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Relationship between CYP2B6*6 and cold pressor pain sensitivity in opioid dependent patients on methadone maintenance therapy (MMT)

Zahari Z, Lee CS, Ibrahim MA, Musa N, Mohd Yasin MA, Lee YY, et al.

Drug Alcohol Depend, 2016 08 01;165:143-50.
PMID: 27289271 DOI: 10.1016/j.drugalcdep.2016.05.028

BACKGROUND: CYP2B6 polymorphisms contribute to inter-individual variations in pharmacokinetics of methadone. Increased pain sensitivity is frequently reported by opioid dependent patients on methadone maintenance therapy (MMT). It is possible, therefore, that genetic polymorphisms in CYP2B6, which affects the metabolism of methadone, influence pain sensitivity among patients on MMT. This study investigated CYP2B6 polymorphisms and pain sensitivity in this group.
METHODS: The cold pressor pain responses of 148 opioid dependent patients receiving MMT were evaluated using the cold pressor test (CPT). DNA was extracted from whole blood and subjected to polymerase chain reaction (PCR)-genotyping.
RESULTS: Of the 148 subjects, 77 (52.0%) were carriers of CYP2B6*6 allele. CYP2B6*6 allele carriers had shorter cold pain threshold and pain tolerance times than non-carriers of CYP2B6*6 allele (21.05s vs 33.69s, p=0.036 and 27.15s vs 44.51s, p=0.020, respectively). Pain intensity scores of the CYP2B6*6 allele carriers was 67.55, whereas that of the CYP2B6*6 allele non-carriers was 64.86 (p=0.352).
CONCLUSION: Our study indicates that the CYP2B6*6 allele is associated with a lower pain threshold and lower pain tolerance among males with opioid dependence on MMT. The CYP2B6*6 allele may provide a mechanistic explanation for clinical observations of heightened pain sensitivity among opioid dependent patients receiving MMT.
Social attitudes, self-description and perceived reasons for using drugs: a survey of the secondary school population in Malaysia

Spencer C, Navaratnam V

Drug Alcohol Depend, 1980 Jun;5(6):421-7.
PMID: 7379698

The present paper is the third and concluding part of a study of the secondary school population of two of Malaysia's thirteen states, Penang and Selangor. Since completion of the two earlier papers, the research team has investigated the pattern and nature of drug use among the equivalent population in a third state, Kelantan, and has again found essentially the same pattern of results: youthful drug use is most clearly related to precocious self-assertion, and a set of beliefs and attitudes about drugs and drug taking, and is largely unrelated to indicators of social deprivation or personal problems. The significance of this repeated finding in Kelantan is that, in this much more rural and traditional state, adult and established patterns of drug use had historically differed considerably from those found in the two more urban and cosmopolitan states of Penang and Selangor. Our findings indicate that the new pattern of drug use by youth has transcended the older cultural differences between the states, and is in turn explained by a more universally familiar set of characteristics in adolescent development.
Social background and attitudes towards drugs as predictors of drug use among Malaysian students

Spencer C, Navaratnam V

Drug Alcohol Depend, 1980 Jun;5(6):411-9.
PMID: 7379697

Those Malaysian secondary schoolchildren who have ever used an illicit drug do not differ significantly in terms of social class background, ethnicity or rural/urban location, from the majority of their contemporaries who have not used drugs. The cross-sectional data show a rapid secular trend towards the sexes being equally involved in drug use. Significant differences between ever and never users are, however, found in their attitudes towards drug taking and their beliefs about the properties of drugs, although both groups share the same rather negative image of the typical drug user. Thus, drug users have accepted some of the attitudes towards drug issues which are normative in the non-user group, whilst developing other attitudes which are consistent with their continuing use. It is argued that adolescent drug abuse in Malaysia is not to be linked specifically with social deprivation, but should be seen as being part of the life style of particular groups in all strata of society.
The drug abuse problem in Peninsular Malaysia: parent and child differences in knowledge, attitudes and perceptions

Low WY, Zulkifli SN, Yusof K, Batumalail S, Aye KW

Drug Alcohol Depend, 1996 Oct;42(2):105-15.
PMID: 8889409

A survey was carried out to gather information on knowledge, attitudes and perception of parents and their children in relation to drug abuse matters. Significantly more teenagers knew more of the cause of drug addiction, as well as places for treatment and rehabilitation. Both teenagers and parents were also aware of reasons why drug addicts find it difficult to change their habits, mainly lacking motivation to stop taking drugs and that drug addicts do not have the power to control themselves. Teenagers were significantly more aware of effects of negative parental attitudes contributing to drug abuse, apart from school factors. Personal experiences before abusing drugs such as knowledge of pleasurable effects of drugs and where to obtain them has also a role to play in leading to drug abuse. There was also agreement that unfulfilled needs such as 'not being respected recognised for ones capabilities' and 'not being loved or treated fairly by parents', were causes of drug abuse. Significantly more teenagers knew of the ways of abusing drugs, mainly by injection, smoking and sniffing, and also sources of information via the mass media, social clubs, rehabilitation centres and schools. However, both the parents and teenagers were relatively ignorant of the long term effects of abusing drugs.
The effect of alcohol level on male and female drivers: Important facts

