The collaboration between healthcare professionals from the two cities has uncovered the patterns of substance abuse.

Substance abuse is a major factor which affects public health everywhere in the world, regardless of the national differences, economic development, life expectancy, and social conditions. Figures that characterise drug and alcohol use in particular population groups are very important to doctors, scientists, and government officials — to make decisions on how to improve the situation. Prescription medicines, if misused, may also lead to negative clinical effects, like recreational drugs. And sometimes it is hard to detect substance abuse immediately when people are admitted to emergency departments. The recent study performed jointly by healthcare officials and scientists from Moscow and Oslo has shed light on the differences in the drug use in the two cities, across various age groups and groups with different social and economic standing. The results have been published in the journal BMJ Open.

The study — set at two emergency departments, one in Oslo and one in Moscow — sought to determine the frequency of substance use among acutely hospitalised patients, aged 18 or older. The sites did not admit persons with injuries and/or requiring surgical interventions. A total of 2874 participants were included in Oslo, and 3009 — in Moscow, with almost equal distribution between male and female patients in each case. The data were collected between November 2016 and December 2017.

Upon enrolment, the patients were asked to fill out a questionnaire to learn about their age, gender, marital status, and employment status. The participants’ psychological distress was measured using the Symptom Checklist 5 (SCL-5), and self-reported alcohol use was assessed by the Alcohol Use Disorder Identification Test-4 (AUDIT-4). The patients were also asked to report the use of benzodiazepines and/or barbiturates (‘sedatives’), z-hypnotics (‘sleeping medications’), opioids (‘painkillers’), and illicit drugs (‘narcotic substances’). Blood samples were collected and analysed to detect the presence of psychoactive substances using liquid chromatography–mass spectrometry.

‘We focused on the detection of psychoactive substances — such as narcotic drugs, psychotropic substances, and prescription drugs used for recreational purposes — in hospitalised patients. We have shown that substance use among them is very common and can cause various side effects, especially in older patients’, said Aleksei Petukhov, Associate Professor at the Department of Pharmaceutical and Toxicological Chemistry (Sechenov University) and one of the authors of the paper.

In Oslo, 32.3% of the participants tested positive for one or more psychoactive medicinal drugs (benzodiazepines, z-hypnotics, opioids, or barbiturates), and 12% were positive in Moscow. In the Norwegian sample group, medications were abused primarily by persons aged 61 to 70, and by those who experienced psychological distress. In Moscow, younger patients — aged 18 to 40 years — tested positive more frequently than older participants, while psychological distress was also a significant contributor.

Differences were found also in the types of psychoactive drugs. For example, z-hypnotics are very uncommon in Russia, while phenazepam — a benzodiazepine commonly prescribed in Russia — is not marketed in Norway. Barbiturates are widely used sedatives in Russia, but not in Norway.

This population study has demonstrated that a significant proportion of the admitted patients used one or more psychoactive medicinal drugs, in particular benzodiazepines (in Oslo and Moscow) and opiates (in Oslo). The number of positive tests was lower in Moscow. The authors suggest using a wide screening for drugs and other substances among the hospitalised persons — to prevent the misuse of prescription medications and to control substance abuse.

The research was carried out by Sechenov University, Oslo University Hospital (Norway), Lovisenberg Diaconal Hospital (Oslo, Norway), Moscow Department of Health (Russia), Russian Medical Academy of Continuous Professional Education (Moscow, Russia), University of Oslo (Norway), and Demikhov Moscow Clinical Hospital (Russia).

Read more:

Gamboa D, et al. Prevalence of psychoactive substance use among acutely hospitalised patients in Oslo and Moscow: a cross-sectional, observational study. BMJ Open (2020).