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The use of non-medical fentanyl and structurally related compounds has changed drastically over the last ten years. Community members working with individuals who use fentanyl intentionally currently struggle with the rapidly evolving drug markets and patterns of use, thereby failing to adapt treatment approaches and harm reduction strategies to individuals with severe opioid use disorder (OUD) and concurrent psychiatric disorders.
Objectives
This systematic review aims to evaluate intentional fentanyl among PWUD by summarizing demographic variance, concurrent disorders, and resulting patterns of use.
Methods
The search strategy in this study was developed with a combination of free text keywords and Mesh and non-Mesh keywords, and adapted with database-specific filters to Ovid MEDLINE, Embase, Web of Science, and PsychINFO (May 2021). The search results resulted in 4437 studies after de-duplication, of which 132 were selected for full-text review. A total of 42 articles were included in this review.
Results
It was found that individuals who use fentanyl intentionally were more likely to be young, male, and Caucasian. Individuals who intentionally use fentanyl were more commonly homeless, unemployed or working illegally, and live-in cities. Independent correlates of any purposeful fentanyl use included moderate/severe depression.
Conclusions
Individuals who intentionally use fentanyl are more likely to report injection drug use and polysubstance use, including cocaine use, heroin use, and methamphetamine use. Among PWUD, individuals who intentionally use fentanyl have the most severe substance use patterns, the most precarious living situation, and the most extensive overdose history and higher proportion of ever having a mental health diagnosis.
One of the most recent topics in addictive disorders is videogame-use disorder which is continuously under research, especially in adolescents. The specific structure of digital games (immortality, infinity, etc.) can sensitize adolescents to the development of problematic use. The number of researches about problematic video game use has increased significantly during the last decade. In 2013, this problem was included among “Disorders requiring further research” in DSM-5, and it was also included in ICD-11 as a separate diagnostic category in 2019.
Objectives
We review studies investigating the association between the co-occurrence of ADHD and video game use in adolescents. We attempt to summarize new theoretical approaches to video game use disorder and the areas of present research.
Methods
We conducted a literature search in 4 databases (PubMed, Medline, Google Scholar, Web of Science) using keywords (ADHD, adolescents, video game use disorder, internet addiction, game addiction) over the past 5 years. Exclusion criteria were the following: publication date before 2014, adult population, or comorbidity beside ADHD.
Results
The comorbidity of video game use disorder and ADHD was frequent. Primarily cross-sectional studies examined the presence of hyperactivity, attention deficit, and impulsivity symptoms separately. The presence of attention deficit clearly showed an association with the development of video game use disorder.
Conclusions
Adolescents diagnosed with ADHD have a greater possibility of developing video game use disorder and/or problematic psychoactive substance users. More attention should be paid to this comorbidity in not only the diagnostic process, but also in the development of prevention programs.
Disclosure
No significant relationships.
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