Substance abuse In Middle Eastern adolescents living in two different countries: spiritual, cultural, family and personal factors

Follow-Up of a Sample of Patients with Substance Use Disorder After Completing a Rehabilitation Program in a Continuous Care Unit in Eastern Province of Saudi Arabia, from 2012 to 2022: A Retrospective Study

Purpose

There has been limited research on Saudi patients with substance use disorders (SUDs) that has examined and assessed the psychotherapy modalities utilized in rehabilitation. Therefore, there is a need to evaluate rehabilitation programs in the continuous care unit of the Erada Complex for Mental Health, Eastern Province, Saudi Arabia.

Patients and Methods

The purpose of this study was to compare patients who finished the program with those who did not in order to determine the rate of re-admission and recurrence. Male patients (1160) aged >20 who had been diagnosed with SUDs were included in this retrospective cohort study. After ruling out mood, anxiety, psychosis, and other psychiatric disorders, they commenced a one-year rehabilitation program. Six months after leaving the facility, all participants who completed the program or not were re-admitted had relapses and underwent urine toxicological tests.

Results

Data analysis showed that 34.97% of patients completed the program, while 65.03% of patients did not complete the program. Within 6 months of follow-up after discharge, re-admission occurred in only 13.1% of patients that completed the program, but patients who did not complete the program had a readmission rate that reached 26.9% with statistical significance. In comparison between the two groups regarding relapse without needing admission, there was a significant difference between patients who completed the program (reached 14%) and those who did not complete the program (reached 28.9%). With a logistic regression model, the only significant predictor was completion of the program (the odds ratio was 0.42).

Conclusion

The present results in this study revealed that patients with substance use disorder who had finished the specific rehabilitation program in the continuous care unit had lower risk of relapse and re-admission. Further studies are needed to elucidate the importance of the rehabilitation programs in the management of substance use disorder.

Determining the Effects of Ramadan Fasting on Risky Behaviors of Turkish Nursing Students

The aim of this study was to determine the effect of nursing students' fasting during Ramadan on their risky behaviors. This study was conducted in a university located in 2022 using the prospective cohort study method. The data were collected from the nursing department students through face-to-face questionnaires. The sample of the study consisted of 186 nursing students. The data were obtained using a descriptive information form, which consists of questions regarding the descriptive characteristics of the nursing students, and the risky behaviors form, created by the researchers, to evaluate the effect of fasting during Ramadan on nursing students' risky behaviors. According to the findings of the research, it has been determined that the students who always fast during Ramadan have regular sahur. When the students' level of religious faith and fasting and having sahur status were compared with their risky behaviors, the mean scores of exercise and nutrition increased significantly, and the mean scores of interpersonal relationships decreased significantly. It was determined that the majority of students had a high level of religious faith, fasted and had sahur during Ramadan. Consequently, while Ramadan fasting negatively affected students' physical activity, nutrition and sleep patterns, it positively affected their interpersonal relationship status.

The prevalence and treatment utilization of substance use disorders among Muslims in the United States: A national epidemiological survey

BACKGROUND AND OBJECTIVES

Research on substance use disorder (SUD) among Muslims in the United States (US) is limited. There are several unique factors, including denial and stigma, that make this population at risk of SUD. This study explored the prevalence, treatment utilization, and impact of SUD among Muslims in the US compared with a matched control group from general respondents.

METHODS

Data from 372 self-identified Muslims were obtained from the National Epidemiologic Survey on Alcohol and Related Conditions III. A matched non-Muslim control group (N = 744) were selected based on demographics and other SUD-related clinical variables. The impact of SUD was assessed using the 12-Item Short Form Health Survey (SF-12).

RESULTS

Among the 372 Muslims, 53 (10.85%) had lifetime alcohol/drug use disorder, while 75 (18.42%) had lifetime tobacco use disorder (TUD). With statistical significance, alcohol use disorder (AUD) was lower while TUD was higher in the Muslim group than in the control group. The rates of all other substances were not statistically different between the Muslim and control groups. The Muslim group have higher help-seeking and a lower mean score on the SF-12 emotional scale than the control group.

CONCLUSION AND SCIENTIFIC SIGNIFICANCE

Muslim Americans have higher prevalence of TUD, lower prevalence of AUD, and similar prevalence of other SUD compared to the public. Affected individuals have poor emotional functioning which may be exacerbated by the impact of stigma. This is the first study to estimate prevalence of variety of SUD in American Muslims from a national representative sample.

A retrospective analysis of substance use among female psychiatric patients in Saudi Arabia

Objective

This study investigated the prevalence of substance use (SU), and its risk factors, among women attending psychiatric outpatients center in Saudi Arabia.

Design

A retrospective cross-sectional design.

