heroin and Marijuana-Abuse

A review of the evidence was conducted regarding asthma associated with the use of cocaine, heroin, and marijuana.. A search of the English literature was performed via PubMed/Medline and EMBASE using the search terms asthma AND cocaine, heroin, and marijuana. When pertinent articles were found, salient references in those articles were assessed.. Due to the relatively small number of studies, we included all studies and cases.. For several decades, case reports, retrospective studies, and laboratory investigations have demonstrated that inhalation of cocaine or heroin is associated with increased asthma symptoms and reduced pulmonary function. Smoking crack cocaine, nasal insufflation of cocaine or heroin, and smoking heroin increases the risk of emergency department visits and hospitalizations for asthma. Although frequent smoking of marijuana may cause symptoms of cough, sputum production, and wheezing in the general population, more studies are needed specifically in patients with asthma. Smoking marijuana with concomitant tobacco use is common and further worsens the respiratory symptoms.. Use of cocaine and heroin in patients with asthma should be avoided. Pending further studies, it would be prudent for patients with asthma to avoid smoking marijuana. Clinicians need to be vigilant regarding use of these drugs in their patients with hyperreactive airway disease.

Topics: Administration, Inhalation; Asthma; Cannabis; Cocaine-Related Disorders; Crack Cocaine; Heroin; Heroin Dependence; Humans; Marijuana Abuse; Marijuana Smoking; Respiratory Function Tests; Respiratory Sounds; Retrospective Studies; Substance-Related Disorders

The objective of this review is to describe self-administration procedures for modeling addiction to cocaine, cannabis and heroin in the human laboratory, the benefits and pitfalls of the approach, and the methodological issues unique to each drug. In addition, the predictive validity of the model for testing treatment medications will be addressed. The results show that all three drugs of abuse are reliably and robustly self-administered by non-treatment-seeking research volunteers. In terms of pharmacotherapies, cocaine use is extraordinarily difficult to disrupt either in the laboratory or in the clinic. A range of medications has been shown to significantly decrease cocaine's subjective effects and craving without decreasing either cocaine self-administration or cocaine abuse by patients. These negative data combined with recent positive findings with modafinil suggest that self-administration procedures are an important intermediary step between pre-clinical and clinical studies. In terms of cannabis, a recent study suggests that medications that improve sleep and mood during cannabis withdrawal decrease the resumption of marijuana self-administration in abstinent volunteers. Clinical data on patients seeking treatment for their marijuana use are needed to validate these laboratory findings. Finally, in contrast to cannabis or cocaine dependence, there are three efficacious Food and Drug Administration-approved medications to treat opioid dependence, all of which decrease both heroin self-administration and subjective effects in the human laboratory. In summary, self-administration procedures provide meaningful behavioral data in a small number of individuals. These studies contribute to our understanding of the variables maintaining cocaine, marijuana and heroin intake, and are important in guiding the development of more effective drug treatment programs.

Topics: Cannabinoids; Cocaine; Cocaine-Related Disorders; Heroin; Heroin Dependence; Humans; Illicit Drugs; Marijuana Abuse; Models, Psychological; Self Administration; Social Environment; Treatment Outcome

This article includes a summary and critique of methodological limitations of the peer-reviewed studies of developmental outcome during the first 2 years in children prenatally exposed to the most commonly used drugs of abuse: tobacco, alcohol, marijuana, heroin/methadone, and cocaine. Reported effects vary by specific drug or drug combinations and amount and timing of exposure; however, few thresholds have been established. Drug effects also appear to be exacerbated in children with multiple risks, including poverty, and nonoptimal caregiving environments. Although prenatal exposure to any one drug cannot reliably predict the outcome of an individual child, it may be a marker for an array of variables that can impact development. Appropriate intervention strategies require future research that determines which factors place exposed children at risk and which are protective for optimal development.

Topics: Alcoholism; Child Abuse; Child Development; Child, Preschool; Cocaine; Cocaine-Related Disorders; Ethanol; Female; Heroin; Heroin Dependence; Humans; Infant; Infant, Newborn; Marijuana Abuse; Methadone; Nicotine; Poverty; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Risk Factors; Smoking; Substance-Related Disorders

Sub-Saharan Africa is one of the top three regions with the highest rates of opioid-related premature mortality. Nyaope is the street name for what is believed to be a drug cocktail in South Africa although recent research suggests that it is predominantly heroin. Nyaope powder is most commonly smoked together with cannabis, a drug-use pattern unique to the region. Due to the increasing burden of this drug in low-income communities and the absence of human structural neuroimaging data of combination heroin and cannabis use disorder, we initiated an important cohort study in order to identify neuroanatomical sequelae. Twenty-eight male nyaope users and thirty healthy, matched controls were recruited from drug rehabilitation centers and the community, respectively. T1-weighted MRI images were obtained using a 3 T General Electric Discovery and cortical thickness was examined and compared. Nyaope users displayed extensive grey matter atrophy in the right hemispheric medial orbitofrontal, rostral middle frontal, superior temporal, superior frontal, and supramarginal gyri (two-sided t-test, p < 0.05, corrected for multiple comparisons). Our findings indicate cortical abnormality in nyaope users in regions involved in impulse control, decision making, social- and self-perception, and working memory. Importantly, affected brain regions show large overlap with the pattern of cortical abnormalities shown in heroin use disorder.

