Drug addiction profile and monitoring liver functions tests of addicts at a specialized psychiatric treatment center

Öz

Background/Aim: Drug addiction a public health problem, which Algeria cannot escape from. According to the Algerian National Office for the Fight Against Drug Abuse and Addiction (ONLCDT), 9,680 drug addicts were treated in the first half of 2019. The lack of information and prevalence data continues to impede determining the extent of drug use in Africa. This study aims to determine the profile of drug abuse consumption in a specialized psychiatric treatment center and identify the impact of drug use on the disruption of liver function in patients admitted to the center in 2019. Methods: In this retrospective cohort study, we used the data of 80 drug addicts in statistical analyses. Results: Males were more prevalent than females (92% vs 8%), and most patients were living in urban areas (67%). The majority were married (84%) and unemployed (58%). The ages of most addicts (52%) ranged between 21 - 40 years. The mean duration of drug use was 5.15 years (SD=2.3). Cannabis was the most prevalent (n=34, 20%) drug used, followed by ecstasy (MDMA) (n=28, 17%), and others (cocaine 15%, alcohol 15%, amphetamine 10%, benzodiazepine 11%, LSD 10%, nicotine 6%). The mean number of drugs abused per patient was 2.35. The most marked observation from data comparison was the significant correlation between drug abuse duration and liver function tests (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, bilirubin) (P<0.05). Hepatic serology results show that 16% and 7.5% were hepatitis C and hepatitis B positive, respectively. Conclusion: Given the differences in sociodemographic and drug addiction, further studies involving a large population are needed to identify the factors associated with drug addiction. Algeria has few rehabilitation centers, all of which are limited in clinical capacities and need to be improved.

Anahtar Kelimeler

• Drug addiction
• liver functions tests
• epidemiology
• Drug Treatment Center

Kaynakça

1. 1. United Nations on Drug and Crime (UNODC). World Drug Report 2019 [Internet]. [cited 2020 Apr 18]. Available from: https://wdr.unodc.org/wdr2019/
2. 2. Algerian National Office for the Fight against Drug abuse and Addiction (ONLCDT); Satististical review of the first eleven months of 2019 [Internet]. [cited 2020 Apr 22]. Available from: https://onlcdt.mjustice.dz/onlcdt_fr/donnees_statistiques/bilan[2019].pdf
3. 3. Donepudi I, Massoumi H, Dharmarajan TS, Pitchumoni CS. Drug-induced liver injury. Geriatr Gastroenterol. 2012;409–20. doi: 10.1007/978-1-4419-1623-5_41
4. 4. Björnsson E, Kalaitzakis E, Olsson R. The impact of eosinophilia and hepatic necrosis on prognosis in patients with drug-induced liver injury. Aliment Pharmacol Ther. 2007;25(12):1411–21. doi: 10.1111/j.1365-2036.2007.03330.x
5. 5. Degenhardt L, Hall W. Extent of illicit drug use and dependence, and their contribution to the global burden of disease. Lancet. 2012;379(9810):55–70. doi: 10.1016/S0140-6736(11)61138-0
6. 6. Kamali EP. Felony and the Guilty Mind in Medieval England. Cambridge University Press 2019;348:1–30. https://doi.org/10.1017/9781108670890
7. 7. Byrd RS, Weitzman M, Doniger AS. Increased drug use among old-for-grade adolescents. Archives of Pediatrics & Adolescent Medicine. 1996;150(5):470-6. doi: 10.1001/archpedi.1996.02170300024006
8. 8. Demirci AÇ, Erdoʇan A, Yalçin Ö, Yildizhan E, Koyuncu Z, Eseroʇlu T, et al. Sociodemographic characteristics and drug abuse patterns of adolescents admitted for substance use disorder treatment in Istanbul. Am J Drug Alcohol Abuse. 2015;41(3):212–9. doi: 10.3109/00952990.2014.973961