Materials and methods

We reviewed outpatients' records of 200 female patients with a history of SU from a psychiatric unit in Jeddah, Saudi Arabia from December 2018 to February 2019. The researchers developed the pro forma, and 2 psychiatrists and a family medicine physician validated the form.

Results

The most common and widely used were psychoactive substances (58%), followed by central nervous system (CNS) depressants (22%), and finally cannabinols (9.5%). Overall, the highest substance use was the amphetamine-cannabis-nicotine (ACN) representing nearly half of the illicit items (46.6%), followed by heroine-alcohol-benzodiazepine (16.4%), and with the lowest being benzodiazepine-nicotine (1.7%). There was a significant difference between the single substance and multiple substance use in terms of age (p = 0.001), smoking behavior (p = 0.001), patients past history (p = 0.005), and age of the patient at the start of drug use (p = 0.005).

Conclusion

Although the prevalence of substance use among women is low in Saudi Arabia, screening of substance use disorders risks and building a rehabilitation program to control drug dependence are needed.

Religion Involvement and Substance Use Problems in Schoolchildren in Northern Chile

(1) Background: Religious involvement and spirituality have proven to be sources of well-being for individuals at different moments in life and are also associated with a decrease in depression, anxiety, and substance use. Therefore, these could be protective factors against stressful conditions and contribute to mental health. The aim of the present study was to analyze the relationship between religious involvement and substance use among students in northern Chile. (2) Methods: The design is retrospective ex post facto with only one group, and the sample included 2313 adolescents between 12 and 18 years of age from public and private schools. A subscale of the Child and Adolescent Assessment System was used to assess substance use and Universal Age I-E-12 to measure religious involvement. (3) Results: The findings suggest that the intrinsic orientation of religiousness (β = −0.048, p < 0.014), age (β = 0.374, p < 0.000), gender (β = 0.039, p < 0.040), and ethnic identity (β = 0.051, p < 0.008) have significant correlations with substance use. (4) Conclusions: The intrinsic orientation of religion is a relevant variable associated with consumption due to its non-instrumental characteristics of religion and practices aimed at self-exploration and self-knowledge that favor the subjective well-being of individuals, which could prevent drug use from becoming an alternative for dealing with conflicts in the children and young population of this region of Latin America.

Explaining Cannabis Use by Adolescents: A Comparative Assessment of Fuzzy Set Qualitative Comparative Analysis and Ordered Logistic Regression

Background: This study assesses the relevance of several factors that the literature on the substance use of adolescents considers relevant. The factors embed individual variables, such as gender or age; factors linked with parental style; and variables that are associated with the teenager’s social environment. Methods: The study applies complementarily ordered logistic regression (OLR) and fuzzy set qualitative comparative analysis (fsQCA) in a sample of 1935 teenagers of Tarragona (Spain). Results: The OLR showed that being female (OR = 0.383; p < 0.0001), parental monitoring (OR = 0.587; p = 0.0201), and religiousness (OR = 0.476; p = 0.006) are significant inhibitors of cannabis consumption. On the other hand, parental tolerance to substance use (OR = 42.01; p < 0.0001) and having close peers that consume substances (OR = 5.60; p < 0.0001) act as enablers. The FsQCA allowed for fitting the linkages between the factors from a complementary perspective. (1) The coverage (cov) and consistency (cons) attained by the explanatory solutions of use (cons = 0.808; cov = 0.357) are clearly lower than those obtained by the recipes for nonuse (cons = 0.952; cov = 0.869). (2) The interaction of being male, having a tolerant family to substance use, and peer attitudes toward substances are continuously present in the profiles that are linked to a risk of cannabis smoking. (3) The most important recipe that explains resistance to cannabis is simply parental disagreement with substance consumption. Conclusions: On the one hand, the results of the OLR allow for determining the strength of an evaluated risk or protective factors according to the value of the OR. On the other hand, the fsQCA allows for the identification not only of profiles where there is a high risk of cannabis use, but also profiles where there is a low risk.

Work schedule and substance abuse in vocational students

BACKGROUND

Drug abuse is one of the world's most serious and rapidly rising problems, causing a wide variety of health issues with significant morbidity and mortality. This study aimed to explore the association between part-time work and substance abuse among vocational students.

DESIGN AND METHODS

We conducted a cross-sectional analytical study that included all part-time working male students from five vocational male schools, and we used a standardized pretested questionnaire after obtaining written informed consent.  A One-Step Multi-Drug Screen Test was used to assess the substances that were abused.

