Journal of Addiction
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Problematic Use of Cannabis in Cotonou: Profile of Some Subjects Received in the Laboratory between 2016 and 2021

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Journal of Addiction publishes original research articles and review articles related to all aspects of addiction.

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Research Article

Direct Medical Cost of Treating Substance Use Disorders in Two Tertiary Hospitals in South-West, Nigeria: A Cross-Sectional Study

Introduction. Successful interventions for substance use disorders (SUDs), though obtainable, are not effectively utilized due to the high cost of treatment. The adoption of any given therapy is often impeded by insufficient evidence of the effectiveness of such treatment. Objective. This study aimed to assess the direct medical cost of treating SUD in two tertiary hospitals in South-West, Nigeria. Methods. A descriptive, cross-sectional survey of patients managed for SUD at the two psychiatric hospitals was carried out between January and June 2020. The inclusion criteria were patients with SUD above 18 years of age, registered and managed at the two hospitals. Data were collected from selected patients' case notes using a standardized data collection tool and analyzed using descriptive and inferential statistics. Results. The average costs of treatment for alcohol use disorder, drug use disorder, and drug and alcohol use disorder were ₦146,425.38 ± 57,388.84, ₦135,282.09 ± 53,190.39, and ₦143,877.33 ± 68,662.04, respectively. This translates to $384.82, $355.53, and $378.12, respectively. The highest contributors to SUD treatment cost are inpatient admissions and the cost of medicines; inpatient admissions include accommodation, feeding, and laundry. Conclusion. Considering that over 60% of the Nigerian population lives below the poverty line, the direct cost of SUD treatment is unaffordable to the patients and the health care system, which is grossly underfunded.

Research Article

Prevalence and Factors Associated with Problematic Internet Use among Ethiopian Undergraduate University Students in 2019

Background. Problematic Internet use is characterized by excessive or poorly controlled preoccupations, urges, or behavior regarding computer use and Internet access which lead to impairment or distress. It has been found that the occurrence rate of problematic Internet use among university students ranges from 0.8% to 47.7%. Despite this, there are multiple challenges that relate to problematic Internet use, which remain underrecognized and largely ignored by stakeholders and are not well known, especially in low-income countries, including Ethiopia. Therefore, this study was conducted aiming to assess the prevalence of problematic Internet use and its associated factors among undergraduate students. Methods. Cross-sectional study was employed from May 1st to June 1st, 2019. A multistage sampling technique was used to get a total of 846 undergraduate students. Data were collected by using self-administered structured questionnaires of Young’s Internet Addiction Test. The collected data were coded and entered into EpiData 3.1 and analyzed by using SPSS version 22; bivariate and multivariate logistic regression analysis was conducted to identify factors associated with problematic Internet use, and statistical significance was considered at value <0.05. Results. For a total of 846 study participants, the response rate was 761 (90%) and the prevalence of problematic Internet use was 19.4%. Multiple logistic regression model revealed that being male [AOR = 1.69, 95% CI: 1.80, 6.41], depression [AOR = 3.61, 95% CI: 2.40, 5.43], and khat or caffeinated drinks [AOR = 1.86, 95% CI: 1.21, 2.87] were significantly associated with problematic Internet use. Conclusion. This study revealed that there was high prevalence of problematic Internet use among Dilla University students and there were various factors associated with increased prevalence of problematic Internet use. Therefore, students need to be educated about the safe, valuable, and healthy practices of Internet use. Furthermore, it is better to counsel on substance use and its consequences to overcome the anticipated increase in problematic Internet use.

Research Article

Mobile Phones: Vital Addiction or Lethal Addiction? Mobile Phone Usage Patterns and Assessment of Mobile Addiction among Undergraduate Medical Students in Telangana, India

Background. Increased mobile phone usage among undergraduate medical students causes a detrimental effect on their health. The main focus of this study is to determine the pattern of mobile phone usage among undergraduate medical students in Hyderabad, India, and the detrimental effect on their health due to excess mobile use. Materials and Methods. A cross-sectional study was conducted among undergraduate medical students from various medical colleges in Hyderabad, India, from September 2020 to January 2021. Data were collected from 626 respondents using a semistructured, pretested questionnaire. Smartphone Addiction Scale-Short Version (SAS-SV) was used to assess the risk of smartphone addiction. Microsoft Excel and SAS were employed to analyze the data. Associations were examined using Fisher’s exact test. Results. 100% of the respondents were using mobiles, with 83.2% spending more than 4 hours on them. Only 22% reported that no mobile use during classes. Half (51.6%) admitted to keeping their mobiles close by while sleeping. 84.3% used social networking apps via their mobiles. Common symptoms arising from prolonged mobile usage included eye strain (67.9%), blurred vision (31.4%), and numbness or tingling in palms (30.9%). 52.70% of the respondents were at high risk of mobile addiction according to SAS-SV. Screen time more than 4 hours was associated with high risk of mobile addiction (). Significant association was found between high risk of mobile addiction and eye strain (), blurry vision (), numbness/tingling in palms (), and heat/tingling in the auditory area (). Conclusion. The study shows the alarming rate of risk of smartphone addiction among medical students. Students can be encouraged to assess their mobile addiction status and become aware of the issue. More research may be performed to develop standardized tools for early identification of mobile addiction and appropriate therapies for its rectification.

