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Background: Drug use has been popular these days because of various effects on the body and mind. Drugs may alter the way a person thinks and behaves and act. This, in turn, affects their social relationship resulting in negative outcomes. The literature shows that pattern of consumption of alcohol use, varies by marital status, revealing heavy alcohol use among divorced or single people than among those who are married. Aims and Objectives: Impact of marital or romantic relationship status on substance use among males aged 1535 years residing in urban slums. Materials and Methods: The proposed study was carried out in urban slums of Amritsar city. In each slum, house to house survey was conducted and the household having a male between age group of 1535 years was noted as per the definitions of case and control. From each slum 15 cases and 15 controls (matched for age) for each age band were selected. For each case, one control (age matched) was selected keeping in mind to take only either one case or control from one household. As soon as, 60 cases and 60 controls were included, further survey was stopped in that slum. Similar methodology was followed in the remaining three slums selected to get a total sample of 480 (240 controls and 240 cases). Results: Among unmarried majority of substance users (73.1%) were not having friend from opposite sex in comparison to substance non-users (58.6%). Among users and non-user majority 67.5% and 61.8%, respectively, said they will get married according to their parents choice. Among married majority of substance users (67.8%) got married at age ≤24 years whereas majority of substance non-users (62.1%) married at an age >24 years. Among substance users, a relatively lower proportion (65.3%) gave consent before marriage in comparison to substance non-users (81%). Conclusion: The present study concludes that single and non-dating relationships were associated with heavy drinking and substance use in comparison to marriage and dating relationships. [Natl J Physiol Pharm Pharmacol 2021; 11(12.000): 1356-1360]

A large amount of the current literature has focused on the characteristic symptoms of attention deficit hyperactivity disorder (ADHD) in children and adolescents. In contrast, less attention has been devoted to ADHD clinical subtypes in adult patients. We evaluated 164 consecutive adult ADHD (A-ADHD) outpatients using DSM-5 criteria and many specific rating scales and questionnaires. A principal component factor analysis was performed on clinical and symptomatological variables to describe potential clinical variants. We sought to determine different A-ADHD variants focusing on demographic and clinical features. A four-factor solution was identified, and patients were clustered, according to their z-score, in 4 subgroups. The first was marked out by Emotional Dysregulation (ED), the second by Substance Use (SU), the third by Core-ADHD Symptoms (Co-ADHD) and the fourth by Positive Emotionality (PE). Predominantly ED patients showed worse overall function, early treatment with antidepressants and a greater presence of borderline personality disorder than predominantly Co-ADHD patients. Predominantly SU patients reported high rates of bipolar disorder and severe general psychopathology. The PE factor was related to hyperthymic temperament and hypomania and showed a higher level of functioning. Females with A-ADHD showed a lower risk of being included in SU, and A-ADHD patients with co-occurring delayed sleep phase had less risk of being included in the SU factor than the prevailing Co-ADHD group. Our empirically based description of four clinical A-ADHD variants shows several aspects beyond the definition given by the DSM-5 diagnostic criteria.

In response to a sharp rise in opioid-involved overdose deaths in the USA, states have deployed increasingly aggressive strategies to limit the loss of life, including civil commitment—the forcible detention of individuals whose opioid use presents a clear and convincing danger to themselves or others. While civil commitment often succeeds in providing short-term protection from overdose, emerging evidence suggests that it may be associated with long-term harms, including heightened risk of severe withdrawal, relapse and opioid-involved mortality. To better assess and mitigate these harms, states should collect more robust data on long-term health outcomes, decriminalise proceedings and stays, provide access to medications for opioid use disorder and strengthen post-release coordination of community-based treatment.

Social network analysis (SNA) and social network-based interventions (SNI) are important analytical tools harnessing peer and family influences critical for HIV prevention and treatment among substance users. While SNA is an effective way to measure social network influences, SNI directly or indirectly involves network members in interventions. Even though these methods have been applied in heterogeneous ways, leading to extensive evidence-based practices, systematic reviews are however, lacking. We searched five bibliographic databases and identified 58 studies involving HIV in substance users that had utilized SNA or SNI as part of their methodology. SNA was used to measure network variables as inputs in statistical/mathematical models in 64 % of studies and only 22 % of studies used SNI. Most studies focused on HIV prevention and few addressed diagnosis (k = 4), care linkage and retention (k = 5), ART adherence (k = 2), and viral suppression (k = 1). This systematic review highlights both the advantages and disadvantages of social network approaches for HIV prevention and treatment and gaps in its use for HIV care continuum.

