RESUMEN
Drug abuse is a serious public health problem. Moreover, co-occurring mental health and substance abuse disorders are common among drug users. This paper examines psychiatric disorders of young cocaine and heroin users using the World Mental Health Composite International Diagnostic Interview (WMH-CIDI). A cohort of 1266 young (18-30 years) current regular cocaine (705) and heroin (561) users were recruited outside the health services in Barcelona, Madrid and Seville, Spain. The WMH-CIDI was used to evaluate mental disorders; the Severity of Dependence Scale (SDS) measured the degree of dependence; and the Duke-UNC Functional Social Support Questionnaire (FSSQ) assessed social support, in a crosssectional study design. About 43% was diagnosed with a lifetime mental disorder. The most common diagnoses were depression (37.5%) and specific phobia (6.8%). During the last 12 months, prevalence rates were also slightly higher in heroin group (26.4%) than in cocaine cohort (21.7%). Every day cocaine consumption, having unstable living conditions and low social support were variables highly associated with psychiatric morbidity in cocaine cohort. In heroin cohort, earning money through illegal activities was associated with psychiatric morbidity, while the moderate use of alcohol acted as a protective factor for mental pathology. Morbidity was associated to having received psychiatric/psychological treatment during the last 12 months in both cohorts. This study has shown a relatively high prevalence of psychiatric morbidity in cocaine and heroin users recruited in non-clinical settings. Future studies examining differences between cocaine and heroin patterns of consumption associated with mental diseases are necessary.
Asunto(s)
Trastornos Relacionados con Cocaína/complicaciones , Dependencia de Heroína/complicaciones , Trastornos Mentales/etiología , Adolescente , Adulto , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Características de la Residencia , España , Adulto JovenRESUMEN
AIMS: To describe the prevalence of recent use of alcohol, medication, and illegal drugs among patients who attended emergency departments (EDs) as a result of suffering an injury due to any external mechanism and to identify factors associated with alcohol and drug use. METHODS: A cross-sectional study was conducted in eight university hospitals in Spain. Participants were adult patients admitted to a trauma ED. Oral fluid was used to test for psychoactive substances analyzed by gas chromatography-mass spectrometry. Socio-demographic data and information on circumstances of the injury were collected through interviews. RESULTS: The analysis included 1579 patients admitted to the EDs (56.4% men). Among young people (< 40 years), 21.4% of men and 8.5% of women were positive for any illegal substance, primarily cannabinoids or cocaine; 24.7% of men and 14.8% of women were positive for alcohol. Among patients > or = 40 years, 7.4% of men and 1.6% of women were positive for any illegal substance, and 16.3% and 11.0% respectively for alcohol. Prevalence of substance detected varied across mechanism of injury, gender and age group. Night-time injury was associated with substance use. CONCLUSIONS: A high proportion of injured patients who were treated in an EDs tested positive for psychoactive drugs. Routine testing at trauma departments would maximize the identification of patients who may benefit from referral to specialized addiction treatment centers, or brief interventions.
Asunto(s)
Servicio de Urgencia en Hospital/estadística & datos numéricos , Admisión del Paciente/estadística & datos numéricos , Trastornos Relacionados con Sustancias/epidemiología , Heridas y Lesiones/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores Sexuales , España/epidemiología , Detección de Abuso de Sustancias/métodosRESUMEN
BACKGROUND AND OBJECTIVE: To evaluate access to sterile syringes and its association with injection risk behaviour in Madrid and Barcelona. MATERIALS AND METHODS: Cross-sectional community study by computer-assisted personal interview in 465 young heroin injectors between 2001 and 2003. RESULTS: Some 4.2% had not obtained any free sterile syringes in the previous 12 months. In Madrid 32.1% had obtained all their sterile syringes free of charge (ASSF), versus 44.6% in Barcelona (p<0.01). Not sharing (not using syringes used by someone else and not front/backloading) was associated with obtaining ASSF (OR=1.69) and with sporadic injection (OR=1.83). Not reusing one's own syringes was associated with the same two variables (OR=4.02 and OR=2.50, respectively). CONCLUSIONS: Access to sterile syringes is very high in Madrid and Barcelona, although the two cities have different approaches. The acquisition of all syringes free of charge should be facilitated, especially among frequent injectors.