Kit Sang Leung

Washington University in St. Louis, Saint Louis, MO, United States

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Publications (8)19.3 Total impact

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    ABSTRACT: Simultaneous sedative-alcohol use (SSAU) is a matter of public health concern. It is important to address the various motives individuals may have for involvement in SSAU. To explore the motives associated with SSAU. Data were collected as part of the ongoing Prescription Drug Misuse, Abuse, and Dependence study in St. Louis. For this analysis, the sample included 173 participants who reported nonmedical sedative use for more than 5 days, and use of alcohol, in the past 12 months. SSAU was defined as past 12-month use of sedatives and alcohol together/at the same time. Past 12-month SSAU was reported by 61% of the sample. Multivariate logistic regression indicated that for every increment of one motive, participants were significantly more likely to report SSAU (adjusted odds ratio (aOR): 1.30; 95% confidence interval (CI): 1.12-1.52). Furthermore, reporting sedative use "to get high, to change mood, to relieve stress, to party, and 'just because' " was independently associated with the past 12-month SSAU. Past 12-month SSAU was also found to be significantly associated with simultaneous use of sedatives and cannabis in the past 12 months. A higher number of motives, as well as specific motives reported for sedative use, were found to be significantly associated with past 12-month SSAU. Findings underscore the need for considering motives in tailoring preventive interventions for reducing SSAU. It may be equally important to direct efforts toward decreasing the number of motives, as well as addressing the specific motives reported for sedative use.
    The American Journal of Drug and Alcohol Abuse 01/2012; 38(4):359-64. · 1.55 Impact Factor
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    ABSTRACT: Non-medical use of sedatives is an ongoing problem. However, very little is known about the characteristics of individuals who use sedatives non-medically, or the motives behind such use. The present analysis, involving a sample of individuals reporting non-medical use of sedatives in the past 12 months (N=188), examined the relationship between socio-demographic variables, past-year use of other licit and illicit drugs, type of non-medical use (use in ways other than as prescribed, use when not prescribed, or both), motives, and past 12-month sedative use. Past 12-month sedative use was dichotomized as Heavy Use (>90 pills in past 12 months) and Less Heavy Use (≤90 pills), using a median split. Multivariate logistic regression analyses indicated that Heavy Use of sedatives was significantly associated with positive diagnoses for sedative use disorder and prescription opioid use disorder, a higher number of motives for sedative use, and reporting 'sedative use in ways other than as prescribed' and 'both forms of non-medical use, namely, other than as prescribed, and when not prescribed,' compared to non-prescribed use. Although in univariate analyses a positive diagnosis for past 12-month cocaine use disorder, and individual motives for sedative use such as 'to get high' and 'for pain relief', significantly predicted past 12-month Heavy Use, their effects diminished and became non-significant after adjusting for other covariates. Findings underscore the need for considering differential risk factors in tailoring preventive interventions for reducing non-medical sedative use.
    Addictive behaviors 09/2010; 36(1-2):103-9. · 2.25 Impact Factor
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    ABSTRACT: The aims of this study were to test if outcomes would be different when family members of alcohol-dependent individuals were included in intervention and to examine the factors associated with relapse during a 6-month follow-up period. Ninety male participants admitted for 3 weeks at an inpatient facility in India were randomly assigned to individual relapse prevention (IRP), dyadic relapse prevention (DRP), and treatment as usual (TAU), with 30 participants in each group. In IRP, intervention was administered to the individual participant. In DRP, both the participant and a family member were included in intervention. In all three conditions, family members stayed in the facility with participants. Participants were followed up for 6 months after discharge from the treatment center. DRP consistently performed better than TAU on all of the outcomes (reduction in quantity of alcohol, drinking days, and number of days with dysfunction in family, occupational, and financial dimensions). DRP participants also reported a significant reduction in the quantity of alcohol, drinking days, and family problems, compared with IRP. Results of Cox regression showed that being in IRP/TAU groups, early-onset dependence (<25 years), and paternal history of alcohol dependence were associated with relapse after adjusting for baseline alcohol use and other covariates. Findings provide evidence for the effectiveness of Western-based family-oriented intervention for alcohol-dependent patients in India; also, findings might help to alert treatment providers that some subsets of alcohol users might need more tailored interventions and rigorous monitoring during follow-up.
    Journal of studies on alcohol and drugs 07/2010; 71(4):581-7. · 1.68 Impact Factor
