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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]

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: 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.

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]

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.

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

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.

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]

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]

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.

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.

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]

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: 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]

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]

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]

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]

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: 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.

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]

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.

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]

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]

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.

Introduction: The North-Eastern, North-Western, and North-Central cities in Nigeria comprise of 19 states, each with its own governor. With over 400 ethnicities in the country, Northern Nigeria is home to many ethnic groups nearly half of whom are the Hausa-Fulani whose main religion is Islam. Practices in Northern Nigeria has favoured polygamy, early child marriage, and a lack of desire for western education while encouraging the strictly Islamic studies especially among the Hausa/Fulanis. Northern Nigeria is also known for its gender inequality and poverty. Prescription drug abuse has become more common in recent years even among women in Northern Nigeria. Objectives: This study's objectives include finding out the predicting factors to entry into prescription drug use among women in Northern Nigeria. Highlighting the causes of growing numbers in prescription drug abuse as well as recommending solutions in form of preventative measures. Methods: Eight articles were selected after being critically appraised for this study following a set of inclusion and exclusion criteria. For this mixed method Systematic Review (SR), a thematic analysis was used for the results and findings. Results: This research shows that some of the factors in the rise of prescription drug abuse among women in Northern Nigeria include: unemployment, insurgency due to the activities of violent extremist organization—Boko Haram—in the Northern region, as well as family dynamics which involves family history of drug misuse, early marriage, and a lack of education. Conclusion: Understanding the factors influencing women into drug use in Northern Nigeria can help end the cycle. This study suggests recommendations to prompt a decline in the rising numbers of prescription drug use among women in Northern Nigeria.

Copyright of Journal of Taibah University Medical Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To determine whether the rescheduling of gabapentinoids in England as Schedule 3 Controlled Substances in April 2019, changed prescribing behaviour for gabapentinoids by general practitioners. Methods: Data on the monthly number of prescription items and the monthly average dose per prescription item were analysed for the period April 2017 to April 2021 under three models: (i) a simple linear regression, (ii) a linear spline with a knot at April 2019, and (iii) a parallel slopes model with time before and after the rescheduling as a covariate. Best fit models were selected based on them having the lowest corrected Akaike's information criterion. Auto‐regressive integrated moving average (ARIMA) models were also generated. Results: For gabapentin, the best fit model for the number of prescription items was the simple linear model, and for the dose per prescription item it was the parallel slopes model. For pregabalin, the best fit model was the linear spline for the number of prescription items and the dose per prescription item. For all models, the interval estimates for the slopes were consistent with no change or no meaningful change in prescribing behaviour after April 2019. Forecasts from ARIMA models for gabapentin and pregabalin were consistent with no change in the number of prescription items per month. However, forecasts for the dose per prescription item for gabapentin or pregabalin did not fully capture the post‐April 2019 trajectories. Conclusion: The reclassification of gabapentinoids did not materially change the prescribing behaviour of these drugs by general practitioners in England. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Recent media reports commented about a possible issue of the misuse of antidiabetics related to molecules promoted as a weight-loss treatment in non-obese people. We evaluated here available pharmacovigilance misuse/abuse signals related to semaglutide, a glucagon-like peptide-1 (GLP-1) analogue, in comparison to other GLP-1 receptor agonists (albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, and tirzepatide) and the phentermine–topiramate combination. To acheieve that aim, we analyzed the Food and Drug Administration's FDA Adverse Events Reporting System (FAERS) dataset, performing a descriptive analysis of adverse event reports (AERs) and calculating related pharmacovigilance measures, including the reporting odds ratio (ROR) and the proportional reporting ratio (PRR). During January 2018–December 2022, a total of 31,542 AERs involving the selected molecules were submitted to FAERS; most involved dulaglutide (n = 11,858; 37.6%) and semaglutide (n = 8249; 26.1%). In comparing semaglutide vs. the remaining molecules, the respective PRR values of the AERs 'drug abuse', 'drug withdrawal syndrome', 'prescription drug used without a prescription', and 'intentional product use issue' were 4.05, 4.05, 3.60, and 1.80 (all < 0.01). The same comparisons of semaglutide vs. the phentermine–topiramate combination were not associated with any significant differences. To the best of our knowledge, this is the first study documenting the misuse/abuse potential of semaglutide in comparison with other GLP1 analogues and the phentermine–topiramate combination. The current findings will need to be confirmed by further empirical investigations to fully understand the safety profile of those molecules. [ABSTRACT FROM AUTHOR]

Background: Antibiotics are being used frequently in dental infection and this study focused on the knowledge and behavior on antibiotic use of dentistry patients to reveal major mistakes leading to drug misuse. Methods: This cross-sectional survey was conducted among Trakya University Faculty of Dentistry patients between March and June 2019. The data were collected using a questionnaire and analyzed using IBM SPSS Statistics 22 (IBM SPSS, Turkey) for statistical analysis. Chi-square test, Fisher's Exact test, Fisher Freeman Halton test, and Continuity (Yates) Correction were used for comparison of qualitative data and frequency. Significance was evaluated at the p