Topics: Adult; Atrophy; Cannabis; Case-Control Studies; Cerebral Cortex; Cohort Studies; Gray Matter; Heroin; Heroin Dependence; Humans; Illicit Drugs; Magnetic Resonance Imaging; Male; Marijuana Abuse; Neuroimaging; South Africa

In the United States, 15 states and the District of Columbia have implemented recreational cannabis laws (RCLs) legalizing recreational cannabis use. We aimed to estimate the association between RCLs and street prices, potency, quality and law enforcement seizures of illegal cannabis, methamphetamine, cocaine, heroin, oxycodone, hydrocodone, morphine, amphetamine and alprazolam.. We pooled crowdsourced data from 2010-19 Price of Weed and 2010-19 StreetRx, and administrative data from the 2006-19 System to Retrieve Information from Drug Evidence (STRIDE) and the 2007-19 National Forensic Laboratory Information System (NFLIS). We employed a difference-in-differences design that exploited the staggered implementation of RCLs to compare changes in outcomes between RCL and non-RCL states.. Eleven RCL and 40 non-RCL US states.. The primary outcome was the natural log of prices per gram, overall and by self-reported quality. The primary policy was an indicator of RCL implementation, defined using effective dates.. The street price of cannabis decreased by 9.2% [β = -0.092; 95% confidence interval (CI) = -0.15-, -0.03] in RCL states after RCL implementation, with largest declines among low-quality purchases (β = -0.195; 95% CI = -0.282, -0.108). Price declines were accompanied by a 93% (β = -0.93; 95% CI = -1.51, -0.36) reduction in law enforcement seizures of cannabis in RCL states. Among illegal opioids, including heroin, oxycodone and hydrocodone, street prices increased and law enforcement seizures decreased in RCL states.. Recreational cannabis laws in US states appear to be associated with illegal drug market responses in those states, including reductions in the street price of cannabis. Changes in the street prices of illegal opioids analyzed may suggest that in states with recreational cannabis laws the markets for other illegal drugs are not independent of legal cannabis market regulation.

Topics: Cannabis; Heroin; Humans; Illicit Drugs; Legislation, Drug; Marijuana Abuse; United States

Illicit drug use contributes to substantial morbidity and mortality. Drug scheduling, a legal measure in drug enforcement, is often structured as a hierarchy based on addiction tendency, abuse trends, and harm, but may lack data-driven evidence when classifying substances. Our study aims to measure addiction tendency and use trends based on real-world data. We used the open access database of National Police Agency, Ministry of the Interior in Taiwan and analyzed all daily criminal cases of illicit drugs from 2013 to 2017 and monthly illicit drug enforcement data from the same database from 2002 to 2017. We hypothesized that repeat and frequent use despite legal consequence may be a reflection of addictive behavior, and empirical mode decomposition was applied in analysis to calculate addiction tendency indices and intrinsic 15-year use trends. Our analysis showed heroin has the highest addiction index, followed by methamphetamine. 3,4-Methyl enedioxy methamphetamine, marijuana, and ketamine had lower addictive propensities. This result is consistent with most drug scheduling hierarchies. 15-year use trends of substances were consistent with previous epidemiological studies.

Topics: Amphetamine-Related Disorders; Anesthetics, Dissociative; Cannabis; Central Nervous System Stimulants; Crime; Databases, Factual; Hallucinogens; Heroin; Humans; Illicit Drugs; Ketamine; Marijuana Abuse; Methamphetamine; N-Methyl-3,4-methylenedioxyamphetamine; Narcotics; Opioid-Related Disorders; Psychiatric Status Rating Scales; Substance-Related Disorders; Taiwan

