and post-survey data was then analyzed to assess knowledge gain and behavioral intentions about safe medication practices, as well as program perception and program satisfaction.ResultsProgramming occurred between May 2022 and September 2022. In total, OSU Extension Educators collectively engaged 843 individuals in a prevention education program utilizing the GROAT materials. After excluding participants under 50 years of age, there were 297 pre surveys and 245 post surveys included in the data analysis. Knowledge gains from pre- to post-survey showed a significant increase in correct responses in seven of the eight questions asked regarding safe medication practices. All five questions evaluating behavioral intentions demonstrated positive results after the programming (p

Background Work-related musculoskeletal disorders (WRMDs) are frequently observed among market vendors, and engaging in health risk behaviors can exacerbate these issues, leading to various health problems. Common health risk behaviors among market vendors include alcohol consumption and insufficient physical activity. However, there is currently a lack of research examining the prevalence of WRMDs and health risk behaviors among market vendors in Bangkok. Furthermore, the emerging trend of drug misuse within this group remains poorly understood. This study aims to explore the prevalence of muscle pain and flexibility issues and assess health risk behaviors, including alcohol consumption, inadequate exercise, and drug misuse, among market vendors. Methods A mixed-method study was undertaken among 213 market vendors in Bangkok. Data collection utilized direct observation techniques, questionnaires, and muscle flexibility tests. Qualitative data were elucidated and showcased through textual descriptions and quotations. Quantitative data were analyzed using descriptive statistics to present numerical and percentage values. Results Qualitative findings revealed that market vendors often engage in static muscular work and maintain awkward postures due to their job characteristics and workstation setups. Quantitatively, the right arm was the most common pain region (34.7%), followed by the left leg (31.0%), right leg (30.0%), and left arm (28.6%). Additionally, 64.3% of participants showed poor muscle flexibility. The study also found that 35% of market vendors resorted to alcohol and 11.7% to drug misuse to cope with fatigue and prevent adverse symptoms. Moreover, 68.5% of participants reported no regular exercise due to lack of time. Conclusion The study highlights the prevalence of musculoskeletal issues among market vendors, largely attributed to static muscular work and awkward postures dictated by their job roles and workstation arrangements. The right arm emerged as the most commonly affected area, followed by the left leg, right leg, and left arm, with significant rates of reported pain. The research also points to a notable lack of muscle flexibility in a majority of vendors and a concerning tendency towards alcohol and drug misuse as coping mechanisms for fatigue and symptom management. Furthermore, a significant portion of the vendors do not participate in regular exercise, primarily due to time constraints. These findings can be used to implement health prevention programs within the market vendor group.

Drug misuse and overdoses (DMO) continue to rise in the United States and around the world. As the COVID-19 pandemic lockdown brought America to a standstill, the drug overdose epidemic took a sharp turn for the worse. Poorly built environments have been said to pose greater risks for substance use. The inequitable race and socioeconomic status distribution of the built environment might be tipping drug overdose and deaths toward minority populations. This review examined the contribution of the built environment to drug misuse and overdose to identify further research and policy needs. Databases like PubMed and Google Scholar were searched for peer-reviewed empirical studies in the English language published from 2010 to March 2021. MeSH search terms were built environment, overdose, drug, and drug overdose. Using the PRISMA flow diagram of article selection, title, and abstract screening plus text narrative synthesis of included articles were done. The built environment features making it more conducive to initiating and maintaining DMO included disinvestment, geographical context (urban versus rural), spatial characteristics of the built environment, easy access to drugs, low access to interventions, and built-environment-associated environmental and social stressors. Built environment features play some roles in drug misuse problems. Policies and programs are needed that place the built environment at the centre of health, drug overdose prevention, and harm reduction, provide increased treatment facilities for addicted persons, ensure stricter opioid prescription measures, and address poverty as well as hopelessness due to disinvestment.

