Search

Dear Dr. Harvey This letter to the editor responds to recent papers published by the Journal of Loss and Trauma about COVID-19 impact on university student fear, mental health and substance use (Ka...

INTRODUCTION: Schizophrenia, although a debilitating mental illness, greatly affects individuals physical health as well. One of the leading somatic comorbidities associated with schizophrenia is cardiovascular disease, which has been estimated to be one of the leading causes of excess mortality in patients diagnosed with schizophrenia. Although the shared susceptibility to schizophrenia and cardiovascular disease is well established, the mechanisms linking these two disorders are not well understood. Genetic studies have hinted toward shared lipid metabolism abnormalities co-occurring in the two disorders, while lipid compounds have emerged as prognostic markers for cardiovascular disease. In particular, three ceramide species in the blood plasma, Cer(d18:1/16:0), Cer(d18:1/18:0), and Cer(d18:1/24:1), have been robustly linked to the latter disorder. AIM: We aimed to assess the differences in abundances of Cer(d18:1/16:0), Cer(d18:1/18:0), and Cer(d18:1/24:1) in the blood plasma of schizophrenia patients compared to healthy controls. METHODS: We measured the abundances of Cer(d18:1/16:0), Cer(d18:1/18:0), and Cer(d18:1/24:1) in a cohort of 82 patients with schizophrenia and 138 controls without a psychiatric diagnosis and validated the results using an independent cohort of 26 patients with schizophrenia, 55 control individuals, and 19 patients experiencing a first psychotic episode. RESULTS: We found significant alterations for all three ceramide species Cer(d18:1/16:0), Cer(d18:1/18:0), and Cer(d18:1/24:1) and a particularly strong difference in concentrations between psychiatric patients and controls for the ceramide species Cer(d18:1/18:0). CONCLUSIONS: The alteration of Cer(d18:1/16:0), Cer(d18:1/18:0), and Cer(d18:1/24:1) levels in the blood plasma might be a manifestation of metabolic abnormalities common to both schizophrenia and cardiovascular disease.

Dear EditorThis letter to the editor responds to the recently published paper in the Journal of Loss and Trauma about COVID-19’s impact on Russian university student fear, mental health, and substa...

Dear EditorThis letter to the editor responds to recently published papers in the Journal of Loss and Trauma about the COVID-19 impact on student fear, mental health, and substance use (Isralowitz ...

Aim Schizophrenia manifests differently in women and men. This disease starts at a young age, leads to disability at working age. The aim of our work was to study sex differences, association between social factors and different parameters of the clinical picture and the course of the disease. Methods This study was performed using population of Russian patients (men: 345, women: 310). Patients were examined using DSM-V, Bush-Francis catatonia rating scale (BFCRS), Positive and Negative Syndrome Scale (PANSS), 4-Items Negative Symptoms Assessment (NSA-4) and Frontal Assessment Battery (FAB). Results Sex differences were mainly shown through negative symptoms, which were more severe in male patients. Men were shown to experience a decrease in social functioning and earlier age of onset. A positive family history further influenced negative symptoms and age of onset. When comparing scores before and after inpatient treatment (4 weeks), sex differences were not so pronounced. Female patients and patients with high levels of education, no conflictual relationship with family and active labour activity showed a later age of onset of the prodromal events and manifestation age. The decrease in the number of social contacts correlated with lower age of disability. The association between social factors and the severity of psychotic symptoms was shown across DSM-V, PANSS, NSA-4 and FAB, but not for BFCRS. Social factors were associated with negative symptoms of schizophrenia, but not with positive. Conclusion For successful treatment of patients with schizophrenia, the discussed factors must be considered and schizophrenia treatment methods should be primarily aimed at improving social functioning.

COVID-19 is a major source of fear, stress, and anxiety as well as a major factor impacting the health and wellbeing of people worldwide. The present study builds on the recently developed "Fear of COVID-19 Scale" (Ahorsu et al., In International Journal of Mental Health and Addiction, 10.1007/s11469-020-00270-8, 2020). The sample comprised of 850 participants, male and female young adults from Russia and Belarus. The majority of survey participants are university students and graduates. Females, students, and others from Russia report higher levels of COVID-19-related fear than those from Belarus. Respondents from Russia and Belarus report less fear than people from Iran who were surveyed earlier. The scale used for the present survey evidenced a good Cronbach's Alpha measure of internal consistency or reliability (0.809). Clearly, further research is needed across locations and over time about the nature and extent of fear caused by COVID 19. Overall, the FCV-19S appears to be a valuable and brief instrument that may provide useful information for intervention and policy purposes to migrate fear and problem behavior linked to infectious disease outbreaks.

