Prevalence and predictors of club drug use among club-going young adults in New York city

Self-administration acquisition latency predicts locomotor sensitivity to cocaine in male rats

Individual differences in drug use emerge soon after initial exposure, and only a fraction of individuals who initiate drug use go on to develop a substance use disorder. Variability in vulnerability to establishing drug self-administration behavior is also evident in preclinical rodent models. Latent characteristics that underlie this variability and the relationship between early drug use patterns and later use remain unclear. Here, we attempt to determine whether propensity to establish cocaine self-administration is related to subsequent cocaine self-administration behavior in male Sprague-Dawley rats (n = 14). Prior to initiating training, we evaluated basal locomotor and anxiety-like behavior in a novel open field test. We then trained rats to self-administer cocaine in daily 3 h cocaine (0.75 mg/kg/infusion) self-administration sessions until acquisition criteria (≥30 active lever presses with ≥70 % responding on the active lever in one session) was met and divided rats into Early and Late groups by median-split analysis based on their latency to meet acquisition criteria. After each rat met acquisition criteria, we gave them 10 additional daily cocaine self-administration sessions. We then conducted a progressive ratio, cocaine-induced locomotor sensitivity test, and non-reinforced cocaine seeking test after two weeks of forced abstinence. Early Learners exhibited significantly less locomotion after an acute injection of cocaine, but the groups did not differ in any other behavioral parameter examined. These results indicate that cocaine self-administration acquisition latency is not predictive of subsequent drug-taking behavior, but may be linked to physiological factors like drug sensitivity that can predispose rats to learn the operant task.

Sex work, syndemic conditions and condomless anal intercourse among men who have sex with men who engage in sex work in Latin America

Background In Latin American countries and Suriname, sexual transmission is one of the most common modes of HIV transmission, and men who have sex with men (MSM) who engage in sex work constitute a key population. Methods In a sample of MSM (N =53,166) from the Latin American Internet Survey (2018) across 18 countries, we examined how sex work engagement is associated with syndemic conditions (multidrug use, homophobic abuse, depression/anxiety, alcohol dependency (CAGE alcohol questionnaire) and internalised homonegativity) and condomless anal intercourse with non-steady male partners using separate logistic regressions. We then used a structural equation model to determine if and how syndemic conditions mediate the relationship between sex work engagement and non-steady male partners. Results We found that getting paid for sex was associated with less condom use for anal intercourse with non-steady male partners and particular syndemic conditions, such as multidrug use, homophobic abuse and alcohol dependency. In our structural equation model, the results showed that the direct relationship between sex work engagement and non-steady male partners was positive and significant, and syndemic conditions partially mediated this relationship. Conclusion Our results highlight the continuing need for including MSM who engage in sex work and those who experience syndemic conditions in the prevention strategies targeted to MSM in Latin America and Suriname, to prevent the transmission of HIV.

An Analysis of Tobacco and Marijuana Use by Middle School and High School Bisexual and Homosexual Students Surveyed by the National Youth Tobacco Survey From 2020 to 2022

OBJECTIVES

This study aimed to analyze tobacco and marijuana use by middle and high school students identifying as bisexual, gay, lesbian, or heterosexual using data from the National Youth Tobacco Survey (NYTS) spanning from 2020 to 2022. By comparing substance use patterns among different sexual orientation groups, the study sought to identify disparities and potential socioeconomic factors influencing these behaviors.

METHODS

Data from the 2020 to 2022 NYTS were analyzed, focusing on responses regarding ever use of cigarettes, e-cigarettes, and marijuana by students of varying sexual orientations. Descriptive statistics and chi-square tests were employed to analyze differences in substance use and socioeconomic indicators between sexual orientation groups.

RESULTS

Of the 37 541 students included in the analysis, significant differences in substance use were observed among bisexual, gay, lesbian, and heterosexual students. Bisexual and gay/lesbian students exhibited higher rates of ever use of cigarettes, e-cigarettes, and marijuana compared to heterosexual students. In addition, socioeconomic differences, such as lower rates of family vehicle ownership and reduced access to vacations, were noted among bisexual and gay/lesbian students.

CONCLUSIONS

The findings underscore significant differences in tobacco and marijuana use by adolescents based on sexual orientation, mirroring differences observed in LGBTQ adults. These results highlight the importance of targeted interventions, educational initiatives, and support systems tailored to the unique needs of LGBTQ youth. Addressing socioeconomic disparities and fostering inclusive environments are crucial steps in promoting the health and well-being of LGBTQ adolescents. Continued research and collaborative efforts are essential in mitigating health disparities and creating equitable environments for all adolescents.

Trends in reported and biologically confirmed drug use among people who use ecstasy in the nightclub/festival-attending population, 2016-2022

Background

Nightclub/festival attendees are a population with high rates of party drug use, but research is needed to determine whether there have been shifts in unintended drug exposure in this population (e.g., via adulterants) to inform prevention and harm reduction efforts.

Methods

Adults entering nightclubs and festivals in New York City were asked about past-year drug use in 2016 through 2022, with a subset providing a hair sample for testing. We focused on the 1943 who reported ecstasy use (of which 247 had a hair sample analyzed) and compared trends in self-reported drug use, drug positivity, and adjusted prevalence (adjusting for unreported use).

Results

MDMA positivity decreased from 74.4 % to 42.3 %, and decreases occurred regarding detection of synthetic cathinones ("bath salts"; a 100.0 % decrease), MDA (a 76.9 % decrease), amphetamine (an 81.3 % decrease), methamphetamine (a 64.2 % decrease), and ketamine (a 33.4 % decrease) (ps < .05). Although prevalence of MDA and synthetic cathinone use was comparable between self-report and adjusted report in 2022, gaps in prevalence were wider in 2016 (ps < .01). Adjusted prevalence of synthetic cathinone use decreased more across time than prevalence based on self-report (a 79.4 % vs. 69.1 % decrease) and adjusted report for MDA use decreased more than prevalence based on self-report (a 50.6 % vs. 38.9 % decrease).

Conclusions

Combining self-report and toxicology tests helped us determine that decreases in drug use/exposure were steeper regarding adjusted prevalence. Underreported drug exposure-possibly due to exposure to adulterants-appears to have had less of an effect on prevalence in 2022 than it did in 2016.

Can research on entactogens contribute to a deeper understanding of human sexuality?

In recent years, scientific research into the therapeutic potential of psychedelic compounds has experienced a resurgence of interest. New studies have shown promising results, supporting the use of psychedelic drugs in treating various psychiatric disorders, including treatment-resistant depression, post-traumatic stress disorder, and even alcohol addiction. The FDA has recognized 3,4-methylenedioxymethamphetamine (MDMA) as a breakthrough therapy to treat symptoms of post-traumatic stress disorder. At the same time, interviews with recreational MDMA users have documented experiences of emotional intimacy while using MDMA, often without the desire for penetrative sex. However, some people have reported that MDMA increases their sexual arousal and specifically use it to enhance their sexual performance. This study aims to analyze current and planned research on the psychophysiological effects of entactogens on human sexuality. With their prosocial potential, the pharmacokinetic and neuroendocrine effects of entactogens may recreate the subjective experience of emotional intimacy, the initiation of intimate relationships, or even feelings of 'falling in love' with previously neutral individuals while under the influence of entactogens. This includes MDMA-induced sexual arousal-like effects observed through subjective behavioral perceptions of desire and arousal and specific physiological markers such as oxytocin and prolactin. Modern MDMA-assisted psychotherapy (MDMA-AP) protocols are transparent and follow strict ethical guidelines. However, despite these proposed ethical principles, little consideration has been given to the potential neurobehavioral effects of entactogens on the sexuality of participants in MDMA-AP protocols. The psychophysiological and sexual effects of entactogens should be discussed more openly in current MDMA-AP protocols, including the potential experience of the phenomenon of sexualized pharmacotransference.

Prevalence and Correlates of Past Year Ecstasy/MDMA Use in the United States

OBJECTIVES

3,4-Methylenedioxymethamphetamine (MDMA) (also known as "ecstasy" or "Molly") has regained attention in recent years for its efficacy in treating posttraumatic stress disorder, and the drug was granted breakthrough therapy designation for such use by the US Food and Drug Administration in 2017. However, little is known about the current epidemiology of recreational ecstasy/MDMA use.

