Journal of Addiction http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Investigation of Cognitive Improvement in Alcohol-Dependent Inpatients Using the Montreal Cognitive Assessment (MoCA) Score Thu, 01 Dec 2016 13:09:44 +0000 http://www.hindawi.com/journals/jad/2016/1539096/ Background. Cognitive dysfunction is a common feature in alcohol use disorders. Its persistence following alcohol detoxification may impair quality of life and increase the risk of relapse. We analyzed cognitive impairment changes using the Montreal Cognitive Assessment (MoCA) score in a large sample of alcohol-dependent inpatients hospitalized for at least 4 weeks. Method. This was an observational longitudinal survey. Inclusion criteria were alcohol dependence (DSM-IV) and alcohol abstinence for at least one week. The MoCA test was administered on admission and at discharge. Results. 236 patients were included. The mean MoCA score significantly increased from on admission to at discharge. The corresponding effect-size of improvement was high, 1.1 [95% CI 1.0–1.2]. The degree of improvement was inversely correlated with the baseline MoCA score. The rate of high and normal, that is, >26, MoCA values increased from 15.8% on admission to 53.8% at discharge. MoCA score improvement was not correlated with the total length of abstinence prior to admission. Conclusion. The MoCA score seems to be a useful tool for measuring changes in cognitive performance in alcohol-dependent patients. A significant improvement in cognitive function was observed whatever the degree of impairment on admission and even after a long abstinence period. Stéphanie Pelletier, Bertrand Nalpas, Régis Alarcon, Hélène Rigole, and Pascal Perney Copyright © 2016 Stéphanie Pelletier et al. All rights reserved. The Impact of Social Structures on Deviant Behaviors: The Study of 402 High Risk Street Drug Users in Iran Thu, 17 Nov 2016 08:51:34 +0000 http://www.hindawi.com/journals/jad/2016/6891751/ This study is a sociological analysis of the three dimensions of social structure including institutional, relational, and embodied structures that have an impact on the individuals’ deviant behaviors in the society. The authors used a mix method to analyze the qualitative and quantitative data of 402 high risk abandoned substance users in 2008 in Tehran, capital city of Iran. The leading reasons of substance use were categorized into four fundamental themes as follows: stress, deviant social networks, and low social capital and weak social support sources. In addition, the epidemiology model of regression analysis provides a brief explanation to assess the association between the demographical and etiological variables, and the drug users’ deviant behaviors. In sum, substance use is discussed as a deviant behavior pattern which stems from a comorbidity of weak social structures. Maryam Mehrabi, Sharareh Eskandarieh, Mahmoud Khodadost, Maneli Sadeghi, Ali Nikfarjam, and Ahmad Hajebi Copyright © 2016 Maryam Mehrabi et al. All rights reserved. nor-BNI Antagonism of Kappa Opioid Agonist-Induced Reinstatement of Ethanol-Seeking Behavior Sun, 06 Nov 2016 14:33:12 +0000 http://www.hindawi.com/journals/jad/2016/1084235/ Recent work suggests that the dynorphin (DYN)/kappa opioid receptor (KOR) system may be a key mediator in the behavioral effects of alcohol. The objective of the present study was to examine the ability of the KOR antagonist norbinaltorphimine (nor-BNI) to attenuate relapse to ethanol seeking due to priming injections of the KOR agonist U50,488 at time points consistent with KOR selectivity. Male Wistar rats were trained to self-administer a 10% ethanol solution, and then responding was extinguished. Following extinction, rats were injected with U50,488 (0.1–10 mg/kg, i.p.) or saline and were tested for the reinstatement of ethanol seeking. Next, the ability of the nonselective opioid receptor antagonist naltrexone (0 or 3.0 mg/kg, s.c.) and nor-BNI (0 or 20.0 mg/kg, i.p.) to block U50,488-induced reinstatement was examined. Priming injections U50,488 reinstated responding on the previously ethanol-associated lever. Pretreatment with naltrexone reduced the reinstatement of ethanol-seeking behavior. nor-BNI also attenuated KOR agonist-induced reinstatement, but to a lesser extent than naltrexone, when injected 24 hours prior to injections of U50,488, a time point that is consistent with KOR selectivity. While these results suggest that activation of KORs is a key mechanism in the regulation of ethanol-seeking behavior, U50,488-induced reinstatement may not be fully selective for KORs. Erin Harshberger, Emily A. Gilson, Kelli Gillett, Jasmine H. Stone, Laila El Amrani, and Glenn R. Valdez Copyright © 2016 Erin Harshberger et al. All rights reserved. Heavy Alcohol Drinking Associated Akathisia and Management with Quetiapine XR in Alcohol Dependent Patients Tue, 25 Oct 2016 12:42:43 +0000 http://www.hindawi.com/journals/jad/2016/6028971/ Heavy drinking contributes to involuntary body movements such as akathisia. Quetiapine has been shown to alleviate symptoms of akathisia; however, its efficacy in the alcohol dependent population is not well established. Thus, we aimed to identify efficacy of Quetiapine in treating akathisia in very heavy drinking alcohol dependent patients. 