Abuse of pharmaceutical drugs is a major public health and social problem worldwide. Mostly abused drugs mainly include opioids such as morphine, tramadol, methadone and fentanyl, sedative-hypnotics such as benzodiazepines and non-benzodiazepines, and central stimulants such as Ritalin (methylphenidate), Adderall (amphetamine and dextroamphetamine) and modafinil. Abuse of pharmaceutical drugs not only causes direct damage to multiple systems of the body, but also significantly increases risks of mental and physical diseases, imposing a heavy burden on individuals, families and society. Therefore, the prevention and control of pharmaceutical drug abuse are of vital importance. The Chinese government has taken strict administration measures for pharmaceutical drugs with abuse risk. However, confronting endless new drugs and changing abuse trends, it is necessary to further strengthen management and prevention of pharmaceutical drugs, monitor the trend of abuse, establish rapid response mechanisms, popularize relevant knowledge, and develop specific therapeutic drugs and intervention means, in order to promote prevention and treatment of pharmaceutical drug abuse.
Analgesics, Opioid/adverse effects* ; Central Nervous System Stimulants/adverse effects* ; Humans ; Illicit Drugs/adverse effects* ; Substance-Related Disorders/prevention & control*

PURPOSE: This study aimed to determine whether a blended Infant MassageeParenting Enhancement Program (IMPEP) improved maternal psychosocial health outcomes (parenting stress, depressive symptoms, self-esteem, maternal attachment) and maternal-infant interaction among substanceaddicted mothers (SAMs) actively engaged in outpatient rehabilitation. METHODS: Designed as a randomized, three-group controlled trial testing two levels of psychoeducational intervention (IMPEP vs. PEP) and a control group (standard care parenting resources), the studywas conducted in two substance abuse centers in southeast Florida on a convenience sample of 138 recovering SAM-infant pairs. IMPEP or PEP classes were held weekly onWeeks 2e5, with data collected at baseline (Week 1),Week 6, andWeek 12 via structured interviews, observation (Observation Checklist onMaternal-Infant Interaction), and self-administered questionnaires (Abidin Parenting Stress Index, Beck Depression Inventory, Rosenberg Self-Esteem Scale, Muller's Maternal Attachment Inventory), analyzed descriptively and inferentially using Kruskall-Wallis analysis of variance and post hoc Wilcoxon rank sum and Mann-Whitney U tests. RESULTS: Both IMPEP and PEP groups had significantly increased Parenting Stress Index scores (decreased parenting stress) and decreased Beck Depression Inventory scores (decreased depressive symptoms) compared to controls at Week 12, whereas there were no clinically meaningful differences among study groups in Rosenberg Self-Esteem Scale, Muller's Maternal Attachment Inventory, or Observation Checklist on Maternal-Infant Interaction scores. Only the IMPEP group showed significant improvements in both psychological and physical (waist-hip ratio) measures of parenting stress over time. CONCLUSIONS: The findings suggest that infant massage blended into a structured parenting program has value-added effects in decreasing parenting stress and maternal depressive symptoms, but not on SAM's self-esteem, attachment, or maternal-infant interaction.
Adult ; Depressive Disorder/*prevention & control ; Female ; Florida ; Humans ; Infant ; Infant, Newborn ; Male ; Massage ; Maternal Behavior/*psychology ; Mother-Child Relations/*psychology ; Mothers/*education/*psychology ; Parenting/*psychology ; Program Evaluation ; Self Concept ; Stress, Psychological ; Substance-Related Disorders/*psychology/rehabilitation ; Young Adult

Several epidemiological studies have shown that exercise (EX) and physical activity (PA) can prevent or delay the onset of different mental disorders, and have therapeutic benefits when used as sole or adjunct treatment in mental disorders. This review summarizes studies that used EX interventions in patients with anxiety, affective, eating, and substance use disorders, as well as schizophrenia and dementia/mild cognitive impairment. Despite several decades of clinical evidence with EX interventions, controlled studies are sparse in most disorder groups. Preliminary evidence suggests that PA/EX can induce improvements in physical, subjective and disorder-specific clinical outcomes. Potential mechanisms of action are discussed, as well as implications for psychiatric research and practice.
Anxiety Disorders/prevention & control/therapy ; Databases, Factual ; Dementia/prevention & control/therapy ; Eating Disorders/prevention & control/therapy ; *Exercise ; Humans ; Mental Disorders/prevention & control/*therapy ; Mood Disorders/prevention & control/therapy ; Motor Activity ; Obsessive-Compulsive Disorder/prevention & control/therapy ; Schizophrenia/prevention & control/therapy ; Substance-Related Disorders/prevention & control/therapy

BACKGROUNDFollowing the increased human immunodeficiency virus (HIV) notification (infection) rates via sexual transmission and increased abuse of new synthetic drugs instead of heroin in China, a study on HIV infections and risk factors among synthetic drugs and heroin users in Beijing was conducted to provide a cue for further development of targets and strategies of HIV/AIDS control and prevention for different drug populations.