Abstract Background Monitoring self-reported suicide attempts (SA) with nationally representative surveys is important to initiate suicide prevention strategies. The aim of the study was to assess the prevalence of SA and compare deliberate self-harm, (DSH), mental health, drug misuse and traumas between SA and non-suicide attempters (NSA). Methods In this cross-sectional survey of a representative sample (N=1757) of the Norwegian population, we compared people with self-reported SA (n=54) to NSA (n=1703) regarding sociodemographic data, mental health problems, drug misuse and exposure to trauma. Results The prevalence of SA was 3.1 %. There was a higher proportion of welfare recipients and more deliberate self-harm, mental health problems, drug misuse and traumas in the SA group compared to NSA. Conclusion This national study confirms the association between suicide attempt and deliberate self-harm, mental health problems, drug misuse and traumas.

Introduction: Evidence suggests an increasing misuse of veterinary medicines by humans. This study aims to analyse Adverse Events (AEs) associated with selected veterinary products using the Food and Drug Administration Adverse Events Reporting System (FAERS). Methods: A descriptive pharmacovigilance analysis was conducted on AEs related to 21 drugs approved for human and/or animal use. Results: A total of 38,756 AEs, including 9566 fatalities, were identified. The United States reported the highest number of cases (13,532), followed by Canada (2869) and the United Kingdom (1400). Among the eight drugs licenced exclusively for animals, levamisole, pentobarbital, and xylazine were most frequently reported. Reports predominantly involved males (57%) from the 18–64 age group, with incidents related mainly to overdose, dependence, and multi-agent toxicities. Unmasking techniques revealed ‘intentional overdose’ as the primary reaction. Polysubstance use was evident in 90% of the drugs, with benzodiazepines/Z-drugs and opioids as common co-used classes. Conclusions: Veterinary medications are increasingly infiltrating the illicit drug market due to their pharmacological properties. This trend highlights the need for heightened vigilance and awareness to prevent further public health risks associated with the adulteration of illicit substances with veterinary products like xylazine and pentobarbital.

This study aims to analyze demographic, clinical, and biochemical markers of geriatric individuals admitted to emergency clinics due to poisoning to develop preventive public health projects for poisoning prevention. This study was a two-center study. Patients were categorized into accidental, suicide, and misuse groups, and the patient's clinical and laboratory data were compared. The study included individuals aged 65 and over admitted to hospital emergencies between June 1, 2021, and June 1, 2023. The mean age of the patients admitted with poisoning was 71.7±6.3 years, and the median was 70 (65-90). 69.2% (n=27) of the patients were female, and 30.8% (n=12) were male. Common causes included misuse and suicidal poisoning, drug ingestion, corrosive substance exposure, and pesticide poisoning, Antidepressants and analgesic drugs were the most common agents. There was a statistically significant difference between the mean age rank scores of patients categorized into 3 groups: accidental, suicidal, and misuse (H(3):11.186, p=0.004). The risk of being elderly in accidental poisoning and abuse (nonsuicide) patients was 1.203 times that of suicide patients. In other words, it was 20% higher (odds ratio=1.203, CI 95% [1.001-1.446], p=0.049). The mean rank score of troponin values differed significantly between the groups (p=0.027). The study highlights the high rate of poisoning among the elderly, especially women, and suggests preventive public health projects, increased public awareness, and strengthened health policies to improve their quality of life. [ABSTRACT FROM AUTHOR]

Background: Monitoring self-reported suicide attempts (SA) with nationally representative surveys is important to initiate suicide prevention strategies. The aim of the study was to assess the prevalence of SA and compare deliberate self-harm, (DSH), mental health, drug misuse and traumas between SA and non-suicide attempters (NSA). Methods: In this cross-sectional survey of a representative sample (N=1757) of the Norwegian population, we compared people with self-reported SA (n=54) to NSA (n=1703) regarding sociodemographic data, mental health problems, drug misuse and exposure to trauma. Results: The prevalence of SA was 3.1 %. There was a higher proportion of welfare recipients and more deliberate self-harm, mental health problems, drug misuse and traumas in the SA group compared to NSA. Conclusion: This national study confirms the association between suicide attempt and deliberate self-harm, mental health problems, drug misuse and traumas. [ABSTRACT FROM AUTHOR]

