Background: Current national prevalence estimates of DSM-5 diagnosed substance use disorders (SUDs) among adults with justice system involvement are lacking. Methods: This study drew from NESARC-III data (n = 36,309; 2012–2013), a nationally representative U.S. sample, to examine current and lifetime alcohol use disorder (AUD) and drug use disorder (DUD) diagnoses among adults reporting current or prior drug-related, alcohol-related, and general legal problems. Results: Adults reporting current alcohol-related legal problems were 22 times more likely to have a current AUD diagnosis (AOR = 22.0, 95% CI = 12.1; 40.1) and 15 times more likely to have had a lifetime AUD diagnosis (AOR = 15.2, 95% CI = 7.5; 30.9) than adults without alcohol-related legal problems. Adults with lifetime drug-related legal problems were 3–5 times more likely to have a current (AOR = 2.6, 95% CI = 2.1; 3.2) and lifetime (AOR = 5.1, 95% CI = 4.3; 6.1) DUD diagnosis, with stimulant use disorder being the most prevalent (AOR = 5.4, 95% CI = 4.5; 6.5). Adults with general legal problems were around 3 times more likely to have a current AUD (AOR = 3.2, 95% CI = 2.6; 4.0) or DUD (AOR = 3.5, 95% CI = 2.8; 4.4). Women with any type of legal problem were more likely to have SUD diagnoses than men. Conclusions: SUD diagnoses are prevalent among adults reporting legal problems, particularly those involving alcohol. There is a continued need for community-based addiction prevention and intervention efforts, especially for women with justice system involvement.

Background: Drug use is a public health problem associated with increased mortality, morbidity and lack of contact with healthcare. Stigmatization and discrimination surround drug use. Harm reduction aims to improve health without coercive measures to become drug-free in collaboration with people who inject drugs. Harm reduction is evidence-based, cost-effective and reduces the spread of infectious diseases. Needle exchanges provide information about drug-related risks and offer protection against this.  Aim: The aim was to describe experiences of harm reduction in needle exchanges in people who inject drugs.  Method: A qualitative literature study was carried out according to Polit and Beck's nine-step model. 11 articles were included and analyzed thematically according to the model of Braun and Clarke.  Results: The main finding is that people who inject drugs experience that needle exchanges offer knowledge and enable harm reduction. Needle exchanges are a place of health promotion for people who inject drugs.  Conclusion: How people who inject drugs experience the services and what makes them return is important knowledge for harm reduction to reach more people. Continued research is needed on how needle exchanges can reach more people who inject drugs. / Bakgrund: Drogbruk är ett folkhälsoproblem förenat med ökad dödlighet, sjuklighet och bristande kontakt med hälso- och sjukvård. Stigmatisering och diskriminering omgärdar drogbruk. Skadereduktion syftar till att förbättra hälsan utan tvingande åtgärder rörande drogfrihet. Skadereduktion är evidensbaserat, kostnadseffektivt och minskar spridningen av smittsamma sjukdomar. Sprututbyten ger information om drogrelaterade risker och erbjuder skydd mot dessa.  Syftet: Att beskriva erfarenheter av skadereduktion vid sprututbyten hos personer som injicerar droger. Metod: En kvalitativ litteraturstudie enligt Polit och Becks niostegsmodell. Elva artiklar inkluderades och analyserades tematiskt enligt modell av Braun och Clarke. Resultat: Huvudfynd är att personer som injicerar droger upplever att sprututbyten erbjuder kunskap och möjliggör skadereduktion. Sprututbyten är en plats för hälsopromotion för personer som injicerar droger.  Slutsats: Hur personer som injicerar droger upplever erbjuden skadereduktion vid sprututbyten och vad som får dem att återkomma är betydelsefull kunskap för att skadereduktion ska nå fler. Fortsatt forskning behövs om hur sprututbyten kan nå fler personer som injicerar droger.

The purpose of this study is to estimate the association between sibling drug use and adolescent alcohol, cigarette, and marijuana use. Research is conducted using survey data from a probability sample of 4,987 adolescents in grades 9–12 in Utah. To account for the limited frequency of drug use among respondents, Poisson regression is used to estimate models for each type of drug. In support of current literature, findings indicate that having a sibling who uses drugs increases the frequency of drug use substantially, even when peer influences are taken into account. Significant sibling associations with adolescent drug use found in this study support the assumptions of social learning theory. Findings suggest that sibling influence is largely due to social learning, as older sibling influences are demonstratively more significant than younger sibling influences.

