Perceived risk associated with ecstasy use: a latent class analysis approach.

This study aims to define categories of perceived health problems among ecstasy users based on observed clustering of their perceptions of ecstasy-related health problems. Data from a community sample of ecstasy users (n=402) aged 18 to 30, in Ohio, was used in this study. Data was analyzed via Latent Class Analysis (LCA) and Regression. This study identified five different subgroups of ecstasy users based on their perceptions of health problems they associated with their ecstasy use. Almost one third of the sample (28.9%) belonged to a class with "low level of perceived problems" (Class 4). About one fourth (25.6%) of the sample (Class 2), had high probabilities of "perceiving problems on sexual-related items", but generally low or moderate probabilities of perceiving problems in other areas. Roughly one-fifth of the sample (21.1%, Class 1) had moderate probabilities of perceiving ecstasy health-related problems in all areas. A small proportion of respondents (11.9%, Class 5) had high probabilities of reporting "perceived memory and cognitive problems", and of perceiving "ecstasy-related problems in all areas" (12.4%, Class 3). A large proportion of ecstasy users perceive either low or moderate risk associated with their ecstasy use. It is important to further investigate whether lower levels of risk perception are associated with persistence of ecstasy use.

Illicit use of pharmaceutical opioids among young polydrug users in Ohio.

This study, conducted in Columbus, Ohio, identified the predictors of current (past 30 day) illicit use of pharmaceutical opioids among young individuals (n=402) with a history of MDMA/ecstasy use who were recruited in 2002-2003 using respondent-driven sampling. To be eligible, participants had to be 18-30 years old, not involved in a drug abuse treatment, and report MDMA/ecstasy use at least once in the past 6 months. About 81% reported lifetime, and more than 31% reported current illicit use of pharmaceutical opioids. Logistic regression analysis revealed that illicit use of pharmaceutical tranquilizers and pharmaceutical stimulants were the strongest predictors of illicit use of pharmaceutical opioids. Risk of pharmaceutical opioid use was also greater among those who had higher levels of depressive symptoms and reported current use of hallucinogens and inhalants. Our findings suggest that the non-medical use of pharmaceutical opioids is a part of polydrug use practices that often incorporate illicit use of other prescription drugs. The observed relationship between depressive symptoms and illicit use of pharmaceutical opioids may have important implications for prevention programming and should be examined in future research.

Constructing a consensus-based prevention outcome measurement instrument.

This article describes Ohio's Prevention Evaluation Project (PEP). The purpose of the project was to develop a process and instrument to assess behavioral and attitudinal outcomes in primary drug abuse prevention programs targeting young people aged twelve to seventeen. One of PEP's principal achievements was the inclusion of community prevention program providers from throughout the state in the evaluation instrument development. The effort produced a self-administered questionnaire to capture data on young peoples' drug use practices, attitudes toward drugs, and problematic behaviors. Most significantly, the product produced was the acceptance and endorsement of community-based programs. The forty-one-item questionnaire has good to excellent reliability for virtually all measures, as assessed by the test-retest method. The instrument is a product of a process that brought together a university-based research team, state alcohol and drug abuse prevention administrators, and representatives of public programs. PEP demonstrates how to productively link service providers, administrators, and evaluators to develop a process for assessing the effectiveness of prevention programs. The process and tools described serve as a model for other communities wanting to evaluate their prevention programming.

Anti-leukemia selectivity in actinomycin analogues.

An excellent anti-leukemia activity has been found in a group of actinomycin D analogues derivatized at the 2,2'- or 5,5'-position of the depsipeptides. On the basis of the water solubilities, the DNA binding affinities, the RNA synthesis inhibitory activities, the anticancer activities of actinomycin D (AMD), and the crystal structures of DNA-AMD complexes, it becomes clear that AMD is extremely well designed as an effective poison produced by micro-organisms. The anticancer activity of AMD is mainly due to its selective inhibition of RNA synthesis. We have hypothesized that a modification on the AMD structure at a site not involved in DNA interaction can either increase or decrease the diffusion rate of the analogue into certain cancer cells. Since the i-propyl groups of the D-valine residues at the 2,2'-positions and N-methyl-L-valine residues at the 5,5'-positions in the depsipeptides do not participate in interaction with DNA, these amino acid residues were replaced with other D-amino acid residues and N-methyl-L-amino acid residues, respectively. The cancer screen tests have indicated that AMD analogues 2,2'-D-PheAMD, 2,2'-D-OmeAMD, 5,5'-L-TyrAMD, 5,5'-D-ValAMD, 5,5'-D-TyrAMD, 5,5'-D-PheAMD, and 5,5'-D-OmeAMD, inhibit selectively the growth of leukemia cell lines at about 100- to 500-fold lower drug concentrations than those required to inhibit other cancer cell lines.