Medical and allied health sciences professionals are increasingly dealing with clients who use cannabis for medical and recreational purposes. Yet, university curricula in many countries do not provide education for students and professionals in medicine and allied health fields including psychology about medical cannabis (MC) use. This study compares the attitudes and beliefs toward medical cannabis among psychology students at universities in Malta and Russia. Data were collected through an online survey for Maltese students and a pen-and-paper survey for Russian students. The present study did not evidence any difference based on gender. However, students who reported personal cannabis use, regardless of country status, were more likely to recommend MC for patient treatment and believe cannabis use does not pose serious physical or mental health risks. Significant differences among the students from Malta and Russia may be attributed to the legal standing of MC in the countries involved. However, a key finding from all students is the dearth of education about cannabis for health-related conditions and the need for curricula based on evidence-based research for informed decision-making.

Depression is a serious mental disorder that affects more than 300 million people worldwide. Due to the lack of effective treatment methods, the pathogenesis of depression is necessary to study in order to understand its development and find new therapies. The review describes the main mechanisms of depression, including the monoamine hypothesis, impairment of the hipotalamic-pituitary-adrenal axis, decreased production of neurotropic factors, and neuroinflammation. Genetic correlations, gene polymorphisms, and epigenetic mechanisms are also considered. Common and different features of the etiology are analyzed for depression and depressive conditions associated with other pathologies (schizophrenia, Parkinson disease, and Alzheimer's disease). Modern experimental methods used to investigate the molecular mechanisms of depressive conditions are described with a focus on gene knockouts in laboratory animals and the CRISPR/Cas technology. Consideration is given to optogenetic and chemogenetic methods and analyses of genetic polymorphisms and their combinations. The data may provide for a better integral understanding of the modern ideas about the pathogenesis of depression as an isolated or comorbid disorder and the prospects in studying the mechanisms of depressive conditions.

Dear Dr. Harvey, In July 2020 a Journal of Loss and Trauma letter to the editor was published titled “Fear, Depression, Substance Misuse and Related Conditions among Multi-National Medical Students...

Dear Dr. Harvey,The Ben Gurion University of the Negev—Regional Alcohol and Drug Abuse Research Center (Israel) cooperates with Russian Federation colleagues to research mental health and substance...

Objectives: To examine attitudes and beliefs about medical cannabis (MC), and specifically about its application for pain management, across medical students in Israel and Thailand. Design: Cross-sectional survey which measured attitudes and beliefs about MC. Participants were additionally asked to rate the perceived efficacy of MC for different medical conditions that are related to pain (arthritis, chronic pain, fibromyalgia and multiple sclerosis). Pearson's Chi-squared test was used to compare between students from the participating universities. Results: 430 medical students participated, 37.9 % (n = 163) from Israel and 62.1 % (n = 267) from Thailand. Personal cannabis use was reported by 55.6 % of the Israeli and only by 6.9 % of the Thai students (p < .001). Israeli secular students, compared to those from Thailand, were more likely to recommend MC for patient treatment, less concerned about serious physical and mental health risks, and more inclined to support legalization of recreational cannabis. Israeli students reported more permissive attitudes toward MC, but reported feeling less prepared to answer patient/client questions about MC than their Thai counterparts. Conclusions: The findings of this study accentuate the need for curriculum designed around MC use to promote students' preparedness to serve patients in pain or with other medical conditions that may benefit from MC use.

We investigated the associations of DRD3 rs6280, HTR1A rs6295, BDNF rs6265, SCL6A4 rs16965628, and 5HT2A rs7322347 with schizophrenia in a case–control study, and associations of these genetic variants with several clinical features. We also investigated markers of inflammatory response (C-reactive protein, IL-2, IL-6, IL-10), the activity of leukocytic elastase (LE) and α1-proteinase inhibitor (a1-PI), antibodies to S100B and myelin basic protein (MBP) in schizophrenia. Clinical symptoms were assessed on three scales: Positive and Negative Syndrome Scale, The Bush – Francis Catatonia Rating Scale and Frontal Assessment Battery. All SNPs were typed using predesigned TaqMan SNP genotyping assays. The biomarkers related to the immune system were routinely tested using ELISA kits. The association with schizophrenia was found for DRD3 rs6280 (p = 0.05) and HTR2A rs7322347 (p = 0.0013). We found differences between groups by parameters of LE and a1-PI and LE/a1-PI (p < 0.001). And IL-6 was evaluated in the schizophrenia group (p < 0.001). We showed that patients with the TT allele (BDNF rs6265) had more severe impairments in frontal lobe function. a1-PI can serve as a marker for assessing the severity of frontal lobe damage in patients with frontal dementia. We found some biological parameters reflecting the severity of frontal dysfunction in schizophrenia.