Background: The prescribing rate of opioids is increasing and is a main contributor to opioid misuse. Community pharmacists can help reduce opioid misuse rates by carrying out prescription and over-the-counter (OTC) opioid misuse prevention services. Understanding the barriers and facilitators to community pharmacists' involvement has the potential to improve these services. Objective: To review the literature on the barriers and facilitators of community pharmacists' involvement in prescription and OTC opioid misuse prevention. Methods: A systematic review of primary research was carried out in MEDLINE, Embase, Scopus, Web of Science, CINAHL, and APA PsycINFO from January 2022 to March 2022. Narrative synthesis underpinned by the COM-B model was used to analyse findings from the included articles. Studies were included if they used qualitative or mixed methods; published in English and focussed on OTC or prescription opioids. Results: Ten studies were included in the review. Barriers and facilitators were grouped into individual, environmental, and system-level factors. Based on the COM-B model, these factors were classified as capabilities (knowledge and skill), opportunities (e.g. relationship with prescribers, time), and motivation (pharmacists' attitude). Conclusion: Improving pharmacists' capabilities and opportunities might improve pharmacists' motivation to offer opioid misuse services. This could improve pharmacists' behaviour, that is, their role in preventing prescription and OTC opioid misuse. The findings of this review were based on information obtained from primary evidence from qualitative studies; However. further empirical work is needed to identify how pharmacists can be supported. [ABSTRACT FROM AUTHOR]

To investigate veterinarians' experience and perception of the risk of veterinary prescription medication (VPM) misuse and abuse by the public and veterinary professionals and to determine the clinical context in which respondent veterinarians prescribed certain VPMs. Anonymous online voluntary survey. A total of 361 of 7126 veterinarians registered as practicing in the UK, who provided e-mail contact details to the Royal College of Veterinary Surgeons Knowledge for participation in research. Respondents included general practitioners, with or without further qualifications, and European specialists, covering charity, private or academic small, large or mixed animal practice. The anonymous online survey, open from September to December 2021, posed 27 questions regarding personal experience and perception of VPM misuse or abuse, including which VPMs were considered most at risk of abuse by clients or veterinary staff. Thematic analysis was performed on free-text sections. The participation rate was 5% (361/7126), and the completion rate 60% (216/361 respondents). Of these, 88% of respondents somewhat agreed, agreed or strongly agreed that some VPMs were at risk of abuse. A third (29.9%; 107/358) had suspected an owner of taking VPMs, and one fifth (20.1%; 72/358) had suspected veterinary staff. Perceptions regarding the likelihood of public VPM abuse ranged from not suspecting a problem to having first-hand experience. Drugs considered most at risk of owner abuse were opioids, benzodiazepines and gabapentin, and those for veterinary staff were opioids, benzodiazepines and ketamine. Numerous 'red flags' prompting suspicion of VPM abuse were identified alongside ways of mitigating risk. Veterinarians in the UK reported varied experiences with, awareness of, and attitudes towards VPM abuse by the public and veterinary staff. Although not quantified, the UK veterinary industry could be a source of abusable drugs. [ABSTRACT FROM AUTHOR]

Objective: The use of prescription stimulants for cognitive enhancement by healthy university students, identified as the largest cohort of cognitive enhancer (CE) users, is of growing interest. The purpose of this study was to look at the understanding, perception, experience, and level of access of CEs among healthy university students in the United Arab Emirates (UAE). Methods: The study was conducted in six highly competitive university programmes. Semi-structured interviews were conducted with 18 university students to discuss their own experiences and those of their friends and peers regarding the use of prescription stimulants. In addition, semi-structured interviews were conducted with seven teaching faculty staff members (registered pharmacists and medical doctors) to explore their views on the use of CEs in their university. Results: Data were analysed thematically for the identification of themes and subthemes within the data using coding. It was found that, 'Adderall' was the most common prescribed CE drug and caffeine super strength pills were the most common non-prescribed CE drug, both reported to enhance concentration, motivation, and meet academic deadlines. Conclusions: It is expected that the findings of this study will be of interest to a wide range of services in UAE universities. This will enable them to raise awareness about the use of CEs among students. [ABSTRACT FROM AUTHOR]