The epidemiology of physical attack and rape among crack-using women.

This prospective study examines the epidemiology of physical attack and rape among a sample of 171 not-in-treatment, crack-cocaine using women. Since initiating crack use, 62% of the women reported suffering a physical attack. The annual rate of victimization by physical attack was 45%. Overall, more than half of the victims sought medical care subsequent to an attack. The prevalence of rape since crack use was initiated was 32%, and the annual rate was 11%. Among those women having been raped since they initiated crack use, 83% reported they were high on crack when the crime occurred as were an estimated 57% of the perpetrators. Logistic regression analyses showed that duration of crack use, arrest for prostitution, and some college education were predictors of having experienced a physical attack. Duration of crack use and a history of prostitution were predictors of suffering a rape. Drug abuse treatment programs must be sensitive to high levels of violence victimization experienced by crack-cocaine using women. Screening women for victimization, and treating the problems that emanate from it, may help make drug abuse treatment more effective.

The Ohio Substance Abuse Monitoring Network: constructing and operating a statewide epidemiologic intelligence system.

Working with the Ohio Department of Alcohol and Drug Addiction Services (ODADAS) and researchers at the University of Akron, Wright State University's Center for Interventions, Treatment, and Addictions Research developed the Ohio Substance Abuse Monitoring (OSAM) Network to provide a statewide summary of substance abuse trends. Ten key informants across the state collect qualitative and statistical data on substance abuse trends in their regions and prepare biannual reports. The OSAM network has a rapid response capability through which key informants can investigate special issues related to substance abuse identified by ODADAS and provide policymakers with timely, statewide reports. Within 12 months after operations began, the key informants produced reports on drug abuse trends and rapid response issues for the state. These reports prepared policymakers to respond more effectively to prevention and substance abuse treatment needs.

Crack-cocaine use and health status as defined by the SF-36.

The Medical Outcomes Study Short Form 36 (SF-36) was administered to 443 not-in-treatment, crack-cocaine smokers to explore the relationship between frequency of crack, alcohol, and tobacco use, addiction to these drugs, and health status. The reliability of the SF-36 with crack smokers was also assessed. Statistically significant, negative associations emerged between frequency of crack use and all SF-36 subscales except physical functioning. There were not significant associations between frequency of alcohol or tobacco use and any SF-36 subscale. Self-assessed addiction to crack was strongly and negatively associated with all SF-36 subscales: alcohol and tobacco addiction were also negatively associated with health status, but not to the degree of crack. The SF-36 produces reliable data on the health status of crack users and, as such, may have a useful role in assessments involving crack-using populations.

Longitudinal application of the medical outcomes study 36-item short-form health survey with not-in-treatment crack-cocaine users.

BACKGROUND: The Medical Outcomes Study SF-36 has been used infrequently with substance abusers. OBJECTIVES: The objectives of this study were to use the SF-36 to assess changes in the health status of crack-cocaine users over time, to determine the characteristics of users who change, to assess the influence of frequency of crack use on SF-36 health status, and to determine the utility of the SF-36 with crack users. DESIGN: A multilevel model was used to analyze data that were collected every 6 months over a 2-year period. SUBJECTS: The sample consisted of 439 not-in-treatment crack-cocaine users. MEASURES: The SF-36 was administered at baseline and follow-up interviews. Data on the frequency of crack-cocaine use were also collected. RESULTS: On average, SF-36 health status remained fairly static during the study although statistically significant increases in scores occurred on the social functioning and role-emotional subscales. Variation in subjects' health trajectories occurred but was not, for the most part, explained by individual characteristics. Frequency of crack use was negatively related to scores on the physical functioning, social functioning, and mental health subscales. Most subscales did not reflect what are commonly recognized to be the health-compromising effects of cocaine use, raising questions about the use of the SF-36 with illicit drug users. CONCLUSIONS: Changes in crack users' SF-36 health status were uncommon. Frequency of crack use was negatively associated with health status. Several SF-36 subscales may be helpful in studies involving illicit drug users in which limited assessments of health status are needed.

Catalytic antibodies for complex reactions: hapten design and the importance of screening for catalysis in the generation of catalytic antibodies for the NDA/CN reaction.

