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James E, Wynn L. Testosterone vs. steroids: Comparing the disciplined bodywork projects of performance and image enhancing drug users in Australia. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 107:103776. [DOI: 10.1016/j.drugpo.2022.103776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/14/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022]
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Cooley BN, Sample LL, Rolf K, Garman JD. The Americanization of Karen Refugee Youth: Exploring Attitudes Toward and Use of Methamphetamine. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2021; 66:306624X211022655. [PMID: 34075796 DOI: 10.1177/0306624x211022655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Drug use among refugee populations is a concerning trend in many urban American cities. For instance, Omaha, Nebraska is home to an estimated 7,000 refugees from Myanmar, with at least 75% of those being Karen refugees. The purpose of this paper is to explore methamphetamine use among Karen adolescents in Omaha and to examine whether Karen youth bring their drug use habits with them from refugee camps or if they learn about drugs from their American peers. Two focus groups of Karen youth and two focus groups of Karen parents were conducted to examine methamphetamine use among this population. Findings suggest, like most youth, the Karen children were reluctant to disclose their own use of drugs, but they did see the use of methamphetamine and other drugs in their schools. It appears drug use among the Karen youth is acquired during the "Americanization" of these children in Omaha schools.
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Jeffries S, Rao P, Chuenurah C, Fitz-Gerald M. Extending borders of knowledge: gendered pathways to prison in Thailand for international cross border drug trafficking. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2021; 28:909-933. [PMID: 35694652 PMCID: PMC9176368 DOI: 10.1080/13218719.2021.1894263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Few researchers have concerned themselves with qualitative gender-comparative studies of women's and men's prison trajectories - particularly appraisals relating to international cross border drug trafficking (ICBDT). Using life history interviews with prisoners incarcerated in three regions of Thailand, we describe, examine and compare the features of women's and men's pathways to prison for ICBDT. Overall, the findings point to both similarities and divergences in experiences by gender. Three pathways to prison emerged for both women and men: (1) 'deviant' lifestyle, (2) economic familial provisioning and (3) inexperience and deception. However, gendered variance was found within these pathways; an additional woman-only trajectory, the romantic susceptibility pathway, was also identified.
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Affiliation(s)
- Samantha Jeffries
- School of Criminology and Criminal Justice, Griffith Criminology Institute, Griffith University, Mt Gravatt, Australia
| | - Prarthana Rao
- Office of the Bangkok Rules and Treatment of Offenders, Thailand Institute of Justice, Bangkok, Thailand
| | - Chontit Chuenurah
- Office of the Bangkok Rules and Treatment of Offenders, Thailand Institute of Justice, Bangkok, Thailand
| | - Michelle Fitz-Gerald
- School of Criminology and Criminal Justice, Griffith Criminology Institute, Griffith University, Mt Gravatt, Australia
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Khan SI, Khan MNM, Irfan SD, Rumayan Hasan AM, Ross AG, Horng LMS, Lachowsky N, Knudson G, Azim T. The Effects of Methamphetamine Use on the Sexual Lives of Gender and Sexually Diverse People in Dhaka, Bangladesh: A Qualitative Study. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:479-493. [PMID: 32239362 PMCID: PMC7529687 DOI: 10.1007/s10508-020-01674-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 06/11/2023]
Abstract
Methamphetamine use has increased among gender and sexually diverse people in several countries, including Bangladesh. This study aimed to explore the effects of methamphetamine on the sexual lives of these people in Dhaka, Bangladesh. An exploratory qualitative study was conducted, comprising 30 in-depth interviews with gender and sexually diverse people including males having sex with males, male sex workers, and transgender women (hijra) under HIV intervention coverage. Ten key informant interviews were also conducted with individuals who have expertise in relevant disciplines such as drug use, harm reduction, and HIV and AIDS. Digitally recorded data were manually analyzed under the thematic analysis framework. Findings indicated that many participants reported that methamphetamine brought changes in their sexual lives such as increased sexual drive, engagement in group sex, the increased ability to perform serial sex, transactional sex, impulsive and coercive sex, initiation and switching of male-to-male sexual practices, and limited condom use. Key informants noted that there is a dearth of methamphetamine-related services in Bangladesh. Methamphetamine use was found to lead to diverse effects on the sexual lives of gender and sexually diverse people, thus making it a driving force for shaping sexual practices and, hence, sexual risks. Therefore, it is essential for policy-level stakeholders and program managers to consider the risks of methamphetamine use due to their negative ramifications on sexual health, including HIV risks.
