Methamphetamine-using parents: the relationship between parental role strain and depressive symptoms

Paternal methamphetamine exposure induces higher sensitivity to methamphetamine in male offspring through driving ADRB1 on CaMKII-positive neurons in mPFC

Paternal abuse of drugs, such as methamphetamine (METH), elevates the risk of developing addiction in subsequent generations, however, its underlying molecular mechanism remains poorly understood. Male adult mice (F0) were exposed to METH for 30 days, followed by mating with naïve female mice to create the first-generation mice (F1). When growing to adulthood, F1 were subjected to conditioned place preference (CPP) test. Subthreshold dose of METH (sd-METH), insufficient to induce CPP normally, were used in F1. Selective antagonist (betaxolol) for β1-adrenergic receptor (ADRB1) or its knocking-down virus were administrated into mPFC to regulate ADRB1 function and expression on CaMKII-positive neurons. METH-sired male F1 acquired sd-METH-induced CPP, indicating that paternal METH exposure induce higher sensitivity to METH in male F1. Compared with saline (SAL)-sired male F1, CaMKII-positive neuronal activity was normal without sd-METH, but strongly evoked after sd-METH treatment in METH-sired male F1 during adulthood. METH-sired male F1 had higher ADRB1 levels without sd-METH, which was kept at higher levels after sd-METH treatment in mPFC. Either inhibiting ADRB1 function with betaxolol, or knocking-down ADRB1 level on CaMKII-positive neurons (ADRB1CaMKII) with virus transfection efficiently suppressed sd-METH -evoked mPFC activation, and ultimately blocked sd-METH-induced CPP in METH-sired male F1. In the process, the p-ERK1/2 and ΔFosB may be potential subsequent signals of mPFC ADRB1CaMKII. The mPFC ADRB1CaMKII mediates paternal METH exposure-induced higher sensitivity to drug addiction in male offspring, raising a promising pharmacological target for predicting or treating transgenerational addiction.

Housing Correlates in Pregnant and Parenting Women Using Methamphetamine and Accessing Psychiatric Care

BACKGROUND

Integrated care is a promising model for pregnant and parenting women with problems related to methamphetamine use. Yet more research is imperative to guide services for this vulnerable population as methamphetamine use contributes to housing instability, which is associated with heavier use and overdose death.

METHOD

This prospective observational study analyzed how housing at discharge from psychiatric care was related to patient characteristics, program participation, and aftercare in 102 pregnant and/or parenting women.

RESULTS

Twelve of 23 women who were unstably housed at admission (three of six homeless) achieved stable housing by discharge from integrated care. Women were more likely unstably housed at discharge when unstably housed at admission, single, living apart from at least one minor, or when the other parent had a substance use disorder (p < 0.05). Unstably housed women at discharge were also more likely to have used social and inpatient services, and to transition to inpatient rehabilitation (p < 0.05). Among baseline characteristics, logistic regression identified unstable housing at admission (OR = 6.07) and being single (OR = 4.01) as the strongest unique contributors to unstable housing at discharge (p < 0.05).

CONCLUSION

Unstably housed women and single women seem particularly at risk of remaining in precarious living conditions despite accessing integrated care for problems associated with methamphetamine use. Future work should investigate whether stronger partnerships with government and community agencies could be a way forward to help these women attain and maintain stable housing.

Parent and child co-resident status among an Australian community-based sample of methamphetamine smokers

INTRODUCTION

Children in families where there is substance misuse are at high risk of being removed from their parents' care. This study describes the characteristics of a community sample of parents who primarily smoke methamphetamine and their child or children's residential status.

DESIGN AND METHODS

Baseline data from a prospective study of methamphetamine smokers ('VMAX'). Participants were recruited via convenience, respondent-driven and snowball sampling. Univariable and multivariable logistic regression analyses were used to estimate associations between parental status; fathers' or mothers' socio-demographic, psychosocial, mental health, alcohol, methamphetamine use dependence, alcohol use and child or children's co-residential status.

RESULTS

Of the 744 participants, 394 (53%) reported being parents; 76% (88% of fathers, 57% of mothers) reported no co-resident children. Compared to parents without co-resident children, parents with co-resident children were more likely to have a higher income. Fathers with co-resident children were more likely to be partnered and not to have experienced violence in the previous 6 months. Mothers with co-resident children were less likely to have been homeless recently or to have accessed treatment for methamphetamine use.