Objectives Worldwide, considerable attention is being given to cannabis use for medical conditions. In the current study, we sought to assess attitudes and beliefs about MC among social work students from the US and Israel. Methods We sought to assess attitudes and beliefs about MC among a sample of 417 social work students (230 from the US and 187 from Israel) who voluntarily participated in an anonymous online survey. Chi-square tests were used to analyze differences between groups. Results Most of the US and Israeli participants (84.3 % and 96.7 %, respectively) reported no formal education about MC; and, they would recommend MC for their clients. Participants who reported any cannabis use, compared to non-users, were more likely to believe MC could benefit physical or mental health and less inclined to believe use of the substance poses serious physical or mental health risks. Secular, compared to religious students, believed it has more benefits for physical and/or mental health. Conclusions Our findings evidence a considerable dearth of formal evidence-based education about cannabis for medical conditions in two university-based cohorts, despite beliefs in MC as useful for physical and mental health conditions. Efforts to develop curricula and training programs for social work students are needed since they will be among key professionals addressing client needs from health care and counseling perspectives.

Objectives To assess knowledge, attitudes and beliefs regarding medical cannabis among Israeli medical, nursing, social work and other health related students as well as to outline the formation of an instrument for standardized data collection on these topics. Methods An invitation to participate with a link for the online survey was sent to all students pursuing a degree in medicine, nursing, social work, and other health disciplines in the Ben Gurion University of the Negev, Israel. The instrument included 32 items that measured knowledge, attitudes and beliefs regarding medical cannabis. In addition, demographic data were collected and participants were asked about the frequency of medical or recreational cannabis use. Results Among the 763 participants, 596 were females (78 %), and the mean age was 25.8 years. While the reported personal use of medical cannabis was minimal (1.9 %), cannabis use for recreational purposes was relatively common (54.0 %). The vast majority believed that medical cannabis holds significant health benefits but expressed concerns regarding potential risks of cannabis use. Additionally, the vast majority of students felt unprepared to answer patients' questions about medical cannabis and expressed a desire to receive more training. Several significant differences between the different academic disciplines were observed. Conclusions In light of current regulatory and scientific developments, it is apparent that students of health professions will need a greater level of understanding of medical cannabis than previous generations of students. This study emphasizes the ample need for more knowledge and formal education to students of health and related professions.

Dear Dr. Harvey,The global spread of coronavirus disease (COVID-19) and the uncertainties linked to infection, quarantine, social interaction, and prevention generate anxiety, depression, and subst...

Despite significant research, the benefits and risks of cannabis for medical purposes remain elusive. However, there is one factor about the substance that is clear - there is a dearth of knowledge about attitudes and beliefs toward its use in Russia where the substance in any form is strictly prohibited. The aim of this study was to examine the impact of affiliation with religion on university student attitudes and beliefs toward cannabis for medical conditions. Survey data were collected from 828 medical and allied health students at two Russian universities. Findings indicate that students with a religious affiliation were significantly more likely to express negative attitudes towards medical cannabis.

Objectives To assess the relationship between religiosity and medical cannabis (MC) knowledge, attitudes and beliefs among university medical and allied health (i.e., nursing and social work) students. Methods This study uses data collected from 540 Israeli male and female, Jewish and Bedouin-Arab, religious and secular students. Pearson’s chi-squared and Fisher exact tests for categorical variables were used to determine the relationship. Results Religious, compared to secular, students reported less personal cannabis use and contact with others who use the substance. Regarding attitudes and beliefs, religious students were more likely to believe cannabis use poses serious physical and mental health risks and were less likely to recommend it for patient treatment. The majority of all students, religious and secular, believed cannabis can be addictive; are not prepared to answer patient/client MC questions; and, have not received formal education about MC. Religiosity was not found related to student knowledge about cannabis and its use for medical conditions. Conclusions This study is the first in Israel to examine the relationship between religiosity and student MC knowledge, attitudes and beliefs. Results evidence the relationship that should be used for curriculum development, education and field practice purposes linked to patient care.

We investigated the associations of rs4680 COMT, rs6280 DRD3, and rs7322347 5HT2A with youth-onset schizophrenia in the Russian population in a case–control study, and the role of the genotype in the severity of clinical features. The association between rs7322347 and schizophrenia (p = 0.0001) is described for the first time. Furthermore, we found a link with rs6280 and rs4680 in females (p = 0.001 and p = 0.02 respectively) and with rs7322347 in males (p = 0.002). Clinical symptoms were assessed on three scales: the Clinician-Rated Dimensions of Psychosis Symptom Severity scale, Positive and Negative Syndrome Scale, and Frontal Assessment Battery. Gender differences in clinical features are of particular interest. In our study we found gender differences in the severity of clinical features—higher scores for delusions (Positive and Negative Syndrome Scale and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) in males and higher scores for depression, delusions, somatic concern, motor retardation, poor attention were found in females.

