Alcohol and substance use, until recently, were believed to be a predominantly male phenomenon. Only in the last few decades, attention has shifted to female drug use and its repercussions in women. As the numbers of female drug users continue to rise, studies attempt to understand gender-specific etiological factors, phenomenology, course and outcome, and issues related to treatment with the aim to develop more effective treatment programs. Research has primarily focused on alcohol and tobacco in women, and most of the literature is from the Western countries with data from developing countries like India being sparse. This review highlights the issues pertinent to alcohol and substance use in women with a special focus to the situation in India.

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Introduction Opioid-dependent men suffer from sexual dysfunctions in the short and long term. The medications used for long-term pharmacotherapy of opioid dependence also affect sexual functioning, though this has been a poorly investigated area so far. Aim To study the sexual dysfunction in opioid-dependent men receiving buprenorphine and naltrexone maintenance therapy. Methods A semistructured questionnaire and Brief Male Sexual Functioning Inventory (BMFSI) was administered to a sample of 60 sexually active men, receiving buprenorphine (n = 30) and naltrexone (n = 30) maintenance therapy for opioid dependence. Main Outcome Measures Prevalence of premature ejaculation, erectile dysfunction, low sexual desire, weakness due to semen loss, and overall satisfaction. Results About 83% of the men on buprenorphine and 90% on naltrexone reported at least one of the sexual dysfunction symptoms. The commonly reported dysfunctions were premature ejaculation (83% in buprenorphine and 87% in naltrexone), erectile dysfunction (43% in buprenorphine and 67% in naltrexone), and loss/reduction in sexual desire (33% in buprenorphine and 47% in naltrexone). On BMSFI however, there were no significant differences among both the groups. Conclusion Opioid dependence as well as its pharmacological treatment is associated with sexual dysfunctions, which has clinical implication. Future research should explore this further using biochemical analyses.

It is important to address problematic internet use among medical students. The correlates can help identify those at increased risk.

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Context:Inadequate training of medical practitioners is a key factor responsible for inappropriate use of opioid analgesics.Aims:We assessed the current knowledge, attitude, prescribing practices, and barriers perceived by the Indian medical practitioners in three tertiary care hospitals toward the use of opioid analgesics.Subjects and Methods:Web-based survey of registered medical practitioner employed at three chosen tertiary health care institutions in New Delhi.Statistical Analysis Used:Descriptive analysis of survey responses was carried out. Comparative analysis was done using Chi-square test, independent samples t-test, and Pearson correlation coefficient.Results:The response rate was 10.4% (n = 308). Two-thirds of the participants (61.7%) had never received formal pain management training, and 86.7% participants would like further training. Most participants (71.1%) agreed that opioids should be prescribed in cancer pain, while 26.3% agreed that opioids should be prescribed in noncancer pain. Half of the participants agreed that SOS (if necessary) dosing schedule (48.4%), low dosage (61.7%), and short duration of use (51.4%) could decrease the harmful effect of opioids. Lack of information about opioid-related policies and addiction potential were identified as the most common barriers to prescribing opioids. Those seeing more patients with chronic noncancer pain come across opioid misuse and diversion more often (P = 0.02). Those who understood addiction were more likely to agree that patients of chronic cancer pain with substance use disorders should be prescribed opioid analgesics (P < 0.01).Conclusions:Indian medical practitioners felt the need for formal pain management training. There is a lack of consensus on how to manage the pain using opioid analgesics. Tough regulations on medical and scientific use of opioids are the most commonly reported barrier to prescribing them.

Although substance misuse among children in India has been documented for over a decade, volatile substance misuse (VSM) is a comparatively recent phenomenon there. This paper reviews available Indian studies about VSM among street children and documents the extent of misuse, experienced benefits and harms, and risk factors. Reported perceived benefits include enhanced physical strength, decreased shyness, sleep induction, feeling good, and numbing physical and psychological pain. Identified risk factors include domestic violence, a dictatorial father, presence of stepparents, migrant status, and substance use in the family. Limitations of the current paper and the need for further research are discussed.

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