DISCUSSION AND CONCLUSIONS

The prevalence of non-co-resident children was much higher than previously reported in studies of parents who use methamphetamine; irrespective of whether in or out of treatment. There is a need for accessible support and services for parents who use methamphetamine; irrespective of their child or children's co-residency status. Research is needed to determine the longitudinal impact of methamphetamine use on parents' and children's wellbeing and to identify how parents with co-resident children (particularly mothers) can be supported.

Maternal role strain and depressive symptoms among female sex workers in Mexico: the moderating role of sex work venue

Stressors that arise in parenting are likely to have an adverse impact on the psychological well-being of female sex workers (FSWs), particularly in low- to middle-income countries (LMIC). This study examined the association between maternal role strain and depressive symptoms among 426 FSW mothers with dependent-age children (aged < 18 years) in Tijuana and Cd. Juarez, Mexico (2016-2017). Four dimensions of maternal role strain (e.g., child emotional and behavioral problems) were examined in relation to maternal depressive symptoms. We also investigated whether the relationship between maternal role strain and depressive symptoms was modified by venue of sex work. Compared to indoor/establishment-based FSWs, street-based FSWs reported significantly more child-related financial strain. In multiple regression analysis, having more depressive symptoms was associated with identifying as a street-based FSW, greater use of drugs, lower emotional support, more child-related financial strain and more emotional and behavioral problems in children. A significant interaction was identified such that the association between maternal role strain and depressive symptoms was stronger for indoor/establishment-based compared to street-based FSWs. These findings suggest the need to address parenting strain and type of sex work venue in the development of counseling programs to improve the mental health of FSWs in LMIC.

Impact of time perspectives on texting intervention to reduce HIV/STI transmission among female sex workers in Tijuana and Ciudad Juarez, Mexico

Text messages may sustain post-counseling gains in behavioral improvements and reduce HIV/STI incidence. However, their effectiveness may depend on the messages' time perspective and characteristics of the individual. We evaluated the impact of time perspective on a text messaging intervention designed to maintain improvements in safer sex practices among drug-using and non-drug-using female sex workers (FSWs) in Tijuana (n = 141) and Cd. Juarez (n = 129), Mexico. FSWs received the efficacious Mujer Segura intervention, and were randomized to receive safer sex maintenance text messages with either a short-term or future-oriented time perspective. The outcome was HIV/STI incidence rate over 6-month follow-up. In Tijuana, combined HIV/STI incidence density was lower among FSWs in the FUTURE group (31.67 per 100 py) compared to women in the SHORT-TERM group (62.40 per 100 py). Conversely, in Cd. Juarez, HIV/STI incidence density was lower (although non-significant) among FSWs in the SHORT-TERM group (19.80 per 100 py) compared to those in the FUTURE group (35.05 per 100 py). These findings suggest that future-oriented text messages may sustain post-counseling improvements in sexual risk behavior among FSWs, but findings may vary by FSWs' characteristics (e.g., drug use), and by region and context.

Methamphetamine Use in German Families: Parental Substance Use, Parent-Child Interaction and Risks for Children Involved

BACKGROUND

With an immense increase in methamphetamine use in Germany in the past decade, large sections of the drug-using community have been identified as parents of young children.

OBJECTIVE

With the fast-emerging issue of psychosocial and familial consequences of methamphetamine use, this study focused on gaining an insight into substance use, parenthood, and parenting by German methamphetamine users, with special emphasis on the psychological outcomes for the children involved.

METHODS

We conducted 24 qualitative interviews with parents (16 mothers and eight fathers), who were in outpatient treatment for their Crystal Meth use and were currently abstinent from using drugs. Personal information on parenting, drug use, and effects on the children was supplemented by standardized parents' reports on the children's behavioral patterns.

RESULTS

Parenting was described as challenging and often emotionally neglectful, impulsive, and inconsistent. The interview results further indicated an inter-relatedness of substance use and the parental role. Overall, children of methamphetamine users appeared to be at an increased risk of pre-and postnatal substance exposure and great psychosocial distress, especially evident in externalizing behavior such as hyperactivity and behavioral problems.

CONCLUSION

Results demonstrate the complex problems of methamphetamine-involved parents and suggest the need for a close cooperation between addiction treatment and child welfare services in providing appropriate psychological and educational support for parents and children.