RESULTS

A total of 316 out of the 400 invited students participated in our study. Of the total screened subjects, 26.6 % were abusing substances. Twenty-five (36.2%) day working adolescents, nine (14.0%) night working adolescents, and forty (36.0%) day and night working adolescents were abusers.Tobacco was the most widely abused drug (68%) in the form of smoking, followed by cannabis (24%), marijuana (16.4%), alcohol (10%), and opioid (6.3%). Night workers had significantly lower rates of smoking, cannabis, Marijuana, alcohol, or opioids abuse, and Logistic regression was performed to ascertain the effects of the work schedule on the likelihood that participants have substance abuse; Night workers were 7.14 times less likely to have substance abuse than day workers, while day and night work did not differ from day work.

CONCLUSIONS

The prevalence of drug abuse in vocational students is considered high and a serious problem that damages the youth and the community.

Inspiring Muslim Minds: Evaluating a Spiritually Adapted Psycho-educational Program on Addiction to Overcome Stigma in Canadian Muslim Communities

The stigma of addiction in Muslim communities is a significant barrier to accessing mental health services. The objective of this study was to evaluate the impact of a newly developed spiritually-adapted addictions psychoeducational program with adult Muslims in the mosque setting. Ninety-three individuals were recruited from nine different mosques within Toronto, Canada. Ninety-minute seminars were presented. This study used a convergent mixed method design. There was a significant increase in the participants' self-reported knowledge (t = 3.6; p < 0.001), a more positive attitude on two scales (t = 3.7; p < 0.001 and t = 2.9; p = 0.005) and an increase in willingness to seek help from a medical doctor and mental health professional (t = 4.4; p < 0.001 and t = 2.2; p = 0.03, respectively) post-seminar as compared to baseline. Qualitative data confirmed these changes. Evidence-informed spiritually-adapted outreach program in the mosque setting can help reduce addiction related stigma in Muslim communities.

"An undercover problem in the Muslim community": A qualitative study of imams' perspectives on substance use

BACKGROUND

Mainstream Islam prohibits alcohol and other drugs, yet substance use is prevalent in Muslim-American communities. Previous studies have not examined how imams, leaders of mosques, address substance use in their communities. This study aimed to explore imams' perspectives and approaches toward Muslim Americans with substance use disorders (SUD).

METHODS

Qualitative study of imams in New York City recruited by convenience sampling. We conducted one-on-one semi-structured interviews to address how imams perceive and address substance use. Using an inductive thematic analysis approach, we created an initial coding scheme which was refined iteratively, identified prominent themes, and created an explanatory model to depict relationships between themes.

RESULTS

All imams described substance use within a shared underlying framework of religious prohibition of alcohol and other drugs. Their perceptions of individuals with SUD diverged between a focus on sin, shame, and social disruption vs. a focus on acceptance and forgiveness. Furthermore, imams diverged between conceptualizing their communities as comprising mosque-going individuals without SUD vs. broader communities that include individuals with SUD. While imams acknowledged how some imams' judgmental language toward SUD may perpetuate stigma, they also identified therapeutic approaches toward SUD: non-judgmental engagement, encouragement of recovery, prayer, and referral to resources.

CONCLUSIONS

This study is among the first to illustrate the range of perceptions and approaches to substance use among Muslim American imams. These perceptions have potentially divergent impacts- shaming or assisting individuals with SUD. An understanding of these complexities can inform provision of culturally competent care to Muslim-American patients with SUD.

Slowing the Tide of Alcohol Use Disorders

Alcohol use disorders (AUDs)-a spectrum including at-risk drinking, alcohol abuse, dependence, and addiction-is a highly prevalent problem worldwide with a substantial economic impact. The toll of alcohol on individual health and healthcare systems is devastating. Alcohol is estimated to be the fifth leading risk factor for global disability-adjusted life years. Tackling the problem of AUD requires a comprehensive strategy that includes solid action on price, availability, and marketing of alcohol. Restricting or banning alcohol advertising may reduce exposure to the risk posed by alcohol at the individual and general population level. Warning labels about the cancer risks associated with drinking have a high degree of public support and may be an inexpensive and acceptable way to educate the public. Religiosity may reduce risk behaviors and contribute to health decision making related to alcohol use.

The influence of coping skills training and family health education on self-esteem among adolescents in substance abuse prevention

OBJECTIVE

Substance abuse is one of the most serious problems in Indonesia and is highly prevalent among adolescents. Therefore, psychotherapy is needed in preventing substance abuse for adolescents. This study aims to analyze the influence of coping skills training and family health education on self-esteem in a sample of 87 young people.

METHOD

The sample was divided into two groups using simple random sampling. ANOVA was used to determine differences between the control group and those receiving coping skills training and family health education.

RESULTS

Self-esteem improved significantly in the group that received the experimental training (F(1.85)=44.70, p<0.001). Some practical implications can be deduced for psychiatric nurses to implemented coping skill training and family health education as a standard treatment in substance abuse prevention among adolescents.