9. 9. Lamptey.JJ. Sociodemographic caractéristique of substances abusers admitted to a private specialist clinic. Ghana Medical Journal. 2005;39(1). doi: 10.4314/gmj.v39i1.35973
10. 10. Gradus JL, Leatherman S, Curreri A, Myers LG, Ferguson R, Miller M. Gender differences in substance abuse, PTSD and intentional self-harm among veterans health administration patients. Drug Alcohol Depend. 2017;171:66–9. doi: 10.1016/j.drugalcdep.2016.11.012
11. 11. Lopez-Quintero C, Cobos JP de los, Hasin DS, Okuda M, Wang S, Grant BF, et al. Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: Results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drug Alcohol Depend. 2011;115(1–2):120–30. doi: 10.1016/j.drugalcdep.2010.11.004
12. 12. Chen CY, Storr CL, Anthony JC. Early-onset drug use and risk for drug dependence problems. Addict Behav. 2009;34(3):319–22. doi: 10.1016/j.addbeh.2008.10.021
13. 13. Namita S. Effect of marital status on substance abuse. International Journal of Recent Scientific Research. 2018. 9(5), pp. 27012-27015. doi: 10.24327/ijrsr.2018.0905.2168
14. 14. Galea S, Ahern J, Tracy M, Rudenstine S, Vlahov D. Education inequality and use of cigarettes, alcohol, and marijuana. Drug Alcohol Depend. 2007;90(SUPPL. 1):4–15. doi: 10.1016/j.drugalcdep.2006.11.008
15. 15. Henkel D. Unemployment and substance use: A review of the Literature (1990-2010). Curr Drug Abuse Rev. 2011;4(1):4–27. doi: 10.2174/1874473711104010004
16. 16. Galea S, Rudenstine S, Vlahov D. Drug use, misuse, and the urban environment. Drug Alcohol Rev. 2005;24(2):127–36. doi: 10.1080/09595230500102509
17. 17. Zhou Y, Zhao M, Zhou C, Li R. Sex differences in drug addiction and response to exercise intervention: From human to animal studies. Front Neuroendocrinol. 2016;40:24–41. doi: 10.1016/j.yfrne.2015.07.001
18. 18. Vederhus JK, Kristensen Ø, Timko C. How do psychological characteristics of family members affected by substance use influence quality of life? Qual Life Res. 2019;28(8):2161–70. doi: 10.1007/s11136-019-02169-x
19. 19. Argyriou E, Um M, Carron C, Cyders MA. Age and impulsive behavior in drug addiction: A review of past research and future directions. Pharmacol Biochem Behav. 2018;164:106–17. doi: 10.1016/j.pbb.2017.07.013
20. 20. Belghazi D, Moussaoui D, Kadri N. Spécificités épidémiologiques, cliniques et culturelles des patients hospitalisés au centre psychiatrique universitaire Ibn-Rochd de Casablanca. Ann Med Psychol (Paris). 2016;174(2):100–4. doi: 10.1016/j.amp.2013.07.008
21. 21. Algerian National Office for the Fight against Drug abuse and Addiction (ONLCDT); statistical review of 2018 [Internet]. [cited 2020 Apr 29]. Available from: https://onlcdt.mjustice.dz/onlcdt_fr/donnees_statistiques/bilan[2018].pdf
22. 22. International Narctics Control Board ; Report of the INCB for Africa of 2019;66–70 [Internet]. [cited 2020 Apr 29]. Available from: https://www.incb.org/documents/Publications/AnnualReports/AR2019/Annual_Report_Chapters/AR2019_Chapter_III_Africa.pdf
23. 23. European Monitoring Center for Drugs and Drug addicition; European drug report Lisbon, June 2019. ISBN 978-92-9497-398-6. doi: 10.2810/191370
24. 24. Legleye S, Spilka S, Le Nezet O, Hassler C, Choquet M. Alcool, tabac et cannabis à 16 ans - Evolutions, usages récents, accessibilité et modes de vie. Premiers résultats du volet français de l’enquête ESPAD 2007. Tendances. 2009;(64):1–6.
25. 25. Soumahoro MK, Kouassi PD, Ipou SY, Mian NNA, Ouattara A, Dosso M. Épidémiologie De La Consommation Des Substances Psychoactives En Côte D ’ Ivoire : Revue Systématique De La Littérature Epidemiology of Psychoactive Substances Consumption in Ivory Coast : systemic review study. 2018;34–42.
