scholarly journals Pneumomediastinum as a complication of MDMA (3,4-methylenedioxymetamfetamine, Ecstasy) ingestion

2016 ◽  
Vol 15 (3) ◽  
pp. 152-156
Author(s):  
Suleiman Ezoubi ◽  
◽  
Hassan Kahal ◽  
W Stephen Waring ◽  
◽  
...  
Keyword(s):  
Drug Use ◽  
Literature Review ◽  
Illicit Drug ◽  
Previous History ◽  
Illicit Drug Use ◽  
Recreational Drug ◽  
Spontaneous Pneumomediastinum ◽  
Gastrointestinal Pathology ◽  
History Of

MDMA (3,4-methylenedioxymethamfetamine, Ecstasy) is a widely used recreational drug. We present a case of pneumomediastinum as a complication of MDMA use in a 21-year-old man with no previous history of lung or gastrointestinal pathology. We have performed a literature review, and summarised the symptoms, signs, and prognosis for this under-recognised complication of a commonly used recreational drug. We recommend enquiring about illicit drug use in any patient presenting with spontaneous pneumomediastinum.

Outcomes of coronary artery bypass grafting in patients with a history of illicit drug use

2003 ◽  
Vol 92 (5) ◽  
pp. 593-595 ◽  
Author(s):  
Praphul Misra ◽  
Gloria C. Caldito ◽  
Aman K. Kakkar ◽  
Mary C. Mancini ◽  
Pratap C. Reddy
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Drug Use ◽  
Coronary Artery Bypass ◽  
Illicit Drug ◽  
Artery Bypass ◽  
Illicit Drug Use ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
History Of

Association between tobacco use and symptom expression, alcoholism, and illicit drug use in patients with advanced cancer.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 154-154
Author(s):  
YuJung Kim ◽  
Rony Dev ◽  
Akhila Sunkepally Reddy ◽  
David Hui ◽  
Gary B. Chisholm ◽  
...  
Keyword(s):  
Drug Use ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Advanced Cancer Patients ◽  
Pain Expression ◽  
History Of ◽  
Former Smokers ◽  
Never Smokers

154 Background: Our aim was to determine the association between smoking status and symptom expression, opioid use, alcoholism, and illicit drug use in advanced cancer patients. Methods: We retrospectively reviewed 560 consecutive charts from the outpatient Supportive Care Center and identified 300 advanced cancer patients who completed a comprehensive smoking questionnaire. Data on the Edmonton Symptom Assessment Scale (ESAS), morphine equivalent daily dose (MEDD), CAGE (Cut Down, Annoyed, Guilty, Eye Opener) questionnaire for alcoholism screening, and history of illicit drug use were collected. Results: Among 300 advanced cancer patients, 119 (40%) were never-smokers, 148 (49%) were former smokers, and 33 (11%) were current smokers. Compared with never-smokers, current smokers were more likely to be men (58% vs. 29%, P=0.004), report a higher pain expression (median 7.0 vs. 5.0 by the ESAS, P=0.007), be CAGE positive (≥2 yes response) (42% vs. 3%, P<0.001), and have a history of illicit drug use (33% vs. 3%, P<0.001). Compared with never-smokers, former smokers were more likely to be men (60% vs. 29%, P<0.001), have head and neck cancer or lung cancer (30% vs. 13%, P=0.001), be CAGE positive (21% vs. 3%, P<0.001), and have a history of illicit drug use (16% vs. 3%, P<0.001). Current smokers reported a higher pain expression than former smokers (median 7.0 vs. 6.0 by the ESAS, P=0.01), had higher CAGE positivity (42% vs. 21%, P=0.01) and more frequent illicit drug use (33% vs. 16%, P=0.03). The MEDD and the timing of palliative care referral were not significantly different between current or former smokers compared with never-smokers. However, a higher proportion of current smokers were receiving opioids with MEDD ≥30mg at the time of palliative care consultation compared with never-smokers (70% vs. 52%, P=0.08). Conclusions: Our study suggests that current tobacco use is associated with a higher pain expression. In addition, any history of tobacco use is associated with a history of illicit drug use and alcoholism. Advanced cancer patients who smoked cigarettes may be at an increased risk for chemical coping or stronger opioid utilization and further studies are needed.

