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From March to July of 2011, the authors investigated the prospective association between illicit drug use and cognitive functioning during the midadult years. A total of 8,992 participants who were surveyed at 42 years of age in the National Child Development Study (1999–2000) were included. The authors analyzed data on 3 cognitive functioning measures (memory index, executive functioning index, and overall cognitive index) when the participants were 50 years of age (2008–2009). Illicit drug use at 42 years of age was based on self-reported current or past use of any of 12 illicit drugs. Multivariable regression analyses were performed to estimate the association between different illicit drug use measures at 42 years of age and cognitive functioning at 50 years of age. A positive association was observed between ever (past or current) illicit drug use and cognitive functioning (β = 0.62, P < 0.001), although the effect size was small. Even though there was no clear evidence against the null hypothesis, drug dependence (β = −0.27, P = 0.58) and long-term illicit drug use (β = −0.04, P = 0.87) tended to be negatively associated with cognitive functioning. At the population level, it does not appear that current illicit drug use is associated with impaired cognitive functioning in early middle age. However, the authors cannot exclude the possibility that some individuals and groups, such as those with heavier or more prolonged use, could be harmed. [ABSTRACT FROM PUBLISHER]

Aims The transition from prison back into the community is particularly hazardous for drug-using offenders whose tolerance for heroin has been reduced by imprisonment. Studies have indicated an increased risk of drug-related death soon after release from prison, particularly in the first 2 weeks. For precise, up-to-date understanding of these risks, a meta-analysis was conducted on the risk of drug-related death in weeks 1 + 2 and 3 + 4 compared with later 2-week periods in the first 12 weeks after release from prison. Methods English-language studies were identified that followed up adult prisoners for mortality from time of index release for at least 12 weeks. Six studies from six prison systems met the inclusion criteria and relevant data were extracted independently. Results These studies contributed a total of 69 093 person-years and 1033 deaths in the first 12 weeks after release, of which 612 were drug-related. A three- to eightfold increased risk of drug-related death was found when comparing weeks 1 + 2 with weeks 3–12, with notable heterogeneity between countries: United Kingdom, 7.5 (95% CI: 5.7–9.9); Australia, 4.0 (95% CI: 3.4–4.8); Washington State, USA, 8.4 (95% CI: 5.0–14.2) and New Mexico State, USA, 3.1 (95% CI: 1.3–7.1). Comparing weeks 3 + 4 with weeks 5–12, the pooled relative risk was: 1.7 (95% CI: 1.3–2.2). Conclusions These findings confirm that there is an increased risk of drug-related death during the first 2 weeks after release from prison and that the risk remains elevated up to at least the fourth week. [ABSTRACT FROM AUTHOR]

The authors tested the hypothesis that the birth prevalence of gastroschisis is positively associated with use of recreational drugs in early pregnancy. A matched case-control study was carried out in three regions of the United Kingdom over the period January 2001 through August 2003. For each case, three liveborn controls were matched by initial intended place of delivery, region, and maternal age. Maternal hair analysis provided independent verification of recreational drug use. Conditional logistic regression was used to estimate mutually adjusted odds ratios. Estimates were revised using data from hair analysis. Statistically significant adjusted odds ratios for gastroschisis were associated with first-trimester use of 1) any recreational drug (odds ratio (OR) = 2.2, 95% confidence interval (CI): 1.2, 4.3) and 2) vasoconstrictive recreational drugs (defined as cocaine, amphetamines, and ecstasy) (OR = 3.3, 95% CI: 1.0, 10.5). Other significant exposures included aspirin use (OR = 20.4, 95% CI: 2.2, 191.5), cigarette smoking (OR = 1.7, 95% CI: 1.1, 2.6), and prior history of gynecologic infection/disease (OR = 2.6, 95% CI: 1.2, 5.6). Recreational drug use is a significant risk factor for gastroschisis and is one of a constellation of potentially preventable exposures which include cigarette smoking, aspirin use, and history of gynecologic infection/disease. Maternal hair analysis proved an acceptable and valuable method of independently verifying recreational drug use. [ABSTRACT FROM PUBLISHER]

Abstract: Background: Concerns about gay men''s methamphetamine use reflect its physical and psychological harms, and association with sexual-risk behaviour and HIV infection. Existing research suggests gay men''s use in the UK is low and may be largely confined to London. Methods: Cross-sectional survey of convenience sample of UK gay men. Results: Methamphetamine was used by a significant minority of gay men in London but also in other regions. Overall, use was highest among those men aged 30–49, HIV-positive and reporting sexual-risk behaviours. Conclusion: Methamphetamine was used by a significant minority of gay men in and outside London. Targeted prevention and treatment services should be developed and evaluated. [Copyright &y& Elsevier]