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Affiliation(s)
- Sharful Islam Khan
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Avenue, Mohakhali, Dhaka, Bangladesh.
| | - Mohammad Niaz Morshed Khan
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Avenue, Mohakhali, Dhaka, Bangladesh
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Samira Dishti Irfan
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Avenue, Mohakhali, Dhaka, Bangladesh
| | - A M Rumayan Hasan
- Programme for HIV and AIDS, Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), 68 Shaheed Tajuddin Ahmed Avenue, Mohakhali, Dhaka, Bangladesh
| | - Allen G Ross
- Infectious Diseases Division, International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Lily Ming-Sha Horng
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, Palo Alto, CA, USA
| | - Nathan Lachowsky
- Faculty of Human and Social Development, School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Gail Knudson
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | - Tasnim Azim
- International Centre for Diarrhoeal Diseases Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Methamphetamine Use Behavior, Abnormal Symptoms, and Domestic Violence Among Drug Users in Thailand. ADDICTIVE DISORDERS & THEIR TREATMENT 2020. [DOI: 10.1097/adt.0000000000000188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lasco G. Drugs and drug wars as populist tropes in Asia: Illustrative examples and implications for drug policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 77:102668. [DOI: 10.1016/j.drugpo.2020.102668] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
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Khan SI, Khan MNM, Hasan AMR, Irfan SD, Horng LMS, Chowdhury EI, Azim T. Understanding the reasons for using methamphetamine by sexual minority people in Dhaka, Bangladesh. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 73:64-71. [PMID: 31344562 DOI: 10.1016/j.drugpo.2019.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 05/09/2019] [Accepted: 07/02/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Internationally, methamphetamine use is prevalent among males who have sex with males (MSM) and transgender women (hijra), with studies showing its association with risky sexual behaviours leading to HIV transmission. This study aimed to explore the underlying reasons for methamphetamine use among MSM and hijra in Bangladesh. METHODS We conducted 30 in-depth interviews with MSM and hijra and six focus groups with MSM, hijra and service providers. Data were thematically analysed using manual data analysis procedures. FINDING Reasons cited for using methamphetamine varied across feminized MSM (i.e. kothis), masculine MSM (i.e. panthis), male sex workers and hijra. For sex workers, increased sexual pleasure and consequent ability to take more clients increased their income. For panthis, methamphetamine enhanced feelings of masculinity and sexual prowess. Kothis were able to feel more feminine due to their ability to receive multiple partners each night. For all participants, methamphetamine restored self-esteem and relieved the stress resulting from stigma. CONCLUSIONS Findings indicate that reasons for using methamphetamine are not only rooted in the individual's psyche but also grounded in the socio-cultural expectations about masculinities and femininities in Bangladeshi society. Limited knowledge about the complexities concerning methamphetamine use mean that appropriate counselling and treatment services are non-existent in Bangladesh. The study findings can be used to refine national and international harm reduction policies so as to incorporate and address methamphetamine use.
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Affiliation(s)
- Sharful Islam Khan
- Program for HIV and AIDS, Infectious Diseases Division, icddr,b, Bangladesh.