Opioid misuse has reached epidemic proportions among emerging adults in the U.S. To inform prevention efforts, this study examined adolescent factors related to alcohol and marijuana (AM) use that are associated with a higher or lower risk for opioid misuse during emerging adulthood.. We used 11 waves of survey data from a diverse California cohort (N = 6,509). Predictor variables from waves 1-7 (ages 11-17) included individual (resistance self-efficacy, positive expectancies) family (older sibling and important adult use), and peer (perceived norms, time spent with peers who use, peer approval) factors. Opioid misuse at wave 8 (mean age = 18.3) and wave 11 (mean age = 21.6) included heroin and nonmedical prescription drug use.. Initial latent growth models (LGMs) indicated that nearly all intercepts and slopes for individual, family, and peer AM factors predicted opioid misuse at waves 8 and 11. These associations were reduced to non-significance after adjusting for prior other substance use with the exception of three intercepts: positive expectancies, peer approval, and older sibling use predicted a higher probability of opioid misuse at wave 8.. Stronger AM positive expectancies, perceived peer approval of AM use, and older sibling AM use during adolescence are associated with a higher likelihood of opioid misuse during the transition to emerging adulthood. However, most adolescent factors were no longer associated with subsequent opioid misuse after adjusting for history of other substance use, highlighting the importance of considering the larger context of substance use in studies of opioid misuse among young people.

Topics: Adolescent; Adolescent Behavior; Adult; Alcohol Drinking; Analgesics, Opioid; Child; Female; Heroin; Humans; Male; Marijuana Abuse; Marijuana Smoking; Opioid-Related Disorders; Peer Group; Prescription Drug Misuse; Prescription Drugs; Surveys and Questionnaires; Young Adult

Topics: Cannabidiol; Cannabis; Cues; Heroin; Humans; Marijuana Abuse

The Kreek-McHugh-Schluger-Kellogg (KMSK) scales provide a rapid assessment of maximal self-exposure to specific drugs and can be used as a dimensional instrument. This study provides a re-evaluation of the KMSK scales for cannabis, alcohol, cocaine, and heroin in a relatively large multi-ethnic cohort, and also the first systematic comparison of gender-specific profiles of drug exposure with this scale.. This was an observational study of n = 1,133 consecutively ascertained adult volunteers. The main instruments used were the SCID-I interview (DSM-IV criteria) and KMSK scales for cannabis, alcohol, cocaine, and heroin.. Participants were 852 volunteers (297 female) with specific DSM-IV abuse or dependence diagnoses, and 281 volunteers without any drug diagnoses (154 female). Receiver operating characteristic (ROC) curves were calculated for concurrent validity of KMSK scores with the respective DSM-IV dependence diagnoses. The areas under the ROC curves for men and women combined were 99.5% for heroin, 97% for cocaine, 93% for alcohol, and 85% for cannabis. Newly determined optimal KMSK "cutpoint" scores were identical for men and women for cocaine and heroin dependence diagnoses, but were higher in men than in women, for cannabis and alcohol dependence diagnoses.. This study confirms the scales' effectiveness in performing rapid dimensional analyses for cannabis, alcohol, cocaine, and heroin exposure, in a cohort larger than previously reported, with "cutpoints" changed from initial determinations, based on this larger sample. The KMSK scales also detected gender differences in self-exposure to alcohol and cannabis that are associated with the respective dependence diagnoses.

Topics: Adult; Alcoholism; Cannabis; Cocaine; Cohort Studies; Diagnostic and Statistical Manual of Mental Disorders; Female; Heroin; Heroin Dependence; Humans; Male; Marijuana Abuse; Middle Aged; ROC Curve; Sex Characteristics; Substance-Related Disorders; Young Adult

Since 2000, heroin use patterns have shifted within the United States. How this change may relate to polydrug use among local heroin users is unknown. Although polydrug use has been studied, user perceptions of drug use in terms of health risks, arrest risk, availability, cost, liking, and dependence have not been considered.. Data are presented from a brief, face-to-face survey conducted in 2016 of 200 non-in-treatment heroin users from Cleveland, OH. We assessed the use of and attitudes on alcohol, marijuana, methamphetamine, heroin, crack cocaine, powder cocaine, and prescription drugs. We estimated polydrug (concurrent past month) use with cluster analysis and latent profiles. Regression analysis estimated the strength of relationships between attitudes and frequency of use.. We identified five clusters: Cluster 1 used heroin concomitantly with alcohol and occasionally crack; Cluster 2 used heroin and crack cocaine daily; Cluster 3 used heroin daily and almost exclusively; Cluster 4 used heroin and marijuana daily; and Cluster 5 were part-time drug users. Drug use frequency was associated with liking and being anxious when drugs could not be obtained. High perceived availability of heroin and cocaine and low cost facilitated polydrug use.. Understanding polydrug use clusters among heroin users is important for addressing the larger opioid epidemic. Users' perceptions of a drug's availability and cost appeared to facilitate polydrug use and justify more detailed future research on drug access.

