Are Polydrug Users More Physically and Verbally Aggressive? An Assessment of Aggression Among Mono- Versus Polydrug Users in a University Sample

Detection of substance use in clinical forensic cases: urine analysis of victims and perpetrators

This study investigates the prevalence of substance use among victims and perpetrators involved in clinical forensic cases. Urine samples from 455 individuals aged 18 and above, collected in 2019, were analyzed using two LC-MS-based analytical methods and an HS-GC-FID method for the most frequently reported substances of abuse and medication. Data from case documents, encompassing gender, age, and the individual's role, were recorded in a database. Both the urine samples and the information from case documents were fully anonymized. The most frequently detected substance was alcohol (37% of all cases), followed by cannabis (22% of all cases) and central nervous system stimulants (24% of all cases). Other classes of substances detected included benzodiazepines, anabolic steroids, antipsychotic agents, and antidepressants. No drugs or alcohol were detected in 32% of the victims and 19% of the perpetrators. The study also examines the interrelationship of drug patterns between victims and perpetrators, and results show that both parties were influenced by substances at the time of the incident. Furthermore, there was a significant difference in the use of substances between perpetrators of blunt and sharp force cases and perpetrators in cases of sexual assault. Timely sample collection and a structured toxicological analysis of both victims and perpetrators in the same case are vital in clinical forensic cases to enhance comprehension of the connection between criminal activities and substance use. This understanding enables the development of prevention strategies at an informed level.

Aggressive behaviours associated with MDMA and psychedelics: a narrative review

OBJECTIVE

Monoamine neurotransmitters play a role in aggression, especially when altered by illicit substances. However, some literature suggests that not all illicit substances may lead to aggression, notably psychedelics. This narrative review investigates the associations between serotonergic psychedelics and MDMA on aggressive behaviour.

METHODS

PubMed and PsycINFO were searched for original, peer-reviewed articles evaluating the effects of serotonergic psychedelics and 3,4-methyl enedioxy methamphetamine (MDMA) on violent and aggressive behaviour using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

After removing duplicates, a total of 555 articles were screened, with 16 meeting the inclusion criteria. One additional article was obtained through reference screening bringing the total to 17 articles. Of these 17 articles, 14 studies focused on MDMA and three on serotonergic psychedelics. Findings were mixed, with some results demonstrating increased aggression following psychedelics and others suggesting protective effects. Limitations in the current literature include varied definitions of psychedelics, lack of standardised objective outcome measures and failure to control for confounding.

CONCLUSION

As psychedelic research continues to expand, further assessment on the effects of serotonergic psychedelics and MDMA on aggressive behaviour is required.

Police-Identified Psychological Distress, Substance Use, and Physical Violence Among Male Intimate Partner Stalkers

Risk factors for stalking violence are not well understood and few studies have examined psychological distress and substance use specifically. This study aimed to assess whether factors extant in police data could predict severity of stalking violence against intimate partner victims. Western Australia Police Force provided data for 603 men linked to a stalking charge relating to a female intimate partner. Binomial logistic regressions showed police-identified histories of psychological distress and drug use predicted moderate violence, but not severe violence. A co-occurring history of drug use and alcohol use was the strongest predictor of moderate violence (OR = 6.8). These findings suggest accounting for violence severity and substance type when examining stalking violence risk factors. Whether psychological distress and/or substance use were active problems for the men during their stalking behavior is unknown, however the detection of these problems may indicate an unmet need for treatment among this group.

Substance use and victimization experiences among college students in Spain

OBJECTIVE

We examined relationships between different types and patterns of substance use and victimization experiences.

PARTICIPANTS

College students from two universities in Spain completed an online, cross-sectional survey.

METHOD

A series of tetrachoric correlations were estimated to examine the bivariate associations between different types of substances and victimization experiences. Regression analyses then examined relationships between patterns of substance use (non-users, mono-users, and poly-users), and victimization.

RESULTS

Slightly over half (57.7%) of students reported any form of victimization during the previous year, and most students (87.0%) reported using substances during the last three months. Polysubstance users were more likely than non-users to experience any victimization, as well as multiple forms of victimization.

CONCLUSIONS

Findings highlight the importance of differentiating types and patterns of substance use when developing prevention and intervention programs. Implementing intervention strategies that target polysubstance users and decrease substance use could reduce rates of victimization among college students.