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. [ABSTRACT FROM AUTHOR]

Gabapentinoids (gabapentin and pregabalin) are widely used in clinical practice, but recent evidence indicates that they carry an increased risk of misuse. As healthcare professionals (HCPs) and policymakers plan different strategies to promote harm reduction, it is important to understand different interested party viewpoints. To explore prescriber, pharmacist, and drug policy expert (DPE) awareness, opinions, and experiences regarding gabapentinoid misuse. A qualitative description study using individual semi-structured virtual interviews was conducted between February and April 2021. Participants included prescribers (physicians, physician assistants [PA], or nurse practitioners [NP]) and pharmacists practicing in outpatient, ambulatory, or community-based healthcare settings; individuals with relevant drug policy expertise were also included. Qualtrics (Provo, Utah) and Zoom (San Jose, California) were used to facilitate quantitative (for initial screening and participant characteristics) and qualitative (interview) data collection. Data were coded and organized into themes in NVivo (QSR International; Burlington, Massachusetts) using thematic analysis steps. A total of 43 individuals participated in this study, including 16 (37.2%) pharmacists, 13 (30.2%) physicians, seven (16.3%) NPs, four (9.3%) DPEs, two (4.7%) pharmacist/DPEs, and one (2.3%) PA. Results were organized along four themes: (1) challenges/opportunities in gabapentinoid use; (2) gabapentinoid misuse awareness; (3) solutions to gabapentinoid misuse and (4) contributing barriers in pain management. Participants invoked different opinions in their consideration of gabapentinoid misuse, including the desire for harm reduction, the limitations of the current healthcare and insurance system, the lack of options for pain and substance use disorder treatment, and the influence of patient expectations. Gabapentinoid misuse was commonly framed in comparative fashion to ongoing concerns with opioids, and proposed solutions often focused less on regulatory control and more toward patient and HCP education and an overhaul of the health system approach to substance use and healthcare overall. [ABSTRACT FROM AUTHOR]

Introduction: Rational use of medicine (RUM) is critical for achieving therapeutic goals and avoiding unwanted effects. However, irrational medicine use is becoming a severe issue worldwide since it leads to increased medical costs and unwanted effects. Students as prospective professional nurses need to have knowledge that supports the rational use of medicine to ensure rational administration of the medicine for patients. Methods: This descriptive research was conducted to identify knowledge of rational use of medicine among nursing students of Faculty of Nursing Universitas Padjadjaran. Quantitative data was collected by asking respondents to fill out questionnaires. A total of 285 respondents had filled out an online research questionnaire (response rate=76.61%). The collected data were analyzed with descriptive analysis (frequency, percentage, and average). Result: The results of this study showed that there is some knowledge related to (RUM) which is not appropriate, such as assuming that over the counter medicines are safe to consume with prescribed medicines (53.3%); tablet medicines can be divided to be administered in child patients (57.9%). In addition, almost all respondents considered it unnecessary to be cautious in giving medication to pregnant and lactating mothers (41.1%) and the elderly (40.4%). Conclusion: Thus, nursing students are expected to gain RUM knowledge to obtain better RUM attitudes and behaviors in providing nursing interventions.

Based on assumptions of the Job Demands-Resources model, we investigated employees' willingness to use prescription drugs such as methylphenidate and modafinil for nonmedical purposes to enhance their cognitive functioning as a response to strain (i.e., perceived stress) that is induced by job demands (e.g., overtime, emotional demands, shift work, leadership responsibility). We also examined the direct and moderating effects of resources (e.g., emotional stability, social and instrumental social support) in this process. We utilized data from a representative survey of employees in Germany (N = 6454) encompassing various job demands and resources, levels of perceived stress, and willingness to use nonmedical drugs for performance enhancement purposes. By using Structural Equation Models, we found that job demands (such as overtime and emotional demands) and a scarcity of resources (such as emotional stability) increased strain, consequently directly and indirectly increasing the willingness to use prescription drugs for cognitive enhancement. Moreover, emotional stability reduced the effect of certain demands on strain. These results delivered new insights into mechanisms behind nonmedical prescription drug use that can be used to prevent such behaviour and potential negative health consequences. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Moral judgment is of critical importance in the work context because of its implicit or explicit omnipresence in a wide range of work- place practices. The moral aspects of actual behaviors, intentions, and consequences represent areas of deep preoccupation, as exemplified in current corporate social responsibility programs, yet there remain ongoing debates on the best understanding of how such aspects of morality (behaviors, intentions, and consequences) interact. The ADC Model of moral judgment integrates the theoretical insights of three major moral theories (virtue ethics, deontology, and consequentialism) into a single model, which explains how moral judgment occurs in parallel evaluation processes of three different components: the character of a person (Agent-component); their actions (Deed-component); and the consequences brought about in the situation (Consequences-component). The model offers the possibility of overcoming difficulties encountered by single or dual-component theories. Methods: We designed a 2 × 2 × 2-between-subjects design vignette experiment with a Germany-wide sample of employed respondents (N = 1,349) to test this model. Results: Results showed that the Deed-component affects willingness to cooperate in the work context, which is mediated via moral judgments. These effects also varied depending on the levels of the Agent- and Consequences- component. Discussion: Thereby, the results exemplify the usefulness of the ADC Model in the work context by showing how the distinct components of morality a􀀀ect moral judgment. [ABSTRACT FROM AUTHOR]