METHODS

We estimated past-year prevalence and correlates of ecstasy/MDMA use based on a representative sample of noninstitutionalized US individuals 12 years or older from the 2015-2020 National Survey on Drug Use and Health (N = 315,661).

RESULTS

An estimated 0.9% (95% confidence interval [CI] = 0.9-1.0) of individuals used ecstasy/MDMA in the past year. Compared with those ages 35-49 years, all younger age groups were at increased odds for use, while those older than 50 years (adjusted odds ratio [aOR] = 0.14, 95% CI = 0.08-0.23) were at low odds for use. Compared with heterosexual men, those identifying as bisexual women (aOR = 1.32, 95% CI = 1.02-1.72) were at increased odds for use, and compared with White individuals, those identifying as Asian (aOR = 1.92, 95% CI = 1.42-2.59), Black (aOR = 1.70, 95% CI = 1.41-2.06), or multiracial (aOR = 1.61, 95% CI = 1.19-2.16) were at increased odds for use. Past-year use of other drugs (e.g., cannabis, ketamine), prescription drug misuse (e.g., pain relievers, stimulants), nicotine dependence (aOR = 1.21, 95% CI = 1.00-1.45), and alcohol use disorder (aOR = 1.41, 95% CI = 1.25-1.58) were also associated with increased odds for use.

CONCLUSIONS

While use of ecstasy/MDMA continues to be relatively rare, findings from this study can help inform prevention and harm reduction strategies, especially among certain subpopulations that are at high risk for use.

Trends and correlates of discordant reporting of drug use among nightclub/festival attendees, 2019-2022

INTRODUCTION

People who attend nightclubs and festivals are known for high prevalence of party drug use, but more research is needed on underreporting in this population, in part because unintentional drug exposure through adulterated drug products is common. We examined the prevalence of drug use in this population, based both on self-reporting and on hair test results, with a focus on the detection of underreported use.

METHODS

Adults entering nightclubs and festivals in New York City were asked about past-year drug use in 2019-2022 (n = 1,953), with 328 providing an analyzable hair sample for testing. We compared trends in self-reported drug use, drug positivity, and "corrected" prevalence, adjusting for unreported use, and delineated correlates of testing positive for ketamine and cocaine after not reporting use (discordant reporting).

RESULTS

Of the 328 who provided a sample, cocaine and ketamine were the most frequently detected drugs (55.2% [n = 181] and 37.2% [n = 122], respectively), but these were also the two most underreported drugs, with 37.1% (n = 65) and 26.4% (n = 65), respectively, testing positive after not reporting use. Between 2019 and 2022, positivity decreased for cocaine, ketamine, 3,4-methylenedioxy-metamfetamine, and amfetamine, and underreported exposure to cocaine and ketamine also decreased (P < 0.05). Underreporting of the use of these drugs was common, but we also detected underreported exposure to ethylone, fentanyl, 3,4-methylenedioxyamfetamine, metamfetamine, and synthetic cannabinoids. Prevalence of discordant reporting of cocaine use was higher among those testing positive for ketamine exposure (adjusted prevalence ratio = 2.63; 95% CI: 1.48-4.69) and prevalence of discordant reporting of ketamine use was lower post-coronavirus disease caused by the SARS-CoV-2 virus (adjusted prevalence ratio = 0.39; 95% CI: 0.16-0.91) and among those reporting cocaine use (adjusted prevalence ratio = 0.53; 95% CI: 0.32-0.89).

DISCUSSION

Underreporting of drug use was common, suggesting the need for researchers to better deduce intentional underreporting versus unknown drug exposure via adulterants.

CONCLUSIONS

Researchers should consider both self-report and toxicology results from biological samples when examining trends in use.

Prevalence and Correlates of GHB Use among Adults in the United States

Gamma-hydroxybutyrate (GHB) was a somewhat prevalent club drug two decades ago, but research has been lacking regarding the current epidemiology of use. In this study, prevalence and correlates of past-year GHB use were estimated based on noninstitutionalized US adults participating in the 2015-2020 National Survey of Drug Use and Health (N= 241,675). An estimated 0.05% (95% CI: 0.04-0.07) of adults in the US have used GHB in the past year. Compared to those age 18-25, those age 35-49 were at increased odds for use (aOR = 2.28, 95% CI: 1.02-5.10), and compared to heterosexual men, gay men in particular were at high odds for use (aOR = 27.82, 95% CI: 11.09-69.80). Those identifying as bisexual men (aOR = 3.39, 95% CI: 1.17-9.82) and lesbian/bisexual women (aOR = 3.37, 95% CI: 1.44-7.90) were also at high odds for use. Despite all drugs examined being significant correlates of use in bivariable models (ps < .001), only past-year use of methamphetamine (aOR = 15.68, 95% CI: 7.40-33.25), ketamine (aOR = 8.52, 95% CI: 2.67-27.20), and ecstasy (aOR = 4.41, 95% CI: 1.80-10.75) was associated with increased odds of use in the multivariable model. Results suggest that GHB use is currently rare, but gay men and people who use other party drugs are at particularly high risk for use.

Trends in drug use among nightclub and festival attendees in New York City, 2017-2022

BACKGROUND

Drug use is prevalent among people who attend electronic dance music (EDM) parties at nightclubs or festivals. This population can serve as a sentinel population to monitor trends in use of party drugs and new psychoactive substances (NPS) that may diffuse through larger segments of the population.

METHODS

We surveyed adults entering randomly selected EDM parties at nightclubs and dance festivals in New York City about their drug use in 2017 (n=954), 2018 (n=1,029), 2019 (n=606), 2021 (n=229), and 2022 (n=419). We estimated trends in past-year and past-month use of 22 drugs or drug classes based on self-report from 2017-2022 and examined whether there were shifts pre- vs. post-COVID (2017-2019 vs. 2021-2022).

RESULTS

Between 2017 and 2022, there were increases in past-year and past-month use of shrooms (psilocybin), ketamine, poppers (amyl/butyl nitrites), synthetic cathinones ("bath salts"), and novel psychedelics (lysergamides and DOx series), increases in past-year cannabis use, and increases in past-month use of 2C series drugs. Between 2017 and 2022, there were decreases in past-year heroin use and decreases in past-month cocaine use, novel stimulant use, and nonmedical benzodiazepine use. The odds of use of shrooms, poppers, and 2C series drugs significantly increased after COVID, and the odds of use of cocaine, ecstasy, heroin, methamphetamine, novel stimulants, and prescription opioids (nonmedical use) decreased post-COVID.

CONCLUSIONS

We estimate shifts in prevalence of various drugs among this sentinel population, which can inform ongoing surveillance efforts and public health response in this and the general populations.

Age-related patterns of cocaine and methamphetamine use across the life course in the United States: Disparities by gender and sexual identity among adults

PURPOSE

Research showing substance use decreases over the life course has focused primarily on heterosexual adults. We examined how age-related patterns of cocaine and methamphetamine use vary by sexual identity and gender among a national sample.

METHODS

We included 191,954 adults aged 18-64 from the 2015-2019 National Survey on Drug Use and Health. We described the weighted prevalence of past-year cocaine and methamphetamine use and used logistic regressions to estimate relative odds of past-year cocaine and methamphetamine use by age, stratified by gender and sexual identity (heterosexual, gay/lesbian, bisexual).

RESULTS

Cocaine and methamphetamine use was highest among lesbian, gay, and bisexual (LGB) adults compared to their heterosexual counterparts. Gay/lesbian men and women and bisexual men were also more likely to use cocaine at later ages. Heterosexual adults ages 26-34 (adjusted odds ratio [aOR] = 0.73; confidence interval [CI] = 0.65-0.83) were less likely than those 21-25 to report past-year cocaine use, but there were no differences between those ages 26-34 and 21-25 among any LGB sub-group. Heterosexual (aOR = 1.62; CI = 1.28-2.04) and gay (aOR = 2.93; CI = 1.26-6.80), men ages 26-34 were more likely to report past-year methamphetamine use than their counterparts ages 21-25. There were no age-related differences in past-year methamphetamine use between bisexual men and gay/lesbian women.