Success in generating catalytic antibodies as enzyme mimics lies in the strategic design of the transition-state analog (TSA) for the reaction of interest, and careful development of screening processes for the selection of antibodies that are catalysts. Typically, the choice of TSA structure is straightforward, and the criterion for selection in screening is often binding of the TSA to the antibody in a microtiter-plate assay. This article emphasizes the problems of TSA design in complex reactions and the importance of selecting antibodies on the basis of catalysis as well as binding to the TSA. The target reaction is the derivatization of primary amines with naphthalene-2,3-dicarboxaldehyde (NDA) in the presence of cyanide ion. The desired outcome is selective catalysis of formation of the fluorescent derivative in preference to nonfluorescent side-products. In the study, TSA design was directed toward the reaction branch leading to the fluorescent product. Here, we describe a microtiter plate-based assay that is capable of detecting antibodies showing catalytic activity at an early stage. Of the antibodies selected, 36% showed no appreciable binding to any of the substrates tested, but did show catalytic activity in derivatizing one or more of the amino acids screened. In contrast, only two out of 77 clones that showed binding did not show catalysis. Thus, in this complex system, observation of binding is a good predictor of the presence of catalytic activity, and failure to observe binding is a poor predictor of the absence of catalytic activity.

Crack-cocaine users as victims of physical attack.

This study evaluates the correlates of physical attack among people who use crack cocaine in Dayton, Ohio. Using a retrospective and prospective natural history design, data from baseline and 1-year follow-up interviews were used to calculate the prevalence of physical attack and the annual rate of physical attack suffered by 440 not-in-treatment crack-cocaine users. Logistic regression was used to determine the correlates of physical attack. The lifetime prevalence of physical attack was 63.0%; the annual rate was 36.8%. At baseline, daily crack users were more likely to report a previous attack since they began using crack (odds ratio [OR], 1.81; 95% confidence interval [CI], 1.18-2.77). Longer duration of crack use was also associated with experiencing an attack (OR, 1.09; 95% CI, 1.04-1.14). Between baseline and 12-month follow-up, the odds of men being attacked were significantly less than those for women (OR, 0.48; 95% CI, 0.23-0.99). Physical attack is widespread among crack-cocaine users, and does not vary by ethnicity. Injuries often result in the need for medical care. Over the short term, women are at increased risk. Accessible and effective drug abuse treatment is needed to diminish the harm this population suffers.

HIV needle risk behaviors and drug use: a comparison of crack-smoking and nonsmoking injection drug users in Ohio.

This study compares the drug use and needle risk behaviors among 733 crack-smoking injection drug users (IDUs) and 518 nonsmoking IDUs. Participants were recruited in Dayton and Columbus, Ohio, for the Cooperative Agreement for AIDS Community-Based Outreach/Intervention Research Program from 1992 to 1996. Crack-smoking IDUs were more likely to be male, African-American, and 30 to 40 years of age, but less likely to be married or living with a sex partner compared to nonsmokers. Daily crack users were less likely to be daily injectors but more likely to use alcohol daily when compared to non-crack users and less-than-daily crack smokers. IDUs who smoked crack less than daily were more likely to have injected with needles and syringes used by others. There is an urgent need for additional research on the relationship between drug injection and crack smoking as well as improved HIV risk-reduction interventions that include drug abuse treatment components focusing on issues surrounding crack-cocaine addiction.

A comparison of total body water analyses: bioelectric impedance analysis versus the tritiated water method.

Bioelectric impedance analysis (BIA) is used to measure the body composition and total body water of normal subjects. The purpose of this study was to determine if the hydration of patients with burns could be assessed by BIA. Assessments of total body water as determined by BIA and the tritiated water method were prospectively compared. The 2 analyses were performed 48 hours after admission for 5 patients with acute burns to determine the correlation of the 2 methods. The patients had a mean age of 36.4+/-14.7 years (range, 20-56 years), a mean burn size of 39.4%+/-15.9% of the body surface area (range, 23%-65%), and a mean full-thickness burn size of 27.7% of the body surface area. The total body water was measured on admission and again at 48 hours postburn. There is an excellent relationship between BIA and tritiated-water-method determinations of the total body water of patients with severe burns (r = 0.958). This correlation suggests that BIA provides an accurate measure of total body water, and so it is a reliable means of monitoring fluid resuscitation in patients with burns.

Hydroquinone-based derivatization reagents for the quantitation of amines using electrochemical detection.

Two new reagents, NDTE (2,5-dihydroxyphenylacetic acid, 2,5-bis-tetrahydropyranyl ether p-nitrophenyl ester) and HLTE (homogentisic gamma-lactone tetrahydropyranyl ether), are described for the chemical derivatization of primary and/or secondary amines to form an electrochemically active product. These reagents undergo reaction with the aforementioned analytes to form a product possessing the hydroquinone moiety, thus allowing for reversible electrochemical detection at mild oxidation potentials. The reactivity of each reagent was demonstrated by using N-ethylbenzylamine (EBzA) and the dipeptide isoleucine leucine methyl ester as model analytes. The investigation included the isolation and identification of the intermediates and final products from derivatization of EBzA. These isolated standards were subsequently characterized with respect to electrochemical properties by means of cyclic voltammetry. In LC-EC experiments, the concentration limit of detection (CLOD) of the purified EBzA product was determined to be 5 nM (100 fmol) at a detection potential of +200 mV vs Ag/AgCl ([Cl-] = 3 M). The CLOD values obtained by LC-EC after derivatization of aqueous solutions of EBzA and Ile-Leu-OMe with NDTE were 25 nM (250 fmol) and 250 nM (2.5 pmol), respectively.