108 male and female heavy alcohol consuming study participants received 13 weeks of Quetiapine XR. Drinking history (Timeline Followback, TLFB), depression (Montgomery-Asberg Depression Rating Scale, MADRS), and movement (Barnes Akathisia Scale, BARS) measures were collected at baseline (0 W), week 6 (6 W), and week 12 (12 W). The role of drinking, symptoms of depression, and efficacy of Quetiapine for treating akathisia were assessed. In patients with no symptoms of depression (low MADRS), Quetiapine treatment decreased symptoms of akathisia. Patients with clinically significant depression (high MADRS) reported a significant increase in akathisia measures at 6 W which eventually decreased at 12 W to below baseline levels. The increase in akathisia at 6 W corresponded with a significant increase in the patients’ total drinks and heavy drinking pattern. Treatment with Quetiapine progressively lowered the occurrence of akathisia in alcohol dependent patients who do not show symptoms of depression. Quetiapine treatment lowered akathisia over time in heavy drinkers who had clinically significant symptoms of depression. Zimple Kurlawala and Vatsalya Vatsalya Copyright © 2016 Zimple Kurlawala and Vatsalya Vatsalya. All rights reserved. Substance Use Disorders in Elderly Admissions to an Academic Psychiatric Inpatient Service over a 10-Year Period Wed, 19 Oct 2016 11:15:21 +0000 http://www.hindawi.com/journals/jad/2016/4973018/ Objective. There is a paucity of research on substance use disorders (SUDs) in the elderly psychiatric population. This study examines SUDs in a geriatric psychiatry inpatient service over a 10-year period. Methods. Data from 1788 elderly psychiatric inpatients from a ten-year period was collected. Variables collected included psychiatric diagnoses, SUD, number of psychiatric admissions, and length of stay. Those with and without a SUD were compared using Chi-Square or Student’s -test as appropriate using SPSS. Results. 11.7% () of patients had a SUD, and the most common substance was alcohol at 73.3% () or 8.6% of all admissions. Other SUDs were sedative-hypnotics (11%), opiate (2.9%), cannabis (1%), tobacco (1.4%), and unspecified SUD (38.6%). SUD patients were significantly younger, divorced, male, and less frequently readmitted and had shorter lengths of stay. The most common comorbid diagnoses were major depression (26.1%), bipolar disorder (10.5%), and dementia (17.1%). Conclusions. Over 10% of psychogeriatric admissions were associated with a SUD, with alcohol being the most common. Considering the difficulties in diagnosing SUD in this population and the retrospective study design, the true prevalence in elderly psychiatric inpatients is likely higher. This study adds to sparse literature on SUD in elderly psychiatric patients. Dennis Dombrowski, Nelly Norrell, and Suzanne Holroyd Copyright © 2016 Dennis Dombrowski et al. All rights reserved. Family-Based Intervention Program for Parents of Substance-Abusing Youth and Adolescents Wed, 05 Oct 2016 11:49:59 +0000 http://www.hindawi.com/journals/jad/2016/4320720/ The use of drugs among adolescents/youth often results in a high degree of distress for the family members who live with them. This in turn can lead to a deterioration of mental (psychological) health, hindering any attempt to successfully cope with the situation. The goal of our research was to study the effect of the Community Reinforcement and Family Training (CRAFT) program on parents of adolescents/young adult drug users. Study volunteers () were parents from Valencia (Spain) that were divided into two groups. The experimental group () was made up of parents whose sons and daughters exhibited problems with drug use and the constructed noncausal baseline group () was made up of parents whose sons and daughters did not show any substance abuse problems. For both groups, self-esteem (Rosenberg Self-Esteem Scale), depression (BDI-II), anxiety (STAI), and anger (STAXI-II) were evaluated before and after the application of the CRAFT program. Results show a significant improvement in the experimental group’s self-esteem, depression, and anger state and a decrease in negative moods. These changes in parents produce a positive effect on their substance-using sons and daughters: of the 25 participants, 15 contacted specialized addiction treatment resources for the first time. David Bisetto Pons, Remedios González Barrón, and Álvaro Botella Guijarro Copyright © 2016 David Bisetto Pons et al. All rights reserved. The Prevalence of and Factors Associated with Alcohol-Related Problems in a Community Sample of African American Women Mon, 26 Sep 2016 16:49:27 +0000 http://www.hindawi.com/journals/jad/2016/7513827/ Purpose. This study examines the prevalence of alcohol-related problems, the factors underlying these problems, and whether or not there is evidence of syndemic effects in a community population of southern, urban African American women. Methods. Questionnaire-based interviews were conducted with 817 women, all African American, from 80 targeted census block groups in Atlanta, Georgia. Results. Most of the alcohol users (67.8%) experienced at least one problem as a result of their alcohol (ab)use, with most women experiencing two or more such problems. Eight factors were found to be associated with experiencing more alcohol problems: being aged 30 or older, having had no recent health insurance, lower levels of educational attainment, self-identifying as lesbian or bisexual, experiencing greater amounts of childhood maltreatment, greater impulsivity, perceiving one’s local community or neighborhood to be unsafe, and having a larger number of criminally involved friends. Conclusions. Drinking-related problems were prevalent in this population. Numerous factors underlie the extent to which African American women experienced problems resulting from their alcohol use. There is strong evidence of syndemic-type effects influencing drinking problems in this population, and future efforts to reduce the negative impact of alcohol (ab)use ought to consider the adoption of programs using a syndemics’ theory approach. Hugh Klein, Claire E. Sterk, and Kirk W. Elifson Copyright © 2016 Hugh Klein et al. All rights reserved. Cross-Sectional Survey on Quitting Attempts among Adolescent Smokers in Dharan, Eastern Nepal Thu, 22 Sep 2016 13:48:16 +0000 http://www.hindawi.com/journals/jad/2016/6859291/ Background. Adolescents frequently attempt smoking cessation but are unable to maintain long term abstinence because they are dependent on nicotine and experience withdrawal symptoms. Objectives. This study aimed to explore the quitting attempts