CONCLUSIONS

Patterns of cocaine and methamphetamine use across the life course for LGB individuals differ from those of heterosexuals. This has implications for targeted prevention efforts to address stimulant use among minoritized populations.

Cannabis Use, Use Motives and Cannabis Use Disorder Among Berlin College Students

This study described cannabis use behavior among college students in Berlin, in particular, differences in use motives between subjects with frequent use and those with signs of cannabis use disorder (CUD). Cross-sectional data were collected via an online survey among Berlin college students ( N=9350; 50.7% women; Mage=24.4). Motivation scales were computed based on an exploratory factor analysis. Effects of these motive scales were compared using multivariate regression models, where the dependent variable was use intensity (ordinal), frequent use (twice or more per week, binary) or a positive substance use disorder screening test (binary). Cannabis use is known to be particularly prevalent among Berlin college students, which was confirmed by our data. The most frequent use motive was enhancement, which, however, was not associated with frequent use or CUD. The motives predicting frequent use (sociability) are different from motives predicting CUD (coping), even when controlling for a wide array of covariates.

Sexual Orientation and Age of First Drug Use Among Adults in the United States

BACKGROUND

Early onset of drug use could lead to long-term impairments, and research suggests that substance use and substance use disorders are more common among lesbian, gay, and bisexual (LGB) individuals. We sought to determine whether adults of different sexual identities were at differential risk for an earlier onset of drug use.

METHODS

We examined data from adults participating in the five waves (2015-2019) of the National Survey on Drug Use and Health, a nationally representative sample of noninstitutionalized adults in the United States. We determined whether current sexual identity was associated with retrospectively reported age of the first use of marijuana, cocaine, inhalants, ecstasy, and methamphetamine.

RESULTS

Compared to heterosexual individuals of the same sex, gay men had a later age of onset of use of all five drugs examined (marijuana, cocaine, inhalants, ecstasy, and methamphetamine) and bisexual men had a later onset of marijuana and inhalant use. Bisexual women had earlier age of onset for marijuana, cocaine, and ecstasy use. When examining early initiation (prior to age 15), both lesbian and bisexual women had greater odds of early initiation for marijuana, cocaine, and ecstasy; bisexual men had greater odds of early initiation for cocaine. Gay men had lower odds of initiation prior to age 15 for marijuana, inhalants, and methamphetamine.

CONCLUSIONS

Current sexual identity is a correlate of earlier onset drug use. Longitudinal research is needed to further examine such associations as sexual identity can shift over time. Results are discussed in relation to prevention efforts aiming younger LGB persons.

No Good Time Without Drugs: Qualitative Study Among Nightlife Attendees in Tbilisi, Georgia

INTRODUCTION

Individuals who visit nightclubs and electronic dance music (EDM) festivals tend to use psychoactive substances, often multiple substances, in this setting and are at risk of serious negative health effects. This paper aims to explore respondents' experiences and perceptions in order to have a better understanding of patterns and motives related to psychoactive substance use and high-risk behaviours in EDM event attendees.

METHODS

In-depth and focus group interviews with 30 EDM event attendees who reported psychoactive substance use at nightlife events. The data was analysed using the Nvivo-v.10 software.

RESULTS

Mixing multiple substances to get the desired effects was common. Ecstasy was often combined with Jager (alcohol). Drug use in nightlife settings occurred in a group of friends and was perceived as an essential part of having a good time. Most participants reported that they did not use drugs outside nightlife settings. The dangerous synthetic hallucinogen NBOMe was still on the scene. The respondents had a very low level of knowledge about, and perception of, the risks associated with drug consumption. Knowledge about risk minimisation strategies was very low or non-existent.

CONCLUSIONS

Polydrug use and a lack of perceived harmful effects put drug-using nightlife attendees at increased risk of negative health consequences. Future research should focus on identifying strategies to raise the awareness of people who use drugs in nightlife settings and encourage them to employ health protection strategies. Using the social network infrastructure can be thought of as one potentially beneficial approach.

Concerts, bars, parties, and raves: Differential risk for drug use among high school seniors according to venue attendance

Background: Nightlife attendance is an established risk factor for drug use, but studies have not focused on adolescent general population samples or compared risk according to type(s) of venues attended. We examined whether attendance of various types of venues was associated with drug use. Methods: Data were examined from an annual nationally representative survey of high school seniors in the US (2014-2019, N = 11,565). We determined whether past-year attendance of parties, concerts, bars or nightclubs, and raves or dance music events was associated with past-year drug use using mixed-effects logistic regression. Mall and movie attendance were examined as negative controls. Results: Compared to those who reported not attending specific venues, attending parties was associated with higher odds of using alcohol in particular (aOR = 5.03, 95% CI: 3.92-6.44). Attending concerts was associated with higher odds for use of alcohol, cannabis, ecstasy, and nonmedical use of prescription stimulants and opioids. All drugs examined were concentrated among those who attend bars, nightclubs, raves, and dance parties. Rave or dance party attendance was associated with higher odds for use of ecstasy (aOR = 3.71, 95% CI: 2.50-5.50) and methamphetamine (aOR = 4.92, 95% CI: 2.43-9.96) in particular, and bar or nightclub attendance was associated with higher odds of use of cocaine (aOR = 6.49, 95% CI: 4.37-9.63), ecstasy (aOR = 6.49, 95% CI: 4.54-9.27), and methamphetamine (aOR = 5.49, 95% CI: 2.57-11.72) in particular. Attending movies was associated with lower odds for use of cocaine and nonmedical prescription stimulant use. Conclusion: We determined differential risk of drug use depending on types of venues attended by adolescents.

Uso de club drugs entre estudantes de graduação: prevalência, características associadas e a influência dos pares

RESUMO Objetivo Medir a prevalência do uso na vida, no último ano e no último mês de duas club drugs – o ecstasy e o LSD –, bem como as características associadas ao uso dessas substâncias, no último mês, entre estudantes de graduação de uma universidade no Sul do Brasil. Métodos Trata-se de um estudo transversal conduzido no ano de 2015 com amostragem aleatória sistemática por conglomerados. Participaram 1.423 estudantes de graduação. Foi utilizado um modelo de análise multivariável em três níveis hierárquicos por meio da regressão de Poisson com ajuste robusto da variância. Resultados As prevalências de uso na vida, no último ano e no último mês de club drugs foram de 12,7%, 7,8% e 3,8%, respectivamente. Indivíduos do sexo masculino, com orientação sexual homossexual ou bissexual, mais jovens, que moravam com seus pares, solteiros, e que relataram uso no último mês de tabaco e maconha apresentaram maior probabilidade de ter feito uso no último mês de alguma club drug. Entretanto, a variável mais fortemente associada a esse desfecho foi ter algum amigo que já fez uso de alguma droga ilícita na vida (RP = 19,54). Conclusões O ambiente universitário parece ser um terreno fértil para a difusão do uso de club drugs. O fortalecimento de uma rede de apoio institucional da universidade, capaz de propor atividades de prevenção, bem como de identificar, acolher e encaminhar casos em que haja abuso e dependência dessas substâncias, pode ser uma estratégia importante para lidar com essa problemática.

Cocaine Rituals in Club Culture: Intensifying and Controlling Alcohol Intoxication

Clubbing is an important part of the nighttime economy, and cocaine use is, for some young people, an essential part of this clubbing culture. However, the interaction rituals around the use of powder cocaine in this context remain understudied. This study is based on qualitative interviews with young adult recreational cocaine users ( n = 28) and explores how they use cocaine in club settings, in relation to rituals and drinking culture. The analysis identified three main explanations for using cocaine: (a) unity with friends because of shared transgression, (b) the high as a “collective effervescence,” and (c) the possibility to control, extend, and intensify drinking to intoxication. These three explanations illustrate how cocaine rituals were deeply integrated in drinking-to-intoxication rituals, and how the illegality of cocaine use reinforced feelings of unity with friends. In the nighttime economy, cocaine use and its related rituals are used to intensify and control alcohol-fuelled partying.

