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Mijatović Jovin V, Dickov I, Ratković D, Dickov A, Tomas A. Synthetic cannabinoids awareness among patients with opioid use disorder in Serbia - A survey based cross-sectional pilot study. Front Psychiatry 2023; 14:987726. [PMID: 36960457 PMCID: PMC10028092 DOI: 10.3389/fpsyt.2023.987726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/18/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction There is limited data on the awareness and use of synthetic cannabinoids (SCs) in high-risk population in Serbia, despite SCs becoming more and more common at illicit drug market. Aim This pilot study aimed to examine the awareness and prevalence of use of SCs in patients with an opioid-use disorder and to identify patient characteristics and other factors associated with SCs use. Patients and methods This cross-sectional study was conducted at the Clinic for Psychiatry, Clinical Center Vojvodina, Serbia, the largest tertiary health care institution in this region of the country. All patients hospitalized due to the treatment of opioid dependence during November and December 2017 were included (response rate 100%), and filled-out an anonymous questionnaire specifically developed for the purpose of this study. Differences between patients reporting SCs use and those who did not were compared using chi-square test with values of p < 0.05 were considered significant. Results Out of 64 patients (median age 36.37 years), one third (32.81%) reported using SCs. Socio-demographic characteristics of the subjects were not associated with SCs use. There were differences in the most common sources of information reported between the SCs users and non-users. Majority of SCs users (76.0%) were informed about SCs through friends, compared with just 26.0% of non-users (<0.001). Nearly all study participants (93.8%) were daily tobacco users. The share of respondents reporting alcohol and marihuana use was significantly higher among the SCs users (52.0% vs. 20.9%, p = 0.011 and 15.6% vs. 12.5%, p = 0.015), respectively. Higher share of SCs users used multiple psychoactive substances (38.1% vs. 16.3%), and this difference was statistically significant (p = 0.047). The most commonly reported adverse effect of SCs among users included dry mouth (81.0%), trouble thinking clearly (52.4%) and panic attacks (52.4%). Conclusion Understanding the awareness and use of SCs among high-risk drug users, as well as associated factors can help improve substance-use disorder treatment in our setting. Educational activities targeting public are urgently needed to raise awareness on SCs, considering that social contacts are the main sources of information on SC for this vulnerable population. Users of SCs have also reported using other psychoactive substances more often, and this calls for a holistic approach addressing multiple factors to improve substance-use treatment in our setting.
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Affiliation(s)
- Vesna Mijatović Jovin
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- *Correspondence: Vesna Mijatović Jovin,
| | - Isidora Dickov
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinic for Gynecology and Obstetrics, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Dragana Ratković
- Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinic for Psychiatry, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Aleksandra Dickov
- Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinic for Psychiatry, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Ana Tomas
- Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
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Kühnl R, Aydin D, Horn S, Olderbak S, Verthein U, Kraus L. Taking the cat-and-mouse game to the next level: different perspectives on the introduction of the German New Psychoactive Substances Act. Harm Reduct J 2022; 19:122. [PMID: 36329471 PMCID: PMC9632031 DOI: 10.1186/s12954-022-00704-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/13/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To counteract the spread of new psychoactive substances (NPS) and to prevent the emergence of novel substances, specifically designed as a response to the legal control of individual substances, a new law was introduced in Germany in 2016: the New Psychoactive Substances Act (NpSG). The NpSG combines a generic approach with the waiver of criminal liability for the acquisition and possession of NPS for personal use, which is a novelty in German narcotics law. The present study aimed at exploring the impact of the introduction of the NpSG from three different perspectives-NPS users, staff of addiction care facilities, and members of law enforcement authorities-to better understand the dynamics surrounding such a change in legislation and to contribute to the body of international experience in dealing with NPS. METHODS Semi-structured narrative interviews were conducted with a total of 193 representatives of the three different groups affected by the law. These interviews included questions on perceived changes associated with the introduction of the NpSG as well as questions on opinions regarding legal and criminal policy issues. The analysis was carried out using qualitative content analysis according to Mayring. RESULTS Most interviewees welcomed the non-criminalisation approach of the NpSG but also noticed that, in practice, not much has changed for users. Nevertheless, the changes in legislation have had an impact on the market. For example, novel substances have emerged circumventing the new legislation. According to users, this has led some to reduce NPS use and others to adopt more hazardous consumption patterns. Overall, most respondents did not expect the introduction of the NpSG to bring any significant changes. CONCLUSIONS Although the idea of non-criminalisation inherent to the NpSG is appreciated and the generic approach has been well implemented in the law, thus covering a wide range of substances, the introduction of the law-perhaps for that very reason-has also had unintended and negative consequences, taking the cat-and-mouse game to the next level. To end the game, or at least to defuse the game situation, a combination of different strategies will be necessary, with legislation always playing a key role.
