Samantha Gross

Patterns of Simultaneous Polysubstance Use in Canadian Rave Attendees

The aim of this study was to examine rave-related polydrug drug use and to determine if patterns of substance use were associated with previous rave attendance. One hundred and eighty-six rave attendees (50% female) representing a wide range of ages (16 to 47 years; mean = 23.5, sd = 5.15) and levels of rave attendance experience (1 to 400 events) completed structured interviews in Montreal, Canada between November 2002 and September 2003 about their rave attendance patterns and their use of various licit and illicit substances at the most recently attended event. On average, participants reported using 2.5 different psychoactive substances (excluding tobacco) at the most recent event attended. Cannabis, alcohol, MDMA (ecstasy), amphetamine, cocaine, ketamine, and GHB were the most frequently reported substances, and details about their orders of administration, dosages, and patterns of co-administration are presented and discussed. The total lifetime number of raves attended by participants varied considerably (mean = 48.6; sd = 69.7; median = 25), and there was a positive correlation between the number events attended and number of substances used at the most recent event attended (p < 0.001). Analyses revealed that individuals reporting the use of ketamine, GHB, and/or cocaine at the most recent event had attended significantly more events than nonusers even when controlling for various demographic variables. A subset of respondents (n = 27) completed a second interview to determine the reliability of their responses. Results indicated that respondents could reliably recall details about which drugs were used, the total doses administered, as well as order of drug administration.

Ecstasy and drug consumption patterns: A canadian rave population study

Objective: This study investigates the drug consumption patterns of a sample of rave attendees in the city of Montreal, Quebec, and seeks to identify the prevalence of 3,4-methylendioxymethamphetamine (MDMA) and other drug use in this population. Method: We administered a self-report questionnaire to 210 respondents. For various licit and illicit substances, participants reported their age of first use, number of lifetime uses, and usage in the previous 30 days. Results: We found a significant rank order for the sequence of first use: 1) alcohol, 2) nicotine, 3) cannabis, 4) LSD, 5) psilocybin, 6) amphetamine, 7) cocaine, 8) MDMA, 9) gamma-hydroxybutyrate (GHB), 10) ephedrine, 11) ketamine. Alcohol and cannabis were the most commonly used substances, both in cumulative number of lifetime uses and in usage in the preceding 30 days. MDMA and amphetamine were also notable as the next 2 most popular drugs for use in the preceding 30 days and in terms of those who had tried the drugs at least once. We identified a progressive rank order of experimentation, with early alcohol or cannabis use (or both) associated with the early use of all other drugs tried by more than 25% of the sample. We found MDMA and amphetamine use to be prevalent, as was general experimentation with all drugs studied, other than heroin. Conclusion: Drug consumption levels were substantial in this “rave” population, particularly with respect to recent use of MDMA, amphetamine, cannabis, and alcohol. Results also indicate that the sequence of drug experimentation in this population follows an identifiable pattern.

Cannabis use in adolescents: the impact of risk and protective factors and social functioning

The study uses a school-based sample to test the social and familial risk and protective factors relating to cannabis use. Based on a self-completion survey of 2078 14-16-year-olds (mean age of 15 years) attending seven standard state-run secondary schools in south London, an assessment was made of rates and risk factors for cannabis use. Twenty-four per cent of the total sample had ever used cannabis, with 15% having done so in the month prior to assessment. In addition to greater likelihood of illicit drug use, lifetime cannabis users were less likely to spend time regularly with both their mothers and fathers, but more likely to spend free time with friends who smoked, drank alcohol and used illicit drugs, and with friends involved in criminal activities. Among those who had ever used cannabis, frequency of cannabis use was predicted (using linear regression) by two onset factors (earlier initiation of drinking and cannabis use were both linked to more frequent use) and two social factors (more time spent with drug-using friends and less time spent with the mother). Overall, the study showed that early onset, itself predicted by social networks, is linked to more frequent use of cannabis and that this appears to be sustained by less time spent with parents and more with drug-using peers.