Nightlife and Drug Use in Tbilisi, Georgia: Results of an Exploratory Qualitative Study

Tbilisi is fast becoming a regional hub for electronic dance music. This study describes the use of illicit psychoactive drugs by frequent nightclub visitors in a club setting. We conducted 16 qualitative in-depth interviews with young nightclubbers with a history of drug use in Tbilisi. The majority of respondents had experience with two or more drugs consumed in a club setting, with the most prevalent substances being MDMA/ecstasy, amphetamines, and synthetic cannabinoids. Most respondents had limited information regarding the drugs they consumed. Often this information was provided by dealers or friends and was limited to the name of the drug (but not the substance) and its expected effects. Receiving often unknown substances from unknown people was prevalent. The majority of respondents reported combining psychoactive substances with alcohol, or mixing the use of other substances. Participants by their own account indicated a lack of knowledge about the adverse effects of drugs, as well as an ignorance of overdose signs and response strategies. Study findings may guide future efforts to investigate the prevalence and context of club drug use in the country, to assess health risks associated with it, and to propose strategies to mitigate those risks.

'Higher education' - substance use among Berlin college students

Berlin is internationally known for its intense nightlife associated with high rates of psychoactive substance use. Previous studies conducted in other cities indicated college students as a group at high risk for substance (mis-)use that was associated with individual psychological and cognitive impairments as well as lower academic performance. The aim of this study was to provide detailed data about the substance use patterns of Berlin college students. In addition, major protective and risk factors were analysed. An online questionnaire assessing sociodemographic data and various relevant aspects of both legal and illegal substance use such as consumption pattern and frequency as well as risk-taking behaviour was developed and distributed among colleges in Berlin. A sample of 9351 participants from 17 different colleges in Berlin completed the questionnaire. The study revealed high lifetime (69.3%), past year (45.9%) and past month (28.3%) prevalence of illicit substance use in the sample. Daily tobacco-smoking, a mental disorder diagnosis, a positive screening for problematic consumption (Cage-AID), bisexual orientation and living in open relationship were main factors positively associated with the prevalence and the extent of illicit substance use. Students in Berlin appear to show higher rates of illicit substance use than was previously reported for age-matched individuals in the general German population and college students in other cities. Thus, they are a relevant target group for early prevention and intervention concerning substance use and abuse.

Associations between sociodemographic characteristics and substance use disorder severity among methamphetamine-using men who have sex with men

Background: Men who have sex with men (MSM) have elevated rates of substance use disorders (SUDs) and differences across sociodemographic sub-groups of MSM are associated with a greater risk of deleterious outcomes. Although studies have shown that MSM report greater rates of polysubstance use relative to other adult populations, the associations between sociodemographic characteristics and both acute substance use and substance use severity among methamphetamine-using MSM are unknown. Objectives: The present study examines associations between sociodemographic characteristics and (a) recent substance use and (b) SUD severity. Method: From March 2014 to January 2016, 286 methamphetamine-using MSM were recruited to complete a baseline Audio Computer-Assisted Self-Interview (ACASI) assessment and the SCID MINI. Multivariable analyses employed generalized structural equation modeling given the non-continuous nature of the endogenous variables. Results: All measured sociodemographic characteristics except gay self-identification were significantly associated with recent substance use (all ps ≤ .05), and all characteristics except current homelessness were significantly associated with diagnostic SUD severity (all ps ≤ .05). However, nuanced risks were observed in participants' use of specific substances regarding recent substance use and substance use severity. Conclusion: These results suggest that multiple factors contribute to the risks of SUD severity among methamphetamine-using MSM. As such, these results are useful in the tailoring of clinical and psychosocial intervention strategies that serve this and other high-risk populations.

Sexual Orientation Disparities in Prescription Opioid Misuse Among U.S. Adults

INTRODUCTION

The opioid epidemic in the U.S. continues to increase in severity, and misuse of prescription opioids is of particular concern since it commonly precedes heroin use. This study examined whether sexual orientation (i.e., sexual identity and sexual attraction) is a risk factor for prescription opioid misuse and use disorder among a nationally representative sample of adults in the U.S.

METHODS

This study used data from adult participants (ages ≥18 years) in the 2015 National Survey on Drug Use and Health. Chi-square tests and logistic regression examined how sexual identity and sexual attraction relate to past-year and past-month prescription opioid misuse and past-year prescription opioid use disorder. Multivariable models examined associations controlling for demographic characteristics and other drug use. Gender-stratified analyses were also conducted. Data were analyzed in 2018.

RESULTS

In multivariable analyses, compared with those identifying as heterosexual, bisexual individuals were at 1.53 (95% CI=1.20, 1.97) and 1.66 (95% CI=1.14, 2.42) higher odds of reporting past-year and past-month misuse, respectively. In stratified analyses, female bisexuals remained at high risk. Regarding sexual attraction, compared with being attracted to only the opposite sex, being attracted to mostly the opposite sex (AOR=2.15, 95% CI=1.77, 2.63) or being equally attracted to both sexes (AOR=1.78, 95% CI=1.38, 2.30) were associated with higher odds for past-year opioid misuse. In stratified analyses, these associations were limited to females.

CONCLUSIONS

Sexual orientation disparities in opioid misuse and use disorder among a nationally representative sample of U.S. adults was found.

An mHealth Intervention to Improve Young Gay and Bisexual Men's Sexual, Behavioral, and Mental Health in a Structurally Stigmatizing National Context

BACKGROUND

Young gay and bisexual men (YGBM) in some Eastern European countries, such as Romania, face high stigma and discrimination, including in health care. Increasing HIV transmission is a concern given inadequate prevention, travel to high-prevalence countries, and popularity of sexual networking technologies.

OBJECTIVE

This study aimed to adapt and pilot test, in Romania, a preliminarily efficacious mobile health (mHealth) HIV-prevention intervention, created in the United States, to reduce HIV risk among YGBM.

METHODS

After an intervention formative phase, we enrolled 43 YGBM, mean age 23.2 (SD 3.6) years, who reported condomless sex with a male partner and at least 5 days of heavy drinking in the past 3 months. These YGBM completed up to eight 60-minute text-based counseling sessions grounded in motivational interviewing and cognitive behavioral skills training with trained counselors on a private study mobile platform. We conducted one-group pre-post intervention assessments of sexual (eg, HIV-risk behavior), behavioral (eg, alcohol use), and mental health (eg, depression) outcomes to evaluate the intervention impact.

RESULTS

From baseline to follow-up, participants reported significant (1) increases in HIV-related knowledge (mean 4.6 vs mean 4.8; P=.001) and recent HIV testing (mean 2.8 vs mean 3.3; P=.05); (2) reductions in the number of days of heavy alcohol consumption (mean 12.8 vs mean 6.9; P=.005), and (3) increases in the self-efficacy of condom use (mean 3.3 vs mean 4.0; P=.01). Participants reported significant reductions in anxiety (mean 1.4 vs mean 1.0; P=.02) and depression (mean 1.5 vs mean 1.0; P=.003). The intervention yielded high acceptability and feasibility: 86% (38/44) of participants who began the intervention completed the minimum dose of 5 sessions, with an average of 7.1 sessions completed; evaluation interviews indicated that participation was rewarding and an "eye-opener" about HIV risk reduction, healthy identity development, and partner communication.

CONCLUSIONS

This first mHealth HIV risk-reduction pilot intervention for YGBM in Eastern Europe indicates preliminary efficacy and strong acceptability and feasibility. This mobile prevention tool lends itself to broad dissemination across various similar settings pending future efficacy testing in a large trial, especially in contexts where stigma keeps YGBM out of reach of affirmative health interventions.