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    ABSTRACT: Risk perception, perceived behavioral control of obtaining ecstasy (PBC-obtaining), current ecstasy dependence, and recent depression have been associated with past ecstasy use, however, their utility in predicting ecstasy use has not been demonstrated. This study aimed to determine whether these four modifiable risk factors could predict ecstasy use after controlling for socio-demographic covariates and recent polydrug use. Data from 601 ecstasy users in the National Institute on Drug Abuse-funded TriCity Study of Club Drug Use, Abuse and Dependence were analyzed using multivariate logistic regression. Participants were interviewed twice within a 2-week period using standardized instruments. Thirteen percent (n = 80) of the participants reported using ecstasy between the two interviews. Low risk perception, high PBC-obtaining (an estimated ecstasy procurement time < 24h), and current ecstasy dependence were statistically associated with ecstasy use between the two interviews. Recent depression was not a significant predictor. Despite not being a target predictor, recent polydrug use was also statistically associated with ecstasy use. The present findings may inform the development of interventions targeting ecstasy users.
    Addictive behaviors 10/2009; 35(3):201-8. · 2.25 Impact Factor
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    ABSTRACT: This study evaluated the prevalence and reliability of DSM-IV adopted criteria for 3,4-methylenedioxymethamphetamine (MDMA) abuse and dependence with a purpose to determine whether it is best conceptualized within the category of hallucinogens, amphetamines or its own category. Test-re-test study. MDMA users (life-time use >5 times) were recruited in St Louis, Miami and Sydney (n=593). The median life-time MDMA consumption was 50 pills at the baseline. The computerized Substance Abuse Module for Club Drug (CD-SAM) was used to assess MDMA abuse and dependence. The Discrepancy Interview Protocol (DIP) was used to determine the reasons for the discrepant responses between the two interviews. Reliability of diagnoses, individual diagnostic criteria and withdrawal symptoms was examined using the kappa coefficient (κ). findings for baseline data, 15% and 59% met MDMA abuse and dependence, respectively. Substantial test-re-test reliability of the diagnoses was observed consistently across cities (κ=0.69). 'Continued use despite knowledge of physical/psychological problems' (87%) and 'withdrawal' (68%) were the two most prevalent dependence criteria. 'Physically hazardous use' was the most prevalent abuse criterion. Six dependence criteria and all abuse criteria were reported reliably across cities (κ: 0.53-0.77). Seventeen of 19 withdrawal symptoms showed consistency in the reliability across cities. The most commonly reported reason for discrepant responses was 'interpretation of question changed'. Only a small proportion of the total discrepancies were attributed to lying or social desirability. The adopted DSM-IV diagnostic classification for MDMA abuse and dependence was moderately reliable across cities. findings on MDMA withdrawal support the argument that MDMA should be separated from other hallucinogens in DSM.
    Addiction 09/2009; 104(10):1679-90. · 4.58 Impact Factor
  • Kit Sang Leung, Linda B Cottler
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    ABSTRACT: This paper highlights the development of pharmacological and nonpharmacological treatments for pathological gambling and is based on a review of the literature published in the past 12 months. The efficacy of naltrexone treatment for pathological gambling has been replicated in a double-blind, placebo-controlled, confirmatory study. For mood stabilizers, whereas carbamazepine and topiramate continued to produce positive results, olanzapine failed to show superior outcomes compared with placebo control. Two new pharmacological agents for pathological gambling, N-acetyl cysteine and modafinil, produced significant improvement for pathological gamblers. Several studies examined the outcomes of nonpharmacological treatments. Recent studies showed that cognitive-behavioral therapy failed to produce superior outcomes compared with other less costly methods such as brief interventions. Two new nonpharmacological treatment methods have been reported, including the use of videoconferencing in delivering ongoing supervisions after exposure therapy and the congruence couple therapy, which aims to heal the person as a system whole. Recent treatment outcomes studies address not only the effectiveness, but also the efficacy of different treatment approaches. Results of two meta-analysis studies showed that nonpharmacological treatments have a larger overall effect size than pharmacological treatments; however, owing to the diversity in study designs, it is unclear whether nonpharmacological treatments are more effective than pharmacological treatments at this point.
    Current opinion in psychiatry 02/2009; 22(1):69-74. · 3.57 Impact Factor
  • Kit Sang Leung, Linda B Cottler
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    ABSTRACT: This review highlights the epidemiologic research on club drug use in the past year, with a focus on clinical epidemiology, social epidemiology, new methodological approaches, and alternative explanations for drug use behaviors. Although 3,4-methylenedioxy-N-methylamphetamine (MDMA) or ecstasy is currently classified as a type of hallucinogen and its withdrawal is not recognized in the Diagnostic and Statistical Manual of Mental Disorders, there is evidence for the association of withdrawal symptoms with MDMA abstinence. Findings from latent class analysis indicate that MDMA users have a significantly higher risk of dependence than lysergic acid diethylamide users. Research on sociodemographic factors associated with club drug use continues to be a main focus worldwide. New epidemiologic research methods have been developed to enable researchers to monitor real-time drug use behaviors and to conduct surveys on sensitive issues in public places. In addition to traditional behavioral models, researchers began to examine the club drug phenomenon in the context of economic environment. Recent findings on MDMA use further question the current drug classification in the diagnostic systems. Despite the continuous growth in the club drug research literature, there is no study on the influence of genetic factors on club drug use. More research in this area is needed.
    Current Opinion in Psychiatry 06/2008; 21(3):234-41. · 3.42 Impact Factor
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