among adolescent smokers in Dharan Municipality of Eastern Nepal. Methods. A cross-sectional study was conducted using pretested self-administered questionnaire adapted from Global Youth Tobacco Survey to assess current smokers and quitting attempts among 1312 adolescent students in middle (14-15 years) and late adolescence (16–19 years). Chi square test was used for association of various factors with quitting attempts. Results. The prevalence of current smoking was 13.7%. Among the current smokers, 66.5% had attempted to quit in the past because they believed smoking was harmful to health (35.5%). The median duration of quitting was 150 days. Nearly 8% of the current smokers were unwilling to quit in the future because they thought it is already a habit (60%). Smokers who are willing to quit smoking in the future were more likely to have made quitting attempts (OR = 1.36, 95% CI = 0.40–4.45). Conclusion. Relapse often occurs even after multiple quitting attempts. Tobacco focused interventions to support abstinence are important during adolescence to prevent habituation. Pranil Man Singh Pradhan and Kedar Marahatta Copyright © 2016 Pranil Man Singh Pradhan and Kedar Marahatta. All rights reserved. Predictors of Relapse after Inpatient Opioid Detoxification during 1-Year Follow-Up Sun, 18 Sep 2016 10:57:58 +0000 http://www.hindawi.com/journals/jad/2016/7620860/ Introduction. Relapse rate after opioid detoxification is very high. We studied the possibility that predetoxification patient characteristics might predict relapse at follow-up and thus conducted this 1-year follow-up study to assess the predictors of relapse after inpatient opioid detoxification. Materials and Methods. We conducted this study in our tertiary care institute in India over two-year time period (1 Jan 2014 to 31 Dec 2015). Out of 581 patients admitted, 466 patients were considered for study. Results and Discussion. No significant difference was found between relapsed and nonrelapsed patients regarding sociodemographic profile; however substance abuse pattern and forensic history showed significant differences. Relapsed patients abused greater amount and used injections more commonly, as compared to nonrelapsed group. Longer duration of abuse was also a significant risk factor. Patients with past attempt of opioid detoxification and family history (parental or first degree) of alcohol abuse had decreased possibility of maintaining remission during 1-year follow-up. Relapsed patients were found to abuse their spouse or parents. Conclusion. Our study compared profiles of relapsed and nonrelapsed patients after inpatient detoxification and concluded predictors of relapse during 1-year follow-up period. Early identification of predictors of relapse and hence high risk patients might be helpful in designing more effective and focused treatment plan. Harsh Chalana, Tanu Kundal, Varun Gupta, and Amandeep Singh Malhari Copyright © 2016 Harsh Chalana et al. All rights reserved. Effects of a Comprehensive, Multiple Risky Behavior Prevention Program on High School Students Thu, 08 Sep 2016 07:55:30 +0000 http://www.hindawi.com/journals/jad/2016/9545847/ The purpose of this research study was to examine the effect of a multiple risky behaviors prevention program applied comprehensively throughout an entire school system involving universal, selective, and indicated levels of students at a local private high school during a 4-year period. The noncurriculum prevention program was created based upon the key elements of effective prevention programming and the need to address the growing variety of risky behaviors that the youth face today. Results ( to 614) indicated that 7 out of 15 risky behaviors statistically significantly decreased throughout the 4-year study, with 6 behaviors involving alcohol and drugs. However, many of the targeted non-substance-use risky behaviors displayed inconsistent prevalence rate patterns without statistically significant changes. These findings indicate that the frequency and intensity of programming for non-substance-use behaviors should be increased to a value at least equal to that of the substance-use behaviors. Implications for schools, prevention specialists, and future program development and research are discussed. Crystal Collier, Anthony J. Onwuegbuzie, Alicia LaChapelle, and Jessica Davison Copyright © 2016 Crystal Collier et al. All rights reserved. Mid-Adolescent Predictors of Adult Drinking Levels in Early Adulthood and Gender Differences: Longitudinal Analyses Based on the South Australian School Leavers Study Sun, 21 Aug 2016 09:19:11 +0000 http://www.hindawi.com/journals/jad/2016/1489691/ There is considerable public health interest in understanding what factors during adolescence predict longer-term drinking patterns in adulthood. The aim of this study was to examine gender differences in the age 15 social and psychological predictors of less healthy drinking patterns in early adulthood. The study investigates the relative importance of internalising problems, other risky health behaviours, and peer relationships after controlling for family background characteristics. A sample of 812 young people who provided complete alcohol consumption data from the age of 15 to 20 years (5 measurement points) were drawn from South Australian secondary schools and given a detailed survey concerning their psychological and social wellbeing. Respondents were classified into two groups based upon a percentile division: those who drank at levels consistently below NHMRC guidelines and those who consistently drank at higher levels. The results showed that poorer age 15 scores on measures of psychological wellbeing including scores on the GHQ-12, self-esteem, and life-satisfaction as well as engagement in health-related behaviours such as smoking or drug-taking were associated with higher drinking levels in early adulthood. The pattern of results was generally similar for both genders. Higher drinking