Introduction: Over the past decade, frequent use of large quantities of nitrous oxide (N2O) has become more common in the Netherlands. Although N2O poses several negative health consequences for a subgroup of problematic N2O users, there is a lack of knowledge on what characterizes these intensive users. This study therefore aims to provide the demographic and substance use characteristics and experiences during treatment of treatment seeking problematic N2O users and to compare this with a matched group of treatment-seeking problematic cocaine users. Methods: A retrospective chart review was performed of patients who were referred for treatment of problematic N2O use at a large Dutch addiction care facility from January 2020 to September 2022, extracting demographics, pattern of use and follow-up data. Additionally, a subgroup of N2O users was propensity-score matched (1:1) with a subgroup of treatment seeking problematic cocaine users, both groups excluding users with substance use disorders or frequent use of substances other than N2O and cocaine, respectively. Results: 128 patients with a N2O use disorder were included in the total sample and a subgroup of 77 N2O-only users was propensity-score matched on age and sex to 77 cocaine-only users. N2O users were typically young (mean age 26.2 years), male (66.4%), unmarried (82.9%), with a low education level (59.0%) and born in the Netherlands (88.2%), with parents born in Morocco (45.3%). N2O was used intermittently (median 10 days/month, IQR 4.0–17.5 days) and often in very large quantities (median 5 kg [ca. 750 balloons] per average using day, IQR 2–10 kg). Compared to the patients with a cocaine use disorder, matched N2O users were lower educated, more often from Moroccan descent, and less likely to be alcohol or polysubstance users. Despite receiving similar treatments, N2O users were twice as likely to discontinue treatment before completion compared to cocaine users (63 vs. 35%, p = 0.004). Conclusion: Treatment-seeking problematic N2O users are demographically different from treatment-seeking problematic cocaine users and are much more likely to dropout from psychological treatment. Further research is needed into the needs and other factors of problematic N2O users that relate to poor treatment adherence in problematic N2O users.
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Drug consumption estimates are of relevance because of public health effects as well as associated criminal activities. Wastewater analysis of drug residues enables the estimation of drug consumption and drug markets. Short-term and long-term trends of cocaine, MDMA (ecstasy), amphetamine (speed) and methamphetamine (crystal meth), were studied for the city of Amsterdam. MDMA (+41%) and cocaine (+26%) showed significantly higher weekend vs. week consumption, while no differences were observed for the other drugs. The consumption of MDMA, cocaine, amphetamine and methamphetamine significantly increased between 2011 and 2019. Weekly trends emerging from wastewater analyses were supported by qualitative and quantitative data from a recreational drug use monitoring scheme. However, information collected in panel interviews within nightlife networks and surveys among visitors of pubs, clubs and festivals only partially reflected the long term increase in consumption as registered from wastewater analysis. Furthermore, methamphetamine use was not well presented in survey data, panel studies and test service samples, but could be monitored trough wastewater analysis. This illustrates that wastewater analysis can function as an early warning if use and user groups are small or difficult to reach trough other forms of research. All in all, this study illustrates that wastewater-based epidemiology is complementary to research among user groups, and vice versa. These different types of information enable to connect observed trends in total drug consumption to behaviour of users and the social context in which the use takes place as well as validate qualitative signals about (increased) consumption of psychoactive substances. Such a multi angular approach to map the illicit drug situation on local or regional scale can provide valuable information for public health.
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De Leefstijltraining-PLUS is een module voor behandeling en begeleiding van mensen met een Lichte Verstandelijke Beperking (LVB) en problematisch middelengebruik. De training is gebaseerd op de Achilles Leefstijltraining 2 (De Wildt, 2006) en ontwikkeld door het lectoraat GGZ-verpleegkunde van Hogeschool Inholland, Brijder Verslavingszorg, Esdégé-Reigersdaal en 's Heeren Loo Noord-Holland. De training is gedurende een half jaar getest op bruikbaarheid en uitvoerbaarheid en is geëvalueerd door het lectoraat GGZ-verpleegkunde van Hogeschool Inholland. Er zijn werkbladen beschikbaar over alcohol, cannabis, cocaïne en gamen. De cliënten kunnen deze invullen samen met de behandelaar of persoonlijk begeleider. Bij de werkbladen over gamen zijn twee versies ontwikkeld: gamen op de computer en gamen op andere manieren. U kunt de versie gebruiken die van toepassing is.
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This study examined patient and appointment factors as predictors of nonattendance in addiction mental health services. Data were collected from the electronic files of 7,641 patients treated for a substance use disorder in outpatient clinics of an addiction mental health organization in the Netherlands. Negative binomial regression analyses revealed that cocaine use, poly substance use, limitations in interpersonal functioning, presence of anxiety disorder and cluster C personality disorder, age, level of education, source of income, and planning consistency were associated with nonattendance.
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This study examined patient and appointment factors as predictors of nonattendance in addiction mental health services. Data were collected from the electronic files of 7,641 patients treated for a substance use disorder in outpatient clinics of an addiction mental health organization in the Netherlands. Negative binomial regression analyses revealed that cocaine use, poly substance use, limitations in interpersonal functioning, presence of anxiety disorder and cluster C personality disorder, age, level of education, source of income, and planning consistency were associated with nonattendance.
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This study examined patient and appointment factors as predictors of nonattendance in addiction mental health services. Data were collected from the electronic files of 7,641 patients treated for a substance use disorder in outpatient clinics of an addiction mental health organization in the Netherlands. Negative binomial regression analyses revealed that cocaine use, poly substance use, limitations in interpersonal functioning, presence of anxiety disorder and cluster C personality disorder, age, level of education, source of income, and planning consistency were associated with nonattendance.
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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.
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Maken sociaal werkers gebruik van straattaal? En zo ja, in hoeverre is dat een internationaal fenomeen? Jolanda Berends, Karin Landsbergen en Feruze Sarikas¸ zochten antwoord op deze vragen toen ze begin april de Social Work and Social Development Conference 2024 in Panama bijwoonden.
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Based on the results of two research projects from the Netherlands, this paper explores how street oriented persons adapt and use digital technologies by focusing on the changing commission of instrumental, economically motivated, street crime. Our findings show how social media are used by street offenders to facilitate or improve parts of the crime script of already existing criminal activities but also how street offenders are engaging in criminal activities not typically associated with the street, like phishing and fraud. Taken together, this paper documents how technology has permeated street life and contributed to the ‘hybridization’ of street offending in the Netherlands—i.e. offending that takes place in person and online, often at the same time.
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