scholarly journals Auditory skill analysis of a group of subjects with history of illicit drug use

2009 ◽  
Vol 75 (5) ◽  
pp. 685-693
Author(s):  
Daniela de Lucas Rosseto ◽  
Silvana Cristina Ribeiro ◽  
Mônica Pires de Castro Mendonça ◽  
José Antônio A. de Oliveira ◽  
Ana Cláudia Mirândola Barbosa Reis ◽  
...  
Keyword(s):  
Drug Use ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
History Of ◽  
Skill Analysis

Testing a General Theory of Drug Abuse and other Deviant Adaptations

1985 ◽  
Vol 15 (4) ◽  
pp. 477-492 ◽  
Author(s):  
Howard B. Kaplan
Keyword(s):  
Drug Use ◽  
General Theory ◽  
Illicit Drug ◽  
Deviant Behavior ◽  
Multivariate Analyses ◽  
Illicit Drug Use ◽  
The Self ◽  
Social Evaluation ◽  
Level Of Involvement ◽  
History Of

I present an outline of the current state of an evolving general theory of deviant behavior, particularly as it applies to the explanation of the onset and continuity or change in level of involvement in illicit drug use. Self-derogation remains a central organizing concept in the theory. The need for self-approval disposes a person to illicit drug use, depending upon the social evaluation of this pattern in the person's membership/reference groups and the history of net self-enhancing/self-devaluing experiences in these groups. The initiation of illicit drug use is a function of circumstances influencing the opportunities for, and the self-evaluative relevance of anticipated consequences of, the illicit drug use. The continuity of the illicit drug use is a function of the self-evaluative relevance of the perceived consequences of initial drug use, and of changes in the circumstances that provide opportunities for and redefine the self-evaluative relevance of normative standards. The results of recent multivariate analyses are described. These results point to the usefulness of the theory both as a guide for research and as a framework for integrating the results of multivariate analyses estimating the onset and continuity or changes in level of involvement in illicit drug use.

scholarly journals The SISAP: A New Screening Instrument for Identifying Potential Opioid Abusers in the Management of Chronic Nonmalignant Pain Within General Medical Practice

1996 ◽  
Vol 1 (3) ◽  
pp. 155-162 ◽  
Author(s):  
Robert B Coambs ◽  
Josée L Jarry ◽  
Anusha C Santhiapillai ◽  
Rixi V Abrahamsohn ◽  
Cristina M Atance
Keyword(s):  
Substance Abuse ◽  
Chronic Pain ◽  
Drug Use ◽  
Illicit Drug ◽  
Substance Abusers ◽  
Opioid Analgesics ◽  
Illicit Drug Use ◽  
Screening Instrument ◽  
Prior History ◽  
History Of

BACKGROUND:Many physicians are overly cautious about prescribing opioids for chronic pain because of fears of iatrogenic addiction. However, in patients with chronic pain, addiction to opioid analgesics is exceedingly rare when there is no prior history of alcohol or drug abuse.OBJECTIVE:To validate an instrument that separates possible opioid abusers from those who are at low risk.DESIGN/METHODS:The Screening Instrument for Substance Abuse Potential (SISAP) was designed to identify individuals with a possible substance abuse history quickly and accurately. It is based on the National Alcohol and Drug Use Survey (n=9915). Using the first half of the sample (n=4967), two previously validated alcohol use items were combined with three illicit drug use items. These five questions identified those with a history of alcohol and/or illicit drug use.RESULTS:Using the second half of the sample (n=4948), the validation procedure showed that the five combined items correctly classified 91% of substance abusers and had a low rate of false negatives.DISCUSSION:The SISAP is brief and resistant to misrepresentation or falsification. The SISAP is expected to improve pain management by facilitating focus on the appropriate use of opioid analgesics and therapeutic outcomes in the majority of patients who are not at risk of opioid abuse, while carefully monitoring those who may be at greater risk.