With the rise of drug misuse among workers in recent years, preliminary research on potential risk factors in the workplace of single-type of drug misuse has been reported. This is the first study to examine cross-sectional associations of work stress, in terms of effort-reward imbalance, with multiple drug misuse (including any drug misuse, opioid misuse, sedatives misuse, cannabis misuse, and other drug misuse) during the past 12 months in a national sample of U.S. workers. Data of 2211 workers were derived from the nationally representative and population-based Midlife in the United States (MIDUS) study. Internal consistency reliability and factorial validity of a 17-item effort-reward imbalance measure were robust and satisfactory. After adjustment for relevant covariates, logistic regression analyses showed that workers experiencing effort-reward imbalance at work had significantly higher odds of any drug misuse (OR and 95% CI = 1.18 (1.03, 1.37)), especially opioid misuse (OR and 95% CI = 1.35 (1.07, 1.69)) and other drug misuse (OR and 95% CI = 1.36 (1.01, 1.83)). The findings suggest that a stressful work environment may act as a determinant of drug misuse, and further prospective evidence is needed.

Background: Improper prescription of the type, dose, and duration of antibiotics imposes a financial burden on the health system, can cause many side effects for the patient, and can lead to the emergence of drug-resistant bacteria. This study aimed to determine the profile of prescribing antibiotics in different wards of a hospital and compare it with references. Methods: This study was conducted on the recorded information of 342 patients in the emergency, infectious diseases, pulmonary, and surgical wards of Sayad Shirazi Hospital in Gorgan (north of Iran) in 2019-2020. The type, dose, and duration of the prescribed antibiotics were extracted from each patient's file and compared with references. The compatibility and inconsistency of the prescribed antibiotics were identified and analyzed accordingly. Results: A total of 13 types of antibiotics were prescribed for the patients. There was a 43.7% inconsistency in antibiotic prescription with the references. The most prescribed antibiotic was ceftriaxone (25.6%). Ceftriaxone (11.26%), followed by cefazolin (8.30%), had the most inconsistency in prescription. The most inconsistency in total was respectively observed in the pulmonary (47.9%), general surgery (44.8%), emergency (44.4%), and infectious diseases wards (40.6%). No significant difference was observed between the wards in terms of the total inconsistency of prescribed antibiotics with the references (P = 0.692). Conclusion: The most prescribed antibiotic was ceftriaxone. A high percentage of its prescriptions are without indication and are actually prescribed as empiric. Therefore, it is necessary to monitor the prescription of antibiotics in medical centers based on the indications and available evidence.