| | | | - A M Rumayan Hasan
- Program for HIV and AIDS, Infectious Diseases Division, icddr,b, Bangladesh
| | | | - Lily Ming-Sha Horng
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University, United States
| | | | - Tasnim Azim
- BRAC James P. Grant School of Public Health, BRAC University, Bangladesh
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Galai N, Sirirojn B, Aramrattana A, Srichan K, Thomson N, Golozar A, Flores JM, Willard N, Ellen JM, Sherman SG, Celentano DD. A cluster randomized trial of community mobilization to reduce methamphetamine use and HIV risk among youth in Thailand: Design, implementation and results. Soc Sci Med 2018; 211:216-223. [PMID: 29966816 DOI: 10.1016/j.socscimed.2018.06.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/14/2018] [Accepted: 06/18/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Use of methamphetamines (MA) and other stimulants have consistently been associated with HIV/STI risk globally. We evaluated a community mobilization intervention (Connect to Protect, C2P®) to prevent MA use among youth and reduce HIV risk behaviors through community structural changes. DESIGN A community-randomized trial in northern Thailand with matched districts randomized to C2P intervention or a standard voluntary counseling and testing (VCT) control. Intervention districts formed stakeholders' coalitions to plan tailored local prevention programs. Two independent random household samples of youth aged 14-24 were surveyed in 2009 and 2012. Lifetime and recent MA use was modeled with multilevel logistic regression. RESULTS Intervention initiatives included family-strengthening programs, school-based programs and opening a community drug treatment center. Control communities applied the government-led "war on drugs" approach in addition to youth and family programs. Baseline (N = 1077) and follow-up (N = 1225) samples included 47.5% females and 21.7% aged ≤16. Lifetime MA use in intervention districts reduced from 13.4% to 11.7% compared to reduction from 16.2% to 10.4% in the control districts (non-significant). In models, lifetime MA use was associated with: time (aOR = 0.6, 95%CI: 0.38-0.83), females (aOR = 0.2, 95%CI: 0.15-0.29), increasing age (aOR = 2.4, 95%CI: 1.40-4.20, ages 16-19; aOR = 3.5, 95%CI: 2.00-6.12, ages ≥20), and not being full-time students (aOR = 5.3, 95%CI: 3.77-7.37). Recent MA use showed similar results. Additionally, lifetime MA use was significantly associated with alcohol use, risky sexual behaviors and elevated depressive symptoms. CONCLUSIONS Delay in developing and implementing specific prevention programs in the intervention districts slowed diffusion of the effect into the communities. Secular trends with contentious civil unrest and active drug-enforcement efforts in the control communities also contributed to the null intervention effect. Longer time and intensified efforts stressing a public health approach are needed to demonstrate the effectiveness of community mobilization in reducing substance use and HIV risk in this rural Thai community.
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Affiliation(s)
- Noya Galai
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Statistics, Haifa University, Haifa, Israel.
| | - Bangorn Sirirojn
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
| | - Apinun Aramrattana
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
| | - Kamolrawee Srichan
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
| | - Nicholas Thomson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Asieh Golozar
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Jose M Flores
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Nancy Willard
- Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Pediatrics, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Susan G Sherman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - David D Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Su S, Mao L, Zhao J, Chen L, Jing J, Cheng F, Zhang L. Epidemics of HIV, HCV and syphilis infection among synthetic drugs only users, heroin-only users and poly-drug users in Southwest China. Sci Rep 2018; 8:6615. [PMID: 29700352 PMCID: PMC5919913 DOI: 10.1038/s41598-018-25038-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 03/28/2018] [Indexed: 11/18/2022] Open
Abstract
The number of poly-drug users who mix use heroin and synthetic drugs (SD) is increasing worldwide. The objective of this study is to measure the risk factors for being infected with hepatitis C (HCV), human immunodeficiency virus (HIV) and syphilis among SD-only users, heroin-only users and poly-drug users. A cross-sectional study was conducted in 2015 from a national HIV surveillance site in Southwest China, 447 poly-drug, 526 SD-only and 318 heroin-only users were recruited. Poly-drug users have higher drug-use frequency, higher rates of drug-sharing and unsafe sexual acts than other users (p < 0.05). About a third (36.7%) of poly-drug users experienced sexual arousal due to drug effects, which is higher than the rate among other drug users. Poly-drug users had the highest prevalence of HIV (10.5%) and syphilis (3.6%), but heroin-only users had the highest prevalence of HCV (66.0%) (all p < 0.05) among three groups. Logistic regression shows among poly-drug users, having sex following drug consumption and using drugs ≥1/day were the major risk factors for both HIV (Adjusted odds ratio (AOR) = 2.4, 95% CI [1.8–3.4]; 2.3, [1.6–3.1]) and syphilis infection (AOR = 4.1, [2.1–6.9]; 3.9, [1.8–5.4]). Elevated risk of both HIV and syphilis infection have been established among poly-drug users.