Willingness to provide a hair sample for drug testing among electronic dance music party attendees

Background: Nondisclosure of drug use on surveys is common, and many drug users unknowingly ingest adulterant or replacement drugs, which leads to underreporting of use of these drugs. Biological testing can complement survey research, and hair testing is an appealing method, as many drugs are detectable for months post-use. We examined willingness to donate a hair sample to be tested among those surveyed in a population at high risk for consuming adulterated drugs-electronic dance music (EDM) party attendees. Methods: We surveyed 933 adults entering EDM parties in New York City in 2017. Hair donation response rates and reasons for refusal were examined from this cross-sectional study. Results: A third (n = 312; 33.4%) provided a hair sample. Lack of interest (21.0%), lack of time (19.8%), not wanting a lock of hair cut (17.7%), and disinterest in having hair cut in public (13.8%) were the main reported reasons for refusal; 4.7% refused because they could not receive results. Past-year drug users were more likely to fear identification than nonusers (P < .001). Asian participants were at lower odds of providing a hair sample (adjusted odds ratio [aOR] = 0.53, 95% confidence interval [CI] = 0.32-0.87), and those reporting past-year use of LSD (aOR = 1.62, 95% CI = 1.11-2.35), opioids (nonmedical; aOR = 1.93, 95% CI = 1.25-2.99), and/or methamphetamine (aOR = 3.43, 95% CI = 1.36-8.62) were at higher odds of providing a sample than nonusers of these drugs. Conclusions: Only a third of participants provided a hair sample, and we found individual-level differences regarding willingness to provide a sample. Factors contributing to refusal should be considered to increase response rates and generalizability of results.

The Development of Ecstasy Use Among Juvenile Offenders and Risk Factors for Predicting Heterogeneity: A Group-Based Approach

This study seeks to examine heterogeneity in developmental patterns of ecstasy use during adolescence and early adulthood among juvenile offenders and identify risk factors predicting development. Group-based trajectory modeling was utilized to elucidate heterogeneity in developmental patterns of ecstasy use. Multinomial logistic regression was utilized to identify covariates that affected the risk of assignment to groups elucidated in the trajectory model. A five-group model was found to best fit the ecstasy use data. Baseline measures of deviant peer association, self-control, other drug use, and race were identified as important risk factors predicting patterns of development. Risk of ecstasy use may be greatest for some juvenile offenders during critical periods of the life course and some social and personal characteristics that may elevate risk. Stability that is characteristic of self-control may be highly relevant for predicting persistent ecstasy use during adolescence and early adulthood.

Nonmedical opioid use among electronic dance music party attendees in New York City

BACKGROUND

Nonmedical opioid use remains an epidemic in the United States. Electronic dance music (EDM) party attendees have been found to be at high risk for the use of drugs such as ecstasy, but little is known about nonmedical opioid use in this population.

METHODS

Using time-space sampling, we surveyed 954 individuals (ages 18-40) attending randomly selected EDM parties in New York City in 2017. Participants were asked about the use of 18 different opioids and about willingness to use if offered by a friend in the next 30 days. We estimated the prevalence of use in this population and examined correlates of past-year and past-month use.

RESULTS

Almost a quarter (23.9%) of EDM party attendees are estimated to have used opioids non-medically in their lifetime, and one out of ten (9.8%) in the past year. 5% are estimated to be current users (reporting past-month use), and 16.4% are willing to use opioids non-medically if offered by a friend in the next 30 days. Past-year nonmedical benzodiazepine users were at high odds for reporting current nonmedical opioid use (aOR = 10.11, p < 0.001) and, on average, report using more different opioid drugs in the past year than non-past-year-users (p = 0.012). Nearly three-quarters (73.6%) of those who have used in the past year indicated that they would use again if offered by a friend in the next 30 days.

CONCLUSION

Nonmedical opioid use is prevalent in the EDM scene and many attendees are willing to use if offered. Prevention efforts are needed in this high-risk population.

Polysubstance use profiles among electronic dance music party attendees in New York City and their relation to use of new psychoactive substances

BACKGROUND

Electronic Dance Music (EDM) party attendees are often polysubstance users and are at high risk for use of new psychoactive substances (NPS). We sought to identify patterns of use of common illegal drugs among EDM party attendees, sociodemographic correlates, and use of NPS as a function of patterns of use of more common drugs to inform prevention and harm reduction.

METHOD

Using time-space-sampling, 1045 individuals aged 18-40 were surveyed entering EDM parties in New York City. We queried past-year use of common illegal drugs and 98 NPS. We conducted latent class analysis to identify polysubstance use profiles of use of eight common drugs (i.e., ecstasy, ketamine, LSD, mushrooms, powder cocaine, marijuana, amphetamine, benzodiazepines). Relationships between drug classification membership and sociodemographics and use of drugs within six NPS categories were examined.

RESULTS

We identified four profiles of use of common drugs: non-polysubstance use (61.1%), extensive polysubstance use (19.2%), moderate polysubstance use/stimulants (12.8%), and moderate polysubstance use/psychedelics (6.7%). Those in the moderate/psychedelic group were at higher odds of using NPS with psychedelic-type effects (2C, tryptamines, and other "new" psychedelics; Ps<0.05). Extensive polysubstance users were at increased odds of reporting use of 2C drugs, synthetic cathinones ("bath salts"), tryptamines, other new (non-phenethylamine) psychedelics, new dissociatives, and synthetic cannabinoids (Ps<0.05).

CONCLUSION

NPS preference is linked to the profile of use of common drugs among individuals in the EDM scene. Most participants were identified as non-polysubstance users, but findings may help inform preventive and harm reduction interventions among those at risk in this scene.

GHB-involved crimes among intoxicated patients

INTRODUCTION

In recent years, the involvement of GHB in drug facilitated sexual assaults has been one of the most frequently studied aspects of GHB in both clinical and non-clinical settings. GHB-involved acquisitory crimes, however, can be mentioned as understudied research topics, as well as the poisoning severity properties of GHB.

MEASURES

The medical reports of Péterfy Sándor Street Hospital Clinic and Casualty Centre's 408 GHB-intoxication cases (352 patients) were reviewed and registered. Analyzed data consisted of epicrisis, serum and urine concentration of various substances (including GHB), scores of Glasgow Coma Scale and Poisoning Severity Score.

RESULTS

Majority of the patients were males, in their twenties. GHB was detected in 34.1% and it was solely consumed in 27.7% of all the cases. Ethanol was found to be the most frequently co-ingested substance. A higher rate of severe poisonings was observed among males. We found significant difference in the frequency of enduring sexual assaults and acquisitory crimes between intentional and unintentional GHB intake cases. Among unintentional GHB intake cases, 6.5% endured GHB-involved sexual assaults, whereas 21.7% endured an acquisitory crime. Among recurrent GHB intoxication cases generated by the same patients, voluntary and sole GHB consumptions were more frequently observed, however, enduring any crime was less characteristic.

DISCUSSION

Our results regarding demographic and substance use characteristics and the frequency of GHB-facilitated sexual assaults are in line with former findings. Enduring acquisitory crimes due to unintentional GHB intake was found to be more inherent than enduring sexual assaults. Authors emphasise that the victims of these acquisitory crimes were typically males.

CONCLUSION

GHB's role in drug facilitated acquisitory crimes seems to be significant, although the decrease in GHB's popularity is observed among intoxicated patients as well. The need for further research on GHB's impact on cognitive impairment and on sexual correlates of intentional GHB use is addressed by the authors.

Self-Reported Ecstasy/MDMA/"Molly" Use in a Sample of Nightclub and Dance Festival Attendees in New York City

BACKGROUND

Ecstasy (MDMA) use has regained popularity in the United States, particularly in the form of "Molly," which is often marketed as pure MDMA. Surveys have generally not included "Molly" in the definition of ecstasy, so rates of use may be underestimated. As popularity of ecstasy increases, research is needed to examine use among those at highest risk for use-nightlife attendees.

METHODS

We surveyed 679 young adults (age 18-25) entering nightclubs and festivals holding electronic dance music (EDM) parties in New York City in 2015. A variation of time-space sampling was utilized. We examined prevalence and correlates of self-reported lifetime ecstasy use.

RESULTS

Self-reported lifetime ecstasy use was common (42.8%, 95% CI: 32.8, 52.7). Use was most common among older participants, frequent party attendees, and those reporting higher levels of exposure to users. Those surveyed outside of festivals were less likely to report use compared to those surveyed outside of nightclubs (AOR = 0.37, p = .015). Over a third of ecstasy users (36.8%)reported use in pill, powder, and crystal form. Ecstasy users were also more likely to report use of other drugs, including novel psychoactive substances (e.g., 2C series drugs, synthetic cathinones ["bath salts"]). Half (50.4%) reported suspecting (21.9%) or finding out (28.5%) that their ecstasy had ever contained a drug other than MDMA.

