Current Drug Abuse Reviews - Volume 5, Issue 2, 2012

Recreational diving is an increasingly popular leisure activity. It has been estimated that U.S.A. has 1.2 million recreational scuba divers, and this number grows annually [1]. In addition to recreational divers, there is also a growing number of professional divers. Diving is a potentially dangerous activity, which is why divers should be trained and certified. Hyperbaric circumstances itself may negatively affect cognitive and psychomotor functioning [2]. One of the problems divers may experience is nitrogen narcosis, i.e. an altered state of mind, caused by breathing nitrogen at a high partial pressure. Narcotic effects start to appear at a pressure of 4 bar (30 meters of depth) [3]. This effect has been popularly called the “Martini effect”, since it has been argued that each 10 meters of diving depth corresponds to a performance impairment as produced by one glass of alcohol. So, at 40 meters of depth, a diver feels and functions like he has consumed 4 alcoholic drinks. It is therefore understandable that various rules apply at diving schools to ensure the health and safety of the diver. One of these rules is that divers should not use alcohol, medicinal or recreational drugs around the time of diving. Psychoactive drugs may have adverse effects such as drowsiness or dizziness that interfere with safe diving. Despite rules and recommendations not to use drugs and dive, a great number of divers disregard this advice and report diving shortly after using prescribed or over-the-counter drugs. More than half of N=531 surveyed U.K. divers reported taking overthe- counter drugs within 6 hours before diving, of which analgesics and decongestants were most commonly reported. About 1 in 4 divers reported using prescription drugs within 6 hours of diving [4]. These drugs included cardiovascular and respiratory drugs, but also drugs that cross the blood brain barrier such as anxiolytics, antidepressants, and antihistamines. 26% of divers further reported consuming alcohol within 12 hours before diving. In a second publication, St Leger Dowse et al. reported on illicit drug use among UK divers [5]. Although the absolute numbers of drugged divers was low, the use of cannabis, cocaine and ecstasy within 6 hours before diving was reported. Of N=105 divers who reported illicit drug use, 22 did so within 24 hours before diving. These recent data are a reason for concern, since they show that divers do not take regulations and recommendations regarding drug use seriously. Similar data was also reported in studies with Australian divers [6,7]. On land, the pharmacodynamic effects of drugs have been thoroughly investigated. A great number of medicines, alcohol and illicit drugs have adverse effects that compromise daily activities such as driving a car [8,9]. Other drugs however are devoid of these adverse effects, or may even improve performance [10]. Therefore, if a patient wishes to drive a car or is involved in other potentially dangerous daily activities, physicians often can make a choice between the available treatment options. For example, regarding drugs and driving the International Council on Alcohol, Drugs and Traffic Safety categorized drugs into class 1, 2 or 3 to indicate whether driving is safe or not when treated with a particular drug (www.icadts.org)....

Heavy alcohol use has numerous negative impacts on cognition. In many cases, it appears that excess drinking influences working memory, problem solving, attention, patterns of regional brain activation, and even gray and white matter volume. Due to these effects, most significant conclusions related to cognitive decline are limited to the assumption that “more is worse.” However, heavy alcohol use is a very complex psychosocial behavior and is subject to a problematic number of variables. As a result, it is very difficult to extend generalizations about drinking-related consequences to the overall population since many environmental and biological differences come into play for every individual. Three of these variables shown to have significant impact on cognitive sensitivity to alcohol are age of first alcohol use (age of drinking initiation), specific pattern of alcohol consumption and gender. Potential insight can be gained into how individual drinking scenarios differ in risk for cognitive decline by assessing how each of these important factors influences cognition independently. Although some overlap exists between categories, each still appears to contribute unique influence on likelihood and presentation of cognition-related effects. Based on existing and current research, age and gender tend to augment baseline sensitivity to alcohol, with patterns of alcohol intake also influencing how changes appear. Given these categorical differences, it is important to consider personal alcohol drinking history rather than just aggregate alcohol intake as risk factors in the cognitive impacts of drinking. The objective of this brief review is to examine the role of these factors on the effect of alcohol on cognition.

The focus of this review is on the associations of alcohol use and aspects of romantic relationships. The review covers concepts and methods, partner drinking associations, effects of relationships on drinking, and drinking effects on relationships. Several conclusions were reached. People are attracted to similarly drinking others. With greater relationship commitment there is greater desistance from drinking. Across time and relationship commitment levels, socialization influences vary by gender. A thread throughout the review was the identification of congruent and discrepant drinking among relationship partners. Congruent drinking, even at higher levels, was associated with more positive outcomes whereas discrepant drinking was associated with more negative outcomes. Needed for the future are greater theory development and longitudinal and laboratory studies that include diverse samples and both parties to the relationship.