المخلص: أهداف البحث: العلاج بالاستنشاق هو العلاج المفضل لأمراض الرئة الانسدادي مثل الربو ومرض الانسداد الرئوي المزمن. ومع ذلك، فإن أقصى فائدة من العلاج تعتمد على الاستخدام الصحيح لأجهزة الاستنشاق. في هذه الدراسة، كان هدفنا الأساسي هو تقييم تقنيات استخدام أجهزة الاستنشاق لدى مرضى الربو ومرض الانسداد الرئوي المزمن من أجل تحديد الأخطاء. أيضا، قمنا بفحص تأثير المعلمات المحتملة على معدل إساءة الاستخدام. طرق البحث: تم تسجيل ما مجموعه 300 من مرضى الربو / مرض الانسداد الرئوي المزمن، الذين قدموا عيادات أمراض الصدر وطب الأسرة للمرضى الخارجيين في مستشفى ثالث يقع في أنقرة - تركيا ، في الدراسة. استخدمنا استطلاعًا وجهاً لوجه تضمن أسئلة حول الميزات الاجتماعية والديموغرافية والعلاج بالاستنشاق. بعد ذلك، طلبنا من المرضى توضيح كيفية استخدامهم لأجهزة الاستنشاق وتقييم تقنية الاستنشاق الخاصة بهم بسبب قوائم المراجعة. النتائج: من بين جميع المرضى، كان 70.2٪ يستخدمون أدوية الاستنشاق بشكل غير صحيح. كان معدل إساءة الاستخدام بين مستخدمي أجهزة الاستنشاق بالجرعات المقننة أعلى مقارنة بمستخدمي أجهزة الاستنشاق بالمسحوق الجاف (77.6٪ مقابل 64٪). عند مقارنة أجهزة الاستنشاق بالمسحوق الجاف فيما بينها، كانت معدلات إساءة الاستخدام أعلى بشكل ملحوظ في مستخدمي هانديهالر ومستخدمي أجهزة الاستنشاق ديسكس مقارنة بمستخدمي سانوهالر. تم العثور على الجنس ونوع المرض (الربو / مرض الانسداد الرئوي المزمن) ومدة استخدام جهاز الاستنشاق ومدة المرض ليس لها أي تأثير على سوء الاستخدام. ومع ذلك، فإن العمر المتقدم (> 60 سنة)، ومستوى التعليم الأدنى من المدرسة الثانوية، واستخدام أجهزة الاستنشاق بالجرعات المقننة كانت من العوامل المرتبطة بسوء الاستخدام. كان الخطأ الأكثر شيوعا هو ''عدم التنفس قبل الاستنشاق'' لجميع أنواع الأجهزة (بالنسبة إلى أجهزة الاستنشاق بالجرعات المقننة: 66.7٪ ، و أجهزة الاستنشاق بالمسحوق الجاف: 71.1-82.8٪). الاستنتاجات: تم العثور على معدل إساءة استخدام العقاقير المستنشقة لتكون عالية. من شأن تحديد العوامل المرتبطة بسوء الاستخدام أن يوفر عناصر لتنفيذ الإجراءات لتقليل معدلات فشل العلاج. Abstract: Objectives: Inhaled therapy is the treatment of choice for obstructive lung diseases such as asthma and chronic obstructive pulmonary disease (COPD). However, the maximum benefit from such therapy depends on the correct use of inhaler devices. In this study, our primary aim was to evaluate inhaler techniques in patients with asthma and COPD in order to identify common errors. In addition, we investigated the effect of various parameters on the rate of inhaler misuse. Methods: We enrolled a total of 300 asthma/COPD patients, who presented at the Chest Diseases and Family Medicine Outpatient Clinics of a tertiary hospital located in Ankara, Turkey. We used a face-to-face survey that included questions about sociodemographic features and inhaler therapy. Subsequently, we requested patients to demonstrate how they use their inhalers and assessed their inhalation technique according to checklists. Results: Of the 300 patients, 70.2% used their inhaler drugs incorrectly. The rate of misuse among metered dose inhaler (MDI) users was significantly higher than those using dry powder inhalers (DPIs) (77.6% vs 64%; p = 0.002). When DPI devices were analyzed, the rates of misuse were significantly higher in Handihaler users (p = 0.012) and Diskus inhaler users (p = 0.009) when compared to Sanohaler users. Gender, type of disease (asthma/COPD), duration of inhaler use, and duration of illness had no impact on the rate of misuse. However, an advanced age (>60 years old), a level of education lower than high school, and the use of MDI were all identified as factors associated with misuse. The most common mistake was ‘failing to breath out before inhalation’ for all types of devices (for MDI: 66.7%, and for DPI: 71.1–82.8%). Conclusions: The rate of inhaler drug misuse was high. The identification of factors associated with misuse could provide information to implement appropriate actions to reduce the rates of misuse.

Abstract Introduction The misuse of Pregabalin has been the subject of growing concern for several years. The effects sought are multiple and it is rarely taken as a single drug. It is most frequently used together with opioids, which may increase the risk of fatal overdose. In response to this emerging phenomenon, we seek to better understand the situation of misuse in Belgium and identify the people involved in it. Methodology A qualitative study using semi-structured interviews with 20 participants who misuse Pregabalin was conducted throughout the French-speaking region of Belgium between August 2021 and January 2022. Recruitment mostly took place in addictions centers, shelters for migrants and homeless persons and primary care centers. We then conducted a thematic analysis with the help of Nvivo software. Results A profile emerged, of young male users, immigrants, mainly first generation immigrants coming from North Africa. They had in common a challenging or even traumatic migration pathway and precarious living conditions in Belgian territory. Most of them had no stable income. They saw Pregabalin as enabling them to cope with their daily situation. All had psychiatric and/or somatic comorbidities for which they had apparently not recieved adequate medical care. This seemed to lead many of them to use Pregabalin as self-medication, for anxiety-depressive disorders and chronic pain, and it was sometimes initiated in their home country. Pregabalin was never used alone. Conclusion This study has highlighted a rare and insufficient documented profile of Pregabalin misuse: self-medication among a group of first generation immigrants, most of whom have no previous history of opioid-related disorders. Measures should be taken to improve access to health and social care for this population, considering all their biopsychosocial vulnerabilities.