levels were most strongly associated with smoking and marijuana use and poorer psychological wellbeing during adolescence. Paul H. Delfabbro, Helen R. Winefield, Anthony H. Winefield, and Anne Hammarström Copyright © 2016 Paul H. Delfabbro et al. All rights reserved. Tobacco and Alcohol Use and the Impact of School Based Antitobacco Education for Knowledge Enhancement among Adolescent Students of Rural Kerala, India Wed, 17 Aug 2016 13:10:01 +0000 http://www.hindawi.com/journals/jad/2016/9570517/ Objectives. Limited information is available on adolescent tobacco and alcohol use in rural Kerala, the southernmost state in India. The study was conducted to estimate the prevalence of tobacco and alcohol use among adolescent school students and further to understand the extent of knowledge pertaining to tobacco before and after conducting awareness programmes in schools. Methods. A cross-sectional study was conducted in 10 government schools of rural Thiruvananthapuram district of Kerala state based on a multistaged sampling design. Using a pretested semistructured questionnaire, prevalence and patterns of tobacco use by students and their households, as well as students’ knowledge on tobacco hazards before and after delivering antitobacco messages, were collected. Results. The overall prevalence of self-reported ever users of tobacco in the current academic year was 7.4% (95% CI 5.86–8.94), while that of ever alcohol users was 5.6% (95% CI 4.25–6.95). Knowledge assessment scores revealed a significant increase in the mean knowledge scores after posttraining evaluation (mean score = 10.34) when compared to pretraining evaluation (mean score = 9.26) (). Conclusion. Apart from antitobacco awareness programmes, strict monitoring of trade of tobacco and alcohol products near educational institutions has to be conducted consistently to curb the problem. Radhakrishnan Jayakrishnan, Seema Geetha, Jagathnath Krishna Kumara Pillai Mohanan Nair, Gigi Thomas, and Paul Sebastian Copyright © 2016 Radhakrishnan Jayakrishnan et al. All rights reserved. The Impact of an Implementation Project on Primary Care Staff Perceptions of Delivering Brief Alcohol Advice Thu, 30 Jun 2016 11:30:25 +0000 http://www.hindawi.com/journals/jad/2016/4731571/ Objective. To explore how the perceptions and experiences of working with risky drinkers change over time among primary health care staff during a systematic implementation project. Methods. Qualitative focus group interviews took place before and after the implementation of the project. Results. The staff displayed a positive change during the implementation period with regard to awareness, knowledge, and confidence that led to a change in routine practice. Throughout the project, staff were committed to engaging with risky drinkers and appeared to have been learning-by-doing. Conclusions. The results indicated a positive attitude to alcohol prevention work but staff lack knowledge and confidence in the area. The more practical experience during the study is, the more confidence seems to have been gained. This adds new knowledge to the science of implementation studies concerning alcohol prevention measures, which have otherwise shown disappointing results, emphasizing the importance of learning in practice. Hanna Reinholdz, Preben Bendtsen, Fredrik Spak, and Ulrika Müssener Copyright © 2016 Hanna Reinholdz et al. All rights reserved. Availability of Medical and Recreational Marijuana Stores and Neighborhood Characteristics in Colorado Sun, 24 Apr 2016 09:35:25 +0000 http://www.hindawi.com/journals/jad/2016/7193740/ Objective. To examine the availability of marijuana stores in Colorado and associations with neighborhood characteristics. Methods. The addresses for 650 medical and recreational marijuana stores were geocoded and linked to the characteristics of 1249 census tracts in Colorado. Accounting for spatial autocorrelations, autologistic regressions were used to quantify the associations of census tract socioeconomic characteristics with the availability of marijuana stores. Results. Regardless of store types, marijuana stores were more likely to locate in neighborhoods that had a lower proportion of young people, had a higher proportion of racial and ethnic minority population, had a lower household income, had a higher crime rate, or had a greater density of on-premise alcohol outlets. The availability of medical and recreational marijuana stores was differentially correlated with household income and racial and ethnic composition. Conclusions. Neighborhood disparities existed in the availability of marijuana stores, and associations between availability of stores and neighborhood characteristics varied by store types. This study highlighted the need for regulatory measures to prevent marijuana related outcomes in high risk neighborhoods. Yuyan Shi, Kristin Meseck, and Marta M. Jankowska Copyright © 2016 Yuyan Shi et al. All rights reserved. Prevalence and Correlates of Alcohol Use among a Sample of Nigerian Semirural Community Dwellers in Nigeria Tue, 19 Apr 2016 12:49:56 +0000 http://www.hindawi.com/journals/jad/2016/2831594/ Objective. To determine the prevalence and correlates of alcohol use among a sample of Nigerian semirural community dwellers in Nigeria. Methods. In a single arm nonrandomized intervention study, the assessment of baseline hazardous and harmful alcohol use and associated risk factors was conducted in two semirural local government areas of Oyo State, Nigeria, with the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Participants included 1203 subjects 15 years and older, recruited between October 2010 and April 2011. ASSIST score of 0–10 was classified as lower risk scores, 11–26 as moderate risk, and 27+ as high risk. Results. Prevalence of lifetime alcohol use was 57.9% and current alcohol use was 23.7%. Current alcohol use was more prevalent among the younger age group , male gender , unmarried , low educational level , low