CONCLUSION

A large percentage of nightlife attendees in NYC report lifetime ecstasy use. Findings should inform prevention and harm reduction programming. Further research is needed as ecstasy continues to change (e.g., in form, purity, and name).

Club Drug Use and Risk Management among “Bridge and Tunnel” Youth

Club drugs present a range of risks similar to the range of psychoactive effects resulting from the use of the substances in this classification. These drugs remain in wide use amongst those in rave and club subcultures. This paper explores a range of risk management practices used by youth who utilize club drugs within rave and club subcultures. Through the use of ethnographic methods during a two-year period of fieldwork, the author collected data on club drug use and risk taking among “Bridge and Tunnel” youth. The resulting paper provides a descriptive typology of a series of risk management practices and explores how these practices are strategically deployed in an effort to maximize enjoyment and minimize danger.

Methamphetamine in the Czech Republic

The Czech Republic has a relatively long tradition in the addictive and problem use of methamphetamine, which is called “pervitin” locally. This paper attempts to provide as complex a picture of this phenomenon as possible by analyzing what is known about the Czech methamphetamine situation through scientific monitoring and research. It begins with a brief historical overview and then utilizes five key indicators (surveys, treatment demand, problem drug use estimates, blood borne diseases, and mortality) and some of the core indicators (namely, drug related crime, price and purity data, and estimates of market value) of drug epidemiology that were developed by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). By summarizing and carefully interpreting this data, the specifics of the Czech pervitin scene are described and future research directions are identified.

Correlates of new psychoactive substance use among a self-selected sample of nightclub attendees in the United States

BACKGROUND AND OBJECTIVES

Although new psychoactive substances (NPS) continue to emerge at a rapid rate, US national surveys only measure the use of non-specific categories of NPS and are not designed to access high-risk populations. In this paper we report lifetime use of specific NPS (of 58) and examine correlates of use among a high-risk population: nightlife attendees.

METHODS

The self-selected sample from the Global Drug Survey (2013) consisted of 2,282 respondents in the US, aged 16-60 years, who reported nightclub attendance in the last year. Multivariable logistic regression models determined unique predictors of lifetime use.

RESULTS

Lifetime use of a wide range of NPS was reported (any NPS; 46.4%), including synthetic cannabinoids (24.8%), tryptamines (eg, 4-AcO-DMT, 23.0%), psychedelic phenethylamines (eg, 2C-B, 25I-NBOMe; 21.7%), euphoric stimulants (eg, BenzoFury; 16.2%), and synthetic cathinones (eg, methylone; 10.5%). Females (AOR = 0.49 [.41, .60]) and older respondents (age 22-60; AOR = .73 [.59, .89]) were at lower odds of reporting any lifetime NPS use. Frequent nightclub attendance was associated with increased odds of reporting lifetime NPS use overall (eg, weekly compared with less than once a month, AOR = 2.33 [1.70,3.19]), but not specifically with synthetic cannabinoid use.

DISCUSSION AND CONCLUSIONS

Among a self-selected sample of nightclub attendees, a large range of novel substances were reported, and young attendees, males, and those who attended more frequently were at increased odds of reporting use.

SCIENTIFIC SIGNIFICANCE

Harm reduction initiatives are needed to reduce risk of harm in this population, where environmental characteristics may augment risks associated with consuming lesser-known psychoactive substances. (Am J Addict 2016;25:400-407).

Self-reported use of novel psychoactive substances among attendees of electronic dance music venues

BACKGROUND

Novel psychoactive substances (NPSs) continue to emerge in the United States and worldwide. Few epidemiological studies have examined the prevalence and correlates of use.

OBJECTIVE

We examined the extent of NPS use in a high-risk population-attendees of electronic dance music (EDM) parties at nightclubs and festivals.

METHODS

We surveyed 682 adults (age 18-25) entering EDM events at nightclubs and festivals in New York City (NYC) in 2015. A variation of time-space sampling was used. We examined the prevalence of self-reported use of 196 NPS and correlates of any NPS use.

RESULTS

Over a third (35.1%) of participants reported lifetime use of any NPS. Self-reported use of synthetic cannabinoids was most prevalent (16.3%), followed by psychedelic phenethylamines (14.7%; 2C series: 10.3%, 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine [NBOMe] series: 9.0%, Dox series: 3.5%), synthetic cathinones ("bath salts", 6.9%), other psychedelics (6.6%), tryptamines (5.1%), and dissociatives (4.3%). 2C-I was the most prevalent 2C series drug (5.1%); methylone was the most prevalent synthetic cathinone (3.3%), 2-MeO-ketamine was the most prevalent dissociative (3.7%), and 1P-lysergic acid diethylamide (LSD) (2.9%) was the most prevalent non-phenethylamine psychedelic. Risk factors for NPS use included Ecstasy/MDMA/Molly, LSD, and ketamine use; identifying as bisexual (compared to heterosexual), reporting higher frequency of nightclub/festival attendance, and being surveyed outside of a festival (compared to those surveyed outside of nightclubs).

DISCUSSION

NPS use is prevalent in the nightclub and festival scenes in NYC. Since individuals in these scenes-especially frequent attendees-are at high risk for use, prevention and harm reduction services need to be geared toward this population.

The role of substance use motives in the associations between minority stressors and substance use problems among young men who have sex with men

Young men who have sex with men (YMSM) report higher rates of substance use than their heterosexual peers and minority stress has been posited as a risk factor for substance use. The associations between specific types of minority stress and substance use have been inconsistent throughout the literature and few studies have examined mechanisms underlying these associations. Drawing on minority stress theory and the motivational model of alcohol use, we propose that one mechanism underlying these associations may be people's motivations for using substances, including using substances to cope with negative emotions and to enhance pleasure. The goals of the current study were: (1) to examine the associations among minority stressors, substance use motives, and substance use problems; and (2) to examine substance use motives as mediators of the associations between minority stressors and substance use problems. Baseline self-report data were used from a cohort of 370 YMSM enrolled in a larger study of substance use and sexual behavior. Results indicated that using marijuana to cope mediated the association between victimization and marijuana use problems. Using other drugs to cope mediated the associations between victimization and drug use problems and between internalized stigma and drug use problems. Drinking to cope and to enhance pleasure mediated the association between internalized stigma and alcohol use problems. In sum, substance use motives, especially using substances to cope, act as mechanisms through which certain types of minority stress influence substance use problems among YMSM.

Non-monosexual Partnerships: Information, Motivation and Self-Efficacy among Methamphetamine-Using Men Who Have Sex with Men Who Also Have Sex with Women or Transgender Persons

OBJECTIVES

Sex with more than one gender is associated with higher substance use, and sexual HIV risk.

METHODS

We examined knowledge, motivation, and self-efficacy to engage in safer substance use and sexual behavior among methamphetamine-using U.S. men who have sex with more than one gender (N=343).

RESULTS

Almost half(46.2%) of the men reported having sex with a man and a woman or transgender partner in the last 30 days. Compared to monosexual MSM, non-monosexual MSM reported greater condom use self-efficacy however, they reported more sexual partners who inject drugs.

CONCLUSION

We observed distinct differences between men who do or do not have sex with more than one gender.

Detection of "bath salts" and other novel psychoactive substances in hair samples of ecstasy/MDMA/"Molly" users

BACKGROUND

Ecstasy (MDMA) in the US is commonly adulterated with other drugs, but research has not focused on purity of ecstasy since the phenomenon of "Molly" (ecstasy marketed as pure MDMA) arose in the US.

METHODS

We piloted a rapid electronic survey in 2015 to assess use of novel psychoactive substances (NPS) and other drugs among 679 nightclub/festival-attending young adults (age 18-25) in New York City. A quarter (26.1%) of the sample provided a hair sample to be analyzed for the presence of select synthetic cathinones ("bath salts") and some other NPS. Samples were analyzed using fully validated UHPLC-MS/MS methods. To examine consistency of self-report, analyses focused on the 48 participants with an analyzable hair sample who reported lifetime ecstasy/MDMA/Molly use.