The authors offer a response to the commentary by M. V. Kiang and M. J. Alexander on their study "Motivating better methods--and better data collection--for measuring the prevalence of drug misuse." Topics include the use of bayesian models to generate local prevalence of estimates of opioid misuse using multiple data sources providing indirect information, the importance of highlighting that available data can vary by state, and the need to develop methodology to better use available data.

This case report highlights the difficulties in diagnosing non-ketotic hyperglycinemia in a neonate with maternal substance abuse and neonatal abstinence syndrome. Despite initial treatment for neonatal abstinence syndrome, the neonate suffered sudden cardiopulmonary arrest and had elevated glycine levels in the serum, cerebrospinal fluid, and urine, suggestive of non-ketotic hyperglycinemia. However, immediate treatment failed to improve the newborn's condition, and the infant died of ventilator-associated pneumonia. The report underscores the importance of considering other differential diagnoses in infants with neonatal abstinence syndrome and highlights the challenges of diagnosing and treating rare genetic disorders, such as non-ketotic hyperglycinemia, in the neonatal period. [ABSTRACT FROM AUTHOR]

Internally displaced youth and adolescents may continue to suffer from displacement-associated trauma and stress many years after initial displacement. Hence, our study initially aimed to qualitatively explore how displaced youth and adolescents in Nigeria are coping with the trauma and stress associated with protracted displacement. However, through serendipity, results from the thematic analysis of semi-structured interviews from 22 displaced youths and nine professionals in Abuja revealed that in addition to some positive coping mechanisms, some displaced young males turn to drugs, while some young women turn to transactional sex and multiple sexual partners to deal with the impact of protracted displacement. This may lead to increased crime, morbidity, and mortality, thus requiring immediate intervention. This paper concluded by recommending that social workers help displaced youth and adolescents deal with their current stressors by advocating for the improvement of their living situation while also working with other professionals to intervene on the issue of drug misuse and unhealthy sexual behaviours through continuous education. [ABSTRACT FROM AUTHOR]

Background: Self-medication (SM) is a growing phenomenon worldwide that has recently been classified as one of the most serious public health problems. SM can result in an incorrect self-diagnosis, inappropriate treatment, potential adverse reactions, interactions, and the masking of more sinister disease. Objectives: To assess the prevalence of SM practices amongst healthcare professionals and the general population in Saudi Arabia and to identify the sociodemographic contributing factors to this practice. Methods: A total of 540 participants were enrolled in this study. Participants were asked to complete the study questionnaire comprising two sections to gather demographic information and to collect data regarding SM practice. Results: The prevalence of SM practice among the study participants was 78.6%, and it was the highest among the middle age groups of (21–40 years) 82% compared to the younger and older age groups. The observed prevalence was higher in the female participants (53.7%) and those who live alone. Type of education did not affect the attitude of SM (p = 0.374); however, level of education strongly affected the prevalence of the SM, with higher incidence among university graduates (p < 0.001). Analgesics with antipyretics properties were the most self-medicated drugs. Patients considering their illnesses minor was the main reason behind the high prevalence of this practice. Among healthcare professions the highest prevalence of SM was found among pharmacists (95%), followed by physicians, nurses, and other medical practitioners. Conclusion: The general population should be better educated and made conscious about the consequences, risks, and side effects of SM. Awareness campaigns may prove to be useful in this matter, allowing the patient to consider the appropriateness of this practice. Individuals in the age group of 21–40 years, females, and those who live alone should be considered priority target populations in the design and implementation of SM awareness projects. [ABSTRACT FROM AUTHOR]