METHODSA total of 428 subjects including 224 heroin users and 204 new synthetic drug users was recruited from communities in Beijing by convenience sampling. A χ(2) test was used to compare HIV and syphilis infections between the two subpopulations. Logistic regression models were used to evaluate factors related to HIV, syphilis infections and abuse of synthetic drugs.

RESULTSUnbalanced distributions of demographics were detected between the two subpopulations. Compared with heroin users, most users of synthetic drugs were migrants, single and of younger age (age ≤ 30 years). Ten HIV infections and twenty-four syphilis infections were confirmed among 428 subjects. No significant difference in HIV infection was found between the two subpopulations (crude odds ratio (OR) = 0.46, 95% confidence interval (CI): 0.07 - 15.80 and adjusted odds ratio (AOR) = 1.26, 95%CI: 0.09 - 18.28) while four times as many syphilis infections were identified among users of synthetics drugs (AOR = 3.92, 95%CI: 1.06 - 14.56). HIV and syphilis infections appeared to work synergistically. The migrants who were of Han ethnicity, single and who had stayed in Beijing for more than six months were more likely to abuse synthetics drugs.

CONCLUSIONSThe new synthetic drug users and heroin users are different subpopulations. We optimistically speculate that HIV has not yet been introduced into the former in Beijing, but considering higher syphilis infections in synthetic drug users and the role of syphilis in HIV infection, synthetic drug users, as a possible and important driver of the HIV/AIDS epidemic in Beijing, should be paid more attention in HIV prevention and control strategies.

Adult ; China ; epidemiology ; Drug Users ; Female ; HIV Infections ; epidemiology ; prevention & control ; Heroin Dependence ; complications ; Humans ; Logistic Models ; Male ; Middle Aged ; Pilot Projects ; Substance-Related Disorders ; complications ; Syphilis ; epidemiology

INTRODUCTIONSmoking is one of the leading preventable causes of death throughout the world and can lead to nicotine dependence, particularly when initiated at a young age. This paper describes the prevalence of smoking and nicotine dependence in the adult Singapore resident population, whilst also exploring rates among the major ethnic groups (Chinese, Malay and Indian), different education levels and those with chronic psychiatric and physical comorbidities.

MATERIAL AND METHODSThe Singapore Mental Health Study (SMHS) is a cross-sectional epidemiological study that was conducted between December 2009 and December 2010. Information on smoking status was assessed using the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and the Fagerstrom Test for Nicotine Dependence measured nicotine dependence. Socio-demographic information was also collected.

RESULTSIn total, 6616 respondents participated in the SMHS giving a response rate of 75.9%. We found that 16% of the population were current smokers and 4.5% had nicotine dependence. Current smokers were more likely to be younger (18 to 34 years old), males, Malay and have lower education, whilst males had a 4.6 times higher risk of nicotine dependence to that of females. The prevalence of nicotine dependence was also higher in those with alcohol abuse and those experiencing chronic pain.

CONCLUSIONThe results from this study highlight the important differences in the prevalence of smoking and nicotine dependence among different age groups, gender and ethnicity in Singapore and are important for developing future health policies and targeted preventive strategies.

Adolescent ; Adult ; Aged ; China ; ethnology ; Cross-Sectional Studies ; Educational Status ; Epidemiologic Studies ; Female ; Humans ; Indonesia ; ethnology ; Malaysia ; ethnology ; Male ; Middle Aged ; Multivariate Analysis ; Nicotine ; Prevalence ; Risk Factors ; Sex Factors ; Singapore ; epidemiology ; Smoking ; epidemiology ; ethnology ; Smoking Prevention ; Substance-Related Disorders ; epidemiology ; ethnology ; prevention & control ; Young Adult

Drug abuse continues to be a serious public health threat worldwide. Most drug abuse prevention research has been conducted with predominantly American or European adolescent populations. Little is known about approaches that work best to prevent the initiation of Chinese adolescent drug use. For targeting risk factors of drug initiation in Chinese adolescents, a school-based health intervention program named "Cognition-Motivation-Emotional Intelligence-Resistance Skills" (CMER) was developed to enhance cognition upon drug use, to decrease motivation of drug use and to improve emotional adjusting and drug resistance skills in this study. A total of 798 students from 3 senior high schools in Wuhan, a city in central China, were assigned randomly to intervention and control groups. The intervention group received the CMER program in which knowledge, development of positive attitude and motivation towards drugs and training of peer resistance skills were basic elements. The immediate impact was compared by measuring the above mentioned elements prior to and three-month after the training session. Students from both groups were asked to complete a self-administered questionnaire. The questionnaire included demographic items, self-reported drug use behavior, cognition, attitude, and motivation associated with the initiation of drug use and resistance skills. Three months after the intervention, significant effects were found on "illegal substance use at least once" (P<0.05) between the intervention and control groups. Immediate effects of the intervention were also found on knowledge, motivation and peer resistance skills (P<0.05), but there was no clear evidence for any effects on attitude towards substance use (P>0.05). It was concluded that the CMER program, which significantly increased the knowledge of drugs and peer resistance skills, was effective in the drug abuse prevention in a sample of school students in Wuhan, China.
Adolescent ; Adolescent Behavior ; psychology ; China ; epidemiology ; Cognition ; physiology ; Female ; Health Education ; methods ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Motivation ; School Health Services ; Students ; psychology ; Substance-Related Disorders ; epidemiology ; prevention & control ; Surveys and Questionnaires ; Young Adult

