Prevalence of substance use among Russian, Somali and Kurdish migrants in Finland: A population-based study

Introduction Although substance use is a well-known public health risk factor, European population-based studies reporting the substance use among adult migrant populations are scarce. Objectives We aim to: (1) determine the prevalence of alcohol use, cigarette smoking and consumption cannabis and intravenous drugs in Russian, Somali and Kurdish migrants in Finland and compare them to those of the Finnish general population; (2) determine if socio-economic and migration-related factors are associated with substance use in migrants. Methods We used data primarily from the Finnish migrant health and well-being study. Alcohol use was measured with the AUDIT-C questionnaire, smoking habits and the lifetime cannabis and intravenous drug use were recorded. Age-adjusted prevalence rates were determined by ethnicity and sex. The associations between background factors and substance use were analysed using logistic regression analysis. Results The prevalence rate of risky drinking is lower and the proportion of abstainers is higher in migrants than in the general population. Current smoking is more common in Russian (31%, P < 0,05) and Kurdish (31%, P < 0,05) migrant men than in the general population (21%). Younger age was associated with risky drinking, socioeconomic disadvantage increased the odd for the daily smoking among migrants, and migration-related factors were associated with substance use. Conclusions Migrants report less substance use than the general population, but acculturation-related factors seem to be associated with higher levels of substance use among migrants. Substance use seems to be a gendered phenomenon in migrant populations in comparison to the general population, where lately the alcohol and tobacco consumption of women have been growing. Disclosure of interest The authors have not supplied their declaration of competing interest.

Intro Substance use disorder is a growing phenomenon among the elderly. It is undervalued, misidentified, underdiagnosed and poorly treated. Aim Study prevalence, characteristics and risk factors associated with drug use among the elderly. Method A 6-month prospective study of substance use in elderly patients (65+) who attended the addiction and dual diagnosis unit, Vall d'Hebron University Hospital. Results Fifty-nine patients evaluated, mean age 70.04 years, 60% men. A total of 49.1% are married, 35.8% divorced and 53.8% live with a partner and/or children. A total of 67.3% have basic studies and 78.8% are pensioners. A total of 82.7% have no criminal record. Medical comorbidity presents in 90.4% of the sample, psychiatric and addictive family background in 42.3% and 37.3%. A total of 67.3% have comorbid Axis I (mainly affective disorders) and 25% Axis II (cluster B most). A total of 7.7% attempted suicide at least once. The main substance is alcohol (76.9%), followed by prescription drugs (19.3%). A total of 28.8% are multi-drug users. A total of 67.3% have used tobacco in their life and 63.5% are currently dependent. The average age of onset for a disorder for any substance consumption is 28.19, being lower for alcohol and illegal substances and higher for prescription drugs. A total of 61.5% have gone through treatment before but only 32.7% has been admitted because of addiction. The adherence rate is 90.4% and the relapse rate 8.3% at first month and 13% at 6 months. Conclusions Old adults present differences compared to overall drug user population: prevalence by gender is almost equal, lower Axis II, less multi-drug consumption and both dropout and relapse rate are drastically lower. Introduction Dual diagnosis (DD) is the coexistence of a Psychiatric Disorder (PD), and Substance Use Disorder (SUD). The increase of DD observed in recent years has caused serious problems to both public and private services organization.

Aims
Our aim is to assess the prevalence and features (including clinical and sociodemographic ones) of DD over a decade, comparing the period 2003-2004 and 2013-2014.

Methods
We performed a retrospective study retrieving the medical records of DD patients at their first admission to the Psychiatry Ward AOU "Maggiore della Carità", Novara, Italy. Sociodemographic and clinical features were recorded. The two groups of patients (2003-2004 vs. 2013-2014) were compared.

Results
In both periods DD patients are usually Italian male, aged 19-40, single. They have usually attended middle school, live with parents, have two or more brothers and/or sisters but no kids. DD patients in 2003-2004 and 2013-2014 showed differences as far as employment and diagnosis are concerned. The first were more frequently employed than the latter: moreover the 2003-2004 patients were more frequently diagnosed with a personality disorder while the 2013-2014 patients had mixed diagnoses. We have found differences in the possible predictors of substance abuse in the two periods, as well.
Conclusions The identification of changes in the prevalence of first admission DD patients and their clinical and sociodemographic features may help to highlight an evolving pattern of substance use and to identify possible risk factors which may be the target of prevention and treatment approaches.

Prevalence of substance use among Russian, Somali and Kurdish migrants in Finland: A population-based study
Introduction Although substance use is a well-known public health risk factor, European population-based studies reporting the substance use among adult migrant populations are scarce.

Objectives
We aim to: (1) determine the prevalence of alcohol use, cigarette smoking and consumption cannabis and intravenous drugs in Russian, Somali and Kurdish migrants in Finland and compare them to those of the Finnish general population; (2) determine if socio-economic and migration-related factors are associated with substance use in migrants.