Family composition and symptom severity among Veterans with comorbid PTSD and substance use disorders

Posttraumatic stress disorder (PTSD) and substance use disorders (SUD) frequently co-occur and affect a substantial proportion of military Veterans. Although the impact of parental PTSD and SUD on child development is well-documented, little is known about the influence of family composition on PTSD/SUD symptom severity. The present study investigated children in the home as an independent risk factor for symptom severity in a sample of treatment-seeking Veterans (N = 94; 92% male) with comorbid PTSD/SUD. Twenty-seven percent of the sample had minor children (age 18 or younger) living in the home. Veterans with children in the home evidenced significantly higher PTSD symptomatology as measured by the Clinical Administered PTSD Scale (CAPS; M = 82.65 vs. M = 72.17; t = -2.18; p < .05), and reported using marijuana more frequently than Veterans without children in the home (34% vs. 13% of past 60 days; t = -2.35, p < .05). In a multivariate model, having children in the home accounted for unique variance (ΔR(2) = .07) in PTSD severity after accounting for a range of covariates; however, having children in the home did not account for unique variance in substance use. Directions for future research as well as potential clinical implications for parents seeking treatment for PTSD/SUD are discussed.

Unprotected sexual practices among men who have sex with women and men who have sex with men living with HIV/AIDS in Rio de Janeiro

Combined antiretroviral therapy is now acknowledged for preventing new HIV infections, besides decreasing mortality and morbidity. However, in many Latin America countries the epidemic is still driven by unprotected sexual intercourse. This study aims to describe sexual practices related to HIV/STD and to evaluate factors associated to unprotected sex among men who have sex with women (MSW) and men who have sex with men (MSM) under care at a reference center for HIV in Rio de Janeiro, Brazil. A cross-sectional study, nested in a Brazilian clinical cohort, evaluated the sexual practices of 404 sexually active HIV-positive MSW and men who have MSM. Approximately 30 % of them reported unprotected sexual practices during the 6 months prior to the interview. Most frequent risky practices reported were unprotected vaginal sex among MSW and unprotected receptive anal sex among MSM. Factors increasing the chance of unprotected sexual practices among MSW were the partner's desire of becoming pregnant (OR 2.81; CI 95 %: 1.36-5.95). To have received comments about excessive consumption of alcohol (OR 2.43; CI 95 %: 1.01-5.83), illicit drug use (OR 4.41; CI 95 %: 1.75-11.60) and lived in marital situation (OR 2.10; CI 95 %: 1.09-4.08) were significantly associated with unsafe sexual practices among MSM. The results highlight that health care of men living with HIV, as well as the prevention strategies, must consider the particularities of sexual behavior practiced by people who differ in sexual orientation.

Correlates of drug dealing in female methamphetamine users

Female drug dealers have been a neglected population despite their potentially elevated risk for social, legal, family, and psychological health problems. This study examined correlates of drug-dealing behavior in a sample of 209 female methamphetamine users in San Diego, CA. Twenty-five percent of the sample reported dealing methamphetamine in the past 2 months. Women who dealt methamphetamine were significantly more likely than their nondealing counterparts to have started using illicit drugs before the age of 13 years (68 % versus 44.7 %, p = .003); to have been introduced to methamphetamine by a parent (15.1 % versus 5.8 %, p = .037); and to report currently using methamphetamine to stay awake (84.9 % versus 64.7 %, p = .004), enhance self-confidence (62.3 % versus 45.5 %, p = .025), and feel more attractive (54.7 % versus 38.5 %, p = .029). In a multivariate logistic regression, factors independently associated with methamphetamine dealing were: having a spouse or live-in partner (Adjusted Odds Ratio, AOR = 2.89), using methamphetamine with a broader range of types of person (AOR = 1.46), and reporting lower levels of emotional support (AOR = 0.57). These findings suggest that female methamphetamine dealers are in urgent need of access to substance use treatment, therapies to enhance self-worth and emotional support, and family-based substance use prevention interventions for dependent children and those at risk.

Factors associated with experiences of stigma in a sample of HIV-positive, methamphetamine-using men who have sex with men

BACKGROUND

While methamphetamine users report high rates of internalized or self-stigma, few studies have examined experiences of stigma (i.e., stigmatization by others) and its correlates.

METHODS

This study identified correlates of stigma experiences in a sample of 438 HIV-positive men who have sex with men (MSM) who were enrolled in a sexual risk reduction intervention in San Diego, CA.

RESULTS

Approximately 96% of the sample reported experiences of stigma related to their use of methamphetamine. In multiple regression analysis, experiences of stigma were associated with binge use of methamphetamine, injection drug use, increased anger symptoms, reduced emotional support, and lifetime treatment for methamphetamine use.

CONCLUSIONS

These findings suggest that experiences of stigma are common among methamphetamine users and that interventions to address this type of stigma and its correlates may offer social, psychological, and health benefits to HIV-positive methamphetamine-using MSM.