Topics: Adult; Alcoholism; Amphetamine-Related Disorders; Analgesics, Opioid; Cocaine-Related Disorders; Crack Cocaine; Drug Users; Female; Heroin; Heroin Dependence; Humans; Male; Marijuana Abuse; Middle Aged; Ohio; Self Report; Substance-Related Disorders

Harm reduction policies and attitudes in the United States have advanced substantially in recent years but still lag behind more advanced jurisdictions in Europe and elsewhere. The Obama administration, particularly in its last years, embraced some harm reduction policies that had been rejected by previous administrations but shied away from more cutting edge interventions like supervised consumption sites and heroin-assisted treatment. The Trump administration will undermine some of the progress made to date but significant state and local control over drug policies in the US, as well as growing Republican support for pragmatic drug policies, motivated in part by the opioid crisis, ensures continuing progress for harm reduction.

Topics: Analgesics, Opioid; Harm Reduction; Heroin; Heroin Dependence; Humans; Legislation, Medical; Marijuana Abuse; Needle-Exchange Programs; Politics; Public Policy; United States

Alprazolam is a benzodiazepine anxiolytic widely prescribed for treatment of panic-disorder and social phobias, although this medication is also subject to abuse. In this paper, the concentrations of alprazolam in venous blood samples from impaired drivers were compared with femoral blood samples from forensic autopsies classified as intoxication or other causes of death (e.g. natural, trauma). After liquid-liquid extraction (n-butyl acetate) alprazolam was determined in blood by capillary gas chromatography with a nitrogen-phosphorous detector. The mean (median) and range of alprazolam concentrations in blood from impaired drivers (n = 773) were 0.08 mg/L (0.05 mg/L) and 0.02-3.9 mg/L, respectively. Many traffic offenders had co-ingested ethanol (13%), amphetamine (46%), cannabis (32%), or heroin (14%), as well as other drugs. In deaths attributed to drug intoxication, the mean (median) and range of alprazolam concentrations in blood (n = 438) were 0.10 mg/L (0.06 mg/L) and 0.02-1.6 mg/L, respectively, which were not much different from other causes of death (n = 278); 0.08 mg/L (0.05 mg/L) and 0.02-0.9 mg/L. Median concentrations of alprazolam in blood from living and deceased persons did not seem to depend on the number of co-ingested substances. The result of this pharmacoepidemiological study suggests that alprazolam is a fairly innocent drug when used as monotherapy, but toxicity problems arise when co-ingested with illicit drugs and/or psychoactive medication.

Topics: Age Factors; Alcoholism; Alprazolam; Amphetamine; Anti-Anxiety Agents; Automobile Driving; Crime; Databases, Factual; Female; Forensic Toxicology; Heroin; Humans; Illicit Drugs; Male; Marijuana Abuse; Psychotropic Drugs; Substance Abuse Detection; Substance-Related Disorders; Sweden; Wounds and Injuries

The rapid increase in communication and transportation between Africa and other continents as well as the erosion of social fabric attended by poverty, ethnic conflicts, and civil wars has led to increased trafficking and consumption of illicit drugs. Cannabis dominates illicit trade and accounts for as much as 40% of global interdiction. Due to escalating seizures in recent years, the illicit trade in heroin and cocaine has become a concern that has quickly spread from West Africa to include Eastern and Southern Africa in the past 10 years. All regions of Africa are characterized by the use of cannabis, reflecting its entrenched status all over Africa. Most alarming though is the use of heroin, which is now being injected frequently and threatens to reverse the gain made in the prevention of HIV/AIDS. The prevalence of HIV infection and other blood-borne diseases among injection drug users is five to six times that among the general population, calling for urgent intervention among this group. Programs that aim to reduce the drug trafficking in Africa and needle syringe programs as well as medication-assisted treatment (MAT) of heroin dependence while still in their infancy in Africa show promise and need to be scaled up.

Topics: Acquired Immunodeficiency Syndrome; Africa; Cocaine; Epidemics; Heroin; HIV Infections; Humans; Illicit Drugs; Marijuana Abuse; Needle-Exchange Programs; Prevalence; Risk Factors; Substance Abuse, Intravenous

gamma-Hydroxybutyrate (GHB) is a drug of abuse with a status as being safe. In spite of a reputation of low toxicity, a huge number of deaths associated with this drug have been recorded during recent years in Sweden. It is unclear whether coingestion with other drugs or ethanol causes death in GHB overdoses or whether GHB itself is the main cause of death.. The aim of this study was to analyze the cause of death in GHB-related fatalities seen in our region.. All cases of deaths with GHB during the year 2000-2007 in the region of western Sweden were studied retrospectively. The cases were classified as either GHB poisonings without any, with a minor or a major influence of other drugs on the cause of death.. Twenty-three cases were diagnosed as deaths due to GHB overdose. Ninety-one percent coingested other substances. Ninety-one percent of the decedents were male. Age varied between 16 and 46, with the median age at 25 years. Forty-three percent of the cases were classified as GHB poisonings without any or a minor influence of other drugs on the cause of death. Thirty percent also ingested ethanol. Two patients (9%) were only intoxicated with GHB.. Intoxication with GHB carries some mortality. Combining GHB with ethanol does not explain the many deaths in our region, nor do extremely high plasma concentrations of GHB. The intake of opioids increases the toxicity of GHB. The drug itself has such biological activities that an overdose is dangerous and may lead to death.

