New Report Sheds Light on Global Epidemiology of Stimulant-Use Disorders

A brand new study by researchers at the Australia National Health and Medical Research Council estimates the global burden of disease due to cocaine and amphetamine. Based on large systematic reviews of epidemiological data, disease models and global prevalence estimates, the authors present comorbidity-adjusted years of life lost to disability (YDL), years of life lost (YLL) and disability-adjusted life years (DALY) estimates. The authors note that their estimates include only the disease burdens attributable directly to amphetamine- and cocaine-use disorders, leaving out the likely considerable HIV- and HCV-attributable costs and burden.

via ScienceDirect:

Abstract

Aims

To estimate the global prevalence of cocaine and amphetamine dependence and the burden of disease attributable to these disorders.

Methods

An epidemiological model was developed using DisMod-MR, a Bayesian meta-regression tool, using epidemiological data (prevalence, incidence, remission and mortality) sourced from a multi-stage systematic review of data. Age, sex and region-specific prevalence was estimated for and multiplied by comorbidity-adjusted disability weightings to estimate years of life lost to disability (YLDs) from these disorders. Years of life lost (YLL) were estimated from cross-national vital registry data. Disability-adjusted life years DALYs) were estimated by summing YLDs and YLLs in 21 regions, by sex and age, in 1990 and 2010.

Results

In 2010, there were an estimated 24.1 million psychostimulant dependent people: 6.9 million cocaine and 17.2 million amphetamines, equating to a point prevalence of 0.10% (0.09-0.11%) for cocaine, and 0.25% (0.22-0.28%) for amphetamines. There were 37.6 amphetamine dependence DALYs (21.3-59.3) per 100,000 population in 2010 and 15.9 per 100,000 (9.3-25.0) cocaine dependence DALYs. There were clear differences between amphetamines and cocaine in the geographic distribution of crude DALYs. Over half of amphetamine dependence DALYs was in Asian regions (52%), whereas almost half of cocaine dependence DALYs was in the Americas (44%, with 23% in North America High Income).

Conclusion

Dependence upon psychostimulants is a substantial contributor to global disease burden; the contribution of cocaine and amphetamines to this burden varies dramatically by geographic region. There is a need to scale up evidence-based interventions to reduce this burden.

Figure 1 compares the DALYs of amphetamines and cocaine between genders:

Fig. 2 shows the distribution of "crude estimated DALYs" due to either substance:

And Fig. 3 shows "Country-level DALYs per 100,000 population due to amphetamine dependence, age-standardized, for persons in 2010":

Source:
http://www.sciencedirect.com/science/article/pii/S0376871614000234

Gender Specific Treatment Reduces Recidivism by 67%

Here's the abstract from a new study that used random assignment in prison (a nearly impossible task in itself) and found that trauma-informed, gender-specific care served female inmates better. Not very surprising but the authors are to be commended for their methodological rigor. Even more impressive, though was a whopping 67% reduction in reincarceration within 12 months after parole. Wow!

Read more about it here.

MW

 A randomized experimental study of gender-responsive substance abuse treatment for women in prison

• Nena Messina, Ph.D.
, 
• Christine E. Grella, Ph.D.
, 
• Jerry Cartier, M.A.
, 
• Stephanie Torres, M.S.

UCLA Integrated Substance Abuse Programs, 1640 S. Sepulveda Blvd., Suite 200, Los Angeles, CA 90025, USA

Received 1 July 2009; received in revised form 26 August 2009; accepted 20 September 2009. published online 16 December 2009.

• Abstract
• Full Text
• PDF
• References

Abstract 

This experimental pilot study compared postrelease outcomes for 115 women who participated in prison-based substance abuse treatment. Women were randomized to a gender-responsive treatment (GRT) program using manualized curricula (Helping Women Recover and Beyond Trauma) or a standard prison-based therapeutic community. Data were collected from the participants at prison program entry and 6 and 12 months after release. Bivariate and multivariate analyses were conducted. Results indicate that both groups improved in psychological well-being; however, GRT participants had greater reductions in drug use, were more likely to remain in residential aftercare longer (2.6 vs. 1.8 months, p < .05), and were less likely to have been reincarcerated within 12 months after parole (31% vs. 45%, respectively; a 67% reduction in odds for the experimental group, p < .05). Findings show the beneficial effects of treatment components oriented toward women's needs and support the integration of GRT in prison programs for women.