Differences in drug use among rural and suburban high school students in Ohio.

This exploratory study examines differences in the prevalence of drug use by gender among twelfth grade students (n = 464) in selected rural and suburban high schools in west-central Ohio. The lifetime use of alcohol and other drugs is common among all groups. Proportionally fewer boys in rural schools than boys in suburban schools reported the use of marijuana, inhalants, and LSD, or recent episodes of drunkenness. No statistically significant differences emerged between girls in rural and suburban schools. Afterschool employment practices may help explain the observed differences.

Evaluation of HIV risk reduction intervention programs via latent growth model.

The latent growth model (LGM) has drawn increasing attention in behavioral studies using longitudinal data. The LGM captures the level and trajectory of behavior change, variation in both the initial status and the trend of behavior change, as well as the time-ordered covariation between the initial status and change. This study demonstrates how the LGM can be applied in the evaluation of intervention programs targeting HIV risk behavior among drug users. Multi-group piecewise latent growth models were fit to longitudinal data with three repeated response measures.

Understanding HIV risks of chronic drug-using men who have sex with men.

Focus groups and individual structured interviews were conducted in six cities with 98 predominantly street-recruited men who had a recent history of smoking crack or injecting drugs and who reported having had sex with other men (MSM) in the past year. Twenty-six focus groups explored the cultural and social context of participant's drug use and sexual activity and addressed outreach and HIV prevention issues pertinent to this population. Narrative summaries developed from verbatim focus group transcripts identified seven themes: (a) sexual orientation and gender identity; (b) interactions within and between MSM networks; (c) drug use, sexual activity and personal relationships; (d) HIV transmission bridges; (e) preferred HIV information sources; (f) HIV knowledge, prevention practices and risk behaviours; and (g) availability of HIV and drug-related services. Of the 98 MSM drug users, 42% identified publicly as gay or homosexual; 35% identified publicly, but only 21% privately, as heterosexual. A total of 51% had one or more female sex partners in the past year. There was a high frequency of unprotected sex in conjunction with drug use and a distinct preference for having sex when high. For most participants, drug use rather than sexual orientation formed the core of personal identity. Participants reported associating primarily with other drug users, usually MSM, and had limited contact with people who did not use drugs and the mainstream gay community. Participants' sexual and drug-injecting activities were judged to be a bridge for transmission of HIV to both people who used drugs and those who did not.

Identification of inosine as an endogenous modulator for the benzodiazepine binding site of the GABAA receptors.

Previously we have reported the presence of endogenous ligands that are involved in the regulation of the binding of muscimol to the GABA binding site of the GABAA receptors. Here, we report the presence of multiple forms of endogenous ligands in the brain which modulate the binding of flunitrazepam (FNZP) to the benzodiazepine (BZ) binding site of the GABAA receptor. Furthermore, one of the endogenous ligands for the BZ receptors, referred to as EBZ, has been identified as inosine based on the following observations: (1) standard inosine and the EBZ have identical NMR and UV spectra; (2) the elution profile of inosine and the EBZ from a HPLC column are indistinguishable, and (3) inosine and the EBZ show identical activity in inhibiting [3H]FNZP binding.

Needle transfer among injection drug users: a multilevel analysis.

OBJECTIVE: The purpose of the study described here is to extend our understanding of needle transfer behaviors among injection drug users (IDUs) by combining both micro and macro variables in a multilevel model. METHODS: A sample of 8,404 IDUs interviewed at 18 sites of the National Institute on Drug Abuse (NIDA) Cooperative Agreement for AIDS Community-Based Outreach/Intervention Program (COOP) was used for the study. A multilevel model was employed to deal with intraclass correlation in the sample and to evaluate the impact of micro and macro variables on needle transfer among IDUs. RESULTS: A significant intraclass correlation was detected in the sample. Needle transfer was associated with both the individual characteristics and the features of the social setting in which they were embedded. Some of the micro slopes were fixed, while some varied from site to site, depending on the values of macro variables. The micro intercept and the micro slope of ethnicity vary randomly across social settings, while they are partially determined by macro variables. CONCLUSION: Considering the intraclass correlation in the data and the effects of contextual features on individual behaviors, multilevel analysis of HIV risk behaviors should be considered when combining data from micro and macro levels (e.g., individual and project site levels).