Patterns and sociodemographic characteristics of substance abuse in Al Qassim, Saudi Arabia: a retrospective study at a psychiatric rehabilitation center

BACKGROUND

The problem of substance abuse is one of the top 20 risk factors for poor health worldwide. Though widely prevalent in the Middle East, there are few studies in Saudi Arabia.

OBJECTIVE

Record the pattern of substances abuse and the sociodemographic characteristics of abusers attending the local rehabilitation center.

DESIGN

Descriptive, retrospective medical record review.

SETTING

Patients admitted to psychiatric rehabilitation center.

METHODS

The sample included all patients admitted to a rehabilitation center during the period of January 2016-December 2016. Data was collected retrospectively from patient records.

MAIN OUTCOME MEASURES

Descriptive epidemiological data and statistical comparisons.

SAMPLE SIZE

612 patients.

RESULTS

The majority of patients (73%) were 21-40 years of age. Polysubstance abuse (60%) and amphetamine (24%) abuse were most predominant in the 20-40 year olds (45%) and high school dropouts (41%). The average number of drugs being used by polysubstance abusers was 2.5 (and the maximum was 6). There was no relationship of family history of drug abuse and mental illness.

CONCLUSION

There was an increased use of polysubstances and amphetamine with a decreased abuse of prescription drugs when compared to previous studies reported in Saudi Arabia. There was a decreasing prevalence for heroin and alcohol. Substance abusers have certain epidemiological, social and drug patterns and we recommend that authorities and planners integrate their efforts to look for the reasons for substance abuse.

LIMITATIONS

Females not included and prevalence of tobacco smoking not studied.

CONFLICT OF INTEREST

None.

Examination of the community-specific prevalence of and factors associated with substance use and misuse among Rural and Urban adolescents: a cross-sectional analysis in Bosnia and Herzegovina

OBJECTIVE

The community of residence (ie, urban vs rural) is one of the known factors of influence on substance use and misuse (SUM). The aim of this study was to explore the community-specific prevalence of SUM and the associations that exist between scholastic, familial, sports and sociodemographic factors with SUM in adolescents from Bosnia and Herzegovina.

METHODS

In this cross-sectional study, which was completed between November and December 2014, the participants were 957 adolescents (aged 17 to 18 years) from Bosnia and Herzegovina (485; 50.6% females). The independent variables were sociodemographic, academic, sport and familial factors. The dependent variables consisted of questions on cigarette smoking and alcohol consumption. We have calculated differences between groups of participants (gender, community), while the logistic regressions were applied to define associations between the independent and dependent variables.

RESULTS

In the urban community, cigarette smoking is more prevalent in girls (OR=2.05; 95% CI 1.27 to 3.35), while harmful drinking is more prevalent in boys (OR=2.07; 95% CI 1.59 to 2.73). When data are weighted by gender and community, harmful drinking is more prevalent in urban boys (OR=1.97; 95% CI 1.31 to 2.95), cigarette smoking is more frequent in rural boys (OR=1.61; 95% CI 1.04 to 2.39), and urban girls misuse substances to a greater extent than rural girls (OR=1.70; 95% CI 1.16 to 2.51,OR=2.85; 95% CI 1.88 to 4.31,OR=2.78; 95% CI 1.67 to 4.61 for cigarette smoking, harmful drinking and simultaneous smoking-drinking, respectively). Academic failure is strongly associated with a higher likelihood of SUM. The associations between parental factors and SUM are more evident in urban youth. Sports factors are specifically correlated with SUM for urban girls.

CONCLUSIONS

Living in an urban environment should be considered as a higher risk factor for SUM in girls. Parental variables are more strongly associated with SUM among urban youth, most probably because of the higher parental involvement in children' personal lives in urban communities (ie, college plans, for example). Specific indicators should be monitored in the prevention of SUM.

Religiosity and youth substance use in a Muslim context

The literature shows that young people are more vulnerable than adults to substance use. Religiosity is one of the factors that has been considered to protect youth from substance use and has also been interpreted as contributing to the substance abuse recovery process. Conceptualizing religiosity as a multidimensional construct, this study aimed to investigate the influence of religiosity on substance use among youth. Three dimensions of religiosity-belief about religion, religious self-practice, and religious social environment-were examined as predictors of substance use. The survey data collected in 2010 by the Governance of Istanbul, Istanbul Department of Education, and Istanbul Police Department were used. Participants were high school students (n = 31,272) between 14 and 18 years old. Structural equation modeling was used for statistical analysis and hypothesis testing. The study found a negative relationship between the three dimensions of religiosity and substance use. Religious social environment was found to be the strongest of the three dimensions. The findings suggest that religion has the potential to reduce the risk of substance use among youth. Implications for future research and policymakers were also discussed.