Objective: To investigate the relation between cannabis use and psychotic symptoms in individuals with above average predisposition for psychosis who first used cannabis during adolescence. Design: Analysis of prospective data from a population based sample. Assessment of substance use, predisposition for psychosis, and psychotic symptoms was based on standardised personal interviews at baseline and at follow up four years later. Participants: 2437 young people (aged 14 to 24 years) with and without predisposition for psychosis. Main outcome measure: Psychotic symptoms at follow up as a function of cannabis use and predisposition for psychosis at baseline. Results: After adjustment for age, sex, socioeconomic status, urbanicity, childhood trauma, predisposition for psychosis at baseline, and use of other drugs, tobacco, and alcohol, cannabis use at baseline increased the cumulative incidence of psychotic symptoms at follow up four years later (adjusted odds ratio 1.67, 95% confidence interval 1.13 to 2.46). The effect of cannabis use was much stronger in those with any predisposition for psychosis at baseline (23.8% adjusted difference in risk, 95% confidence interval 7.9 to 39.7, P = 0.003) than in those without (5.6%, 0.4 to 10.8, P = 0.033). The risk difference in the “predisposition” group was significantly greater than the risk difference in the “no predisposition” group (test for interaction 18.2%, 1.6 to 34.8, P = 0.032). There was a dose-response relation with increasing frequency of cannabis use. Predisposition for psychosis at baseline did not significantly predict cannabis use four years later (adjusted odds ratio 1.42, 95% confidence interval 0.88 to 2.31). Conclusion: Cannabis use moderately increases the risk of psychotic symptoms in young people but has a much stronger effect in those with evidence of predisposition for psychosis.

The purpose of this study was to increase knowledge of the effects of prenatal substance use and to introduce the special nutritional needs of pregnancy in two counties in a region with high rates of low birth weight and prenatal substance abuse. A comparison of the efficacy of the educational program being delivered by a registered dietitian or by a group of high school students trained by the dietitian was performed. One hundred six high school students participated in the program and took identical pre- and posttests. The tests were compared to measure knowledge gain and were analyzed by paired t-tests. All respondents demonstrated a statistically significant increase in knowledge. The group receiving instruction from the registered dietitian and the group receiving instruction from the trained high school students demonstrated virtually identical gains in knowledge as measured by the testing instruments.

Introduction: Substance use, including cigarette smoking, while pregnant can lead to a plethora of health concerns for both the mother and unborn child including premature birth, low birth weight, and stillbirth. Compared with women nationally, pregnant women in Tennessee are more than three times as likely to smoke during pregnancy. Preliminary findings suggest high levels of religious commitment may be reliable predictors of negative health behaviors. However, the association between religious commitment and substance use has not been thoroughly investigated in pregnant populations. Using a brief measure of religious commitment, it was hypothesized that pregnant women with higher levels of religious commitment would be significantly less likely to engage in cigarette smoking and other substance use. Methods: Participants included 654 pregnant women involved in the Tennessee Intervention for Pregnant Smokers program who completed multiple interviews during pregnancy. Of interest in the current investigation, participants’ religious commitment was measured using two items from the 12-item Surrender Scale, and a 1-item church attendance measure from the Brief Multidimensional Measure of Religiousness/Spirituality. Participants also completed a background information form assessing demographic characteristics, smoking habits, and drug use, with final substance use variables composites of both self-report and urine drug screen results. Results: Direct logistic regression was performed to assess associations between religious commitment and both smoking status (at conception and delivery) and other substance use. All models included level of education, age, marital status, and insurance status. The full direct model predicting smoking status at conception was statistically significant, χ2 (5, n = 654) = 178.76, p < .001, indicating the model could distinguish between participants who did and did not report smoking early in pregnancy. The model as a whole explained between 24% and 32% of the variance in smoking status, and correctly classified 71% of cases. All variables made statistically significant and unique contributions to the model, including religious commitment (OR=.857). A similar pattern was found in the model predicting smoking status at delivery χ2 = 157.01, p < .001. A third regression, using the same predictors, examining the impact of religious commitment on any illicit drug use prior to or during pregnancy, was also statistically significant, χ2 = 58.46, p < .001. Conclusions and Implications: In this sample, religious commitment predicted smoking status and other drug use during and prior to pregnancy. Inquiry into religious commitment as an additional gauge of health behaviors may be beneficial to healthcare professionals. Future research should investigate the possible mechanism of how religious commitment influences health behaviors in pregnancy.