RESULTS

Half (50.0%) of the hair samples contained MDMA, 47.9% contained butylone, and 10.4% contained methylone. Of those who reported no lifetime use of "bath salts", stimulant NPS, or unknown pills or powders, about four out of ten (41.2%) tested positive for butylone, methylone, alpha-PVP, 5/6-APB, or 4-FA. Racial minorities were more likely to test positive for butylone or test positive for NPS after reporting no lifetime use. Frequent nightclub/festival attendance was the strongest predictor of testing positive for MDMA, butylone, or methylone.

DISCUSSION

Results suggest that many ecstasy-using nightclub/festival attendees may be unintentionally using "bath salts" or other NPS. Prevention and harm reduction education is needed for this population and "drug checking" (e.g., pill testing) may be beneficial for those rejecting abstinence.

Effects of 3,4-methylenedioxymethamphetamine on socioemotional feelings, authenticity, and autobiographical disclosure in healthy volunteers in a controlled setting

The drug 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy", "molly") is a widely used illicit drug and experimental adjunct to psychotherapy. MDMA has unusual, poorly understood socioemotional effects, including feelings of interpersonal closeness and sociability. To better understand these effects, we conducted a small (n=12) within-subjects double-blind placebo controlled study of the effects of 1.5 mg/kg oral MDMA on social emotions and autobiographical disclosure in a controlled setting. MDMA displayed both sedative- and stimulant-like effects, including increased self-report anxiety. At the same time, MDMA positively altered evaluation of the self (i.e. increasing feelings of authenticity) while decreasing concerns about negative evaluation by others (i.e. decreasing social anxiety). Consistent with these feelings, MDMA increased how comfortable participants felt describing emotional memories. Overall, MDMA produced a prosocial syndrome that seemed to facilitate emotional disclosure and that appears consistent with the suggestion that it represents a novel pharmacological class.

The behavioural profile of gamma-hydroxybutyrate, gamma-butyrolactone and 1,4-butanediol in humans

Gamma-hydroxybutyrate (GHB) is a putative neurotransmitter, a drug of abuse, and a medical treatment for narcolepsy and other neuropsychiatric disorders. Its precursors gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD) are endogenously converted to GHB and thereby exert their psychobehavioural effects. In humans, GHB has a wide spectrum of properties ranging from stimulation and euphoria in lower doses, to sedation, deep sleep, and coma after ingestion of high doses. However, behavioural studies in healthy volunteers remain scarce and are usually limited to psychomotor performance testing. Most available data arise from either qualitative studies with illicit users or clinical trials examining therapeutic properties of GHB (then usually termed sodium oxybate). Here, we present an overview of the behavioural effects of GHB, GBL, and 1,4-BD in these three populations. GHB and its precursors strongly influence behaviours related to core human autonomic functions such as control of food intake, sexual behaviour, and sleep-wake regulation. These effects are instrumentalised by illicit users and clinically utilised in neuropsychiatric disorders such as narcolepsy, fibromyalgia, and binge-eating syndrome. Considering the industry withdrawal from psychopharmacology development, repurposing of drugs according to their behavioural and clinical profiles has gained increasing relevance. As such, GHB seems to be an attractive candidate as an experimental therapeutic in depression.

Structural equation modeling of the effects of racism, LGBTQ discrimination, and internalized oppression on illicit drug use in LGBTQ people of color

BACKGROUND

Experiences with lesbian, gay, bisexual, transgender, or queer (LGBTQ) discrimination and racism have both been associated with mental health problems and illicit drug use. However, the cumulative effects of both forms of discrimination--and resulting internalized oppression--on illicit drug use in LGBTQ people of color (POC) has not been examined in the research literature.

METHODS

Using online questionnaires, this study collected self-report data from 200 LGBTQ POC about their experiences with racism, LGBTQ discrimination, internalized racism, internalized LGBTQ discrimination, and illicit drug use.

RESULTS

Two structural equation models yielded adequate fit indices in which experiences with racism and LGBTQ discrimination led to more internalized oppression, which then led to greater illicit drug use magnitude. LGBTQ discrimination was directly related to increased internalized oppression, which was positively associated with illicit drug use magnitude; the relationship between LGBTQ discrimination and illicit drug use magnitude was mediated by internalized oppression in both models. However, racism and the interaction between racism and LGBTQ discrimination did not show valid direct effects on internalized oppression or indirect effects on illicit drug use magnitude.

CONCLUSIONS

LGBTQ POC can be the targets of both racism and LGBTQ discrimination, although the current study found that the most psychologically damaging effects may come from LGBTQ discrimination. Interventions meant to decrease or prevent illicit drug use in LGBTQ POC may benefit from helping participants examine the links among LGBTQ discrimination, internalized oppression, and illicit drug use as a coping strategy, focusing on substituting more adaptive coping.

Molly users versus nonusers in a sample of college alcohol drinkers: Differences in substance-related harms and sensation seeking

BACKGROUND

Molly is one form of MDMA (3,4-methylenedioxymethamphetamine) that is touted to be more "pure" and potentially less harmful than other forms, such as ecstasy. Media reports and case studies suggest that this drug is popular among college students and is related to adverse health problems. The current study sought to address the knowledge gaps about Molly by examining whether users differ in substance use outcomes and sensation seeking than nonusers. Specifically, this study tested whether Molly users engaged in heavier use of other substances and experienced more substance-related harms in general than nonusers. Further, the current study investigated whether Molly users exhibited higher levels of sensation seeking than nonusers. Lastly, this study examined whether Molly user status would be associated with substance-related harms beyond the confounding influence of other substance use and trait sensation seeking.

METHODS

Participants were 710 (71.9% female) college alcohol drinkers who completed self-report surveys about substance use (i.e., Molly, alcohol, and other drug use), substance-related problems, and sensation seeking.

RESULTS

Results revealed that approximately 12% of the sample reported lifetime Molly use. Molly users compared with nonusers reported higher levels of other drug use, alcohol use, substance-related problems, and sensation seeking. Further, Molly users reported experiencing poorer substance use outcomes (e.g., blacking out, academic/occupational problems, and withdrawal symptoms) after accounting for sensation seeking and other substance use.

CONCLUSIONS

These findings indicate that Molly users are higher in sensation seeking and that use is uniquely related to greater risk for substance-related harms. These preliminary findings demonstrate a need for correcting possible misperceptions regarding the purity of Molly and educating users on the potential for experiencing associated harms. Such information could be used to develop efficacious prevention programming for college students.

Emotional traits predict individual differences in amphetamine-induced positive mood in healthy volunteers

BACKGROUND

Previous research on emotional correlates of individual differences in subjective responses to D-amphetamine has focused on relatively broad personality traits. Yet, emotional functioning is best characterized by several narrow subcomponents, each of which may contribute uniquely to amphetamine response. Here, we examine several specific subdomains of emotional functioning in relation to acute amphetamine response.

METHOD

At a baseline session, healthy stimulant-naive volunteers (N = 97) completed measures of several subdomains of baseline trait emotional functioning and then completed two counterbalanced experimental sessions during which they received a single oral dose of 20 mg D-amphetamine or placebo. Acute subjective drug response measures were completed at repeated intervals before and after drug administration. Data from subjective measures that were significantly modulated by amphetamine were reduced using principal component analysis (amphetamine or placebo) into three higher-order factors of "positive mood," "arousal," and "drug high." Amphetamine did not significantly alter any "negative" subjective states. Separate multiple regression analyses were conducted regressing these three drug factors on baseline trait emotional functioning scales.

RESULTS

The combined set of trait emotional functioning indicators accounted for approximately 22 % of the variance in acute amphetamine-induced positive mood changes. Greater anticipatory pleasure and greater anxious distress each uniquely predicted greater amphetamine-induced positive mood. Trait emotional functioning did not significantly predict amphetamine-induced changes in arousal or drug high.

DISCUSSION

Emotional traits appear to moderate drug-induced positive mood but not other dimensions of amphetamine effects. Different facets of emotional functioning may differentially modulate amphetamine's subjective effect profile.