Topics: Adolescent; Adult; Central Nervous System Stimulants; Cocaine; Drug Overdose; Female; Hallucinogens; Heroin; Humans; Immunoassay; Male; Marijuana Abuse; Methamphetamine; Middle Aged; N-Methyl-3,4-methylenedioxyamphetamine; Narcotics; Prescription Drugs; Retrospective Studies; Sodium Oxybate; Substance-Related Disorders; Sweden; Young Adult

A 12-year medicolegal investigation of deceased illegal drug users (ILDU) in Stockholm, Sweden, classified on the basis of postmortem chemical tests, showed noticeable variations in causes and manners of death as well as in the distribution of suicide methods. This study offers objective information about connection between the postmortem findings of illegal drugs and the causes and manners of death of their users. However, further studies, comparing prevalence of drug use in general population and at the postmortem tests, are needed for more detailed elucidation of this connection.

Topics: Adolescent; Adult; Aged; Amphetamine; Amphetamine-Related Disorders; Cause of Death; Diagnosis; Female; Heroin; Heroin Dependence; Humans; Male; Marijuana Abuse; Methadone; Middle Aged; Suicide; Sweden

2015 subjects were interviewed at musical events and raves in Northern Italy: average age 25.1, 42% female, 67% work, 42% study, 61% have higher certificate of education. 3.8% used drugs for the first time in the last year, and 60% have been using drugs for over 5 years, age of first use 16.3. In the last year, 26% have tried a mix of drugs, 52% alcohol and drugs, 48% have driven after drinking; drug consumption was: marijuana 58%, hashish 55%, cocaine 24%, popper 12%, hallucinogenic mushrooms 13%, ecstasy 13%, amphetamines 13%, Salvia divinorum 11%, LSD 9%, opium 9%, ketamine 7%, heroin 5%. In the last year, 27% subjects had depression, 25.7% anxiety, 23.7% sleep disorders, 15% financial problems, 13% road accidents, 9% addiction, 6% judicial problems. All problems were correlated to CAGE (Cut, Annoyed, Guilty, Eye-opener) test, drug use and mix drug use; psychological problems were higher for females: anxiety for cocaine, memory and psychosomatic for opium, sleeping disorders for crack, anxiety for popper, hallucinations for LSD and hallucinogenic mushrooms.

Topics: Accidents, Traffic; Adult; Alcoholism; Amphetamines; Anxiety; Crack Cocaine; Depression; Female; Hallucinogens; Heroin; Humans; Italy; Ketamine; Male; Marijuana Abuse; Nicotine; Opium; Sleep Wake Disorders; Substance-Related Disorders; Surveys and Questionnaires

This study was performed on a representative sample of the Danish population in order to investigate the connection to the use of psychoactive drugs and quality of life (QOL) by way of a questionnaire-based survey. The questionnaire was mailed in February 1993 to 2,460 persons aged between 18 and 88, randomly selected from the CPR (Danish Central Register), and 7,222 persons from the Copenhagen Perinatal Birth Cohort 1959-61. A total of 1,501 persons between the ages 18 and 88 years and 4,626 persons between the ages 31 and 33 years returned the questionnaire (response rates of 61.0% and 64.1%, respectively). Variables investigated in this study were ten different psychotropic drugs and quality of life. Our study showed that over half the Danish population had used illegal psychotropic drugs. The most commonly used was cannabis (marijuana) though experience of this drug appeared not to co-vary with QOL to any significant extent. Cocaine, amphetamine, and psilocybin had been used by 1.2 to 3.3% of the population and this varied with QOL to a clear albeit small extent. LSD has been used by 1.2% of the population and the users had a QOL score 10% lower than those who had never used psychotropic drugs. The group with the lowest quality of life was found to be persons who had used heroin, morphine, methadone, and a mixture of alcohol and tranquilizers (10-20% below the group with the highest quality of life).