Research Article

Risky Alcohol Use and Comorbidity in a Swedish Adolescent Emergency Psychiatric Inpatient Population

Introduction. Underage drinking is associated with poor mental health. Early detection for risky alcohol use is recommended, although less implemented in adolescent care. The objective of this study was to investigate the prevalence of risky alcohol use and psychiatric comorbidity. Methods. Over a nine-month period, 145 eligible adolescents admitted to the child and adolescent emergency unit in Malmö, Sweden, were offered computerized screening with Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) and Drug Use Disorders Identification Test (DUDIT). Results. Ninety-six patients (73 girls and 23 boys) agreed to participate. The most common diagnoses were affective disorder (41%) and anxiety disorder (27%). Risky alcohol use was found among 33% of the girls and 22% of the boys () and did not differ between diagnostic categories. There was a positive correlation between AUDIT-C and DUDIT scores (). Among adolescents with risky alcohol use, 33% of the girls and 60% of the boys also had a risky drug use. Conversely, 47% of the girls and 60% of the boys with risky drug use also had a risky alcohol use. Conclusion. In view of the poor prognosis of risky alcohol use in adolescents, alcohol and drug habits should be assessed when adolescents seek psychiatric emergency care.

Research Article

High Frequency and Low Intensity Transcranial Magnetic Stimulation for Smoking Cessation

Introduction. Tobacco consumption is one of the main causes of mortality in the world. Because of its effect on health, smoking cessation should be prioritized as an important health intervention; however, current interventions have shown low success rates as only 31% of the cases can stop smoking. In this paper, an intervention with high frequency and low intensity transcranial magnetic stimulation (HFLI TMS) was applied to determine if this type of neuromodulation could have an effect in decreasing tobacco addiction. Methods. Retrospective data from ten ambulatory smoker patients that underwent 24 sessions of HFLI TMS over 8 weeks were retrieved and are here presented. Results. Exhaled CO concentrations were statistically significantly different from baseline at the weeks 3, 5, 6, and 8. After the 24 sessions, all patients stopped smoking; this was confirmed directly by exhaled carbon monoxide and the smoking diary. Three months after intervention, eight out of ten subjects continued without smoking. No severe adverse effects were reported by participants. Conclusions. Overall, employing HFLI TMS appears to have acceptable result; however, further evidence is needed to determine with more certainty its therapeutic effect and adverse effects for addiction intervention.

Research Article

Brief Negative Affect Focused Functional Imagery Training Abolishes Stress-Induced Alcohol Choice in Hazardous Student Drinkers

Introduction. Imagery-based stress management therapies are effective at reducing alcohol use. To explore the therapeutic mechanism, the current study tested whether brief functional imagery training linked to personal negative affect drinking triggers would attenuate sensitivity to noise stress-induced alcohol seeking behaviour in a laboratory model. Methods. Participants were UK-based hazardous student drinkers (N = 61, 80.3% women, aged 18–25) who reported drinking to cope with negative affect. Participants in the active intervention group (n = 31) were briefly trained to respond to personal negative drinking triggers by retrieving an adaptive strategy to mitigate negative affect, whereas participants in the control group (n = 30) received risk information about binge drinking at university. The relative value of alcohol was then measured by preference to view alcohol versus food pictures in two-alternative choice trials, before (baseline) and during noise stress induction. Results. There was a significant two-way interaction where the control group increased their alcohol picture choice from baseline to the noise stress test , whereas the active intervention group did not , and the control group chose alcohol more frequently than the active group in the stress test , but not at baseline . Conclusions. These findings indicate that imagery-based mood management can protect against the increase in the relative value of alcohol motivated by acute stress in hazardous negative affect drinkers, suggesting this mechanism could underpin the therapeutic effect of mood management on drinking outcomes.

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