Polysubstance Use Patterns among Outpatients Undergoing Substance Use Disorder Treatment: A Latent Class Analysis

Substance Use Disorders (SUDs) pose significant challenges to both individuals and society at large. The primary focus of existing research with clinical SUD populations has been on individual substances, but research is required to better understand the profiles of individuals who use different substances simultaneously. The purpose of the current study was, therefore, to identify patterns of use among subjects (n = 1025) who reported using multiple substances by adopting a Latent Class Analysis (LCA) methodology. The Addiction Severity Index (ASI-lite) was included as a measure of substance misuse, we performed LCA to identify patterns of substance use through the administration of the ASI-Lite. Responses were collected from the following substances: alcohol, cannabis/cannabinoids, opioids and heroin, and cocaine. Results identified two latent classes: (1) alcohol use dominant, and (2) poly-abuser use dominants. Class 1 represented 60.0% of the sample and refers to individuals with the dominant use of alcohol, of those a higher proportion (47%) reported low-frequency use (1 to 7 days per month) and 26% reported a frequency of use of 24 to 30 days per month. Furthermore, 18% used alcohol in combination with cocaine. Class 2 represents 40.0% of the sample. This class is characterized by low-frequency and high-frequency users of several substances. The results obtained highlight the importance of deepening the study of the concomitant use of substances in individuals with SUDs to better understand the health risk of the combined use of two or more substances.

Substance use in the emergency department: Screening for risky drug use, using the ASSIST-Lite

INTRODUCTION

Substance use is a common contributing factor to emergency department (ED) presentations. While screening, brief intervention, and referral to treatment for alcohol and tobacco is common in ED settings, it is not routinely conducted for illicit substances. This study aimed to deploy the ASSIST-Lite to screen for risky use of alcohol and other drugs in the ED, to identify differences in risk based on between demographic characteristics.

METHOD

All ED attenders, aged 18 years or older, deemed well enough to participate were approached. Recruitment occurred at the Royal Adelaide Hospital ED between May and June 2017. Participants were asked to self-complete the ASSIST-Lite in the ED waiting room. Overall, 632 people were approached, of which 479 (75.8%) agreed to participate.

RESULTS

Alcohol (72.2%), tobacco (27.1%) and cannabis (15.2%) were most commonly reported. Eighty-nine participants reported moderate- or high-risk use of two substances, and a further 49 individuals reported moderate- or high-risk use of three or more substances. Across most substances, age, gender and employment status was associated with risky substance use, with higher likelihood of risk reported by males, unemployed and younger participants. Unemployment was also significantly associated with increased risk severity for both moderate and high-risk illicit use.

DISCUSSIONS AND CONCLUSIONS

The rate of risky illicit and polysubstance use found here highlight the need more focused research in ED settings. The findings also provide support for more routine screening, and early intervention approaches; and suggest the need for active referral pathways through an alcohol and other drug consultation liaison service.

Psychiatric symptoms, current use of tobacco, alcohol, illicit drug, and poly-substance among medical students in Eastern Turkey

The study aims to investigate the prevalence and patterns of substance use among medical students and to examine associated psychiatric symptoms. It has been observed that depression and psychoticism scores have a significant effect on smoking, and interpersonal sensitivity-hostility-paranoid ideation scores have a significant effect on drinking. It has been shown that interpersonal sensitivity and depression scores are more predictive of mono-and poly-substance use. Revealing the relationship between tobacco, alcohol, poly-substance use, and psychiatric symptoms in the medical school sample shows the importance of practices aimed at increasing students' awareness of their psychiatric symptoms and providing access to psychiatric services.

Stealthing Perpetration and Victimization: Prevalence and Correlates Among Emerging Adults

"Stealthing" is a form of sexual violence wherein a sexual partner purposefully removes a condom during penetration without the receptive partner's knowledge. Given the role of substance use in sexual violence broadly, we examined demographic and substance use correlates of stealthing perpetration (SP) and victimization (SV) among emerging adults. Participants comprised 2,550 18- to 25-year-olds (M age = 20.8, SD = 2.3), recruited via social media (48% female; 53.9% non-Hispanic White; 46.0% had another racial/ethnic identity; 67.4% heterosexual; 85.3% had some college education). Unadjusted analyses (t tests, χ2 analysis) and adjusted logistic regression analyses examined associations between demographics (age, education, race/ethnicity, sexual orientation) and substance use (binge drinking, marijuana use, other illegal drug use, and prescription drug misuse) with male SP and male and female SV. Five percent of males and 18.9% of females reported SV; 6.1% of males reported SP. In adjusted analyses, significant correlates of SP were: non-Hispanic White race/ethnicity (odds ratio [OR] = 0.39), binge drinking (OR = 1.39), cannabis use (OR = 1.37), and other drug use (OR = 1.43). Significant correlates of male SV were: non-Hispanic White race/ethnicity (OR = 0.28), non-heterosexual orientation (OR = 0.24), binge drinking (OR = 1.49), and other illegal drug use (OR = 1.79). Significant correlates of female SV were: older age (OR = 1.13), non-Hispanic White race/ethnicity (OR = 0.57), binge drinking (OR = 1.28), cannabis use (OR = 1.29), and other drug use (OR = 1.22). Consistent with literature linking alcohol to sexual violence, binge drinking correlated with both SV and SP, with other substance use also playing a role. Data are needed to explore these relationships using longitudinal, event-level assessments to investigate the influence of acute intoxication. Interventions to reduce sexually transmitted infections, unintended pregnancy, and sexual assault should include content on stealthing and substance use.