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amphetamines; Cocaine; Cohort Studies; Data Collection; Hallucinogens; Heroin; Humans; Marijuana Abuse; Methadone; Middle Aged; Morphine; Psychotropic Drugs; Quality of Life; Stimulants, Historical; Substance-Related Disorders; Surveys and Questionnaires

Topics: Drug and Narcotic Control; Heroin; Heroin Dependence; Legislation, Drug; Marijuana Abuse; Switzerland

Reported are the results of a survey to assess the prevalence of illicit drug use among high-school students in Jamaica. A total of 2417 high-school students in 26 schools were covered: 1063 boys and 1354 girls of whom 1317 were grade-10 students (mean age 15.7 years) and 1100 were grade-11 students (mean age 16.8 years). Of the students, 1072 and 1345 were from rural and urban schools, respectively, while 1126 and 1291 were children of parents who were professionals and nonprofessionals, respectively. The following drugs were used by the students: marijuana (10.2%), cocaine (2.2%), heroin (1.5%) and opium (1.2%). Illicit drug use among males, urban students and children of professionals was higher than that among females, rural students and children of nonprofessionals, respectively.

Topics: Adolescent; Cocaine-Related Disorders; Female; Heroin; Humans; Jamaica; Male; Marijuana Abuse; Narcotics; Opioid-Related Disorders; Opium; Prevalence

To assess how price and income affect hypothetical drug-purchasing decisions of polydrug abusers undergoing treatment for heroin addiction.. Forty subjects participated in experiments in which they hypothetically "purchased" drugs as price or income varied.. Experiment 1 examined effects of heroin price on purchases of heroin, valium, cocaine, marijuana and alcohol. Experiment 2 examined the effects of both heroin and valium prices on purchases of these drugs. In both these experiments, income remained constant. Experiment 3 examined the effects of increasing income on drug choices, with drug prices constant.. As price of heroin rose in Experiment 1, heroin purchases decreased. Reductions in heroin purchases were proportionally less than price increases, demonstrating inelastic demand for heroin. Valium and cocaine purchases increased as heroin price rose, and cross-price elasticity coefficients indicated that these drugs substituted for heroin. In Experiment 2, demand for both heroin and valium was inelastic. Valium substituted for heroin, but heroin purchases were independent of valium prices, suggesting an asymmetrical substitution effect. Marijuana and alcohol purchases were independent of valium price, but both these drugs substituted for heroin. In Experiment 3 demand for heroin and cocaine was income elastic, with purchases rising in greater proportion than income. Marijuana, alcohol and valium purchases did not vary with income, demonstrating that demand for these drugs was income inelastic. Hypothetical choices were reliable both between and within subjects. Moreover, drug choices in this hypothetical situation were correlated with urinalysis results, demonstrating initial validity of this methodology.. This methodology may be useful for understanding the phenomenon of polydrug abuse.

Topics: Adult; Choice Behavior; Cocaine; Diazepam; Ethanol; Female; Heroin; Humans; Income; Male; Marijuana Abuse; Substance-Related Disorders

The test-retest reliability of lifetime substance abuse and dependence diagnoses obtained by telephone interviewers was investigated. Trained personnel administered two identical interviews based on a modified Diagnostic Interview Schedule-Substance Abuse Module (DISSAM) approximately a week apart for 100 respondents, of whom 55 were receiving alcohol or other drug treatment and 45 and randomly selected from residential households in one Michigan county. The uncorrected agreement for all lifetime dependence diagnoses exceeded 93% for all six categories assessed and the more conservative chance corrected agreement (Cohen's Kappa coefficient kappa) was .92 (alcohol),.76 (marijuana),.87 (cocaine), and .71 (other opiates). Kappa coefficients for hallucinogens and heroin dependence could not be calculated due to low (i.e., 5% or less) base rates. Likewise, kappa was calculated only for a single abuse diagnosis, alcohol, with kappa = .42 and 95% agreement. In the interpretation of kappa, the standard applied was: kappa ranging from .41 to .60 represented moderate agreement, kappa ranging from .61 to .80 represented substantial agreement, and kappa ranging from .81 to 1.00 represented excellent agreement. Thus, test-retest reliability was excellent for lifetime alcohol and cocaine dependence and was substantial for lifetime marijuana and other opiates dependence. These results indicate that lifetime psychoactive substance abuse diagnoses can be obtained fairly reliably over the telephone using trained lay interviewers.

Topics: Adolescent; Adult; Aged; Alcoholism; Cocaine; Data Collection; Evaluation Studies as Topic; Female; Heroin; Humans; Interviews as Topic; Male; Marijuana Abuse; Middle Aged; Narcotics; Psychotropic Drugs; Reproducibility of Results; Sensitivity and Specificity; Substance-Related Disorders

Cocaine, mainly in the form of crack, continues to dominate New York City's illicit drug scene. Trends in cocaine-involved deaths, hospital emergencies, arrest and treatment admissions are reviewed from the late 1980s to the early 1990s. Also, street studies conducted at drug coping areas throughout New York City during this period yield ethnographic insights. At the same time that cocaine trends were showing increases in the 1990s, heroin trends and marijuana trends were also showing decisive increases. An upsurge in heroin activity may be directly related to cocaine activity. Heroin's ameliorative effects for the cocaine user are the most direct association. The sequence-first cocaine, then heroin-has been documented by historians in the field. The association between cocaine trends and marijuana trends is less direct, and may represent the substitution of or a retreat to marijuana, a drug that is perceived as much safer.