The purpose of this study was to examine drug counselors' experience of using reward as a work method and how a more lenient view on substance use can help foster the treatment process and reduce stigma surrounding drug use. The study is based on semi-structured interviews with 4 drug counselors from a municipality in Sweden. The study used a qualitative approach, and the results were analyzed using an abductive approach. The data was analyzed using Becker's theory on labeling and Goffman's theory on stigmatization. The results show that drug-counselors experience the use of reward in drug treatment as an effective tool in creating a positive association to both treatment and the counselors themselves. Reward also helps fulfill an important function in promoting a non-judgmental approach which the counselors then can build upon. The results also show the complexity regarding having a more tolerant outlook on drug consumption, but also that criminalization of drug use is seen as a contributing factor in the stigmatization of youth with substance use disorder. / Syftet med studien var att undersöka behandlares upplevelse av att använda belöning som arbetsmetod samt hur en mer tolerant syn på droganvändningsproblematik kan främja behandlingsprocessen och minska stigmatisering kring droganvändning. Datainsamlingsmetoden är semistrukturerade kvalitativa intervjuer med fyra missbruksbehandlare inom öppenvården. Studien har en kvalitativ ansats och resultatet analyserades utifrån ett abduktivt förhållningssätt. Data analyserades utifrån Beckers stämplingsteori samt Goffmans teori om stigma. Resultat visar att behandlarna upplever att belöning som arbetsmetod skapar en positiv association till såväl behandlarna som behandlingen i sig. Belöningen fyller även viktig funktion i att främja det icke dömande förhållningssättet som behandlarna arbetar utifrån. Vidare visar resultatet av studien att en tolerant syn på droganvändningsproblematik är komplext utifrån rådande lagstiftningen som kriminaliserar allt eget bruk av narkotika, samtidig som kriminaliseringen ses som en bidragande orsak till att ungdomar med en droganvändningsproblematik stigmatiseras.

Objectives: Concurrent substance use disorder (SUD) and posttraumatic stress disorder (PTSD) occur at high rates and are typically associated with poor treatment outcomes in both sexes. However, women have a propensity to cope with increased negative affect via substance use in comparison to men; thus, it is important to elucidate the sex-specific bidirectional relationships between SUD and PTSD to improve our understanding of concurrent SUD/PTSD in men and women. Methods: Using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-Wave 3; n = 36,309), the present study evaluated the impact of sex on the relationship between past-year SUDs (new, remitted, ongoing), including alcohol and drug use, and retrospective transitions in new vs. absent and ongoing vs. remitted diagnoses of PTSD. Additionally, the impact of sex was explored in models examining past year PTSD (new, remitted, ongoing) and retrospective transitions in new vs. absent and ongoing vs. remitted diagnosis of SUDs. Diagnostic transitions were based on retrospective reporting. Results: Results indicated that new, remitted, and ongoing SUDs increase the likelihood of new PTSD diagnoses (OR range = 2.53–8.11; p < 0.05). Among individuals with ongoing drug use disorders (DUD), there were greater odds of ongoing PTSD (OR = 2.10, p < 0.01). When examining the relationship reciprocally, new, remitted, and ongoing PTSD increased the likelihood of new SUDs (OR range = 2.50–8.22; p < 0.05), and ongoing PTSD increased the likelihood of ongoing SUD and DUD (OR = 1.40, 1.70, respectively; p < 0.05). Sex-specific analyses revealed that the relationship between PTSD and SUDs varies between sexes, particularly among women. For instance, women with new PTSD had higher odds of SUDs, and women with ongoing PTSD were almost 2.5 times more likely to have an ongoing DUD. Women with a new PTSD diagnosis were more likely to be diagnosed with a new SUD (OR = 3.27) and an ongoing DUD (OR = 3.08). Conclusions: Results indicate a bidirectional relationship between PTSD and SUD that is in many instances larger in women. Thus, illustrating potential sex-specific differences in underlying mechanisms implicated in SUD/PTSD, warranting additional research.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Indiana University-Purdue University Indianapolis (IUPUI) / Nicotine addiction is an extremely costly and widespread issue that affects millions of people globally and current treatments have relatively low long term efficacy rates. This demonstrates the need for a greater understanding of nicotine addiction and its underlying mechanisms. This study created a C. elegans model of compulsive nicotine use. C. elegans, that were pretreated with nicotine (9.7 μM or 120 μM) from larval stage 4 to gravid adulthood, demonstrated reduced aversion to 10% nonanone in the presence of nicotine compared to untreated worms. The pretreatment concentration of 9.7 μM nicotine was chosen for further study due to its ability to induce aversion resistance without significant changes to locomotor speed, food preference, or benzaldehyde preference. This model was then applied to nicotinic acetylcholine (acr-5, acr-15, acr-16) and dopamine (dop-1, dop-2) receptor knockout mutants to determine the roles of these receptors in the development of aversion resistance. For the acr-5, acr-15, and acr-16 mutants, there was an increase in preference following the administration of 10% nonanone, regardless of pretreatment condition, suggesting that the removal of these receptors induces aversion resistance. For the dop-1 receptor mutant, 10-minute timepoint nicotine preference was reduced following preexposure. For the dop-2 receptor mutant, aversion was enhanced at the 5 mM and 50 mM test concentrations following the administration of 10% nonanone, suggesting that the dop-2 receptor is partially responsible for the development of aversion resistance. Additional research should be conducted to determine the underlying mechanisms of this drug induced aversion resistance. With current the lack of highly efficacious nicotine cessation drugs, this model could be used to test novel therapeutic drugs in a rapid high throughput manner.

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