Trends and Influences in the History of Australian Drug Legislation

1992 ◽  
Vol 22 (3) ◽  
pp. 507-520 ◽  
Author(s):  
Desmond Manderson
Keyword(s):  
Drug Use ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
International Community ◽  
Drug Control ◽  
Drug Problem ◽  
International Consensus ◽  
Drug Legislation ◽  
History Of ◽  
Independent Assessment

In this article the author briefly traces some features in the emergence in Australia of legislation controlling “dangerous drugs” such as opium, morphine, cocaine and heroin from 1900 to 1950. It is argued that, in common with other similar countries, the first laws prohibiting the non-medical use of drugs were enacted as a symptom of anti-Chinese racism and not out of any concern for the health of users. It is further argued that later laws, which built upon that precedent, developed not through any independent assessment of the drug problem in Australia but rather in response to pressure from the international community. Australia's unthinking acceptance of the growing U.S.-led international consensus relating to “dangerous drugs” influenced legislation, policy and attitudes to illicit drug use. The structure of drug control which emerged incorporated and promoted the fears, values and solutions of other societies without any assessment of their validity or appropriateness.

scholarly journals Molecular Epidemiology of Community-Onset (CO), Community-Onset Healthcare-Associated (CO-HA) and Hospital-Onset (HO) Methicillin-Resistant Staphylococcus aureus (MRSA)

2020 ◽  
Vol 41 (S1) ◽  
pp. s70-s71
Author(s):  
Stephanie Thiede ◽  
Darjai Payne ◽  
Alla Aroutcheva ◽  
Michael Schoeny ◽  
Robert Weinstein ◽  
...  
Keyword(s):  
Drug Use ◽  
Illicit Drug ◽  
Genomic Analysis ◽  
Illicit Drug Use ◽  
Cook County ◽  
Public Healthcare ◽  
Genomic Epidemiology ◽  
History Of ◽  
Healthcare Associated ◽  
Community Onset

Background: Previous work suggests an intermingling of community and hospital transmission networks driving the MRSA epidemic, but how those with CO-HA infections fit into the network remains unclear. We integrated epidemiologic data and whole-genome sequencing (WGS) from existing MRSA clinical isolates to determine whether there were distinguishable features of CO-HA MRSA infections that could guide interventions. Methods: We examined 955 existing clinical MRSA isolates from 2011 to 2013 from patients at Cook County Health, the major public healthcare network in Chicago, Illinois. We performed electronic and manual chart review to ascertain community (eg, illicit drug use, incarceration history) and healthcare exposures and comorbidities. WGS was performed on all sequences, and sequences were typed with multilocus sequence typing (MLST). We assessed the distribution of epidemiological factors and sequence type (ST) across onset type. Results: Infections were more frequent in males (70%); 61% of individuals with infection were African American and 21% were Hispanic. Overall, wound infections were the most common (81%) followed by blood (7%) and respiratory (6%). 82% of infections were ST8 (most USA300), 8% were ST5 (USA100) and 10% were other STs (Fig. 1a). Using standard epidemiologic definitions, we identified 523 CO, 295 CO-HA, and 137 HO infections. USA300 infections were common across CO, CO-HA, and HO categories, whereas USA100 was more frequently observed among CO-HA and HO. Current illicit drug use and history of incarceration—factors typically associated with CO-MRSA—were observed among both CO-HA and HO infections. 38% of CO-HA and 36% of HO had a history of MRSA infection or nasal colonization in the prior 6 months. As expected, 73% of CO-HA had a history of recent hospitalization, but this was also true for 44% of HO cases; points for intervention for both groups, especially CO-HA patients, include outpatient, inpatient, and ER care. Diabetes was common across categories, and HIV was more commonly observed among CO-HA cases (Fig. 1b). Conclusions: We characterized the genomic and epidemiologic features of CO-HA MRSA infections relative to CO and HO. By MLST and epidemiological analysis, CO-HA infections share similarities to both CO and HO. Although USA300 infections were the most common strain type, our findings highlight the need for WGS to discern relationships between individuals to understand the intermixing of healthcare and community networks for CO-HA infections. Higher resolution genomic analysis may help guide whether interventions need to be at hospital discharge or in the community to have the most impact on decreasing CO-HA MRSA infections.Funding: Funding: from CDC Broad Agency Announcement: Genomic Epidemiology of Community-Onset Invasive USA300 MRSA Infections; Contract ID: 75D30118C02923Disclosures: None

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