Murthy JK, Das S

Drug Alcohol Depend, 2020 Sep 01;214:108146.
PMID: 32634715 DOI: 10.1016/j.drugalcdep.2020.108146
Trends in medical student use of tobacco, alcohol and drugs in an Irish university, 1973-2002

Boland M, Fitzpatrick P, Scallan E, Daly L, Herity B, Horgan J, et al.

Drug Alcohol Depend, 2006 Nov 8;85(2):123-8.
PMID: 16735098 DOI: 10.1016/j.drugalcdep.2006.03.016

Questionnaire surveys of medical students in an Irish university were carried out in 1973 (n=765), 1990 (n=522) and 2002 (n=537), with differentiation of western students (e.g., from the Republic of Ireland, the UK, or Australia) and non-western students (e.g., Malaysia). We report on changes in tobacco smoking, drinking and drug-taking over three decades, and we note that, among western students, estimated prevalence of being a current smoker has declined overall from 28.8% in 1973 to 15.3% in 1990 to 9.2% in 2002 (p<0.001), falling in both males (p<0.001) and females (p<0.01). Ex-smokers rose from 5.9% to 15.1% between 1990 and 2002, corresponding with the decline in current smokers. The prevalence of current drinkers has risen over the period, to 82.5% among western students in 2002 (p<0.05); female drinking has increased steadily since 1973 (p<0.001), and the overall proportion of CAGE-positive drinkers has risen since 1990 (p<0.001). The mean weekly alcohol consumption has risen in both sexes since 1990 (males 14.3 units to 19.4, p<0.01; females 6.0 to 9.5, p<0.001). There was an increase in the proportion of students ever offered drugs between 1973 and 2002 (p<0.001). Although smoking rates have fallen, our findings show a marked increase in alcohol and drug consumption between 1973 and 2002. Personal misuse of addictive substances by doctors may mean that doctors will fail to take misuse by patients seriously. A need for preventative and ameliorative action during the medical school years is clear.
Fulltext Within-prison drug injection among HIV-infected male prisoners in Indonesia: a highly constrained choice

Culbert GJ, Waluyo A, Iriyanti M, Muchransyah AP, Kamarulzaman A, Altice FL

Drug Alcohol Depend, 2015 Apr 01;149:71-9.
PMID: 25659895 DOI: 10.1016/j.drugalcdep.2015.01.018

BACKGROUND: In Indonesia, incarceration of people who inject drugs (PWID) and access to drugs in prison potentiate within-prison drug injection (WP-DI), a preventable and extremely high-risk behavior that may contribute substantially to HIV transmission in prison and communities to which prisoners are released.
AIMS: This mixed method study examined the prevalence, correlates, and social context of WP-DI among HIV-infected male prisoners in Indonesia.
METHODS: 102 randomly selected HIV-infected male prisoners completed semi-structured voice-recorded interviews about drug use changes after arrest, drug use cues within prison, and impact of WP-DI on HIV and addiction treatment. Logistic regression identified multivariate correlates of WP-DI and thematic analysis of interview transcripts used grounded-theory.
RESULTS: Over half (56%) of participants reported previous WP-DI. Of those, 93% shared injection equipment in prison, and 78.6% estimated sharing needles with ≥ 10 other prisoners. Multivariate analyses independently correlated WP-DI with being incarcerated for drug offenses (AOR = 3.29, 95%CI = 1.30-8.31, p = 0.011) and daily drug injection before arrest (AOR = 5.23, 95%CI = 1.42-19.25, p = 0.013). Drug availability and proximity to drug users while incarcerated were associated with frequent drug craving and escalating drug use risk behaviors after arrest. Energetic heroin marketing and stigmatizing attitudes toward methadone contribute to WP-DI and impede addiction and HIV treatment.
CONCLUSIONS: Frequent WP-DI and needle sharing among these HIV-infected Indonesian prison inmates indicate the need for structural interventions that reduce overcrowding, drug supply, and needle sharing, and improve detection and treatment of substance use disorders upon incarceration to minimize WP-DI and associated harm.