There is a long-standing failure to create an ethical culture around substance use disorders (SUDs) or dependence that actively supports people’s recovery efforts. Issues which impede the development of prorecovery environments are complex, but include the far-reaching effects of the social stigma that surrounds SUDs; and the failure to harness relational and social support that allows debates to transcend blaming individual substance users. As part of efforts to create prorecovery environments, it is important to acknowledge that bioethics debate on SUDs is narrow in scope, prioritising topics related to its traditional interests in individual autonomy and novel technologies. As a result, it has not played a significant role in helping to transform the ethical cultures in which substance use recovery takes place. For example, it largely neglects the ethical challenges of developing an empathic, person-centred approach to substance use problems that listens and responds to the voices of clients. It has also participated little in efforts to develop a positive response to reducing the toxic effects of stigma. Indeed, some contributions from the field fan stigma, rather than alleviate it. The aim of this paper is to seed broader ethical debate, in academic literature and lay/professional communities, on how societies should respond to SUDs: steering a course between the critical, but narrow approach of bioethics and the empowerment discourse of evidence-based treatments.

Telemedicine has the potential to remove geographic and temporal obstacles to health care access. Whether and how telemedicine can increase health care access for underserved populations remains an open question. To address this issue, we integrated facilitated telemedicine encounters for the management of hepatitis C virus (HCV), a highly prevalent condition among people with opioid use disorder (OUD), into opioid treatment programs (OTPs). In New York State, OTPs are methadone-dispensing centers that provide patient-centered, evidence-based treatment for OUD. We investigated the integration and impact of facilitated telemedicine into OTP workflows in these settings. This study aims to understand OTP staff experiences with integrating facilitated telemedicine for HCV treatment into OTPs, including best practices and lessons learned. We conducted semistructured interviews with 45 OTP staff members (13 clinical, 12 administrative, 6 physicians, and 14 support staff members) at least one year after the implementation of facilitated telemedicine for HCV management. We used hermeneutic phenomenological analysis to understand OTP staff experiences. We identified 4 overarching themes illustrating the successful integration of facilitated telemedicine for HCV care into OTPs. First, integration requires an understanding of the challenges, goals, and values of the OTP. As OTP staff learned about new, highly effective HCV therapies, they valued an HCV cure as a \"win\" for their patients and were excited about the potential to eliminate a highly prevalent infectious disease. Second, the integration of facilitated telemedicine into OTPs fosters social support and reinforces relationships between patients and OTP staff. OTP staff appreciated the ability to have \"eyes on\" patients during telemedicine encounters to assess body language, a necessary component of OUD management. Third, participants described high levels of interprofessional collaboration as a care team that included the blurring of lines between disciplines working toward a common goal of improving patient care. Study case managers were integrated into OTP workflows and established communication channels to improve patient outcomes. Fourth, administrators endorsed the sustained and future expansion of facilitated telemedicine to address comorbidities. OTP staff were highly enthusiastic about facilitated telemedicine for an underserved population. They described high levels of collaboration and integration comparable to relevant integrative frameworks. When situated within OTPs, facilitated telemedicine is a high-value application of telemedicine that provides support for underserved populations necessary for high-quality health care. These experiences support sustaining and scaling facilitated telemedicine in comparable settings and evaluating its ability to address other comorbidities. ClinicalTrials.gov NCT02933970; https://clinicaltrials.gov/study/NCT02933970.

The primary objective of this research is to explore how the level of Mental Health Literacy influences the motivation for treatment among individuals dealing with alcohol or substance addiction. The study involved 128 subjects undergoing inpatient treatment at the Alcohol and Substance Abuse Treatment Center. To gather data, researchers utilized a Personal Information Form, Mental Health Literacy Scale, and Treatment Motivation (TM) survey. The scores obtained from the Treatment Motivation Questionnaire and Mental Health Literacy Scale were 94.21±12.2 and 108.03±11.7, respectively. The analysis revealed a statistically significant, albeit weak, positive correlation between the participants' Mental Health Literacy Scale-Knowledge of How to Seek Mental Health Information subscale mean score and both their total Treatment Motivation Questionnaire score and their Interpersonal Help-Seeking subscale mean scores (r=0.284). Conversely, a statistically significant weak negative correlation emerged between the participants' Mental Health Literacy Scale-Knowledge of Professional Help Available subscale mean score and their Treatment Motivation Questionnaire-Distrust in Treatment subscale mean score (r=−0.230). Conclusions drawn from the study indicate that a lack of knowledge regarding addiction and accessing professional assistance, coupled with concerns surrounding stigma, pose as significant barriers to motivation for seeking treatment. Bu çalışmanın amacı alkol/madde bağımlılığı olan bireylerin ruh sağlığı okuryazarlık düzeyinin tedavi motivasyonuna etkisini belirlemektir. Alkol ve Madde Bağımlılığı Tedavi Merkezi'nde yatarak tedavi gören 128 kişi çalışmaya dahil edildi. Veri toplama aracı olarak kişisel bilgi formu, Ruh Sağlığı Okuryazarlığı Ölçeği ölçeği ve Tedavi Motivasyonu (TM) anketi kullanıldı. Tedavi Motivasyonu Anketi ve Ruh Sağlığı Okuryazarlığı Ölçeği puanları sırasıyla 94,21±12,2 ve 108,03±11,7 olarak bulundu. Katılımcıların Ruh Sağlığı Okuryazarlığı Ölçeği-Ruh Sağlığı Bilgisini Nasıl Arayacağı Bilgisi alt ölçek puan ortalaması ile Tedavi Motivasyon Anketi toplam ve Kişilerarası Yardım Arama alt ölçek puan ortalamaları arasında istatistiksel olarak anlamlı pozitif zayıf bir korelasyon vardı (r=0,284). Ancak Ruh Sağlığı Okuryazarlığı Ölçeği-Mesleki Yardım Bilgisi alt ölçek puan ortalamaları ile Tedavi Motivasyon Anketi-Tedaviye Güvensizlik alt ölçek puan ortalamaları arasında istatistiksel olarak anlamlı negatif zayıf bir korelasyon vardı (r=-0,230). Sonuç olarakb ağımlılık konusunda bilgi eksikliği, profesyonel yardımın nasıl alınacağı ve damgalanma endişesinin tedavi motivasyonunun önündeki en büyük engel olduğu kanısına varıldı.

