How psychoactive drugs shape human culture: A multi-disciplinary perspective

Psychometric properties of the modified Drug Abuse Screening Test Sinhala version (DAST-SL): evaluation of reliability and validity in Sri Lanka

BACKGROUND

Psychoactive drug use is an important public health issue in Sri Lanka as it causes substantial health, social and economic burden to the country. Screening for substance use disorders in people who use drugs is vital in preventive health care, as it can help to identify problematic use early. Screening can aid in referring those in need, for the most appropriate treatment and care. Thus, preventing them from developing severe substance use disorders with complications. The Drug Abuse Screening Test (DAST-10) is an evidence-based tool widely used to assess the severity of psychoactive drug use. This study aimed to culturally adapt and evaluate the validity and reliability of the Drug Abuse Screening Test (DAST-10) in Sri Lanka.

METHODS

The DAST-10 was culturally adapted, and the nine-item Sinhala version (DAST-SL) was validated using exploratory and confirmatory factor analysis. The validation study was conducted in the Kandy district among people who use drugs, recruited using respondent-driven sampling. Criterion validity of the questionnaire was assessed by taking the diagnosis by a psychiatrist as the gold standard. Cut-off values for the modified questionnaire were developed by constructing Receiver Operating Characteristic (ROC) curves. The reliability of the DAST-SL was assessed by measuring its internal consistency and test re-test reliability.

RESULTS

The validated DAST-SL demonstrated a one-factor model. A cut-off value of ≥ 2 demonstrated the presence of substance use disorder and had a sensitivity of 98.7%, specificity of 91.7%, a positive predictive value of 98.8% and a negative predictive value of 91.3%. The area under the curve of the ROC curve was 0.98. A cut-off score of ≤ 1 was considered a low level of problems associated with drug use. The DAST-SL score of 2-3 demonstrated a moderate level of problem severity, a score of 4-6 demonstrated a substantial level of problems, and a score of ≥ 7 demonstrated a severe level of drug-related problems. The questionnaire demonstrated high reliability with an internal consistency of 0.80 determined by Kuder-Richardson Formula-20 and an inter-class correlation coefficient of 0.97 for test re-test reliability.

CONCLUSION

The DAST-SL questionnaire is a valid and reliable tool to screen for drug use problem severity in people who use drugs in Sri Lanka.

Self-management with alcohol over lifespan: psychological mechanisms, neurobiological underpinnings, and risk assessment

Self-management includes all behavioural measures and cognitive activities aimed at coping with challenges arising throughout the lifespan. While virtually all of these challenges can be met without pharmacological means, alcohol consumption has long been instrumentalized as a supporting tool to help coping with problems arising selectively at adolescence, adulthood, and ageing. Here, we present, to our knowledge, the first systematic review of alcohol instrumentalization throughout lifespan. We searched MEDLINE, Google Scholar, PsycINFO and CINAHL (from Jan, 1990, to Dec, 2022) and analysed consumption patterns, goals and potential neurobiological mechanisms. Evidence shows a regular non-addictive use of alcohol to self-manage developmental issues during adolescence, adulthood, and ageing. Alcohol is selectively used to overcome problems arising from dysfunctional personality traits, which manifest in adolescence. A large range of psychiatric disorders gives rise to alcohol use for the self-management of distinct symptoms starting mainly in adulthood. We identify those neuropharmacological effects of alcohol that selectively serve self-management under specific conditions. Finally, we discuss the adverse effects and associated risks that arise from the use of alcohol for self-management. Even well-controlled alcohol use adversely impacts health. Based on these findings, we suggest the implementation of an entirely new view. Health policy action may actively embrace both sides of the phenomenon through a personalized informed use that allows for harm-controlled self-management with alcohol.