socioeconomic class , unemployed , and the Christians . Of the current drinkers, the majority (69.1%) were at either moderate or high health risk from alcohol use. Conclusion. Alcohol consumption is prevalent in semirural communities in Nigeria and the majority of these drinkers are at moderate or high health risk. Screening, brief intervention, and referral for treatment for unhealthy alcohol use should be integrated into community care services in Nigerian rural communities. Victor Olufolahan Lasebikan and Bolanle Adeyemi Ola Copyright © 2016 Victor Olufolahan Lasebikan and Bolanle Adeyemi Ola. All rights reserved. Dually Diagnosed Patients with Arrests for Violent and Nonviolent Offenses: Two-Year Treatment Outcomes Mon, 28 Mar 2016 16:32:07 +0000 http://www.hindawi.com/journals/jad/2016/6793907/ The purpose of this study was to examine the history of arrests among dually diagnosed patients entering treatment, compare groups with different histories on use of treatment and mutual-help groups and functioning, at intake to treatment and six-month, one-year, and two-year follow-ups, and examine correlates and predictors of legal functioning at the study endpoint. At treatment intake, 9.2% of patients had no arrest history, 56.3% had been arrested for nonviolent offenses only, and 34.5% had been arrested for violent offenses. At baseline, the violent group had used the most outpatient psychiatric treatment and reported poorer functioning (psychiatric, alcohol, drug, employment, and family/social). Both arrest groups had used more inpatient/residential treatment and had more mutual-help group participation than the no-arrest group. The arrest groups had higher likelihood of substance use disorder treatment or mutual-help group participation at follow-ups. Generally, all groups were comparable on functioning at follow-ups (with baseline functioning controlled). With baseline arrest status controlled, earlier predictors of more severe legal problems at the two-year follow-up were more severe psychological, family/social, and drug problems. Findings suggest that dually diagnosed patients with a history of arrests for violent offenses may achieve comparable treatment outcomes to those of patients with milder criminal histories. Christine Timko, Andrea Finlay, Nicole R. Schultz, and Daniel M. Blonigen Copyright © 2016 Christine Timko et al. All rights reserved. Epidemiology of Substance Use among University Students in Sudan Wed, 24 Feb 2016 11:12:14 +0000 http://www.hindawi.com/journals/jad/2016/2476164/ Background. Youth populations are vulnerable to substance use particularly in developing countries where circumstances may be favorable for it. There is no published data on substance use among the youth in Sudan other than on tobacco use. Objectives. The aim of this study was to investigate the prevalence, circumstances, and factors associated with substance use. Methods. An institution-based survey was conducted on a sample of 500 students. Data was collected using a questionnaire designed by the WHO for student drug surveys and analyzed using IBM SPSS version 20. Results. The overall prevalence of substance use is 31%. The current prevalence of tobacco, cannabis, alcohol, amphetamines, tranquilizers, inhalants, opiates, cocaine, and heroin use was 13.7%, 4.9%, 2.7%, 2.4%, 3.2%, 1%, 1.2%, 0.7%, and 0.5%, respectively. Curiosity (33.1%) was the main reason for initiation of substance use. The main adverse effects reported were health problems (19.7%) and theft (19.7%). Peers (40.9%) were the prime source of substance use. On multivariate analysis, male sex was the principle predictor for substance use (AOR: 5.55; 95% CI: 3.38, 9.17). Conclusion. Strategies to control substance use should encompass the role of the university and parents in observing and providing education to improve awareness of substances and their consequences. Tarig Osman, Cathrine Victor, Alaa Abdulmoneim, Hala Mohammed, Fatima Abdalla, Asma Ahmed, Eiman Ali, and Wael Mohammed Copyright © 2016 Tarig Osman et al. All rights reserved. Correlates of Nine-Month Retention following Interim Buprenorphine-Naloxone Treatment in Opioid Dependence: A Pilot Study Thu, 21 Jan 2016 13:11:25 +0000 http://www.hindawi.com/journals/jad/2016/6487217/ Interim medication-only treatment has been suggested for the initiation of opioid maintenance treatment (OMT) in opioid-dependent subjects, but this rarely has been studied using buprenorphine instead of methadone. Following a pilot trial assessing interim buprenorphine-naloxone treatment in order to facilitate transfer into OMT, we here aimed to study retention, and potential correlates of retention, in full-scale treatment. Thirty-six patients successfully referred from a waiting list through an interim treatment phase were followed for nine months in OMT. Baseline characteristics, as well as urine analyses during the interim phase and during full-scale OMT, were studied as potential correlates of retention. The nine-month retention in OMT was 83 percent (). While interim-phase urine samples positive for benzodiazepines did not significantly predict dropout from full-scale OMT (), urine samples positive for benzodiazepines within full-scale OMT were significantly associated with dropout (), in contrast to other substances and baseline characteristics. Retention remained high through nine months in this pilot study sample of patients referred through buprenorphine-naloxone interim treatment, but use of benzodiazepines is problematic, and the present data suggest that it may be associated with treatment dropout. A. Håkansson, C. Widinghoff, T. Abrahamsson, and C. Gedeon Copyright © 2016 A. Håkansson et al. All rights reserved. The Drinkers Degree: Risk Taking Behaviours amongst Undergraduate Student Drinkers Wed, 02 Dec 2015 14:22:04 +0000 http://www.hindawi.com/journals/jad/2015/965438/ Objective. To examine risk taking behaviours associated with alcohol consumption amongst UK undergraduate students. Design and Methods. A cross-sectional web survey was used to assess attitudes and health behaviours. The survey included the Alcohol Use Disorders Identification Test (AUDIT). Students were also asked about why they drank alcohol; about their preferred alcoholic beverage; and if they had experienced any consequences associated with drinking alcohol as well as questions relating to sexual risk taking, drug use, and smoking. Results. 