Methods
We used data primarily from the Finnish migrant health and well-being study. Alcohol use was measured with the AUDIT-C questionnaire, smoking habits and the lifetime cannabis and intravenous drug use were recorded. Age-adjusted prevalence rates were determined by ethnicity and sex. The associations between background factors and substance use were analysed using logistic regression analysis. Results The prevalence rate of risky drinking is lower and the proportion of abstainers is higher in migrants than in the general population. Current smoking is more common in Russian (31%, P < 0,05) and Kurdish (31%, P < 0,05) migrant men than in the general population (21%). Younger age was associated with risky drinking, socioeconomic disadvantage increased the odd for the daily smoking among migrants, and migration-related factors were associated with substance use. Conclusions Migrants report less substance use than the general population, but acculturation-related factors seem to be associated with higher levels of substance use among migrants. Substance use seems to be a gendered phenomenon in migrant populations in comparison to the general population, where lately the alcohol and tobacco consumption of women have been growing. Introduction Clinical and social improvement after treatment with nalmefene in an alcoholic 41-year-old male, with history of dependence during 20 years. Case report Our patient had been abusing alcohol for almost 20 years with short breaks of abstinence (one month). Before treatment he made a consumption of 105 g of alcohol per day. Serological examination showed hepatic alterations (GGT 2115, ALT 229) and a low amount of platelets (61,000). He also had no other relevant medical history and other possible clinical diagnoses were excluded. After a week detoxification program and alcohol consumption cessation during one month, the analytical values drastically changed: ALT 35, GGT 275, platelets 222,000. Discussion Nalmefene is an opioid system modulator with antagonist activity at the and ␦ receptors and partial agonist activity at the receptor. Nalmefene as-needed has been shown to reduce the total amount of alcohol consumption and number of heavy drinking days and to improve liver function. The aim of this treatment is centered in decreasing consumption rather than achieving a total abstinence. Conclusions Against other pharmacologic approaches such as disulfiram an acamprosate, the options that allow acute consumption help patients in controlling drinking rampage and make them realize they will be able to afford alcohol cessation.

Alcohol use disorder following traumatic brain injury: Lessons learned from bench to bedside
Introduction and objectives Traumatic brain injury (TBI) can result in a variety of neuropsychiatric disturbances ranging from subtle deficits to severe intellectual and emotional disturbances, including cognitive impairments, mood and psychotic disorders and behavioral disturbances. Alcohol use disorder (AUD) and TBI are closely related. The reward-mediated behaviors central to alcohol addiction seem to interact with the cognitive dysfunction of TBI. First, a significant proportion of patients with TBI have a history of alcohol abuse. Second, AUD might jeopardize TBI recovery and trigger or lower seizures threshold. Third, both AUD and TBI share a negative impact on mental functioning (from memory and cognitive performance to mood impairment). Finally, there is some limited and recent evidence that TBI can increase AUD in patients with no history of substance use prior to the injury, by disrupting incentivemotivation neurocircuitry.
Methods We aim to present a 27-year-old Portuguese male patient without prior psychiatric history who developed AUD and epilepsy after TBI (from a work-related fall).
Results After 3 years of treatment, the patient's hasn't achieved abstinence. His treatment included pharmacological therapy with mood stabilizers, flufenazine injections and naltrexone, psychotherapy and rehabilitative interventions.
Conclusions Given the sparse knowledge about this dual diagnosis, the approach of AUD after TBI is still challenging and the best treatment remains to be determined.

Objectives
The aim of this study is to evaluate the use of both legal and illegal substances, and see the difference in consumption patterns that occur in both men and women.

Methods
Surveys have been conducted on consumer habits in the past year among 84 inmates (60 women and 24 men) at the prison Brians 1, interrogating both the consumption of illegal drugs and consumer recreational drugs and routes of administration. Data were analyzed using SPSS program.

Results
A total of 57.1% had used illegal drugs. The most frequent was cannabis, with 54.8% (62.5% men and 51.7% women), followed by heroin, with 23.8% (29.2% in men and 21.7% in women) and cocaine, with 14.3% (20.8% in men and 11.7% women). Use of legal drugs was 45.2% (50% in men and 43.3% women). In this case, the greatest differences were obtained in the use of bupropion (26.7% women versus 0% men), new generation anticonvulsants such as gabapentin and pregabalin (31.7% women and 12.5% men) and the use of intranasal route of administration (31.7% women versus 0% for men). At the other extreme we find more abuse benzodiazepines abuse in men (45.8 versus 20% in women) and sedative antipsychotics (37.5% vs. 8.3%)

Conclusions
Although there is a serious problem with the misuse of legal psychotropic drugs by inmates in prisons, there is still greater consumption of illegal substances. Men's consumption pattern is more "traditional" (predominance of illegal substances and "classical" legal substances orally). Women's consumption pattern is more experimental at both the use of new psychoactive drugs and the use of alternative routes of administration. Disclosure of interest The authors have not supplied their declaration of competing interest. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1081