Occurrence and sources of residues of drugs of abuse in an urban aquifer: Chemical analysis and solute transport modelling

This study investigated the occurrence and potential sources of residues of drugs of abuse in an urban aquifer beneath the City of Ljubljana using water analysis and a solute transport model designed to predict nitrogen distribution. Samples were collected from three sources: 28 wastewater samples (24-h composites), 4 aquifer-recharging river samples (grab), and 22 groundwater samples. The samples were analysed for residues of commonly (ab)used licit drugs (nicotine and alcohol), medications of abuse (morphine, methadone, codeine, and ketamine), and illicit drugs (tetrahydrocannabinol - THC, cocaine, amphetamines, and heroin) using liquid-liquid (alcohol residue) and solid-phase extraction, followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Additionally, we used solute transport modelling to predict the spatial distribution of drug residues in the aquifer and their potential sources. Nicotine (up to 45,7 ng/L), cotinine (up to 5.86 ng/L), trans-3'-hydroxycotinine (up to 0.528 ng/L) and benzoylecgonine (up to 0.572 ng/L) were the most commonly detected drug residues in groundwater, followed by cocaine (<LOQ). In comparison, methadone (0.054 ng/L) was detected only once. A higher prevalence of residues of drugs of abuse was observed in samples obtained at the south-eastern edge of the aquifer, downgradient from the main zone of urbanisation, agreeing with model predictions. Although drug residues were detected in river water, modelling suggests that the city's leaky sewer system is the primary source of drug residues.

Rewarding and Reinforcing Effects of 25H-NBOMe in Rodents

The drug 25H-NBOMe is a new psychoactive substance (NPS). The use of these substances is likely to pose a threat to public health because they elicit effects similar to those of known psychoactive substances with similar chemical structures. However, data regarding the abuse potential of 25H-NBOMe are lacking. Here, we evaluated the abuse liability of 25H-NBOMe in rodents. The rewarding and reinforcing effects were evaluated through conditioned place preference (CPP) and self-administration (SA) tests after administration of 25H-NBOMe. To investigate the effects of 25H-NBOMe on the central nervous system, we determined the changes in dopamine levels by in vivo microdialysis. In the locomotor activity test, 25H-NBOme significantly increased locomotor activity in mice. In the place conditioning test, the 25H-NBOMe (0.1 and 0.5 mg/kg) groups showed a significantly increase in CPP in mice. In the SA test, the 25H-NBOMe (0.01 mg/kg) administered group showed a significant increased number of infusions and active lever presses. In microdialysis, the 25H-NBOMe (10 mg/kg) administered group was significantly increased in rats.

The prevalence, mechanism of action, and toxicity of Nigerian psychoactive plants

Cannabis sativa, Datura stramonium, Nicotiana tabacum, and Carica papaya are plants that naturally grow in Nigeria. They are reportedly rich in neuroactive compounds that are capable of reacting with the nervous system to elicit psychoactive and/or toxic effects that deter predators. However, despite the toxicological potential of these plants, their recreational use is on the rise due to the psychoactivity they proffer and prevalence in Nigeria. The aim of the present study is to evaluate the plants' recreational use, mechanism of actions and toxicities. Relevant published documents on psychoactive plants in Nigeria were obtained from Web of Science between 2002 and 2020. Non-English documents, documents not in Science Citation Index Expanded and Google Scholar were removed while 1186 documents were reviewed. Results showed that the plants are recreationally used in Nigeria with a higher prevalence than the global frequency. They are very addictive and lead to dependence. The plants were also observed to elicit different mechanism of action, though the activation of monoaminergic neurotransmission system was common to all. Regrettably, the plants could be toxic when ingested under non-medical conditions. Conclusively, these plants are addictive with potential toxic effects. Therefore, control of the recreational use of these plants should be revamped and overhauled.

Ancient psychoactive plants in a global village: The ritual use of cannabis in a self-managed community in Catalonia

BACKGROUND

Cannabis is a plant with a rich history of medical, recreational, industrial and spiritual uses. This paper aims to explore drug use rituals as methods of community-controlled use that help maintain a self-regulated and healthy relation to the substance in questions. Furthermore, it explores how cannabis is used in developing spirituality and a sense of community. The ritual use of cannabis is discussed in the context of drug policy.