Tramadol and tapentadol, synthetic opioids commonly prescribed for moderate-to-severe pain, have a unique pharmacology that optimizes their analgesia and safety. However, they are not devoid of risks, presenting addictive, abuse, and dependence potential. While tramadol-reinforcing properties have been documented by various studies with human and animal models, including conditioned place preference (CPP) assays, no similar studies have been performed with tapentadol. In the present study, we performed CPP assays by intraperitoneally administering Wistar rats with a tramadol/tapentadol therapeutic dose. Animal permanence and the number of entries in the CPP compartments were recorded in the preconditioning phase and then 1 (T1), 7 (T7), and 14 (T14) days after conditioning. Both opioids induced a change in place preference (T1), suggesting that they have short-term reinforcing properties. However, only tramadol was associated with place preference retention (T7 and T14), with an increase in the number of entries in the opioid-paired compartment (T1 and T7), showing that it causes rewarding memory and incubation of craving. The results indicate that at therapeutic doses: (1) both drugs cause short-term rewarding effects and (2) as opposed to tramadol, tapentadol does not cause CPP retention, despite its higher central nervous system activity and stricter scheduling. [ABSTRACT FROM AUTHOR]

The Review of Drugs in two parts by Dame Carol Black (2020, 2021) has put new life into the case for properly resourcing substance misuse services in England and Wales. The Black Review has largely been accepted by the UK Government; Dame Carol's analysis and recommendations have been the catalyst for additional funding and a renewed policy focus upon enforcement, treatment and prevention of drug misuse. Nevertheless, the Review has been criticised for focussing upon low-harm recreational drugs, for lacking consideration of co-occurring alcohol and drug misuse, and for accepting the Government's restricted remit which excluded from consideration the harms of criminalisation and the 'war on drugs' (Transform Drugs, 2021). The following will summarise the Black Review, and the associated research and evidence. The article also attempts to elucidate key implications for probation, and the new opportunities for probation professionals to restore their 'fractured relationship' (Ball and Parker, 2022) with substance misuse colleagues. [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 Background Misuse of prescription stimulants (PS) has been reported among students to enhance academic performance in Flanders (Belgium). However, PS misuse among students in the French-speaking community is unknown. The main purpose of the study was to estimate the prevalence of medical use and misuse of PS by university students in the French-speaking community (Belgium), and to investigate the reasons and sources associated with PS misuse. Methods A cross-sectional online survey was performed in 2018. All university students 18 years and older were invited to participate and asked about PS use, including medical (i.e., used for therapeutic purposes) and nonmedical reasons and sources of PS. Results In total, 12 144 students participated in the survey (median age = 21 years, 65.5% female). The estimated prevalence of PS use was 6.9% (ever use) and 5.5% (past-year). Among ever users, 34.7% were classified as medical users and 65.3% as misusers. Lifetime prevalence of misuse was estimated at 4.5%. The most common reason for medical use was treatment of attention disorder (85.9%). Reasons for misuse were mainly to improve concentration (76.1%) or to stay awake and study longer (50.7%). Friends or acquaintances inside the student community and general practitioners were the main sources of PS for misuse (41.5% and 23.5%, respectively). Conclusions This study found that rates of misuse of PS in French-speaking universities in Belgium were in line with studies conducted in Flanders and Europe. Academic institutions can use these results to tailor their drug prevention campaigns.

This study aimed to estimate the prevalence of psychoactive substance use by adolescents from public schools. This is a cross-sectional study that used a random sample of adolescents from five public schools located in a municipality in the central-west region of the São Paulo Metropolitan Area, Brazil. Information on demographic, socioeconomic, and drug use was collected using self-report questionnaires. The sample consisted of 1,460 students, 716 (49%) males, aged 10-19 years (13.19±2.04 years). The prevalence of psychoactive substance use in the last month was 51% for analgesics; 48.8% for alcohol; 37.3% for tobacco; 30.8% for tranquilizers; 23.1% for marijuana; 22.6% for anabolic steroids; 21.6% for ecstasy; 15.3% for amphetamines/stimulants; 13.4% for phencyclidine; 12.9% for cocaine/crack; 12.6% for inhalants/solvents; 11.5% for opiates; 11.4% for hallucinogens; and 16.2% for other unclassified drugs. Elementary and middle school students were more likely to consume tobacco (OR = 2.306; 95%CI: 1.733-3.068; p < 0.001), and male students were more likely to consume any type of substance. We identified a high use of psychoactive substances among this study participants, with a higher prevalence among male students.