Negative implications of exposure to violence on health and wellbeing of youth have been observed and studied worldwide, especially in Israel. Youth in the western Negev of the country have been exposed to missile and terror attacks for more than a decade. However, implications of such prolonged exposure have not been fully studied. This study is aimed at the implications of exposure to such conditions on youth in the town of Ofakim in the Negev. A focus group was conducted with youth following the Israeli Defense Forces’ “Protective Edge” response to continued attacks from Gaza (July–Aug. 2014). Focus group participants reported high stress levels during the operation that resulted in an increase of substance use including alcohol, tobacco, cannabis, synthetic cannabis-like substances (e.g., “Nice Guy,” “Spice” and “Black Mamba”) and changes in eating and sleeping behavior. The Ofakim resilience center served as a shelter for participants providing for them with physical and emotional comfort. Staying in the “shelter” used for protection against missile attack promoted youth resilience. Exposure to violence has a significant impact on the health and wellbeing of young people and others. A secure receptive facility that provides trust and support can serve as an important moderator of the negative impact of emergency conditions. From the results reported in this article, further research is needed to fully assess the long-term effects of stress conditions including the use of cannabis and synthetic cannabis-like substances among youth and other residents in the Western Negev.

This paper aims to review patterns of cannabis (i.e., marijuana and hashish) use among high-risk Israeli youth and young adults based on research conducted by the Ben-Gurion University, Regional Alcohol and Drug Abuse Research Center. A total of 1074 Israeli youth (67.0% male, 33.0% female) were studied from 2004 to 2016. The youth and young adults included those placed in residential programs for learning and/or behavior problems (youth villages) and were school dropouts referred to a 90-day treatment facility for drug abuse. Country of origin, determined by mother’s birthplace, revealed 42.4% of the youth was of Israeli origin and 57.6% from other countries—mostly the former Soviet Union and Ethiopia. About “village” youth, no gender or religious status (secular/non-secular) differences were found for lifetime and last month cannabis use. Immigrant origin youth, than those with Israeli status, reported more lifetime and last month use as well as cannabis availability. Youth from families with low socio-economics status reported a higher rate of last month cannabis use than those with better economic conditions. Among school dropouts, no gender or religious status differences were found for lifetime and last month cannabis use and availability. For all study youth, binary logistic regression results indicated six factors significantly predicted last month cannabis use: male gender, age, last month binge drinking, illicit drug selling, reduced relations with friends, and cannabis availability. In terms of policy and service provision, high-risk youth (e.g., those in residential programs, whether for learning and/or behavior problems) should be priority for drug prevention efforts.

The purpose of this paper is to review cannabis use among a cross section of Israeli high school, school dropouts, university students, hospitality workers, and adults in drug treatment. Based on national statistics, 27.0% last year and 19.1% last month cannabis (i.e., marijuana and hashish) use has been reported among 18–65 year olds. This is a higher rate than what is reported in the USA and European countries. Findings across the study groups evidence high rates of cannabis among school dropouts and adults in drug treatment. University students tend to have a higher rate of current use than hospitality workers. Secular status, regardless of the study group, tends to influence cannabis use. Israeli origin university students and hospitality workers report a higher level of current cannabis use than those with other country origin status (i.e., the former Soviet Union). This paper suggests multiple factors be considered, organized, and sustained for policy and prevention purposes.

Tobacco smoking is a major cause of death and disease. In Israel, it has been reported that 22.7% of the population aged 18 and over smoke, mostly using cigarettes. Another smoking method is through a water pipe called hookah or nargila. This paper reviews recent studies of tobacco use among Israeli youth and young adults as well as research conducted by the Ben Gurion University, Regional Alcohol and Drug Abuse Research Center. Study findings evidence high rates of smoking linked to being male, secular, non-Israeli origin, and school dropout. Hookah use may be a “gateway” to cigarette smoking. Youth and young adults reported they believe smoking prevention programs are not effective and do not have a noticeable effect on smoking-related attitudes and behavior. Motivation, peer-supported activities in school and the community, and family factors have been found to be important for possible smoking cessation. This article suggests multiple factors be considered, organized, and sustained to promote smoking cessation.

Alcohol use that causes damage to health and adverse events is a significant public health concern. However, there is a dearth of information about alcohol use among Russian Federation university students. This cross sectional study of 626 students examined their background characteristics, alcohol use, heavy drinking and related problem behavior. Males were more inclined to use alcohol and drink heavily than females; however, no other gender related behavior differences were found. Regression analysis showed heavy drinking more prevalent among students who worked, lived on campus, missed class because of party habits, smoked cigarettes, mixed alcohol and energy drinks, and drank more because of stress. Study findings contribute to usable information for promoting university student health and well-being including academic success through policy and prevention practices as well as for examining the issue elsewhere for comparison and generalization purposes.