The use of opioids for the treatment of chronic non-cancer pain has become more widespread recently. Available data support the short-term use of opioids in clearly defined nociceptive and neuropathic pain states. Their use in 'pathological' pain states without a clear diagnosis, such as chronic low back pain, is more contentious. A decision to initiate opioid treatment in these conditions requires careful consideration of benefits and risks; the latter include not only commonly considered adverse effects such as constipation, but also opioid-induced hyperalgesia, abuse, addiction and diversion. Ideally, treatment goals should not only be relief of pain, but also improvement of function. Opioid treatment of chronic non-cancer pain requires informed consent by, and preferably a treatment contract with, the patient. Treatment should be initiated by a trial period with defined endpoints using slow-release or transdermal opioids. Ongoing management of the patient requires ideally a multi-disciplinary setting. Treatment should not be regarded as life-long and can be discontinued by tapering the dose.
Analgesics, Opioid ; adverse effects ; therapeutic use ; Humans ; Hyperalgesia ; chemically induced ; Low Back Pain ; drug therapy ; Pain, Intractable ; drug therapy ; Substance-Related Disorders ; prevention & control

PURPOSE: The aim of this study was to construct a structural equation model that would further explain the continuously increasing substance use disorder in Korean adolescents. METHODS: Survey visits using a structured questionnaire were conducted with 3,885 students in 2 middle schools and 2 high schools in Busan. A total of 13 instruments were used in this model. The analysis of data was done with both SPSS 14.0 for descriptive statistics and AMOS 5.0 for covariance structure analysis. RESULTS: Based on the constructed model, belief on substance use was found to have a significantly direct effect in influencing adolescent substance use. In addition, other factors such as family environment, satisfaction with school life, self-concept, social support, and personality vulnerability indirectly affected substance use. The final modified model yielded Chi-square=2,987 (p<.001), df=121, 2/df=22.1, GFI=.96, AGFI=.93, NFI=.91, PNFI=.72, PGFI=.72, RMSEA=.07 and exhibited fit indices. CONCLUSION: This study constructed a model that addresses the factors related to adolescent substance use and explains the relationship of these factors in influencing substance use among Korean adolescents. Findings from this study can contribute to designing appropriate prevention strategies to reduce substance related disorders in adolescents.
Adolescent ; Adolescent Behavior ; Family Relations ; Female ; Humans ; Male ; *Models, Psychological ; Personality ; Questionnaires ; Self Concept ; Social Support ; Substance-Related Disorders/prevention & control/*psychology

Tramadol is a centrally acting analgesic with a dual mode of action. Its analgesic efficacy is attributed to its partial affinity for the mu-opiate receptor and its inhibition of norepinephrine and serotonin reuptake. Acting in a synergistic manner and being more efficacious, tramadol is used worldwide for the treatment of moderate to severe acute or chronic pain. Abuse and dependence of tramadol as well as tramadol-related deaths have been increasingly reported, either ingested alone or taken in combination with other potentially interacting drugs. The possible toxic effect of tramadol was reviewed from aspects of its analgesic mechanisms, adverse effect, dependence, and abuse.
Analgesics, Opioid/poisoning* ; Forensic Toxicology ; Humans ; Substance-Related Disorders/prevention & control* ; Tramadol/poisoning*

PURPOSE: This study was conducted to develop an education program for safe drug use in the rural elderly and to measure the effect of the program. METHOD: This study utilized a nonequivalent control group pretest-posttest design. The subjects of this study consisted of 40 older persons who were more than 65 years old and lived in G and C meon, Y gun, Gyeongsang-bukdo and visited the public health subcenter. Twenty were assigned to the experimental group and 20 to the control group. The education was provided for one and a half hours, once a week for 3 weeks. Data was collected before, right after, and one month after the program. RESULT: The first hypothesis was supported(F=79.24, p=0.000) showing that the knowledge scores of the drug use of the experimental group were significantly higher than those of the control group at post education and one month after education. The second hypothesis was supported(F=23.84, p=0.000) showing that the drug misuse and abuse prevention behavior scores in the experimental group were significantly higher than those of the control group at post education and one month after the education. CONCLUSION: This study suggests that the education for safe drug use is effective in promoting knowledge and behavior for safe drug use of the rural elderly.
Aged ; Aged, 80 and over ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; *Patient Education as Topic ; Program Evaluation ; Rural Population ; Socioeconomic Factors ; Substance-Related Disorders/*prevention & control