Which doctors and with what problems contact a specialist service for doctors? A cross sectional investigation

BackgroundIn the United Kingdom, specialist treatment and intervention services for doctors are underdeveloped. The MedNet programme, created in 1997 and funded by the London Deanery, aims to fill this gap by providing a self-referral, face-to-face, psychotherapeutic assessment service for doctors in London and South-East England. MedNet was designed to be a low-threshold service, targeting doctors without formal psychiatric problems. The aim of this study was to delineate the characteristics of doctors utilising the service, to describe their psychological morbidity, and to determine if early intervention is achieved.MethodsA cross-sectional study including all consecutive self-referred doctors (n = 121, 50% male) presenting in 2002–2004 was conducted. Measures included standardised and bespoke questionnaires both self-report and clinician completed. The multi-dimensional evaluation included: demographics, CORE (CORE-OM, CORE-Workplace and CORE-A) an instrument designed to evaluate the psychological difficulties of patients referred to outpatient services, Brief Symptom Inventory to quantify caseness and formal psychiatric illness, and Maslach Burnout Inventory.ResultsThe most prevalent presenting problems included depression, anxiety, interpersonal, self-esteem and work-related issues. However, only 9% of the cohort were identified as severely distressed psychiatrically using this measure. In approximately 50% of the sample, problems first presented in the preceding year. About 25% were on sick leave at the time of consultation, while 50% took little or no leave in the prior 12 months. A total of 42% were considered to be at some risk of suicide, with more than 25% considered to have a moderate to severe risk. There were no significant gender differences in type of morbidity, severity or days off sick.ConclusionDoctors displayed high levels of distress as reflected in the significant proportion of those who were at some risk of suicide; however, low rates of severe psychiatric illness were detected. These findings suggest that MedNet clients represent both ends of the spectrum of severity, enabling early clinical engagement for a significant proportion of cases that is of importance both in terms of personal health and protecting patient care, and providing a timely intervention for those who are at risk, a group for whom rapid intervention services are in need and an area that requires further investigation in the UK.

Follow-up of Provision of Inpatient Treatment for UK Healthcare Professionals with Alcohol Dependence: Snapshot of a Pilot Specialist National Health Service

Alcohol dependent healthcare professionals (AHCPs) entering a specialized National Health Service (NHS) inpatient treatment facility in southeast London, UK, were investigated. A retrospective case-note analysis was conducted, supplemented with a postal questionnaire. Twenty-three mature (mean age 46.7 years; 13 male) AHCPs, 82% of admissions, with a mean duration of alcohol dependence of 16.5 years were followed-up at an average of 26 months postdischarge. Half of the sample met criteria for lifetime psychiatric disorder. Physical illness was also a prominent problem. At follow-up, six professionals reported continuous abstinence since discharge. For those who continued drinking, there was a significant reduction in daily quantity consumed. This study suggests that the absence of an adequate treatment infrastructure and administrative resources have a major impact on access to treatment services and outcomes for addicted healthcare professionals. There is a need for supported and dedicated services for this group within the UK National Health Service. The studys limitations are noted.

The risk of drug swallowing at the point of arrest: An analysis of 24 cocaine-related deaths following police care or custody in England and Wales

The increase in cocaine use in young people has been reflected in an increase in the number of deaths in which cocaine is identified post mortem. This increase is evident in relation to police custody deaths. In the current analysis, 43 drug-related deaths in custody are considered with cocaine identified in 24 of the post mortem examinations. The article examines the characteristics of these deaths, with particular attention paid to the method and related reasons for drug consumption. Crucially, these deaths contrast with national drug mortality data as they generally involve cocaine consumed by swallowing at the point of arrest. A total of 18 of 24 cocaine deaths involved oral ingestion with at least 15 of these possible attempts at drug concealment occurring at the point of arrest. There is likely to be a considerable risk of loss of life among street-level drug dealers who swallow to avoid drug detection; the article examines the risks associated with this behaviour and possible preventative strategies.

Funder interference in addiction research: An international survey of authors

OBJECTIVE Scientific research is essential to the development of effective addiction treatment and drug policy. Actions that compromise the integrity of addiction science need to be understood. The aim of this study is to investigate funder (e.g. industry, government or charity) interference in addiction science internationally. METHOD Corresponding authors of all 941 papers published in an international specialist journal July 2004 to June 2009 were invited to complete a web questionnaire. A sensitivity analysis with extreme assumptions about non-respondents was undertaken. RESULTS The questionnaire was completed by 322 authors (response fraction 34%), 36% (n=117) of whom had encountered at least one episode (median=3, Interquartile range=4) of funder interference in their research: 56% in Australasia, 33% in Europe, and 30% in North America. Censorship of research outputs was the most common form of interference. The wording or writing of reports and articles, as well as where, when and how findings were released were the areas in which influence was most often reported. CONCLUSIONS Funder interference in addiction science appears to be common internationally. Strategies to increase transparency in the addiction science literature, including mandatory author declarations concerning the role of the funder, are necessary.