Alcohol use is a significant public health concern among university students who tend to have a high level of consumption. There is a dearth of information about female university student alcohol use especially on a cross-national basis. The survey sample consisted of female students from universities located in the cities of Smolensk, Russian Federation (n = 450), and Beer Sheva, Israel (n = 562). The valid and reliable data self-administered collection instrument used, the Substance Use Survey Instrument (SUSI), was translated to Hebrew and Russian and back translated. Binary logistic regression was performed to assess independent predictors of heavy drinking status. Chi-square analysis showed Russian students had significantly lower levels of alcohol use, heavy drinking use, and most related problem behavior than those of their Israeli counterparts. Regression analysis indicated last month smoking, mixing energy drinks and alcohol, being a passenger in a car when the driver had been drinking, academic achievement decline, and missing classes because of party habits significantly predicted heavy drinking among survey participants. Contrary to expected outcomes, Israeli female students reported higher levels of alcohol use and problem behavior than those from the Russian Federation. This survey outcome calls for further investigation of alcohol use beliefs based on ethnic status as well as student background factors that were not addressed.

Shared traumatic reality (STR) is when clinicians function as caregivers and are exposed to the same conditions as their patients. Since 2001, Israeli communities bordering Gaza (i.e., “Otef Gaza”) have experienced repeated missile attacks. Caregivers there have been exposed to trauma on two levels: (1) exposure to vicarious trauma through client interaction and (2) direct exposure resulting from their belonging to the communities affected. Two focus groups of mental health workers (n = 20) from Otef Gaza were conducted. The main theme that emerged was the perception of STR as an ongoing process of adaptation and change rather than a static condition. Participants noted the adaptation process encompass three foci: (1) intrapersonal, (2) clinicians’ spouses and family members, and (3) the broad working environment. Study results contribute to understanding resilience factors and addressing the needs of caregivers in STR conditions.

This cross sectional study examined alcohol use, binge drinking and other problem behavior among Israeli university female students. Scant information is known about Israeli university student alcohol use and related problem behavior. Academic study discipline status (e.g., social work, nursing and other non-helping disciplines) was hypothesized to be a predictor of university student alcohol use and problem behavior rates. Study hypotheses were supported, in part. Academic discipline (social work and nursing) differentiated rates of alcohol use, binge drinking and other problem behavior. However, when grouped into helping and non-helping academic disciples, few differences were evidenced. Students drink more beer, wine and hard alcohol than those 20 years ago at the same university; however, fewer students drive after drinking. Present results, albeit restricted, reflect increased drinking but less driving after drinking after an intensive campaign to curb such problem behavior. Further research is needed of alcohol use and problem behavior for policy, prevention and treatment purposes. Such research should include regular monitoring throughout the country regardless of gender status and academic discipline.

This study examined the substance use patterns of older, experienced adults accepted for college education to be change agents for social and community development in the southern region of Israel. Older and experienced “role model” students (n = 66) and younger regular college education students (n = 304) were compared to determine if type of academic program and gender were related to tobacco, alcohol, cannabis and prescription drug use. Academic program and gender statuses were found related to substance use and problem behavior. The present study findings contribute to understanding the background characteristics of adults being developed through higher education as change agents for social and community development. Also, the findings have policy and program implications for education curriculum development and intervention efforts geared to the health and well-being of college students who will be teachers and “role models” for underserved children and youth.

This article deals with research of Russian university student attitudes toward drug use. Research was conducted in 2015; and, 150 students from Smolensk universities took part. The sample consists of three age groups of students: 17–18, 19, and 20 years and older. Study results show students view people with addiction in a negative context - weak, stupid, unreliable, and unhappy. Also, attitudes reflect support for extreme punishment of drug traffickers for drug distribution blaming Roma “Gypsies.” Age of the student respondents was a significant factor affecting attitudes – older students have a more negative attitude about people with addiction and are more inclined to call for harsh punishment. Study results provide usable information for drug policy, education and prevention efforts in Russia.

Objectives To assess medical student knowledge, attitudes and beliefs about cannabis use for medical conditions in Russia where it is prohibited. Methods This study uses data collected from 463 Russian origin medical students. Pearson Chi-square test for categorical variables was used to determine whether student knowledge, attitudes and beliefs of medical cannabis (MC) are affected by gender and religiosity. Results Overall, Russian university medical students tend to reflect negative attitudes and beliefs toward MC. Female students were more inclined to recommend MC for patient treatment and its legalization; and, believe it is not addictive and does not pose physical or mental health risk. Students who support MC use believe it has treatment benefits, support additional research as well as policy change for its legalization. Secular, more than religious, students report more positive attitudes toward MC use. About 34% of the students indicate they have no knowledge about cannabis use for medical conditions; and, nearly half report feel they are able to answer patient questions about its use for medical condition if such a situation were to exist. Conclusions This study is the first in Russia to examine medical students’ knowledge, attitudes and beliefs toward MC. Results evidence the majority of survey respondents do not support cannabis legalization for any purpose – medical or recreational. They report a dearth of knowledge about the substance and recommend additional evidence-based research and education to enhance their knowledge about its use. The present study has value in terms of providing usable information for possible curriculum development and education purposes as well as policy change about cannabis use for medical conditions in Russia.