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Affiliation(s)
- Shu Su
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Limin Mao
- Center for Social Research in Health, Arts and Social Sciences, UNSW Australia, Sydney, NSW, Australia
| | - Jinxian Zhao
- Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China
| | - Liang Chen
- Division of HIV/AIDS and STI Control, Centers for Disease Control and Prevention, Yuxi Prefecture, Yunnan, China
| | - Jun Jing
- Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China
| | - Feng Cheng
- Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China.
| | - Lei Zhang
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia. .,Research Center for Public Health, School of Medicine, Tsinghua University, Beijing, China. .,Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.
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Guadamuz TE, Boonmongkon P. Ice parties among young men who have sex with men in Thailand: Pleasures, secrecy and risks. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 55:249-255. [PMID: 29691128 DOI: 10.1016/j.drugpo.2018.04.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 03/29/2018] [Accepted: 04/04/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Crystal methamphetamine (ice) has become the substance of choice among young men who have sex with men (YMSM) in urban Thailand. Yet, there is scarce data on this phenomenon, partly due to the difficulty in accessing men who will disclose and openly discuss the social contexts, meanings and risks surrounding ice practice. We present an ethnography of ice parties, critically discussing the in-depth social meanings of ice; the sexual socialities and the secrecy surrounding its use; the transactions between older and younger men; and the role of the Internet and mobile technology. METHODS Forty repeated narrative interviews (life stories), ten focus group discussions, as well as systematic online and offline observations were conducted over a three-year period. Purposive sampling was used to recruit study participants in a variety of online and offline spaces and through working closely with local Thai community-based organizations serving MSM. To be eligible, participants had to be between 18 and 29 years, able to converse in Thai, had used ice, and had anal sex with another man in the past 6 months. We also strived for sample variability with respects to socio-demographic characteristics (e.g., age, educational attainment and living situation). Data analysis was conducted in Thai by two researchers using the constant comparative method based on grounded theory. RESULTS On surface, participants described ice parties as exclusive, in trend, luxurious, fun and pleasurable-a kind of modern camaraderie among beautiful men. In reality, however, this group phenomenon was a social hierarchy containing several important players with relational power to one another, to the ice itself and to the physical space where ice was being consumed. These players included ice suppliers, party hosts, party guests and "icetenders." The paper also discusses the sociality of secrecy that surrounds ice parties as well as the power relations between older relatively rich men who provide ice and the younger men who crave for the chemical, pointing to the risks associated with engagement at ice parties, including instances of rape, violence and unsafe sex. For some participants, ice use was part of their "everyday life," or even believed to be a "rites of passage." For others, it involved sexual silence in cases where they were forced to have (unprotected) sex with certain persons or engage in high-risk activities against their will. CONCLUSIONS Ice parties, where high-risk practices were common, power and agency quickly became relational and negotiable. This paper illuminated the secret sociality of ice so that public health efforts will be better equipped with understanding and reaching out to young men who may be at heightened risk for HIV, STI, violence and other health concerns. Ice parties can, for example, be seen as opportunities for harm-reduction strategies whereby young men are not judged for the activities they engage, but are instead respected and approached in a contextualized, non-judgmental way. Finally, icetenders and party hosts may be individuals where public health practitioners can target and include in the development of novel harm-reduction programs.
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Affiliation(s)
- Thomas E Guadamuz
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakorn Pathom, Thailand; Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakorn Pathom, Thailand.