BACKGROUND: The world has faced an unprecedented challenge since COVID-19 emerged as a pandemic, which has led to quarantine and disruptions in drug services. During the pandemic, drug use habits and availability changed, causing a shift in behaviors and, in turn, medicine misuse. In Iraq, this is a major problem because many medicines can be easily obtained. OBJECTIVE: The study aims to describe the pattern of dispensing medications during the pandemic and to evaluate the biochemical and pathological consequences. METHOD: The analytical, observational, cross-sectional study was performed via a compiled questionnaire for 400 random pharmacists, and the analysis and interpretation of the biochemical changes and medical reports. RESULTS: Results revealed that dispensing of medications since the COVID-19 outbreak has increased by 74%, and the demand for medicines seems higher than required in comparison to the periods before the pandemic, while 60% of the dispensed medicines were taken just in case needed. In addition, the availability of medicines decreased by 61%, and the dispensing of common medicines increased due to the belief in their prophylactic action. Several biochemical abnormalities and pathological consequences were recorded due to the irrational use of medicines, and the highest percentage (12%) was seen in hepatic and liver enzymatic dysfunction and 8% for the endocrine and hormonal abnormalities. CONCLUSION: It can be concluded that most of the dispensed medicines were not used on a therapeutic or scientific basis during the pandemic. [ABSTRACT FROM AUTHOR]

Paracetamol or acetaminophen is a medicine widely used to treat pain. When consumed inappropriately, this drug can cause harm to the health of its users. The present study aimed to carry out a review of the scientific literature with the aim of elucidating the possible complications of the indiscriminate use of paracetamol. To carry out this research, searches were carried out in the MEDLINE, EMBASE and LILACS databases. After the article selection process, nine studies were included to compose the present review. The results of the studies analyzed indicate a greater risk of paracetamol poisoning in patients with a history of substance abuse, such as alcohol and benzodiazepines, and psychiatric problems; The main complications encountered are acute renal failure and drug-induced fulminant hepatitis. [ABSTRACT FROM AUTHOR]

How does knowing another team member is cognitively impaired or enhanced affect people's motivation to contribute to the team's performance? Building on the Effects of Grouping on Impairments and Enhancements (GIE) framework, we conducted two between‐subjects experiments (Ntotal = 2,352) with participants from a representative, nationwide sample of the working population in Germany. We found that another group member's impairment (sleep deprivation) and enhancement (taking enhancement drugs) lowered participants' intentions to contribute to the team's performance. These effects were mediated by lowered perceived competence (enhancement and impairment) and warmth (only enhancement) of the other group member. The reason for being impaired or enhanced (altruistic vs. egoistic reason) moderated the indirect effect of the impairment on intended effort via warmth. Our results illustrate that people's work motivation is influenced by the psychophysiological states of other group members. Hence, the enhancement of one group member can have the paradoxical effect of impairing the performance of another. [ABSTRACT FROM AUTHOR]

Introduction: Second-generation antipsychotics (SGA) are associated with misuse potential; however, there are limited data describing the prevalence and characteristics of this misuse. This study was conducted to identify and describe quetiapine and olanzapine misuse among US adults. Methods: This cross-sectional survey questionnaire was conducted online using Qualtrics research panel aggregator service to identify a quota-based sample of respondents constructed to mimic the general US population aged 18 to 59 years, with regards to gender, geographic region, ethnicity, income, and education level. Misuse was defined as using quetiapine or olanzapine for treatment outside of medical recommendations, for reasons other than a diagnosed medical condition, or obtaining without a prescription. A logistic regression was used to identify factors associated with SGA misuse, incorporating relevant covariates. Results: Among 1843 total respondents, 229 had a history of quetiapine or olanzapine use. Misuse prevalence was estimated to be 6.3% (95% CI: 5.2, 7.5%). Although most respondents (?70%) using quetiapine or olanzapine reported doing so to treat a diagnosed medical condition, those misusing them most commonly did so because prescribed medications failed to relieve their symptoms. Misuse was commonly reported (?50%) concomitantly with opioids, benzodiazepines, or alcohol. Factors significantly associated with quetiapine or olanzapine misuse included employment (OR = 4.64), previous substance use disorder treatment (OR = 2.48), and having riskier attitudes toward medication misuse (OR = 1.23). Discussion: Misuse of quetiapine and olanzapine, while fairly limited in prevalence, appears to be primarily associated with under-treatment of existing medical conditions.