Objective: To assess the knowledge, attitudes, and beliefs of foreign students toward the use of medical cannabis (MC) for pain management. Methods: This study uses data collected from 549 foreign students from India (n = 289) and Middle Eastern countries mostly from Egypt, Iran, Syria, and Jordan (n = 260) studying medicine in Russia and Belarus. Data collected from Russian and Belarusian origin medical students (n = 796) were used for comparison purposes. Pearson’s chi-squared and t-test were used to analyze the data. Results: Foreign students’ country of origin and gender statuses do not tend to be correlated with medical student responses toward medical cannabis use. Students from Russia and Belarus who identified as secular, compared to those who were religious, reported more positive attitudes toward medical cannabis and policy change. Conclusions: This study is the first to examine the attitudes, knowledge, and beliefs toward medical cannabis among foreign students from India and Middle Eastern countries studying in Russia and Belarus, two countries who oppose its recreational and medicine use. Indian and Middle Eastern students, as a group, tend to be more supportive of MC than their Russian and Belarusian counterparts. These results may be linked to cultural and historical reasons. This study provides useful information for possible medical and allied health curriculum and education purposes.

Abstract. Background: There is a dearth of information about mothers in methadone maintenance treatment (MMT), their parental stress, and suicidal ideation. Aim: To evaluate parenting stress and suicidal ideation among heroin-dependent mothers in MMT. Method: The study was conducted at an MMT center. Inclusion criteria were mothers with at least one child between 6–12 years of age. Mothers (n = 41) were interviewed about their background characteristics, drug use, parenting stress, and suicide ideation. Results: The mothers' median age was 44 (27–63 years), 35% were single, 20% married or with a partner, 45% separated or divorced, 83% were Jewish, and about one-third completed elementary school only. Among the study participants, 52% reported ever thinking about suicide, 28% reported past-year ideation, and 15% indicated they were likely to complete suicide someday. Mothers who have used heroin and cannabis reported high levels of parenting stress. Mothers with high parenting stress levels were more likely to report suicidal ideation. Country of origin status did not differentiate those interviewed. Conclusion: This study provides insight into a hard-to-reach population of mothers needing treatment, parental skills training, and mental stress reduction. Further research is needed to generalize the findings for treatment, education, and training purposes.

Aims The aims of the current study were as follows: 1) to assess gerontology graduate students’ beliefs about medical marijuana’s (MMJ) effectiveness for two common age-related conditions - Alzheimer’s (AD) and Parkinson’s disease (PD); 2) to assess students’ beliefs and attitudes toward MMJ; 3) to explore associations linking background characteristics, MMJ-related attitudes and beliefs, and beliefs about the MMJ effectiveness for AD and PD. Method A sample of 104 (84 women and 20 men) gerontology graduate students voluntarily participated in the anonymous online survey. Results The vast majority (95%) of the participants indicated they had no formal education about MMJ and reported being unprepared to answer clients’ MMJ-related questions (84.6%). Most of the participants believed that MMJ is effective for use with AD (70.2%) and PD (80.8%) patients. Participants reported favorable beliefs about MMJ benefits, concerns about risks, the need for training, and positive attitudes toward recreational marijuana use legalization. Prior marijuana use (e.g., self-use, friends or family) was found to be associated with more positive beliefs about MMJ benefits, risks, and its legalization for recreational purposes. Prior marijuana use was the only factor associated with the belief that MMJ is an effective therapy for use with AD or PD patients. Conclusions The study findings show the need for students’ MMJ education in order to provide future gerontology service providers with the necessary knowledge and ability to address clients’ questions about MMJ use. Efforts to develop curricula and training programs need to be promoted.

Problem Scant knowledge exists about high-risk adolescents who are school dropouts in treatment for substance abuse. Purpose This study aims to examine the patterns of cannabis (i.e., marijuana and hashish) use among school dropouts receiving substance abuse treatment based on their gender and country of origin status (i.e., Israeli and former Soviet Union—FSU). Methods A total of 628 dropouts referred to a residential substance abuse treatment facility in Israel from 2004 to 2011 were studied. Chi-square and t test analyses were used to determine the impact of gender and country of origin status on cannabis use. Findings Significant differences exist for age of first, lifetime, and last 30-day cannabis use. FSU youths begin cannabis at an earlier age. Cannabis use tends to be higher among males and those with Israeli country of origin status. Furthermore, cannabis use among dropouts is much higher than those attending school. Conclusions Gender and country of origin status have implications that should be of concern to healthcare professionals treating adolescent substance abuse. Further research is needed to validate the study findings both in Israel and other countries for policy, training, and treatment purposes.

