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    Clinical and Sociodemographic Characteristics of Adolescents Receiving Inpatient Treatment at a Substance Use Treatment Center in Turkey
    (Routledge Journals, Taylor & Francis Ltd, 2025) Tunagur, Mustafa Tolga; Kurt Tunagur, Elif Merve
    Adolescents are at high risk for substance use disorders (SUDs) due to early initiation, polysubstance use, and psychosocial difficulties. However, detailed information about adolescents receiving inpatient treatment for SUDs in Turkey remains limited. This study aimed to evaluate the sociodemographic, clinical, and substance use profiles of adolescents treated at a state-affiliated Child and Adolescent Substance Use Treatment Center (& Ccedil;EMATEM) in Turkey. This retrospective study reviewed the medical records of adolescents admitted to & Ccedil;EMATEM between March 2023 and February 2025. Data on sociodemographic characteristics, substance use patterns, psychiatric comorbidities, and behavioral features were collected. Among 140 adolescents who sought treatment, 56 (40%) received inpatient care. The mean age was 16.2 +/- 1.3 years, and 60.7% were female. The mean age at first use was 12.3 +/- 1.9 years for cigarettes, 14.1 +/- 1.7 years for substances, and 13.6 +/- 1.8 years for alcohol. Polysubstance use was reported by 60.7% of patients. Cannabis, synthetic cannabinoids, and methamphetamine were the most commonly used substances. Running away from home (76.8%), legal/criminal involvement (64.3%), suicide attempts (55.4%), and self-harming behaviors (67.9%) were frequent. Female adolescents were significantly more likely than males to have a history of running away, institutional placement, and suicide attempts (p < 0.05). This study of adolescents in Turkish inpatient substance treatment reveals early polysubstance use and complex psychosocial risks. The heightened suicidality among females calls for gender-specific care, emphasizing the critical need for early prevention and comprehensive rehabilitation.
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    Synthetic Cannabinoid Use is Associated with Higher Systemic Inflammatory Indices than Cannabis Use in Adolescents
    (Springer, 2026) Tunagur, Mustafa Tolga; Kurt Tunagur, Elif Merve
    The growing use of cannabis and synthetic cannabinoids (SCs) among adolescents raises concerns about their distinct physiological effects. This retrospective case-control study evaluated systemic inflammatory indices in 88 adolescents with cannabinoid use disorder (CUD) (mean age = 16.42 +/- 1.06 years; 51.1% male)-subdivided into Cannabis-CUD, SC-CUD, and Dual-CUD groups-compared with 50 healthy controls (mean age = 16.14 +/- 0.80 years; 40% male). & Idot;nflammatory indices, neutrophil-, basophil-, monocyte-, and platelet-to-lymphocyte ratios (NLR, BLR, MLR, PLR, dNLR, and NLPR), and systemic inflammatory indices (SII, SIRI, and AISI), were analyzed using ANOVA and ROC curve analysis. NLR, dNLR, BLR, SII (all p < .001), and NLPR, PLR, SIRI, AISI (p < .05) were significantly higher in the CUD group compared to healthy controls. Compared to controls, SC-CUD showed significantly higher inflammatory indices (p < 0.001 for NLR, BLR, and SII), while Dual-CUD showed moderate elevations (p = 0.009, p = 0.027, and p = 0.003 for NLR, BLR, and SII, respectively). For cannabis-CUD, BLR was the only marker that significantly differed from controls (p = 0.019). ROC analysis identified BLR (AUC = 0.72), SII (AUC = 0.71), and NLR (AUC = 0.70) as the strongest predictors of CUD. These findings highlight the comparatively higher inflammatory indices observed in the synthetic cannabinoid groups and suggest that blood-based indices may help identify adolescents at elevated physiological risk associated with cannabinoid use.
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    Systemic inflammatory indices as biomarkers in adolescents with methamphetamine use disorder: a case-control study
    (Routledge Journals, Taylor & Francis Ltd, 2025) Tunagur, Mustafa Tolga; Kurt Tunagur, Elif Merve
    Background Despite the rising prevalence of methamphetamine use disorder (MUD) among adolescents and its severe consequences, data on hematological inflammatory indices in this population remain limited. Objectives This study aimed to evaluate systemic inflammatory markers in adolescents with MUD and their associations with addiction severity. Methods The retrospective case-control study included 44 adolescents with MUD and 44 age- and gender-matched healthy controls. Hematological indices were calculated from complete blood count data, including neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), Basophil-to-lymphocyte ratio (BLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). Group comparisons, receiver operating characteristic (ROC) analyses, and partial correlations were performed. Results The MUD group included 30 females (68.2%) and 14 males (31.8%); the control group included 25 females (56.8%) and 19 males (43.2%). Adolescents with MUD showed significantly higher neutrophil and platelet counts, NLR, dNLR, PLR, MLR, SII, SIRI, and AISI, alongside reduced lymphocyte counts, compared with controls (all p < .05). ROC analyses revealed good discriminative ability for SII (AUC = 0.79), AISI (AUC = 0.73), and SIRI (AUC = 0.69). Several indices, including NLR, PLR, and SII, correlated negatively with treatment motivation, while PLR and MLR correlated positively with diagnostic severity. Conclusions Adolescents with MUD demonstrate marked systemic inflammatory alterations detectable through routine hematological indices. These markers may serve as low-cost, clinically accessible biomarkers for identifying high-risk individuals and monitoring disease severity, with implications for early intervention and personalized treatment.