| | - Pimpawun Boonmongkon
- Department of Society and Health, Faculty of Social Sciences and Humanities, Mahidol University, Nakorn Pathom, Thailand; Center for Health Policy Studies, Faculty of Social Sciences and Humanities, Mahidol University, Nakorn Pathom, Thailand
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Sychareun V, Santavasy B, Chanlivong N, Fischer A, Thomson N, Power R, Durham J. Methamphetamine-type stimulant use in Lao PDR: qualitative findings from users aged 15-25 years in Vientiane Capital and Vientiane Province. Harm Reduct J 2018; 15:17. [PMID: 29609608 PMCID: PMC5880082 DOI: 10.1186/s12954-018-0222-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 03/12/2018] [Indexed: 11/10/2022] Open
Abstract
Background Methamphetamine is one of the most widely used illicit drugs in several Southeast Asian countries, including the Lao People’s Democratic Republic (PDR). The purpose of this study was to examine the socio-cultural context of its use in Lao PDR. Methods We conducted a cross-sectional qualitative survey among young people, aged 15–24 years, who use methamphetamine (or Yaba as it is commonly known in the region) in Vientiane Capital and Vientiane Province, Lao PDR. In total, we conducted 21 in-depth interviews (6 female, 13 males and 2 transgender) and 8 focus group discussions with 47 participants (10 female, 29 male and 8 transgender). The data analysis drew on the theory and insights of the social theorist Pierre Bourdieu (1990, 1997) to understand the Yaba consumption practices among young Laotians. Results Yaba consumption among young people in this study was used to enhance both productivity and pleasure. Its pleasure-producing affects were often linked to core Laotian notions of having fun, partying and being together. Its increased productivity effects on the other hand, were used to pursue goals related to self-betterment within an emerging market economy. Conclusions This study highlights the complex interaction between agency and identity, structure, context and practices. In terms of public health policy and programme responses, developing proper interventions implies a good understanding of how young people interpret Yaba consumption, its dynamics and the relationships and resources that mediate the behaviours.
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Affiliation(s)
| | - Bangone Santavasy
- Burnet Institute in Laos, Luangprabang Road, Building 06, 2A/03, Ban Sihom, Vientiane, Lao People's Democratic Republic
| | - Niramonh Chanlivong
- Burnet Institute in Laos, Luangprabang Road, Building 06, 2A/03, Ban Sihom, Vientiane, Lao People's Democratic Republic
| | - Andrea Fischer
- The Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, Australia
| | - Nicholas Thomson
- Research Institute of Health Sciences, Chiang Mai University, Chiang Mai, Thailand.,Johns Hopkins, Bloomberg School of Public Health, Baltimore, MD, USA.,Faculty of Biomedical Sciences, School of Public Health, University of Queensland, Herston Road, Herston, Queensland, 4006, Australia
| | - Robert Power
- Burnet Institute in Laos, Luangprabang Road, Building 06, 2A/03, Ban Sihom, Vientiane, Lao People's Democratic Republic
| | - Jo Durham
- Faculty of Biomedical Sciences, School of Public Health, University of Queensland, Herston Road, Herston, Queensland, 4006, Australia
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Noroozi A, Malekinejad M, Rahimi-Movaghar A. Factors Influencing Transition to Shisheh (Methamphetamine) among Young People Who Use Drugs in Tehran: A Qualitative Study. J Psychoactive Drugs 2018; 50:214-223. [DOI: 10.1080/02791072.2018.1425808] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Alireza Noroozi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Malekinejad
- Phillip R. Lee Institute for Health Policy Studies and Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Afarin Rahimi-Movaghar
- Director of Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
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Abstract
BACKGROUND AND OBJECTIVE Males and females who use methamphetamine (MA) differ in sociodemographics, MA diagnoses, comorbidities, and brain activity. The objective of this study was to investigate sex differences in the characteristics of MA use and dependence in patients at a Thai substance treatment center. METHODS Demographic, MA use, and diagnostic data for 782 MA users were obtained by using the Semi-Structured Assessment for Drug Dependence and Alcoholism-Thai version. Categorical comparisons of males (n = 413, 53%) and females (n = 369, 47%) were made by chi-square test. Factors significantly differentiating men and women with respect to MA-dependence were identified by logistic regression analysis controlling for demographic, diagnostic, and MA use variables. RESULTS Males admitted to residential drug treatment for