26. 26. United Nations Office on Drugs and Crime (UNODC). Global overview of drug demand and supply. United Nations, June 2019. ISBN: 978-92-1-148314-7. Available from: https://wdr.unodc.org/wdr2019/prelaunch/WDR19_Booklet_2_DRUG_DEMAND.pdf
27. 27. Wu LT, Parrott AC, Ringwalt CL, Yang C, Blazer DG. The variety of ecstasy/MDMA users: Results from the national epidemiologic survey on alcohol and related conditions. Am J Addict. 2009;18(6):452–61. doi: 10.3109/10550490903206049
28. 28. WHO. Global information system on alcohol and health (GISAH). 2016. [cited 2020 May 1]. Available from: https://www.who.int/substance_abuse/activities/gisah/en/
29. 29. WHO. Global Health Observatory data repository [Internet]. [cited 2020 May 2]. Available from: https://apps.who.int/gho/data/?theme=main
30. 30. Peacock A, Leung J, Larney S, Colledge S, Hickman M, Rehm J, et al. Global statistics on alcohol, tobacco and illicit drug use: 2017 status report. Addiction. 2018;113(10):1905–26. doi: 10.1111/add.14234
31. 31. Salzman C. Addiction to benzodiazepines. Psychiatr Q. 1998;69(4):251–61.
32. 32. Lagnaoui R, Depont F, Fourrier A, Abouelfath A, Bégaud B, Verdoux H, et al. Patterns and correlates of benzodiazepine use in the French general population. Eur J Clin Pharmacol. 2004;60(7):523–9. doi: 10.1007/s00228-004-0808-2
33. 33. Hibell B, Guttormsson U, Ahlström S, Balakireva O, Bjarnason T, Kokkevi A, et al. The 2011 ESPAD Report: Substance Use Among Students in 36 European Countries. 2012. 394 p. ISBN: 978-91-7278-233-4
34. 34. Godoy R, Callejas FJ, Cruz J, Tornero AI, Tárraga PJ, Rodríguez-Montes JA. Comparative analysis: Effectiveness of nicotine addiction treatment in people with psychiatric comorbidity. Semergen. 2018;44(4):249–56. doi: 10.1016/j.semerg.2017.03.008
35. 35. Phillips NL, Milne B, Silsbury C, Zappia P, Zehetner A, Klineberg E, et al. Addressing adolescent substance use in a pediatric health-care setting. J Paediatr Child Health. 2014;50(9):726–31. doi: 10.1111/jpc.12622
36. 36. Gowing LR, Ali RL, Allsop S, Marsden J, Turf EE, West R, et al. Global statistics on addictive behaviors: 2014 status report. Addiction. 2015;110(6):904–19. doi: 10.1111/add.12899
37. 37. O’Brien CP. Evidence-based treatments of addiction. Philos Trans R Soc B Biol Sci. 2008;363(1507):3277–86. doi: 10.1098/rstb.2008.0105
38. 38. Sofuoglu M, Kosten TR. Emerging pharmacological strategies in the fight against cocaine addiction. Expert Opin Emerg Drugs. 2006;11(1):91–8. doi: 10.1517/14728214.11.1.91
39. 39. Martell BA, Mitchell E, Poling J, Gonsai K, Kosten TR. Vaccine pharmacotherapy for the treatment of cocaine dependence. Biol Psychiatry. 2005;58(2):158–64. doi: 10.1016/j.biopsych.2005.04.032
40. 40. WHO. Pharmacological treatment of mental disorders in primary health care. World Health Organization 2009. ISBN 978 92 4 154769 7 https://apps.who.int/iris/handle/10665/44095
41. 41. Hurley J, Green JT. The Liver. SEVENTH ED. Brocklehurst’s Textbook of Geriatric Medicine and Gerontology. Elsevier; 2010. 635–644 p. doi: 10.1016/B978-1-4160-6231-8.10078-9
42. 42. Leggio L, Lee MR. Treatment of Alcohol Use Disorder in Patients with Alcoholic Liver Disease. Am J Med. 2017;130(2):124–34. doi: 10.1016/j.amjmed.2016.10.004
43. 43. Halpin LE, Gunning WT, Yamamoto BK. Methamphetamine causes acute hyperthermia-dependent liver damage. Pharmacol Res Perspect. 2013;1(1):1–11. doi: 10.1002/prp2.8.
44. 44. Degenhardt L, Peacock A, Colledge S, Leung J, Grebely J, Vickerman P, et al. Global prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. Lancet Glob Heal. 2017;5(12):e1192–207. doi: 10.1016/S2214-109X(17)30375-3
45. 45. United Nations on Drug and Crime (UNODC). World Drug Report 2017 [Internet]. [cited 2020 May 6]. Available from: https://www.unodc.org/wdr2017/index.html