Widespread international concern exists about school dropout and substance use among high risk youth. This article examines the issue in Israel and the impact of a 90 day treatment program on a prospective sample of youth. A cohort of 77 youths completed a self-report questionnaire prior to receiving substance abuse treatment. These youth were compared to those attending and disengaged from school. With the exception of inhalants that tend to be a substance more commonly used by youth in school, dropouts report much higher rates of substance use especially those referred to treatment. For this population, the impact of a 90 day residential treatment program was evaluated. Results show the potential such treatment has on reducing substance use. Given the paucity of literature on this topic, this paper makes an initial contribution to understanding a growing problem of youth who have dropped out of school and who are substance users.

Tobacco use through cigarette smoking is one of the most important preventable causes of death and disease in the world. The substance has caused 100 million deaths in the twentieth century; it causes more than 5 million deaths per year. On average, smokers die 13–14 years earlier than nonsmokers. Nearly 80 % of the world’s smokers worldwide are from low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest. The burden of death, disease, and disability caused by the use of tobacco products more than outweighs any economic benefits from their manufacture and sale. Secondhand smoke, the smoke from someone using tobacco, kills people who do not smoke. It contains higher concentrations of cancer causing carcinogens than mainstream smoke. This chapter examines the problem of smoking in the Middle East—particularly among Israeli and Palestinian youth and a prevention/cessation intervention to address this important health problem.

Israel is a nation of immigrants from many countries. From 1989 to 1998, the Israeli population of 4.5 million rose about 20 % primarily from the nearly one million Soviet immigrants, mostly from Russia and the Ukraine, who entered the country. A large proportion of the Russian-speaking immigrants had training and education in a variety of technical and professional fields, and success was an important component of their world view and culture. However, there were immigrants who arrived in Israel with drug abuse problems and others became addicted during the absorption process. Presently, Russian-speaking immigrants are 13 % of the Israel population, but about 25 % of the illicit drug users in the country. Difficulties with the process of acculturation have been linked to the development of emotional and behavioral problems including mental illness, delinquency, and alcohol and drug abuse. And, alcohol and drug use emerges as a coping mechanism to mitigate the stresses that immigrants encounter in the host society. This chapter examines the dynamic and highly complex process of acculturation that can lead to mental health and addiction related problems. A number of conceptual models of acculturation are presented applicable to many different people in many different countries.

The use of harmful substances is a worldwide problem that has a major impact on maternal parenting skills. This study, conducted in cooperation with Professor Debra Murphy of Integrated Substance Abuse Programs, University of California, Los Angeles, examined personal characteristics of substance-abusing mothers and their parenting skills. The study was conducted at the methadone maintenance clinic in Israel where lifetime substance users receive methadone treatment. Results show type of drug used affected anxiety and parenting skills—mothers using alcohol and cannabis had higher stress levels and parenting problems; those using prescription drugs with older children had higher levels of anxiety. Also, higher levels of anxiety were found among mothers who served time in jail/prison. Surprisingly, mothers using opiates reported lower levels of stress compared to mothers that do not. As for parental skills, mothers of children over the age of 18 had more difficulties gaining their child’s cooperation. Mothers who reported higher levels of suicidal thoughts or attempts showed increased parental disappointment about the child, felt rejected by the child, were not satisfied by their parent–child interactions, and had a hard time gaining the child’s cooperation. This study, believed to be the first of its kind in Israel, provides important details about substance-abusing mothers in methadone maintenance treatment and information relevant for service provision and staff training.

The aim of this chapter is to provide the reader with information about the development of a simple and short survey instrument to monitor drug use and related problem behavior among high-risk youth in the Middle East. The development of the instrument occurred in three main phases: (1) collection of existing surveys; (2) contact with relevant health professionals in the United States, in Europe, and in the region; and (3) assessment of prevention and treatment priorities among service providers addressing adolescent drug abuse and addiction problems. Issues for the development of the Substance Use Survey Instrument (SUSI) were refined through consultation with experts and adolescents. During a period of more than 15 years, the valid and reliable instrument has been modified and updated numerous times to address new substances and to simplify the questions asked because of the limited reading comprehension of the target population. Although the instrument is primarily for use with youth at risk including those who dropped out of school, the nature of the instrument has been modified for use with other groups including young adults and adults.