This is a retrospective, population-based cohort study (extracted with VA Informatics and Computing Infrastructure; VINCI) of adult patients (age > 18) in the United States Veterans Affairs Health Care System (VA) who have received care in at least one of seven Central Appalachian VA healthcare systems between January 1, 2014 and December 31, 2017. The study is designed to assess the potential significant correlation between pertinent demographic variables (i.e., age, race, ethnicity, sex, service connection, rurality, era of service, and combat vet status) and diagnosis of Post-Traumatic Stress Disorder (PTSD) and/or Substance Use Disorder (SUD). Using statistical methods, these demographic variables will be held constant to examine the variance explained by military branch of service (i.e., Navy, Marines, Air Force, Army, National Guard) on diagnoses of PTSD and/or SUD. Veterans will be included in the data pull if they have been seen in at least one of the seven Central Appalachian VA healthcare systems and been diagnosed with PTSD and/or SUD through an inpatient or outpatient mental health clinic (verified by clinic stop code). The primary analysis will assess correlation (Pearson's r) between demographic variables and PTSD and/or SUD diagnoses; and using a general linear model (one-way ANOVA) to examine the impact of branch of military service on diagnoses of PTSD and/or SUD after controlling for other pertinent demographic variables.

Purpose The Johnson City Downtown Day Center (JCDDC) provides integrated inter-professional primary care, mental health, and social work case management services to homeless and under-served persons who have difficulty accessing traditional systems. Because of the exponential rise in substance abuse in the Appalachian region, the JCDDC providers and staff initiated SBIRT as recommended standard of care, as endorsed by SAMHSA, United States Public Health Services Task Force, and the National Institute on Alcohol Abuse and Alcoholism. The JCDDC has two mechanisms by which patients can choose to participate in substance abuse treatment: SMART Recovery, and psychiatric nurse practitioner (NP) referrals. The purpose of the project evaluates use of SBIRT at the JCDDC by determining process of (1) referral and (2) follow-up rates of those who received SBIRT; analyzing outcomes by measuring numbers of: (1) screens administered; (2) brief interventions; (3) positive screens; (4) referrals to either SMART Recovery or to the psychiatric NP; (5) participation in one follow-up. Review of Literature: Approximately 6.4 million people, or 2.4% of the U.S. population 12 years and older, currently misuse prescription medications. There is an undeniable and tangible correlation between the chronic disease of substance use disorder and unstable housing or homelessness (de Chesnay & Anderson, 2016). Similarly, substance use disorder was found to be much more common in people facing homelessness than in people who had stable housing (National Coalition for the Homeless, 2009). Substance Abuse and Mental Health Services Administration (SAMHSA) has been the most significant funding source for SBIRT proliferation in the United States. Despite a demonstrated need for substance abuse services among this vulnerable population, people who are homeless have substantially greater barriers to obtaining treatment and often go without. Summary of Innovation or Practice The current SBIRT process includes use of DAST-10 and AUDIT tools. Evaluating clinic processes and outcomes in vulnerable populations who have inconsistent erratic follow-up is challenging. However, new ways of understanding patterns and incremental outcomes is essential to addressing clinic practice that can impact outcomes in vulnerable groups. Implications for NPs The heterogeneity of the homeless population is often precipitated by a host of complicating factors including co-occurring mental illness, multiple chronic conditions, unstable income, and lack of transportation. Therefore, the importance of finding effective, cost-conscious processes that are population specific and patient-centered is essential for future research and policy. The inter-professional model of care also informs future practice by evaluating the feasibility of administering all of the elements of SBIRT in a single facility.

The frequency of illicit use of prescription stimulants (IUPS) was examined in relation to known risk factors. A hierarchical linear regression (N = 903) was used to evaluate self-reported past-year IUPS and demographic variables. Gender (p < .05), race (p < .05), and GPA (p < .01) were significantly associated with the frequency of past-year illicit use. However, Greek organization membership status, perceived ADHD symptoms and access to prescription stimulant medication were not significant individual correlates of past-year IUPS. Additional analyses were conducted on the user subgroup (n = 101) to determine whether these relationships were similar compared to the general sample. Among users, ASRS Inattention and Hyperactivity-Impulsivity Subscale scores were significantly associated with the frequency of past-year IUPS (p < .05), even after accounting for gender, race, and GPA. Interpretations of these findings and implications for future research are discussed.