Background: African American women experience increased rates of sexually transmitted diseases and HIV. The use of alcohol may increase sexual risk behaviors among this population. Purpose: This paper provides a review and critique of the literature examining the association between alcohol use and sexual risk behaviors among African American females including a: (a) synthesis of research findings from adolescent, college-aged/early adulthood, and adult samples; (b) methodological critique of the literature; and (c) guidance for future research. Methods: We reviewed 32 studies examining the association between alcohol use and sexual risk behaviors among African American females across developmental periods. Results: Similar to previous association studies, results suggest that increased use of alcohol is associated with increased sexual risk practices among African American females. Further, even non-abuse levels of drinking among African American females, at all ages, were related to increased sexual risk-taking. Conclusions: Future studies should seek to recruit samples that more fully reflect the diversity of African American women’s experiences across the lifespan. Given the association between alcohol use and/or abuse and the prevalence of STI/HIV-associated risk behaviors and adverse biological outcomes (i.e., STIs, including HIV) among African American females across the lifespan, there is a clear need to develop and evaluate prevention research efforts tailored for this subgroup.

Cocaine is one of the most widely used drugs of abuse. Chest pain is the most common side effect requiring emergency visits after cocaine use. Vasoconstriction and platelet activation are the main effects of cocaine in the vasculature. In this brief review, we consider the most important clinical effects of cocaine abuse on the heart, brain and kidney. Symptoms related to cocaine toxicity such as myocardial infarction, congestive heart failure, arrhythmias, aortic dissection, stroke, renal failure, are similar to the clinical picture of atherosclerotic vascular damage, even if the age of cocaine abusers is usually in the second and third decades. Clinicians (especially emergency department physicians) should consider substance abuse among the differential diagnosis of chest pain in young people.

In this review, we consider the potential service needs of children of substance abusing parents based on what we know about the risk outcomes faced by these children and the parenting deficits often present in these families. Importantly, our review does not address the etiological role of parental substance abuse in children’s negative outcomes but instead we discuss the complex inter-related risk factors that often co-occur with and exacerbate risk associated with parental alcohol and drug use. We first review studies showing the elevated risk that children of substance abusing parents face in general for poorer academic functioning; emotional, behavioral, and social problems; and an earlier onset of substance use, faster acceleration in substance use patterns, and higher rates of alcohol and drug use disorders. We then review studies showing contextual risk factors for children of substance abusing parents, including parenting deficits (less warmth, responsiveness, and physical and verbal engagement as well as harsher and more over-involved interaction styles), greater risk for child maltreatment, and less secure attachment patterns. We conclude with a discussion of future directions for research and guidelines for professionals working with children and their families where parental substance abuse is present.

This paper reviews the efficacy and processes of change within group treatments for alcohol use disorders (AUD). Methodologically rigorous studies examining group treatment for interviewer-diagnosed AUD include evaluations of cognitive-behavioral group treatments that focus on skills for relapse prevention (i.e., coping skills training, coping and social skills training), interactional group therapy, combined pharmacological and group interventions, and group cue exposure treatment. Given the depth of research examining the efficacy of individual treatments for AUD there is a need for further development and evaluation of group treatments that include rigorous clinician-administered diagnostic assessment, implement a control group or active treatment comparison, randomly assign participants to condition, report the racial and ethnic composition of the sample, explore mediators and moderators of intervention efficacy, and implement a manualized treatment protocol. Evaluation of process variables within group treatments for AUD and well designed treatment development studies are also needed to better understand how well established individual treatments for alcohol use disorders can be adapted to function effectively in a group format.

In the last decade a number of products have appeared in various countries that contain synthetic cannabinoids. This article reviews the history of the sale of these drugs, and the evidence that they contain synthetic cannabinoids. The biochemistry of the synthetic cannabinoids identified thus far is discussed, including a discussion of chemical structures and biochemical targets. The cannabinoid receptor targets for these drugs are discussed, as well as other possible targets such as serotonin receptors. Evidence for the abuse potential of these drugs is reviewed. The toxicity of synthetic cannabinoids and cannabinoid products is reviewed and compared to that of the phytocannabinoid Δ9- tetrahydrocannabinol (THC). As cannabinoids are a structurally diverse class of drugs, it is concluded that synthetic cannabinoids should be classified by biological activity rather than by structure, and that if this isn't done, novel synthetic cannabinoids will continue to emerge that fall outside of current regulatory classification models.