Intimate partner violence and substance use risk among young men who have sex with men: The P18 cohort study

OBJECTIVES

Substance use is prevalent among young men who have sex with men (YMSM) and may be associated with intimate partner violence (IPV). Experiences of IPV are associated with several adverse health conditions among adult MSM, but there is a gap in knowledge about this relationship among YMSM, which warrants further investigation.

METHODS

This study employs baseline data from a prospective cohort study to examine lifetime experiences of IPV in relation to substance use in the previous 30 days among n=528 YMSM in New York City from 2009 to 2011. To examine the extent to which IPV (any experiences, victimization, and perpetration) are related to substance use (alcohol, marijuana, stimulant, and other drugs) in the last 30 days, distinct 2-step multinomial logistic regression models, controlling for sociodemographic differences, were constructed.

RESULTS

44.3% reported lifetime IPV experience, with 39.2% of reporting victimization and 30.5% reporting perpetration. IPV is associated with a 1.6 increased odds of 2 or more instances of alcohol use, a 1.6-1.8 increased odds of 2 or more instances of marijuana use, a 1.8-2.5 increased odds of 2 or more instances of stimulant use, and a 4.1-6.1 increased odds of 2 or more instances of other substance use.

CONCLUSION

Findings highlight the strong association between IPV and increased frequency of substance use among YMSM and provide support that violence may exist as part of a syndemic facing YMSM. Prevention and intervention strategies may be improved by addressing substance use in the context of IPV and other related health challenges.

Illicit drug use among rave attendees in a nationally representative sample of US high school seniors

BACKGROUND

The popularity of electronic dance music and rave parties such as dance festivals has increased in recent years. Targeted samples of party-goers suggest high rates of drug use among attendees, but few nationally representative studies have examined these associations.

METHODS

We examined sociodemographic correlates of rave attendance and relationships between rave attendance and recent (12-month) use of various drugs in a representative sample of US high school seniors (modal age: 18) from the Monitoring the Future study (2011-2013; Weighted N=7373).

RESULTS

One out of five students (19.8%) reported ever attending a rave, and 7.7% reported attending at least monthly. Females and highly religious students were less likely to attend raves, and Hispanics, students residing in cities, students with higher income and those who go out for fun multiple times per week were more likely to attend. Rave attendees were more likely than non-attendees to report use of an illicit drug other than marijuana (35.5% vs. 15.6%, p<0.0001). Attendees were more likely to report use of each of the 18 drugs assessed, and attendees were more likely to report more frequent use (≥6 times) of each drug (ps<0.0001). Controlling for sociodemographic covariates, frequent attendance (monthly or more often) was associated with higher odds of use of each drug (ps<0.0001). Frequent attendees were at highest risk for use of "club drugs."

DISCUSSION

Findings from this study can help inform prevention and harm reduction among rave attendees at greatest risk for drug use.

Chasing the bean: prescription drug smoking among socially active youth

PURPOSE

Alternative consumption practices of prescription drug misuse have been less well monitored than general prevalence. We describe prescription drug smoking among socially active youth and highlight correlates of this practice. We also examine its association with drug problems, drug dependence, and mental health.

METHODS

We surveyed 404 young adults recruited from nightlife venues in New York via time-space sampling. We use linear and logistic regression models to examine the probability of smoking prescription drugs and its association with drug problems, dependence, and mental health. Qualitative findings supplement the survey data.

RESULTS

Males have higher odds than females (odds ratio [OR] = 3.4), and heterosexuals have higher odds than sexual minority youth (OR = 2.3) of smoking prescription drugs. Those involved in electronic dance music nightlife have higher odds (OR = 2.1) than those who do not participate in that scene, whereas those in college bar scenes have lower odds (OR = .4) of having smoked prescription drugs. Prescription drug smokers report more drug problems (β = .322) and greater symptoms of dependence net (β = .298) of the frequency of misuse and other characteristics. Prescription drug smokers do not report greater mental health problems. Qualitative interview data support these survey findings.

CONCLUSIONS

Prescription drug smoking is a significant drug trend among socially active youth. It is associated with drug problems and symptoms of dependence net of frequency of misuse. Prevention and intervention efforts for youth who misuse prescription drugs should address the issue of prescription drug smoking, and this may be an area for clinicians to address with their adolescent patients.

Intimate insight: MDMA changes how people talk about significant others

RATIONALE

±3,4-methylenedioxymethamphetamine (MDMA) is widely believed to increase sociability. The drug alters speech production and fluency, and may influence speech content. Here, we investigated the effect of MDMA on speech content, which may reveal how this drug affects social interactions.

METHOD

Thirty-five healthy volunteers with prior MDMA experience completed this two-session, within-subjects, double-blind study during which they received 1.5 mg/kg oral MDMA and placebo. Participants completed a five-minute standardized talking task during which they discussed a close personal relationship (e.g. a friend or family member) with a research assistant. The conversations were analyzed for selected content categories (e.g. words pertaining to affect, social interaction, and cognition), using both a standard dictionary method (Pennebaker's Linguistic Inquiry and Word Count: LIWC) and a machine learning method using random forest classifiers.

RESULTS

Both analytic methods revealed that MDMA altered speech content relative to placebo. Using LIWC scores, the drug increased use of social and sexual words, consistent with reports that MDMA increases willingness to disclose. Using the machine learning algorithm, we found that MDMA increased use of social words and words relating to both positive and negative emotions.

CONCLUSIONS

These findings are consistent with reports that MDMA acutely alters speech content, specifically increasing emotional and social content during a brief semistructured dyadic interaction. Studying effects of psychoactive drugs on speech content may offer new insights into drug effects on mental states, and on emotional and psychosocial interaction.

MDMA: a social drug in a social context

RATIONALE

The drug ±3,4-methylenedioxymethamphetamine (MDMA, "ecstasy," "molly") is thought to produce prosocial effects and enhance social interaction. However, in most laboratory studies to date, the participants have been tested under nonsocial conditions, which may not simulate the effects the drug produces in more naturalistic social settings.

METHODS

Healthy experienced MDMA users participated in three laboratory sessions in which they received MDMA (0.5 or 1.0 mg/kg or placebo, double blind). They were randomly assigned to one of three social conditions, in which they were tested alone (solitary (SOL); N = 10), in the presence of a research assistant (research assistant present (RAP); N = 11) or in the presence of another participant who also received the drug (other participant present (OPP); N = 11).

RESULTS

As expected, MDMA increased heart rate and blood pressure and produced positive subjective effects in all the three groups. It also increased ratings of attractiveness of another person and increased social interaction in RAP and OPP. The social context affected certain responses to the drug. The effects of MDMA were greater in the OPP condition, compared to the SOL or RAP conditions, on measures of "feel drug," "dizzy," and on cardiovascular. But responses to the drug on other measures, including social behavior, did not differ across the conditions.

CONCLUSIONS

These findings provide some support for the idea that drugs produce greater effects when they are used in the presence of other drug users. However, the influence of the social context was modest, and it remains to be determined whether other variables related to social context would substantially alter the effects of MDMA or other drugs.

Prescription Drug Misuse and Sexual Behavior Among Young Adults

Though research indicates a complex link between substance use and sexual risk behavior, there is limited research on the association between sexual risk behavior and prescription drug misuse. In light of alarming increases in prescription drug misuse and the role of demographic characteristics in sexual risk behavior and outcomes, the current study examined demographic differences (gender, sexual identity, age, relationship status, parental class background, and race/ethnicity) in sexual risk behavior, sexual behavior under the influence of prescription drugs, and sexual risk behavior under the influence of prescription drugs in a sample of 402 young adults (ages 18 to 29) who misused prescription drugs. Nearly half of the sexually active young adult prescription drug misusers in this sample reported recent sex under the influence of prescription drugs; more than three-quarters reported recent sex without a condom; and more than one-third reported recent sex without a condom after using prescription drugs. Zero-inflated Poisson regression models indicated that White race, younger age, higher parental class, and being a heterosexual man were all associated with sexual risk behavior, sex under the influence of prescription drugs, and sexual risk under the influence of prescription drugs. Findings have implications for the targeting of prevention and intervention efforts.