METHODS

Ethnographic research methods, such as fieldwork, participant observation, in-depth interviews, and qualitative analysis, were used to research a phenomenological community in rural Catalonia, where ancient psychoactive plants (APP), such as ayahuasca and cannabis, are regularly used in a ritual context.

RESULTS

Cannabis has a long history of ritual/spiritual uses and is still being used for such purposes in Catalonia. The rituals are effective harm reduction techniques and can even generate beneficial effects for the individual as well as the community by strengthening bonds between community members. The rituals associated with APP are seen as spiritual or religious practices, as well as forms of self-care and community-care, rather than involving drug dependence or addiction.

CONCLUSION

The contemporary use of APP in Western societies is gaining popularity. International drug policies and the schedule of controlled drugs claim to be based on scientific evidence, but this evidence is limited. The contemporary myopic focus on the risks and harms of drugs overlooks important realities, such as the benefits of non-problematic drug use. These omissions could in part be rectified through the consideration of scientific findings from the field of ethnography regarding the spiritual and community dimensions of drug use.

The Anesthesiologist's Armamentarium: From Recreation to Medication and Back

For millennia, mankind has sought a means of altering consciousness, often aided by naturally occurring elements. Psychotropic substances have been an integral part of spiritual, medicinal, and recreational aspects of life. The origin of anesthesiology stems directly from the use of recreational drugs; early inhaled anesthetics were first used as a means of entertainment. Hence, it is no surprise that many medications in the anesthesiologist's armamentarium are diverted for recreational use. In the 172 years following the first successful public demonstration of ether anesthesia, many drugs with abuse potential have been introduced to the practice of anesthesia. Although anesthesiologists are aware of the abuse potential of these drugs, how these drugs are obtained and used for recreational purposes is worthy of discussion. There are articles describing the historical and recreational use of specific drug classes. However, to the best of our knowledge, this is the first comprehensive review focusing on the breadth of drugs used by anesthesiologists.

Drug instrumentalization

Psychoactive drugs with addiction potential are widely used by people of virtually all cultures in a non-addictive way. In order to understand this behaviour, its population penetrance, and its persistence, drug instrumentalization was suggested as a driving force for this consumption. Drug instrumentalization theory holds that psychoactive drugs are consumed in a very systematic way in order to make other, non-drug-related behaviours more efficient. Here, we review the evolutionary origin of this behaviour and its psychological mechanisms and explore the neurobiological and neuropharmacological mechanisms underlying them. Instrumentalization goals are discussed, for which an environmentally selective and mental state-dependent consumption of psychoactive drugs can be learned and maintained in a non-addictive way. A small percentage of people who regularly instrumentalize psychoactive drugs make a transition to addiction, which often starts with qualitative and quantitative changes in the instrumentalization goals. As such, addiction is proposed to develop from previously established long-term drug instrumentalization. Thus, preventing and treating drug addiction in an individualized medicine approach may essentially require understanding and supporting personal instrumentalization goals.

Genotoxicity and repair capability of Mus musculus DNA following the oral exposure to Tramadol

Tramadol is an analgesic and psychoactive drug that acts primarily upon the central nervous system where it alters brain function, resulting in temporary changes in perception, mood, consciousness and behavior. The aim of present study was to analyze the genotoxicity and repair capability of DNA after Tramadol exposure in albino mice (Mus musculus). For this purpose, forty mice were divided equally into four groups as; a control group (without drug) and three treatment groups that were treated with three doses of Tramadol as minimum dose group, Intermediate dose group and maximum dose group, corresponding to 25 mg/kg, 50 mg/kg and 75 mg/kg of body weight respectively. The dose was given orally for 15 days. After 15 days peripheral blood was drawn from half mice of each group and subjected to comet assay. While the remaining half mice were given a recovery period of 15 days and same procedure was used for blood collection and comet assay. Significant difference in various comet parameters was observed among control and exposed groups. Maximum damage was observed at highest concentration 75 mg/kg of Tramadol and minimum damage was observed at dose 25 mg/kg of Tramadol, while results of repaired mice group showed that repair capability of Tramadol was minor and recovery of Tramadol required a lot of time. It can be concluded that Tramadol cause genotoxicity that is dose dependent and has low repair capability.

