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Youth in transition: Study protocol of a prospective cohort study into the long-term course of addiction, mental health problems and social functioning in youth entering addiction treatment

BackgroundSubstance use disorders (SUDs) are prevalent in the general population, tend to follow a chronic course, are associated with many individual and social problems, and often have their onset in adolescence. However, the knowledge base from prospective population surveys and treatment-outcome studies on the course of SUD in adolescents is limited at best. The present study aims to fill this gap and focuses on a subgroup that is particularly at risk for chronicity: adolescents in addiction treatment. We will investigate the rate of persistent SUD and its predictors longitudinally from adolescence to young adulthood among youth with DSM-5 SUD from the start of their addiction treatment to 2 and 4 years following treatment-entry. In addition to SUD, we will investigate the course of comorbid mental disorders, social functioning, and quality of life and their association with SUD over time.Methods/designIn a naturalistic, multi-center prospective cohort design, we will include youths (n = 420), who consecutively enter addiction treatment at ten participating organizations in the Netherlands. Inclusion is prestratified by treatment organization, to ensure a nationally representative sample. Eligible youths are 16 to 22 years old and seek help for a primary DSM-5 cannabis, alcohol, cocaine or amphetamine use disorder. Assessments focus on lifetime and current substance use and SUD, non-SUD mental disorders, family history, life events, social functioning, treatment history, quality of life, chronic stress indicators (hair cortisol) and neuropsychological tests (computerized executive function tasks) and are conducted at baseline, end of treatment, and 2 and 4 years post-baseline. Baseline data and treatment data (type, intensity, duration) will be used to predict outcome – persistence of or desistance from SUD.DiscussionThere are remarkably few prospective studies worldwide that investigated the course of SUD in adolescents in addiction treatment for longer than 1 year. We are confident that the Youth in Transition study will further our understanding of determinants and consequences of persistent SUD among high-risk adolescents during the critical transition from adolescence to young adulthood.Trial registrationThe Netherlands National Trial Register Trial NL7928. Date of registration January 17, 2019.

The identification of synthetic drug laboratories based on the detection of precursors

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Feasibility and evaluation of high-fidelity simulation education for acute clinical toxicology

To prepare medical students appropriately for the management of toxicological emergencies, we have developed a simulation-based medical education (SBME) training in acute clinical toxicology. Our aim is to report on the feasibility, evaluation and lessons learned of this training. Since 2019, each year approximately 180 fifth-year medical students are invited to participate in the SBME training. The training consists of an interactive lecture and two SBME stations. For each station, a team of students had to perform the primary assessment and management of an intoxicated patient. After the training, the students completed a questionnaire about their experiences and confidence in clinical toxicology. Overall, the vast majority of students agreed that the training provided a fun, interactive and stimulating way to teach about clinical toxicology. Additionally, they felt more confident regarding their skills in this area. Our pilot study shows that SBME training was well-evaluated and feasible over a longer period.

Dancing to the loop

Partydrugs en studenten: gebruik en kennis van de risico’s

Het gebruik van partydrugs onder jongvolwassenen in Nederland is veelvoorkomend en gaat soms gepaard met ernstige incidenten. Voor effectieve voorlichtingis het van belang te weten wat de risicopopulaties zijn en in hoeverre gebruikers zich bewust zijn van de specifieke risico’s van verschillende partydrugs. Met een schriftelijke enquête onder 514 studenten hebben de auteurs de prevalentie van partydrugsgebruik en het kennisniveau hieromtrent binnen de (Nederlandse en internationale) Groningse studentenpopulatie in kaart gebracht. Het gebruik is hoog: 30,8% van de Nederlandse studenten en 19,8% van de internationalestudenten heeft recentelijk partydrugs gebruikt, waarbij XTC het meestgebruikte middel is. Leden van studentenverenigingen gebruiken aanzienlijkmeer dan niet-leden. Het kennisniveau van de Nederlandse studenten ligt overhet algemeen hoger dan dat van de internationale studenten. De risico’s vanhet combineren van XTC met amfetamine, uppers met downers worden onderschat,evenals die van het combineren van partydrugs met alcohol. Ook weeteen groot deel van de gebruikers niet dat cocaïne en heroïne op elkaar kunnenlijken. Overige kennislacunes, preventiemaatregelen en de implicaties voordrugsvoorlichting en -preventie worden tevens in dit artikel besproken.

University students and the normalisation of illicit recreational drug use

The last decades have seen an increase in the use of illicit recreational drugs. In this article we take a detailed look at the current state of normalisation of the three most popular illicit recreational drugs among Dutch university students in the Netherlands (MDMA/Ecstasy, cocaine and amphetamine) by zooming in on five established aspects of normalisation and expanding on one of those aspects: social accomodation, by adding a behavioural subcomponent (setting of use). For this purpose, we used quantitative data, obtained from four studies (2016, 2017, 2019 and 2020) among Dutch university students in a prototypical university city in the Netherlands (Groningen). Results show that three aspects of normalisation are clearly observable. The drugs are perceived as highly accessible, the last year prevalence of use is high, and experimenting, especially with MDMA/Ecstasy, is common. Accurate knowledge of the drugs and acceptance of occasional use, account in some measure for social accommodation. However, as students do not talk openly about their drug use with everyone in their environment, one cannot speak of cultural accommodation. Thus, although clear signs of normalisation of illicit recreational drugs, especially MDMA/Ecstasy, are observable among Dutch university students, there is no full-scale normalisation of these drugs.