2779 (65% female; 84% White British) students completed some part of the survey. Of these, 98% () completed the AUDIT. Of the 92% that drank 66% () were categorised as being AUDIT positive. 8% () were categorised as probably alcohol dependent. Higher AUDIT scores were significantly associated with negative consequences such as unplanned sexual activity, physical injuries, and arguments. Other risk taking behaviours such as drug use and smoking were also found to be positively correlated with higher AUDIT scores; drug use; and smoking. Conclusions. The results from this study provide insight into students’ alcohol consumption and associated risk taking. University policies need to protect students’ overall health and wellbeing to ensure academic potential is maximised. Gillian O’Neill, Neil Martin, Jennifer Birch, Alison Oldam, and Dorothy Newbury-Birch Copyright © 2015 Gillian O’Neill et al. All rights reserved. Delayed Ego Strength Development in Opioid Dependent Adolescents and Young Adults Tue, 17 Nov 2015 11:21:39 +0000 http://www.hindawi.com/journals/jad/2015/879794/ Objective. To evaluate ego strengths, in the context of Erikson’s framework, among adolescents and young adults diagnosed with opioid dependence as compared to non-drug using youth. Methods. Opioid dependent () and non-drug using control () youth completed the self-administered Psychosocial Inventory of Ego Strengths (PIES). The PIES assesses development in the framework of Erikson’s ego strength stages. Multivariate linear regression modeling assessed the independent association of the primary covariate (opioid dependent versus control) as well as potential confounding variables (e.g., psychiatric comorbidities, intelligence) with total PIES score. Results. Mean total PIES score was significantly lower in opioid dependent youth ( opioid dependent versus control; ). Evaluation of the PIES subscores found significant () delays in all ego strength areas (hope, will, purpose, competence, fidelity, love, care, and wisdom). When adjusting for potential confounders, opioid dependence remained a significant () independent predictor of total PIES score. Conclusion. Adolescents with opioid dependence demonstrated significant delays in ego strength development. A treatment approach acknowledging this delay may be needed in the counseling and treatment of adolescents with opioid dependence. Benjamin A. Abramoff, Hannah L. H. Lange, Steven C. Matson, Casey B. Cottrill, Jeffrey A. Bridge, Mahmoud Abdel-Rasoul, and Andrea E. Bonny Copyright © 2015 Benjamin A. Abramoff et al. All rights reserved. The Cannabis Dilemma: A Review of Its Associated Risks and Clinical Efficacy Sun, 11 Oct 2015 12:46:37 +0000 http://www.hindawi.com/journals/jad/2015/707596/ Cannabis, also known as marijuana, has 9-tetrahydrocannabinol as the main constituent. There has been strict legislation governing the utilization of cannabis locally and worldwide. However, there has been an increasing push to make cannabis legalized, in view of its potential medical and therapeutic effects, for various medical disorders ranging from development disorders to cancer treatment, and being an adjunctive medication for various neurological conditions. It is the aim of this review paper to explore the evidence base for its proposed therapeutic efficacy and to compare the evidence base supporting its proposed therapeutic efficacy with its known and well-researched medical and psychiatric side effects. Melvyn Weibin Zhang and Roger C. M. Ho Copyright © 2015 Melvyn Weibin Zhang and Roger C. M. Ho. All rights reserved. Risk Factors Associated with Unsafe Injection Practices at the First Injection Episode among Intravenous Drug Users in France: Results from PrimInject, an Internet Survey Sun, 04 Oct 2015 06:04:45 +0000 http://www.hindawi.com/journals/jad/2015/507214/ Background. New drug use patterns may increase the risk of human immunodeficiency virus and hepatitis infections. In France, new injection patterns among youths with diverse social backgrounds have emerged, which may explain the persistently high rates of hepatitis C virus infection. This study explores factors associated with injection risk behaviours at first injection among users who began injecting in the post-2000 era. Methods. A cross-sectional study was conducted on the Internet from October 2010 to March 2011, through an online questionnaire. Multivariate logistic regression identified the independent correlates of needle sharing and equipment (cooker/cotton filter) sharing. Results. Among the 262 respondents (mean age 25 years), 65% were male. Both risk behaviours were positively associated with initiation before 18 years of age (aOR 3.7 CI 95% 1.3–10.6 and aOR 3.0 CI 95% 1.3–7.0) and being injected by another person (aOR 3.1 CI 95% 1.0–9.9 and aOR 3.0 CI 95% 1.3–7.1). Initiation at a party was an independent correlate of equipment sharing (aOR 2.6 95% CI 1.0–6.8). Conclusions. Results suggest a need for innovative harm reduction programmes targeting a variety of settings and populations, including youths and diverse party scenes. Education of current injectors to protect both themselves and those they might initiate into injection is critically important. Anne Guichard, Romain Guignard, France Lert, and Elise Roy Copyright © 2015 Anne Guichard et al. All rights reserved. Improving Consumer Satisfaction with Addiction Treatment: An Analysis of Alumni Preferences Mon, 21 Sep 2015 06:55:11 +0000 http://www.hindawi.com/journals/jad/2015/509864/ Objective. The primary objective