Topics: Cocaine; Crack Cocaine; Epidemiology; Heroin; Hospitalization; Humans; Marijuana Abuse; New York City; Substance-Related Disorders

A considerable number of schizophrenic persons also abuse illegal drugs. This comorbidity raises problems of diagnosis which become particularly important when concerning forensic questions. The hypothesis of a distinct psychopathological syndrome of drug induced psychosis is widely criticized in the literature. A case report is presented to demonstrate the problems of differential diagnoses and the difficulties for psychiatric expertizing arising from these problems.

Topics: Adult; Cannabinoids; Commitment of Mentally Ill; Comorbidity; Expert Testimony; Heroin; Heroin Dependence; Humans; Lysergic Acid Diethylamide; Male; Marijuana Abuse; Psychoses, Substance-Induced; Schizophrenia; Schizophrenic Psychology

Topics: Health Surveys; Heroin; Hospitalization; Humans; Marijuana Abuse; Students; Substance-Related Disorders

This paper describes patterns of drug use such as choice of drug, other substances abused, and route of administration in 174 women who reported methamphetamine, cocaine, heroin, or "Ts and blues" abuse during pregnancy. Seventy-five percent (130/174) reported using more than one drug. Other than tobacco, alcohol and cocaine were the drugs most frequently used in combination with other drugs (7% to 53% and 12% to 54% of the time, respectively). The extent of polydrug use observed in this study emphasizes (1) the difficulty in ascribing adverse maternal or fetal health effects to single substances, and (2) the potential for interaction effects due to multiple substance abuse.

Topics: Adolescent; Adult; Age Factors; Alcoholism; Cocaine; Female; Fetal Diseases; Heroin; Humans; Marijuana Abuse; Methadone; Methamphetamine; Odds Ratio; Pentazocine; Pregnancy; Pregnancy Complications; Smoking; Substance-Related Disorders; Tripelennamine

Epidemiology has recently been used to effectively track and analyze drug abuse patterns. This article generally describes methods used in the United States for estimating and monitoring drug abuse. It outlines the advantages and limitations of such data sources as surveys, indicators, and ethnography, and briefly explores the work and utility of local, national, and international drug surveillance networks. In addition, it describes national and local patterns for heroin, cocaine, and marijuana abuse.

Topics: Adolescent; Adult; Child; Cocaine; Heroin; Humans; Marijuana Abuse; Substance-Related Disorders; United States

A study of socio-demographic features of 680 cannabis and heroin addicts showed that the factors like, age, religion, family structure, peer groups and the easy availability of these drugs contribute to the problem of addiction.

Topics: Adolescent; Adult; Child; Female; Heroin; Humans; India; Male; Marijuana Abuse; Substance-Related Disorders

We retrospectively identified 49 cases of recreational drug-induced seizures in 47 patients seen at the San Francisco General Hospital between 1975 and 1987. Most patients experienced a single generalized tonic-clonic seizure associated with acute drug intoxication, but 7 patients had multiple seizures and 2 patients developed status epilepticus. The recreational drugs implicated were cocaine (32 cases), amphetamine (11), heroin (7), and phencyclidine (4). A combination of drugs was responsible in 11 cases. Seizures occurred independent of the route of administration, and occurred in both first-time and chronic abusers. Ten patients (21%) reported having had prior seizures, all with a close temporal association with drug abuse. Other than 1 patient who developed prolonged status epilepticus that caused a fixed neurologic deficit, most patients had no obvious short-term neurologic sequelae.

Topics: Adult; Amphetamines; Cocaine; Drug Combinations; Female; Heroin; Humans; Lysergic Acid Diethylamide; Male; Marijuana Abuse; Phencyclidine; Seizures; Status Epilepticus; Substance-Related Disorders; Time Factors

On the basis of a review of the available information, this article summarizes the situation, patterns and trends in respect of the use of cannabis, heroin and other opiates, cocaine, amphetamines, hallucinogens and inhalants, as well as multiple drug use. The review clearly shows that since the early 1980s there has been an increasing trend in the use of drugs, particularly heroin and cannabis. Drug use predominantly affects young people. The use of two or more drugs simultaneously or successively, often involving alcohol, is reported as the most common pattern of drug use among youth. Drug use has become incorporated into the current youth culture, with all the individual, social and economic implications this engenders. The average age of users at first use of inhalants was 16.3 years, cannabis 17.5 years, hallucinogens 18.8 years, cocaine 20.6 years and amphetamines 23.5 years.