Problematic online gambling among adolescents: A systematic review about prevalence and related measurement issues

BACKGROUND AND AIMS

Despite its illegality among adolescents, online gambling is a common practice, which puts their mental health and well-being at serious risk. This systematic review summarises international scientific literature from the last 20 years on problematic online gambling among adolescents (11-21 years old) to determine its prevalence and to analyse related measurement issues.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed and a protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, IC: CRD42020162932). Five academic databases were consulted, which resulted in an initial sample of 658 papers.

RESULTS

Sixteen studies met the inclusion criteria for this review. All studies were cross-sectional and targeted students from elementary school, secondary school or university. Most followed a convenience sampling procedure. The primary measurement instruments used were the DSM-IV-MR-J and SOGS-RA. Between 0.77% and 57.5% of adolescents present some degree of problematic online gambling (problem, pathological or disordered) depending on the instruments used, the study samples and the timeframe analysed. Between 0.89% and 1% of adolescents exhibited an online gambling disorder.

DISCUSSION AND CONCLUSION

There is a great heterogeneity in the methodology of the reviewed studies (samples, measurement instruments, cut-off points and criteria applied). The limited number of studies and the limited generalizability of their results suggest the need for further research and for development of specific instruments to assess different levels of problematic online gambling in representative samples of adolescents based on clinical 'gold standard' criteria and more accurate cut-off points.

Alcohol-Related, Drug-Related, and Non-Substance-Related Aggression: 3 Facets of a Single Construct or 3 Distinct Constructs?

BACKGROUND

Aggression often occurs alongside alcohol and drug misuse. However, it is not clear whether the latent and manifest relations among alcohol-related, drug-related, and non-substance-related aggression are separate manifestations of a single construct or instead are 3 distinct constructs.

METHODS

To examine these associations, we conducted a preregistered analysis of 13,490 participants in the Collaborative Study on the Genetics of Alcoholism. In a structured interview, participants reported their lifetime perpetration of these 3 aggression phenotypes.

RESULTS

The data were better fit by a model that treated these aggression phenotypes as 3 distinct latent factors, as compared to models in which the items all loaded onto 1 ("general") or 2 ("substance-related" and "non-substance-related") aggression factors. This 3-factor model fit better for men than women. Subsequent exploratory analyses then showed that among these 3 factors, alcohol-related aggression explained the variance of overall aggression better than the other 2 factors.

CONCLUSIONS

Our findings suggest that these 3 forms of aggression are distinct phenotypes (especially among men). Yet, people's alcohol-related aggression can accurately characterize their overall aggressive tendencies across these domains. Future research will benefit from articulating the unique and shared pathways and risk factors underlying each of these facets of aggression.

Polydrug use disorders in individuals with opioid use disorder

BACKGROUND

Understanding the association of polydrug use disorders (PUD) with psychosocial and clinical factors is essential for the treatment of individuals with opioid use disorder (OUD). The aim of this study is to examine whether there is an association between childhood maltreatment, mood disorders, anxiety disorders, personality disorders, or posttraumatic stress disorder (PTSD) and PUD in individuals with OUD.

METHODS

We used data from 356 individuals with OUD in the past 12 months from a nationally representative database in the United States. PUD patients were classified into two groups: a group with additional one substance disorder (OUD + 1) and that with two or more additional substance disorders (OUD + 2). We conducted multivariate logistic regression to predict the PUD status, after adjustment for confounders including childhood maltreatment.

RESULTS

Among all individuals, 57.3% were polydrug users (n = 204) and 42.7% were not (n = 152). There was a high prevalence of childhood maltreatment in both groups, ranging from 16.1% to 59.5%, but the difference was not statistically significant. After adjustment for confounders, we found an association between past-year PTSD and OUD + 2 (odds ratio: 3.98; 95% confidence interval: 1.15-13.72; p = 0.03) but not with OUD + 1.

CONCLUSION

PTSD is highly prevalent in individuals with OUD using multiple substances and could influence PUD. We recommend screening for PTSD in cases of PUD. Future studies should evaluate the effect of PTSD treatment on PUD.