of this investigation is to determine which individual and aggregate factors of residential addiction treatment centers are most significant influencers of alumni satisfaction. Design. Survey targeted alumni of residential addiction treatment facilities. Alumni were queried through a survey, which utilized Likert-scale matrices and binary response options: 379 respondents met the completion threshold. Alumni rated amenities and individual and group counseling factors; additionally, respondents provided feedback on two satisfaction proxies: cost worthiness and future recommendations. Descriptive and relational analyses were conducted, with the latter utilizing logistic regression models. Results. Individual factors’ scores of group counseling, and overall aggregate group counseling score, are most enthusiastically positive. Group counseling is also the most significant influencer of satisfaction. Other significant influencers of satisfaction are met expectations for individual counseling and psychiatric care offerings. Conclusions. While individual counseling and facility amenities should not be ignored, group counseling may be the most significant influencer of alumni satisfaction. Long-term outcomes are not single-faceted; however, treatment providers should be encouraged to invest in high-quality group counseling offerings in order to best satisfy, and thereby empower, clients. Ruchi M. Sanghani and Alexander K. Moler Copyright © 2015 Ruchi M. Sanghani and Alexander K. Moler. All rights reserved. Psychopathology in Substance Use Disorder Patients with and without Substance-Induced Psychosis Mon, 31 Aug 2015 13:04:13 +0000 http://www.hindawi.com/journals/jad/2015/843762/ Background. Substance-induced psychotic disorder (SIPD) is a diagnosis constructed to distinguish substance-induced psychotic states from primary psychotic disorders. A number of studies have compared SIPD persons with primary psychotic patients, but there is little data on what differentiates substance use disorder (SUD) individuals with and without SIPD. Here, we compared psychopathology, sociodemographic variables, and substance use characteristics between SUD patients with and without SIPD. Methods. A retrospective chart review was conducted on newly admitted patients at a rehabilitation centre between 2007 and 2012. Results. Of the 379 patients included in the study, 5% were diagnosed with SIPD and 95% were diagnosed with SUDs without SIPD . More SIPD patients reported using cannabis and psychostimulants, and fewer SIPD patients reported using alcohol than SUDs patients without SIPD. SIPD patients scored higher on the “schizophrenia nuclear symptoms” dimension of the SCL-90R psychoticism scale and exhibited more ClusterB personality traits than SUD patients without SIPD. Discussion. These data are consistent with previous studies suggesting that psychopathology, substance type, and sociodemographic variables play important role in the development of SIPD. More importantly, the results highlight the need for paying greater attention to the types of self-reported psychotic symptoms during the assessment of psychotomimetic effects associated with psychoactive substances. Simon Zhornitsky, Andràs Tikàsz, Élie Rizkallah, Jean-Pierre Chiasson, and Stéphane Potvin Copyright © 2015 Simon Zhornitsky et al. All rights reserved. Psychometric Properties and Validation of the Arabic Social Media Addiction Scale Tue, 11 Aug 2015 08:02:25 +0000 http://www.hindawi.com/journals/jad/2015/291743/ This study investigated the psychometric properties of the Arabic version of the SMAS. SMAS is a variant of IAT customized to measure addiction to social media instead of the Internet as a whole. Using a self-report instrument on a cross-sectional sample of undergraduate students, the results revealed the following. First, the exploratory factor analysis showed that a three-factor model fits the data well. Second, concurrent validity analysis showed the SMAS to be a valid measure of social media addiction. However, further studies and data should verify the hypothesized model. Finally, this study showed that the Arabic version of the SMAS is a valid and reliable instrument for use in measuring social media addiction in the Arab world. Jamal Al-Menayes Copyright © 2015 Jamal Al-Menayes. All rights reserved. Alcohol and Substance Use in the Jewish Community: A Pilot Study Tue, 16 Jun 2015 12:44:04 +0000 http://www.hindawi.com/journals/jad/2015/763930/ Awareness of addictions in the Jewish community is becoming increasingly prevalent, and yet, a gap exists in the literature regarding addictions in this community. Knowledge about the prevalence of addictions within Jewish communities is limited; some believe that Jews cannot be affected by addictions. To address this gap, a pilot study was conducted to gather preliminary evidence relating to addictions and substance use in the Jewish community. Results indicate that a significant portion of the Jewish community knows someone affected by an addiction and that over 20% have a family history of addiction. Future research needs are discussed. Melanie Baruch, Abraham Benarroch, and Gary E. Rockman Copyright © 2015 Melanie Baruch et al. All rights reserved. National Helpline for Problem Gambling: A Profile of Its Users’ Characteristics Sun, 03 May 2015 14:13:51 +0000 http://www.hindawi.com/journals/jad/2015/659731/ Gambling has seen a significant increase in Italy in the last 10 years and has rapidly become a public health issue, and for these reasons the first National Helpline for Problem Gambling (GR-Helpline) has been established. The aims of this study are to describe the GR-Helpline users’ characteristics and to compare the prevalence rates of the users with those of moderate-risk/problematic gamblers obtained from the national survey (IPSAD 2010-2011). Statistical analysis was performed on data obtained from the counselling sessions (phone/e-mail/chat) carried out on 5,805 users (57.5% gamblers; 