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Affiliation(s)
- Regina Kühnl
- IFT Institut für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany.,Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89069, Ulm, Germany
| | - Darya Aydin
- IFT Institut für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany
| | - Sabine Horn
- Unit III.5 Criminal Law, Criminal Procedural Law and Criminal Politics, German Police University, Zum Roten Berge 18-24, 48165, Muenster, Germany
| | - Sally Olderbak
- IFT Institut für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany.,Psychology Department, University of Arizona, 1503 E University Blvd., Tucson, AZ, 85721, USA
| | - Uwe Verthein
- Department of Psychiatry and Psychotherapy, Centre of Interdisciplinary Addiction Research, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Leopoldstraße 175, 80804, Munich, Germany. .,Department of Public Health Sciences, Centre for Social Research on Alcohol and Drugs, Stockholm University, 106 91, Stockholm, Sweden. .,Institute of Psychology, ELTE Eötvös Loránd University, Egyetem tér 1-3, 1053, Budapest, Hungary.
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Deen AA, Claridge H, Treble RD, Hamnett HJ, Copeland CS. Deaths from novel psychoactive substances in England, Wales and Northern Ireland: Evaluating the impact of the UK psychoactive substances act 2016. J Psychopharmacol 2021; 35:1315-1323. [PMID: 34182812 PMCID: PMC8600590 DOI: 10.1177/02698811211026645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND 'Legal highs' began appearing in the UK in the mid-2000s. Whilst many of these substances were controlled under the 1971 Misuse of Drugs Act, novel compounds and new variants of controlled compounds were continuously being introduced to the recreational drug market. The Psychoactive Substances Act (PSA) was therefore implemented in 2016 as a blanket ban on all novel psychoactive substances (NPS). AIM To evaluate the impact of the PSA on deaths following NPS use in England, Wales and Northern Ireland. METHODS Cases reported to the National Programme on Substance Abuse Deaths where death had occurred 3 years pre- or post-implementation of the PSA were extracted. Cases with NPS detected at post-mortem were analysed and compared against cases non-NPS cases. RESULTS 293 deaths with NPS detected were identified; 91 occurring before the PSA and 202 afterwards, indicating an 222.0% post-PSA increase. Contrastingly, non-NPS drug-related death case reporting increased by only 8.0%. Synthetic cannabinoid, anxiolytic/sedative and stimulant NPS were detected in the largest proportions of deaths pre-PSA; post-PSA stimulant NPS detections reduced whilst synthetic cannabinoid and anxiolytic/sedative detections increased.Post-PSA, average decedent age increased significantly (mean age pre-PSA 34.4 ± 10.8 vs post-PSA 38.3 ± 9.4), and they were significantly more likely to have been living in deprived areas (pre-PSA 50.0% vs post-PSA 65.9%). CONCLUSIONS Reporting of deaths following NPS use has risen despite introduction of the PSA. Whilst deaths amongst younger individuals and those living in more affluent areas has reduced, additional approaches to prohibition are needed to curb their persistence in deprived demographics.
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Affiliation(s)
- Adrian A Deen
- Institute of Pharmaceutical Sciences,
King’s College London, London, United Kingdom
| | - Hugh Claridge
- Population Health Research Institute,
St George’s, University of London, London, United Kingdom
| | | | - Hilary J Hamnett
- School of Chemistry, University of
Lincoln, Lincoln, United Kingdom
| | - Caroline S Copeland
- Institute of Pharmaceutical Sciences,
King’s College London, London, United Kingdom,Population Health Research Institute,
St George’s, University of London, London, United Kingdom,Caroline S Copeland, Institute of
Pharmaceutical Sciences, King’s College London, Franklin Wilkins Building,
Stamford Street, London, SE1 9 NH, United Kingdom.
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