This prospective study examined the relationship between work alienation, country of origin and substance use among male hospitality workers in Israel. Results show work alienation more prevalent among Former Soviet Union origin males and those workers who binge drink and use cannabis (i.e., marijuana and/or hashish). Given the paucity of literature on hospitality workers, this brief report contributes to understanding an issue that is neither well understood nor adequately addressed. Further research is needed to validate these findings both in Israel and other countries so that such information can be useful for hotel employment and management policies as well as employee assistance programs.

Widespread international concern exists about the nonmedical use of prescription drugs (NPD), especially among adolescents. This article examines NPD use trends of school dropouts in Israel from 2004 to 2009 based on gender and country of origin status. A cohort of 470 youths completed a self-report questionnaire prior to receiving drug treatment. Females reported NPD at a younger age than males, and their rates of lifetime use and use in the last 30 days were significantly higher. Males, but not females, from former Soviet Union origins reported a higher rate of NPD use than those of Israeli origin. Given the paucity of literature on this topic, this article makes an initial contribution to understanding a growing international problem.

This study examined drug use patterns, HIV/AIDS, and related outcomes among former Soviet Union (FSU) immigrants from Russia, Ukraine and the Caucasus mountain region in Israel who reported heroin use. A total of 253 FSU heroin users were interviewed from 2002 to 2007 as part of a large drug use surveillance study in Israel. Individuals were sampled at drug treatment facilities in an urban population center of the Negev region of Israel. Participants were assessed using the Addiction Severity Index, fifth edition. First, immigrants from Russia and Ukraine were compared; then, as a group, compared to those from the Caucasus region. Overall, ASI composite scores suggested comparable levels of addiction severity between the Russian and Ukrainian groups. However, Kavkaz immigrants are older, less likely to be employed, and have more severe scores on many of the drug use measures as compared to the other two nationalities. This study shows different drug use patterns exist among FSU immigrants. Such differences may be, in part, due to socioeconomic, geographic and other sociodemographic factors. Injection drug use, regardless of country/region of origin is a critical public health problem, especially given the link between injection drug use and infectious disease.

Jewish people from Ethiopia have been immigrating to Israel since 1973. Difficulties with language, unemployment; low socioeconomic status and prejudice have been common place and linked to problem behaviour including school drop out, delinquency and drug abuse among Ethiopian youth. This research examines the patterns of alcohol use and related problem behaviour among male and female Ethiopian youth participating in after-school programs and youth centres. For all alcohol substances (i.e., beer, wine and liquor such as vodka and whiskey), boys were significantly more inclined to drink than girls. The patterns of alcohol use among Ethiopian youth tend to be more similar to those of high-risk youth placed in alternative schools because of learning difficulties and/or behavioural problems than those of other high-school-age youth in the country. Their alcohol use and related problem behaviour, especially driving a car or motorcycle after drinking or being a passenger in a car or on a motorcycle when the dri...

This article aims to examine specific substance use profiles among former Soviet Union (FSU) immigrant and native-born women in Israeli therapeutic treatment facilities. Individuals were sampled at drug treatment facilities and assessed using the Addiction Severity Index. ASI scores suggest differences between the two groups. Among the findings are native born females have been using heroin and amphetamines longer than FSU immigrants; however, immigrant women have more years of alcohol use. FSU women are more inclined to be injection drug users, prefer shorter forms of treatment, and to use alcohol when receiving treatment for heroin addiction. FSU women have higher levels of chronic medical problems, HCV, and HIV/AIDS. The study results tend to support the position that treatment of special populations may be enhanced if their particular needs associated with personal attributes and background characteristcs are considered and met in a treatment environment.

Aims This study examined drug use patterns and severity among native-Israeli and former Soviet Union (FSU) immigrants in Israel who reported heroin use. Design, setting and participants a total of 272 native Israelis and 300 FSU heroin users were interviewed from 2002 to 2006 as part of a large drug use surveillance study in Israel. Individuals were sampled at an intake centre, a methadone clinic and a day-treatment facility in the Negev region of Israel. Participants were assessed using the Addiction Severity Index, fifth edition. Native Israeli and FSU users were compared within two groups: those interviewed at intake and those interviewed in treatment. Findings Overall, ASI composite scores suggested generally comparable levels of addiction severity between the two ethnic groups. Native-born Israelis reported more years of heroin use; however, the FSU immigrants reported longer use of other opiates. The FSU reported significantly more heroin use by injection, and a significantly higher rate of hepatitis C and other chronic medical problems. Comparisons by gender within each group revealed higher drug severity scores for females (native-born Israeli and FSU combined). Females in the intake group had significantly higher severity scores in the areas of employment and psychiatric status when compared to individuals who had been in treatment for some time. Conclusions Except for higher levels of alcohol use, the FSU did not have more severe drug problems than the native Israelis as measured by ASI severity scores. Injection use among FSU, however, is a critical public health problem, especially given the well-established link between injection drug use, hepatitis C and HIV/AIDS.