Prevalence of psychoactive substance use among acutely hospitalised patients in Oslo and Moscow: a cross-sectional, observational study

Abstract

ObjectivesThe use of psychoactive prescription medication is increasing in the general population. This is a cause for concern, particularly among the elderly, where physiological changes related to senescence increase the risk for adverse effects. While previous studies regarding psychoactive substance use have generally been population based, we sought to determine the frequency of such use among acutely hospitalised patients.SettingTwo emergency departments (EDs), one in Oslo and one in Moscow, admitting patients to Departments of Internal Medicine.Participants5583 patients aged ≥18 years participated, distributed evenly between genders and study locations. Patients unable to give informed consent were excluded. The study sites did not admit patients with surgical conditions and/or injuries.Primary and secondary outcomesThe presence of psychoactive substances was determined through blood analysis using liquid chromatography-mass spectrometry. Secondary outcomes comprised demographic data (including age, gender, employment and marital status), degree of psychological distress, concurrent alcohol use, and self-reported alcohol, psychoactive drug and illicit substance use.Results32.3% in Oslo and 12% in Moscow were positive for one or more psychoactive medicinal drugs (benzodiazepines, z-hypnotics, opioids or barbiturates). In Oslo, medicinal drug use was associated with being aged 61 to 70 years (OR 2.40, 95% CI 1.61 to 3.58) compared with 18 to 40 years, and psychological distress (OR 2.61, 95% CI 2.06 to 3.30). In Moscow, psychoactive medicinal drug use was also associated with psychological distress (OR 1.68, 95% CI 1.18 to 2.39), and was less common among patients aged 41 to 60 years (OR 0.62, 95% CI 0.43 to 0.88) than among patients aged 18 to 40 years.ConclusionA significant proportion of admitted patients used one or more psychoactive medicinal drugs, in particular benzodiazepines (Oslo and Moscow) and opiates (Oslo). We suggest formalised screening for inappropriate prescription drug use and increased adherence to clinical prescription guidelines.

Prevalence of psychoactive drugs in injured patients presenting to an emergency department

“…were able to test all patients meeting the inclusion criteria through anonymisation of the tests and their results. Additionally, variability between our results and previously published studies may reflect the highly variable patterns of recreational drug use from one geographic area to another because of differences in cost, supply, legality and cultural preferences 28,29 …”

Multimorbidity, psychoactive substance use and psychological distress among acute medically ill patients: a cross-sectional study

“…Therefore, the probability for adverse events, non-adherence and drug interactions might be elevated due to the diminished metabolic efficiency for both alcohol and other substances and requires careful management among the older patients drinking in a risky manner. 35 36 Nevertheless, in our study, the prevalence of multimorbidity among the young patients (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34) was high (35%). The reason for this might be that our hospital comprises patients from boroughs with low income and low life expectation rates in Norway.…”

“…Of the young multimorbid patients (18-34 years) 14.1% used illicit drugs, 14.1% used psychoactive medicinal drugs and 31.4% reported to have psychological distress. Compared with the young patients, [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] among multimorbid patients aged ≥35 the prevalence of psychological distress decreased with increasing age (for those aged 35-49 years the prevalence was 30.2%; for those 50-64 years it was 26.3%; 65-79 years: 23.9% and for those >80 years it was 13.8%) while the prevalence of psychoactive medicinal drug use increased substantially with increasing age (for those aged 35-49 years the prevalence was 32.6%; for those 50-64 years it was 45.4%; 65-79 years: 43.8% and for those >80 years it was 41.2%). Illicit drugs were most prevalent among those aged Open access years (16.9%) and decreased substantially with increasing age (for those 50-64 years it was 10.7%; 65-79 years 1.3% and for those >80 years it was 0.8%).…”

“…In addition to self-reported data and data from the blood samples presented in our previous studies, 24 26 for this analysis the patients' electronic medical records were systematically reviewed for registration of diagnoses codes according to the 10th revision of the International Classification of Diseases (ICD-10). A limited number of the patients were diagnosed with solely mental and behavioural diseases assigned by F00-F99 ICD-10 diagnostic codes.…”

New Psychoactive Substances: Major Groups, Laboratory Testing Challenges, Public Health Concerns, and Community-Based Solutions

“…Many efects of NPS are yet to be collected and accounted for but are often directly experienced by users/consumers; also, many NPSs actually leave the market before they are identifed, perhaps after at least one death case has been attributable to them. By studying the psychoactive substances' prevalence in hospitalised patients in Moscow and Oslo via cross-sectional/observational fashion, Gamboa et al [74] showed that many patients used at least one medicinal drug with psychoactive efects, especially opiates and benzodiazepines. Elsewhere, to understand the prevalence of NPS usage among patients undergoing drug detoxifcation, Specka et al [9] analyzed responses of 295 patients and observed that majority of the patients were multiple substance users and opiate-dependent.…”