Topics: Adolescent; Adult; Age Factors; Amphetamine; Cocaine; Hallucinogens; Heroin; Humans; Marijuana Abuse; Spain; Substance-Related Disorders

Issues regarding the use of epidemiology in drug abuse research are discussed and systems for monitoring national trends and identifying risk factors are described. Data indicate a general decline in marijuana use among youth, a cohort aging effect among heroin and marijuana users, and increased prevalence and health consequences associated with cocaine use.

Topics: Acquired Immunodeficiency Syndrome; Adolescent; Adult; Child; Cocaine; Epidemiologic Methods; Female; Heroin; Humans; Male; Marijuana Abuse; Population Surveillance; Risk; Substance-Related Disorders

Drug-related deaths encompass fatal overdoses, the medical derangements from chronic consumption, and violent death from the alteration of normal behavioral patterns. Determining the extent to which a drug contributed to a death necessitates correlation of all aspects of the death investigation; autopsy and toxicologic findings must be interpreted in the light of antecedent events, medical and social history, and thorough scene investigation. The approach to the medicolegal investigation of drug-related deaths is discussed along with some legal ramifications and certain potential problems of death certification.

Topics: Autopsy; Cocaine; Death, Sudden; Drug Prescriptions; Ethanol; Forensic Medicine; Heroin; Humans; Illicit Drugs; Marijuana Abuse; Pharmaceutical Preparations; Substance-Related Disorders; Tattooing; Toxicology

The aim of this study was to determine the frequency of chromosome damage in heroin-marijuana addicts and marijuana addicts. A group of 45 subjects, aged between 19 and 21 years, was divided into 15 controls, 15 heroin-marijuana addicts and 15 marijuana addicts. These patients were examined for the presence of chromosome aberrations in their peripheral lymphocytes. The findings indicate that the incidence of chromosome anomalies in heroin-marijuana addicts is approximately 21.3 times greater than in the controls and approximately 7.9 times greater than in marijuana addicts.

Topics: Adult; Chromosome Aberrations; Heroin; Heroin Dependence; Humans; Male; Marijuana Abuse

A sample survey of 712 Iranian youths aged 14 - 18 years, attending secondary schools in the city of Isfahan, indicated that 11% had had experience of drug abuse. The most common pattern was the experimental use of opium, with a minority of users having also used hashish or heroin. No other drugs were reported, but a significant association between the use of opium and of cigarettes and, to a lesser extent, alcohol was observed. However, given a relatively early peak in initiation to opium smoking, it seems that the initiation to the use of cigarettes and alcohol is contemporary with, rather than preceding the initiation to opium. Drug migration patterns described in Western samples and in some areas of South East Asia are not applicable to more traditional societies.

Topics: Adolescent; Age Factors; Alcohol Drinking; Heroin; Humans; Iran; Marijuana Abuse; Opium; Smoking; Substance-Related Disorders

Topics: Cannabinoids; Hair; Heroin; Heroin Dependence; Humans; Italy; Male; Marijuana Abuse; Methods; Morphine

This study examines sequential use of various drugs and alcohol among 1544 subjects being treated for substance abuse in 10 treatment centers. Several models were developed to examine drug usage with respect to specific lags dealing with the number of years between periods of beginning use of different types of drugs. The models also assessed the relationships between the lags from first to regular use of specific drugs. Length of use and amount of the drug used first in a sequence are associated with the lag from regular use of that drug to regular use of another drug--especially when the initial drug is marijuana. Contrary to expectation, shorter lags from first to regular alcohol use point toward longer lags from regular alcohol use to use of other drugs. However, the lag from first to regular alcohol use is positively related to the lag from first to regular marijuana use.

Topics: Alcoholism; Analysis of Variance; Heroin; Heroin Dependence; Humans; Illicit Drugs; Marijuana Abuse; Pharmaceutical Preparations; Time Factors

We interviewed 258 prisoners in Nordern-Switzerland. At that time, 55% suffered from a chronic or an acute illness. 32% smoked 20 and 37% more than 20 cigarettes a day. 46% had consumed drugs in the past (marihuana, LSD, heroin).

Topics: Adult; Aged; Cannabis; Health; Health Status; Heroin; Heroin Dependence; Humans; Lysergic Acid Diethylamide; Male; Marijuana Abuse; Middle Aged; Prisoners; Sexual Behavior; Smoking; Sports; Substance-Related Disorders; Suicide