No description available.

The purpose of this study was to evaluate the relationship between parenting factors and Hispanic adolescent substance use and depression. Specifically, the study examined the relationship between parental support, parental knowledge, and parental psychological control among Hispanic adolescents' use of alcohol, tobacco, marijuana, hard drugs and depressive symptoms. The sample included 839 Hispanic (primarily Mexican) 9th – 12th graders from west Texas area school districts who were given a self-reported survey to assess parental behaviors, substance use, and adolescent depression. Using structural equation modeling (SEM), findings indicated that higher levels of maternal support were related to lower levels of depressive symptoms for both males and female adolescents. Maternal knowledge was found to be significantly associated, for both adolescent genders, with decreased levels of substance use. Paternal knowledge was significantly associated with decreased depressive symptoms in male adolescents. Maternal and paternal psychological control was found to be significantly associated to increased levels of depressive symptoms in female adolescents, whereas only paternal psychological control was found to be significantly associated to increased levels of depressive symptoms in male adolescents. Age was not significantly related to depressive symptoms or substance use. Results are discussed along with implications for therapists working with Hispanic populations.

Bakgrund: Substansbruk av opioider förekommer och därför ses patienter med substansbrukssyndrom dyka upp i vården. Studier pekar på att sjuksköterskor upplever svårigheter med att vårda denna patientgrupp, främst i hur substansbrukare ska smärtlindras och bemötas. Patientgruppen har ofta en högre tolerans mot smärtlindring på grund av toleransutveckling och kräver därför högre doser. Vidare finns mycket stigma kring patienter med substansbrukssyndrom som kan leda till ett sämre bemötande och sämre vård för dessa patienter.   Syfte: att beskriva hur personer med känt substansbrukssyndrom upplever smärtlindring vid akut och långvarig smärta och hur de upplever att de blir bemötta av vårdpersonal i dessa situationer.     Metod: allmän litteraturstudie med en deskriptiv design baserad på tio vetenskapliga artiklar hämtade från Pubmed och Cinahl. Kvalitetsgranskning av artiklar skedde med SBU:s mall för bedömning av studier med kvalitativ metodik. Resultatanalysen gjordes utifrån Popenoe et al:s (2021) beskrivning om kodning och kategorisering.    Resultat: Tre huvudkategorier framkom: otillräcklig smärtlindring, stigmatisering och positiva möten. Substansbrukarna beskrev att de inte alltid fick adekvat smärtlindring och hade upplevelser av dåligt bemötande. Detta påverkade deras vård negativt. Samtidigt fanns de patienter som upplevt bra bemötande från bland annat sjuksköterskor som var trevliga och engagerade sig.   Slutsats: Att vårda patienter med substansbrukssyndrom och samtidig smärta förefaller vara svårt. Okunskapen kring denna patientgrupp leder till ökad ohälsa, både fysiskt och psykiskt. Ämnet är fortsatt relevant än idag och mer studier behövs för att öka kunskapen och medvetenheten hos sjuksköterskor för att kunna bryta stigmatiseringen. / Background: Substance use of opioids occurs and therefore patients with substance use disorder are seen appearing healthcare. Studies indicate that nurses experience difficulties in caring for substance users, mainly in terms of pain management and treatment. Substance users often have a higher tolerance against pain medication and require higher doses. There is a lot of stigma surrounding these patients, which can lead to poorer treatment and care for them.   Purpose: to describe how people with substance use disorder experience pain management in acute and chronic pain and their experience of the encounter with healthcare staff in these situations.    Method: literature review with a descriptive design based on 10 scientific articles retrieved from Pubmed and Cinahl. Quality review of chosen articles was done by using a template for assessment of qualitative studies, from SBU. The result analysis was done based on Popenoe et al´s (2021) description of coding and categorization.   Results: Three categories emerged: inadequate pain relief, stigmatization and positive encounters. Substance users described that they didn’t get adequate pain relief and had experience of bad encounters with staff. This affected their care negatively. There were patients who experienced good encounters from nurses who were kind and engaged in the care.   Conclusion: Caring for patients with substance use disorders and co-occurring pain appears to be difficult. The ignorance surrounding this patient group leads to increased illness. The subject is still relevant today and more studies are needed to increase the knowledge and awareness of nurses in order to break the stigma.

No description available.