42.5% families/friends). This confirms that the problems related to gambling concern not only the gamblers but also their families and friends. Significant differences were found between gamblers and families/friends involving gender (74% of gamblers were male; 76.9% of families/friends were female), as well as age-classes and geographical area. Female gamblers had a higher mean age (47.3 versus 40.2 years) and preferred nonstrategy-based games. Prevalence rates of GR-Helpline users and of moderate risk/problematic gamblers were correlated (Rho = 0.58; ). The results highlight the fact that remote access to counselling can be an effective means of promoting treatment for problem gamblers who do not otherwise appeal directly for services. Luca Bastiani, Maurizio Fea, Roberta Potente, Claudia Luppi, Fabio Lucchini, and Sabrina Molinaro Copyright © 2015 Luca Bastiani et al. All rights reserved. Comorbid Psychopathology and Alcohol Use Patterns among Methadone Maintenance Treatment Patients Mon, 23 Mar 2015 08:24:50 +0000 http://www.hindawi.com/journals/jad/2015/197652/ 130 patients from a methadone maintenance treatment program agreed to complete Symptoms Checklist 90-Revised (SCL-90R) and Alcohol Use Disorders Identification Test (AUDIT) self-report scales. Scores higher than the proposed cut-score on SCL-90R scale were observed on depression, obsessions-compulsions, paranoid ideation, anxiety, anger-hostility, somatization, interpersonal sensitivity, and psychoticism subscales. In sum, 42.9% of our sample exhibited depressive symptomatology, 34.9% obsessive-compulsive symptoms, 29.1% somatization, 27.2% anxiety symptoms, 22.2% paranoid ideation, 19% phobic anxiety, 15.1% psychoticism, and 15.1% hostility and 11.9% presented with symptoms of interpersonal sensitivity. Mean score on AUDIT scale was . 63.0% of our participants scored below cut-off and were classified as having a low level of alcohol-related problems; 24.4% scored in the range of 8–15 which is an indication of alcohol abuse whereas 12.6% scored 16 and above indicative of serious abuse/addiction. Scores on AUDIT scale were positively correlated with length of time on methadone treatment, but not with length of time on drug use or age of our participants. Positive correlations were observed among AUDIT and SCL-90R scores, namely, with global severity index score, positive symptom distress index, positive symptom total, and all primary symptom dimensions subscales except phobic anxiety. Georgios Moussas, Irene Fanouraki, Argiro Pachi, Arezina Asomatou, Olga Drylli, Georgios Paschalakis, Athanasios Tselebis, Konstantinos Giotakis, Dionisios Bratis, Georgios Dermatis, and Meni Malliori Copyright © 2015 Georgios Moussas et al. All rights reserved. Predictors of Intention to Quit Waterpipe Smoking: A Survey of Arab Americans in Houston, Texas Wed, 04 Mar 2015 10:02:53 +0000 http://www.hindawi.com/journals/jad/2015/575479/ Waterpipe smoking has been described as “the second global tobacco epidemic since the cigarette.” Both Middle Eastern ethnicity and having a friend of Middle Eastern ethnicity have been reported as significant predictors of waterpipe smoking. Addressing waterpipe smoking in this ethnic minority is essential to controlling this growing epidemic in the US. We investigated the predictors of an intention to quit waterpipe smoking by surveying 340 Arab American adults in the Houston area. Primary analyses were conducted using stepwise logistic regression. Only 27% of participants reported having an intention to quit waterpipe smoking. Intention to quit waterpipe smoking was significantly higher with history of cigar use, a prior attempt to quit, and not smoking when seriously ill and significantly lower with increasing age, medium cultural acceptability of using waterpipe among family, high cultural acceptability of using waterpipe among friends, longer duration of smoking sessions, and perceiving waterpipe smoking as less harmful than cigarettes. Educational programs that target Arab Americans in general, and specifically older adults, those who smoke waterpipe for more than 60 minutes, those whose family and friends approve waterpipe smoking, and those with no former attempts to quit, may be necessary to increase the intention to quit waterpipe smoking. Liqa Athamneh, Sujit S. Sansgiry, E. James Essien, and Susan Abughosh Copyright © 2015 Liqa Athamneh et al. All rights reserved. Evolution of Metabolic Abnormalities in Alcoholic Patients during Withdrawal Tue, 24 Feb 2015 14:15:17 +0000 http://www.hindawi.com/journals/jad/2015/541536/ Chronic alcohol intoxication is accompanied by metabolic abnormalities. Evolution during the early withdrawal period has been poorly investigated. The aim of this study was to determine the evolution of metabolic parameters during alcohol withdrawal. Patients and Methods. Thirty-three patients admitted in our department for alcohol withdrawal were prospectively included. Results. Baseline hypophosphatemia was found in 24% of cases. FEPO4 was reduced from 14.2 ± 9% at baseline to 7.3 ± 4.2% at day 3 (). FEPO4 inversely correlated with albuminemia (rs = −0.41, P = 0.01). CPK level was 124 ± 104 IU/L in men and 145 ± 85 IU/L in women ( and <192 IU/L, resp.), 7% and 28% of patients having a CPK level >nl, respectively. No correlation was found between the sodium and CPK levels () nor between the CPK level and the amount of alcohol ingested (rs = 0.084, ). Baseline urate level was elevated and returned to normal after three days. Baseline magnesium concentration was normal and stable over time. Conclusion. Chronic alcohol intoxication was accompanied by phosphaturia, rapidly reversible after alcohol withdrawal and inversely correlated with albuminemia, slight hyponatremia, low levels of 25 hydroxy vitamin D, elevated CPK level in about 30% of women, and hyperuricemia with rapid normalization. X. Vandemergel and F. Simon Copyright © 2015 X. Vandemergel and F. Simon. All rights reserved.