MA use had an earlier age of onset for both MA use (17.7 ± 4.1 vs 19.7 ± 6.2 years; t = -5.3, P < 0.001) and dependence (20.4 ± 5.2 vs 22.2 ± 6.4 years; t = -3.6, P < 0.001). Females were more likely than males to be MA-dependent (79% vs 60%; χ1 = 33.7, P < 0.001), and to experience MA withdrawal (65.3% vs 48.9%; χ1 = 21.4, P < 0.001), withdrawal-related hypersomnia (77.2% vs 64.8%; χ1 = 14.5, P < 0.001), fatigue (77.5% vs 70.3%; χ1 = 5.2, P = 0.02), and psychomotor retardation (64.5% vs 57.0%; χ1 = 4.5, P = 0.03). Similarly, females had heavier (eg, largest daily amount [χ1 = 12.4, P < 0.001), more frequent (χ1 = 5.1, P = 0.02]) and greater lifetime episodes of MA use (χ1 = 24.1, P < 0.001) than males. After controlling for such variables by logistic regression, being female remained a significant factor influencing the occurrence of MA-dependence (odds ratio [OR] 2.7, 95% confidence interval [CI] 1.8-4.1, P < 0.001). Shared associated factors (or comorbidities) for MA-dependence in both sexes included nicotine dependence (in males: OR 4.1, 95% CI 2.4-7.0, P < 0.001; and in females: OR 2.4, 95% CI 1.3-4.4, P = 0.007), greater lifetime episodes of MA use (in males: OR 3.5, 95% CI 1.9-6.4, P < 0.001; and in females: OR 5.9, 95% CI 3.1-11.4, P < 0.001), and more frequent use (in males: OR 5.1, 95% CI 2.8-9.1, P < 0.001; and in females: OR 3.6, 95% CI 1.9-6.9, P < 0.001). Comorbid antisocial personality disorder predicted MA-dependence in males only (OR 3.7, 95% CI 1.6-8.6, P = 0.002). CONCLUSIONS The current study highlights both common (eg, nicotine dependence and severity of MA use) and sex-specific differences (eg, MA use/dependence characteristics and comorbidities), including sex itself, with respect to MA-dependence in a Thai treatment cohort.
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DiMiceli LE, Sherman SG, Aramrattana A, Sirirojn B, Celentano DD. Methamphetamine use is associated with high levels of depressive symptoms in adolescents and young adults in Rural Chiang Mai Province, Thailand. BMC Public Health 2016; 16:168. [PMID: 26893284 PMCID: PMC4759778 DOI: 10.1186/s12889-016-2851-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 02/10/2016] [Indexed: 12/03/2022] Open
Abstract
Background High levels of depressive symptoms often occur among individuals that use or that are dependent on methamphetamine (MA). Thailand is currently experiencing an epidemic of MA use among youth. Understanding the nature of the relationship between depressive symptoms and MA use and identifying those most at risk can further understanding of prevention and treatment options for youth who use MA and present with depressive symptoms. Methods In 2011, we conducted a cross sectional epidemiologic study that examined associations between MA use and high levels of depressive symptoms among adolescents and young adults aged 14–29 living in Chiang Mai province, Thailand. A combination of cluster and systematic sampling was conducted to obtain a study sample of participants actively recruited in Chiang Mai province. Depressive symptoms were measured using a Thai translation of the Centers for Epidemiologic Studies Depression scale (CES-D). The independent variables measured reported lifetime and recent MA use within the past 3 months. Multivariate logistic regression models were used to assess associations between MA use and high levels of depressive symptoms. Results Approximately 19 % (n = 394) of the sample reported ever having consumed MA and 31 % (n = 124) of lifetime users reported recent MA use within the past 3 months. Recent MA use was associated with high levels of depressive symptoms (aPOR recent use: 2.60, 95 % CI: 1.20, 5.63). Conclusions This is one of the first studies to examine the association between MA use and high levels of depressive symptoms in a general Thai population. The odds of having high levels of depressive symptoms was significantly greater among recent MA users compared to non-users. These findings support the need for policies, programs and interventions to prevent and treat depressive symptoms presenting among MA using Thai adolescents and young adults in rural Chiang Mai province, Thailand to aid in cessation of MA use. Furthermore, additional research is needed to investigate treatment options for adolescents and young adults in Thailand that use MA and present with high levels of depressive symptoms.
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Affiliation(s)
- Lauren E DiMiceli
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Susan G Sherman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Apinun Aramrattana
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Bangorn Sirirojn
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - David D Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
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