a Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre (HCPA) , Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , Brazil.
b Center for Health Services Research , University of Kentucky , Lexington , Kentucky , USA.
Subst Use Misuse. 2019;54(9):1499-1508. doi: 10.1080/10826084.2019.1589521. Epub 2019 Apr 25.
Club drug users are high risk and vulnerable population for adverse drug-related consequences and sexual risk behaviors. Few investigations have addressed the possible interrelationship between early trauma and PTSD among young club drug using populations. Exposure to traumatic experiences - especially in childhood, has been linked to risk behaviors exposure and substance use disorder. This study aimed to assess and compare drug use patterns and the presence of childhood sexual abuse (CSA) experiences among ecstasy and LSD users with and without Posttraumatic Stress Disorder (PTSD). This cross-sectional study employed targeted sampling and ethnographic mapping approaches via face-to-face interviews conducted at bars and electronic music festivals. The Global Appraisal of Individual Needs questionnaire was used as the primary assessment instrument. Participants were from 18 to 39 years of age, had used ecstasy and/or LSD in the 90 days prior to the interview, and were not in treatment for alcohol and other drug problems. Out of the 240 participants, 123 (51.2%) presented PTSD symptoms. Those presenting PTSD were younger, less educated, with lower income, and presented higher drug use severity than those without PTSD symptoms. Moreover, a higher prevalence of sexual risk behavior was verified among those with PTSD. There was an association between PTSD symptoms and CSA history, where 64.2% of individuals with PTSD also presented CSA, compared to 47% among those without PTSD (p = .028). Individuals with co-occurring history of CSA and PTSD symptoms reported earlier use of ecstasy, LSD, and cocaine compared to individuals with a history of CSA but without PTSD. In the present study, participants with a history of PTSD demonstrate a history of CSA, as well as pronounced severity in several areas - precocity of use, severity of addiction, and greater exposure to situations of sexual risk. Thus, a cycle of traumatization may be established through early potential trauma, which can remain unprocessed and contribute to earlier and more severe substance use and sexual risk behaviors. Identification of PTSD symptoms and risk for HIV and other STIs among young club drug users is critical to address focused treatment approaches for this vulnerable population.
俱乐部药物使用者是不良药物相关后果和性风险行为的高风险和脆弱人群。很少有研究涉及年轻俱乐部药物使用者群体中早期创伤和创伤后应激障碍之间的可能相互关系。暴露于创伤经历 - 尤其是在儿童时期，与风险行为暴露和物质使用障碍有关。本研究旨在评估和比较使用摇头丸和 LSD 的个体中创伤后应激障碍（PTSD）的药物使用模式和童年性虐待（CSA）经历的存在。这项横断面研究采用了靶向抽样和人种学绘图方法，通过在酒吧和电子音乐节上进行面对面访谈。使用全球个体需求评估问卷作为主要评估工具。参与者年龄在 18 至 39 岁之间，在访谈前 90 天内使用过摇头丸和/或 LSD，并且没有接受过酒精和其他药物问题的治疗。在 240 名参与者中，有 123 名（51.2%）出现 PTSD 症状。出现 PTSD 的个体年龄较小，受教育程度较低，收入较低，药物使用严重程度高于没有 PTSD 症状的个体。此外，在 PTSD 患者中还发现了更高的性风险行为发生率。PTSD 症状与 CSA 病史之间存在关联，其中 64.2%的 PTSD 患者也存在 CSA，而 PTSD 患者中为 47%（p=0.028）。同时存在 CSA 病史和 PTSD 症状的个体报告称，与没有 PTSD 的个体相比，他们更早地使用摇头丸、LSD 和可卡因。在本研究中，有 PTSD 病史的参与者有 CSA 病史，并且在多个领域表现出明显的严重程度 - 使用的提前性、成瘾的严重程度和更大的性风险暴露。因此，通过早期潜在创伤可能会建立一个创伤化循环，这种创伤可能未得到处理，并导致更早和更严重的物质使用和性风险行为。识别年轻俱乐部药物使用者中的 PTSD 症状和 HIV 及其他性传播感染的风险对于针对这一脆弱人群的有针对性的治疗方法至关重要。