Background Substance use disorders (SUDs) have been consistently shown to exhibit moderate intergenerational continuity (1–3). While much research has examined genetic and social influences on addiction, less attention has been paid to clients’ and lay persons’ perceptions of genetic influences on the heritability of SUD (4) and implications for treatment. Methods For this qualitative study, twenty-six structured Working Model of the Child Interviews (WMCI) were conducted with mothers receiving inpatient SUD treatment. These interviews were thematically analyzed for themes related to maternal perceptions around intergenerational transmission of substance use behaviours. Results Findings show that over half of the mothers in this sample were preoccupied with their children’s risk factors for addictions. Among this group, 29% spontaneously expressed concerns about their children’s genetic risk for addiction, 54% shared worries about their children’s propensity for addiction without mentioning the word gene or genetic. Additionally, 37% had challenges in even discussing their children’s future when prompted. These concerns mapped onto internal working models of attachment in unexpected ways, with parents who were coded with balanced working models being more likely to discuss intergenerational risk factors and parents with disengaged working models displaying difficulties in discussing their child’s future. Conclusion This research suggests that the dominant discourse around the brain-disease model of addictions, in its effort to reduce stigma and self-blame, may have unintended downstream consequences for parents’ mental models about their children’s risks for future addiction. Parents receiving SUD treatment, and the staff who deliver it, may benefit from psychoeducation about the intergenerational transmission of SUD as part of treatment.

RationaleBehavioral economics has shown that single-item demand indicators are promising for capturing crucial aspects of nicotine reinforcement. It is suggested that brief breakpoint measures perform comparably to full-length demand indices in characterizing nicotine dependence; however, there have been no thorough assessments of their validity in clinical settings.ObjectivesThis study aimed to assess the validity and accuracy of a single-item breakpoint in informing on tobacco demand.MethodsThe sample consisted of 88 treatment-seeking smokers (% males = 70.5%) enrolled in substance use treatment. Participants provided data on smoking characteristics and completed the Fagerström Test for Nicotine Dependence, a single-item breakpoint measure and a 14-item cigarette purchase task (CPT). Hierarchical regressions were performed to compare the predictive capability of a single-item breakpoint and full-length tobacco demand indicators in determining nicotine addiction severity.ResultsThe single-item breakpoint was significantly correlated with all indices stemmed from the CPT and both latent factors (all r values = .250–.368). Neither the brief breakpoint nor the full-length breakpoint significantly predicted nicotine dependence. After controlling for sex and smoking variables, factor 2 [β = .565, p < .001] and its observed variables Omax [β = .279, p = .006], 1/elasticity [β = .340, p = .001], and intensity [β = .551, p < .001], robustly predicted nicotine dependence severity.ConclusionsOur findings do not support the validity of single-item breakpoint measures for characterizing nicotine dependence in substance users. In a bid to foster translational research, brief demand measures capturing Omax, intensity, and elasticity should be developed.

To explore the subjective perceptions of women from rural and urban communities in Bangalore, India, regarding their perspectives about addictive substance use (ASU), and the interventions/support they need to quit use. Based on the data collected, the goal of this study was to develop an intervention that would address the women’s needs. Mixed methods were used as follows: (a) door-to-door survey of women (N = 2044) regarding their use of addictive substances, and (b) focus group discussions with the women to explore their perceptions. Interviews were transcribed verbatim, themes and sub-themes identified. More than one-third (32.7%) reported past 3-month ASU, with majority reporting smokeless tobacco products (82.6%). Alcohol use was reported by 17.4%. Four major themes (with sub-themes) were identified from the focus group discussions: (1) Patterns of use (oral tobacco products-kaddipudi, thambaku; alcohol), (2) Reasons for use (to relieve stress and forget problems, tobacco use as a way of life, for postnatal benefits, due to easy availability, to reduce fatigue and pain, indigestion, hunger), (3) Low risk perception related to ASU (“We know how to use tobacco safely”, “No real harm from tobacco”), and (4) Issues related to quitting ASU and help-seeking (unwillingness to quit, methods of intervention- “videos, or tablets/injections to help us quit ASU”). The findings highlight challenges involved in the development of effective interventions for women. Additionally, there is a clear need for broader community agencies to address psychological, cultural, and social dimensions.