Chemical evidence for the use of multiple psychotropic plants in a 1,000-year-old ritual bundle from South America

Over several millennia, various native plant species in South America have been used for their healing and psychoactive properties. Chemical analysis of archaeological artifacts provides an opportunity to study the use of psychoactive plants in the past and to better understand ancient botanical knowledge systems. Liquid chromatography tandem mass spectrometry (LC-MS/MS) was used to analyze organic residues from a ritual bundle, radiocarbon dated to approximately 1,000 C.E., recovered from archaeological excavations in a rock shelter located in the Lípez Altiplano of southwestern Bolivia. The site is located at an elevation of ∼3,900 m above sea level and contains evidence of intermittent human occupations during the last 4,000 years. Chemical traces of bufotenine, dimethyltryptamine, harmine, and cocaine, including its degradation product benzoylecgonine, were identified, suggesting that at least three plants containing these compounds were part of the shamanic paraphernalia dating back 1,000 years ago, the largest number of compounds recovered from a single artifact from this area of the world, to date. This is also a documented case of a ritual bundle containing both harmine and dimethyltryptamine, the two primary ingredients of ayahuasca. The presence of multiple plants that come from disparate and distant ecological areas in South America suggests that hallucinogenic plants moved across significant distances and that an intricate botanical knowledge was intrinsic to pre-Columbian ritual practices.

Employee Psychoactive Substance Involvement: Historical Context, Key Findings, and Future Directions

Humans have consumed psychoactive substances for millennia, and these substances have played an important role in human culture and human labor. This article investigates our current understanding of the general association between the workplace and employee involvement with psychoactive substances. I begin by briefly exploring the broad evolutionary and historical intersection of psychoactive substances, human culture, and human labor. I then outline the multidimensional nature of employee psychoactive substance involvement and look at its prevalence. Next, I summarize recent research on workplace antecedents, such as work stressors, substance availability, norms, and social control. I then summarize research on the adverse workplace outcomes experienced by employees who use psychoactive substances as well as the collateral effects of such use on coworkers. Throughout the article, I identify directions for future research.

Genetic predilections and predispositions for the development of shamanism

Singh's cultural evolutionary theory of shamanism provides a valuable framework for understanding shamanism. We argue, however, that a full understanding of shamanism should incorporate the psychological predilections and genetic predispositions commonly found in individual shamans. In other words, only a small subset of individuals in a culture is prone or attracted to shamanistic practices, regardless of the evolutionary value of those practices.

Novel Psychoactive Substances-Recent Progress on Neuropharmacological Mechanisms of Action for Selected Drugs

A feature of human culture is that we can learn to consume chemical compounds, derived from natural plants or synthetic fabrication, for their psychoactive effects. These drugs change the mental state and/or the behavioral performance of an individual and can be instrumentalized for various purposes. After the emergence of a novel psychoactive substance (NPS) and a period of experimental consumption, personal and medical benefits and harm potential of the NPS can be estimated on evidence base. This may lead to a legal classification of the NPS, which may range from limited medical use, controlled availability up to a complete ban of the drug form publically accepted use. With these measures, however, a drug does not disappear, but frequently continues to be used, which eventually allows an even better estimate of the drug's properties. Thus, only in rare cases, there is a final verdict that is no more questioned. Instead, the view on a drug can change from tolerable to harmful but may also involve the new establishment of a desired medical application to a previously harmful drug. Here, we provide a summary review on a number of NPS for which the neuropharmacological evaluation has made important progress in recent years. They include mitragynine ("Kratom"), synthetic cannabinoids (e.g., "Spice"), dimethyltryptamine and novel serotonergic hallucinogens, the cathinones mephedrone and methylone, ketamine and novel dissociative drugs, γ-hydroxybutyrate, γ-butyrolactone, and 1,4-butanediol. This review shows not only emerging harm potentials but also some potential medical applications.