BackgroundSelf-medication (SM) is a global public health concern, particularly prevalent in developing nations. It involves the consumption of drugs without professional guidance, encompassing both over-the-counter and prescription medicines. Responsible SM can alleviate healthcare burdens, reduce costs, and empower individuals to manage minor ailments independently. However, improper SM practices can lead to adverse effects, contribute to antimicrobial resistance, and pose various health risks. This study aimed to evaluate the prevalence of SM and related practices of storing medications among students at Lira University, located in Lira City West Division, Northern Uganda.MethodsThis study adopted a quantitative cross-sectional design, focusing on students from various faculties. The sample size comprised 422 students, determined using the Kish Leslie formula. Data collection involved the administration of self-administered questionnaires, and subsequent data analysis was performed using SPSS version 25.ResultsThe study involved participants from Lira University, primarily women (51.2%) with an average age of 23.82. A majority were Christians (59.7%) and single (87.9%). Most were from the Faculty of Health Sciences (63.7%), with third-year students being the largest group (48.3%). Regarding SM, 74.2% practiced SM, with antibiotics (69.2%) and tablets (69.2%) being commonly self-administered. In terms of medication storage, 93.4% kept medicines at home, mostly in cupboards (76.5%), but many were unsure about proper storage practices. Participants exhibited good knowledge of SM's risks and measures to reduce them. There was a significant association between the faculty of study and SM practices (p = 0.015), while other demographic factors showed no significant associations.ConclusionThis study sheds light on the prevalent SM practices among students at Lira University in Northern Uganda. Notably, antibiotics were frequently self-medicated, raising concerns about antibiotic resistance. Additionally, medication storage practices emphasize the need for proper education on storage guidelines. However, the participants exhibited good knowledge of the risks associated with SM, suggesting the potential for effective awareness campaigns. The study recommends targeted health education programs, stricter regulations on medication sales, improved healthcare access, proper medication disposal, further research on the factors driving SM, collaborative efforts, and monitoring of antibiotic use to address this public health issue effectively.

Objective: To investigate the demographic characteristics, substance use, and self‐rated health of people entering treatment in New South Wales public health services for alcohol, amphetamine‐type stimulants, cannabis, cocaine, or opioids use, by principal drug of concern. Design: Baseline findings of a cohort study; analysis of data in patient electronic medical records and NSW minimum data set for drug and alcohol treatment services. Setting, participants: People completing initial Australian Treatment Outcomes Profile (ATOP) assessments on entry to publicly funded alcohol and other drug treatment services in six NSW local health districts/networks, 1 July 2016 – 30 June 2019. Main outcome measures: Socio‐demographic characteristics, and substance use and self‐rated health (psychological, physical, quality of life) during preceding 28 days, by principal drug of concern. Results: Of 14 087 people included in our analysis, the principal drug of concern was alcohol for 6051 people (43%), opioids for 3158 (22%), amphetamine‐type stimulants for 2534 (18%), cannabis for 2098 (15%), and cocaine for 246 (2%). Most people commencing treatment were male (9373, 66.5%), aged 20–39 years (7846, 50.4%), and were born in Australia (10 934, 86.7%). Polysubstance use was frequently reported, particularly by people for whom opioids or amphetamine‐type stimulants were the principal drugs of concern. Large proportions used tobacco daily (53–82%, by principal drug of concern group) and reported poor psychological health (47–59%), poor physical health (32–44%), or poor quality of life (43–52%). Conclusions: The prevalence of social disadvantage and poor health is high among people seeking assistance with alcohol, amphetamine‐type stimulants, cannabis, cocaine, or opioids use problems. Given the differences in these characteristics by principal drug of concern, health services should collect comprehensive patient information during assessment to facilitate more holistic, tailored, and person‐centred care. [ABSTRACT FROM AUTHOR]

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