IntroductionMoral judgment is of critical importance in the work context because of its implicit or explicit omnipresence in a wide range of work-place practices. The moral aspects of actual behaviors, intentions, and consequences represent areas of deep preoccupation, as exemplified in current corporate social responsibility programs, yet there remain ongoing debates on the best understanding of how such aspects of morality (behaviors, intentions, and consequences) interact. The ADC Model of moral judgment integrates the theoretical insights of three major moral theories (virtue ethics, deontology, and consequentialism) into a single model, which explains how moral judgment occurs in parallel evaluation processes of three different components: the character of a person (Agent-component); their actions (Deed-component); and the consequences brought about in the situation (Consequences-component). The model offers the possibility of overcoming difficulties encountered by single or dual-component theories.MethodsWe designed a 2 × 2 × 2-between-subjects design vignette experiment with a Germany-wide sample of employed respondents (N = 1,349) to test this model.ResultsResults showed that the Deed-component affects willingness to cooperate in the work context, which is mediated via moral judgments. These effects also varied depending on the levels of the Agent- and Consequences-component.DiscussionThereby, the results exemplify the usefulness of the ADC Model in the work context by showing how the distinct components of morality affect moral judgment.

Background: Fatal and non-fatal events associated with drug misuse are skyrocketing in most United States jurisdictions, including Indiana. Historically, the role of the judiciary is to arrest, impose sanctions and protect society from harm. Adults arrested for drug abuse in Indiana can be sentenced to 1 of 17 correctional facilities. As an alternative, they may be eligible to participate in a problem-solving court (PSC) programme that refers individuals to treatment as a pretrial diversionary strategy. The aim of the study is to determine which interventions offered by PSCs and correctional facilities impact morbidity and mortality. The study began in 2019 and will end in 2023; therefore, the results in this manuscript are preliminary. Methods: The study cohort included two populations arrested for drug misuse: (1) adults sentenced to Indianan correctional facilities (1 January 2018 to 30 June 2021) and (2) adults participating in an Indiana PSC programme (1 January 2018 to 30 June 2021). The study used a mixed-methods design that integrated qualitative interviews of deputy wardens, PSC team members and service providers with the following quantitative datasets: sentencing information, emergency department visits, inpatient hospitalization admissions, prescription drug monitoring programme data and death records. The individuals will be followed at 2-week, 4-week, 6-month and 1-year intervals post-release. Difference-in-difference and time-toevent analyses will identify impactful interventions. A model will be created to show the effect of impactful interventions in Indiana counties that do not have PSCs. Results: Findings are preliminary. There is variability amongst correctional facilities regarding programme eligibility, provided services and provision of medication-assisted treatment. All correctional facilities were severely impacted by the COVID-19 pandemic. Conclusion: It is anticipated that the adoption of impactful interventions will lower opioid-related morbidity and mortality rates.

Background Paediatric patients are at high risk of medication errors and adverse drug events due to complex medical care. Objective To assess the impact of pharmacist medication review for paediatric patients. Setting A single-centre prospective observational study was performed over 33 months, from February 2018 to October 2020 in a French Hospital. Method Clinical pharmacists provided medication counselling at a hospital and conducted telephone follow-ups between 3 and 7 days after discharge of paediatric patients with chronic diseases for whom treatment was introduced or modified during hospitalisation or hospital consultations. Main outcome measures The incidence of drug-related problems (DRPs), the number and type of pharmacist intervention and paediatrician acceptance rates were assessed. Parents' understanding and drug-related needs were compared before and after medication review. Time to outpatient treatment and patient satisfaction were determined. Statistical analyses were performed in Excel. Results In total, 195 paediatric patients were included. Pharmacists identified 65 interventions, 95% of which were accepted. The most frequent DRPs included inappropriate drug administration (32.3%), herb–drug interactions (24.6%) and dose selection (17%). Parents' knowledge increased by 28% from baseline after pharmacist's medication counselling. Parents' drug-related needs concerning administration and side effects decreased by 67% and 49%, respectively, following the pharmacist's medication counselling. Most (75%) of the patients were able to get their treatment immediately after discharge. Conclusion Clinical pharmacists can improve medication safety for children during the discharge process or consultations, by reducing prescription errors, optimising administration, counselling patients or parents and helping to ensure care continuity. [ABSTRACT FROM AUTHOR]