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Yang KH, Kepner W, Nijum A, Han BH, Palamar JJ. Prevalence and Correlates of Past Year Ecstasy/MDMA Use in the United States. J Addict Med 2023; 17:592-597. [PMID: 37788615 PMCID: PMC10593986 DOI: 10.1097/adm.0000000000001188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
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.
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Affiliation(s)
- Kevin H. Yang
- University of California San Diego School of Medicine, Department of Psychiatry, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Wayne Kepner
- University of California San Diego School of Medicine, Department of Medicine, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Anamika Nijum
- University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Benjamin H. Han
- University of California San Diego School of Medicine, Department of Medicine, 9500 Gilman Drive, San Diego, CA 92093, USA
| | - Joseph J. Palamar
- New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, New York, NY 10016, USA
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2
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van Amsterdam J, Brunt TM, Pierce M, van den Brink W. Hard Boiled: Alcohol Use as a Risk Factor for MDMA-Induced Hyperthermia: a Systematic Review. Neurotox Res 2021; 39:2120-2133. [PMID: 34554408 PMCID: PMC8639540 DOI: 10.1007/s12640-021-00416-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/07/2021] [Accepted: 09/11/2021] [Indexed: 11/10/2022]
Abstract
Although MDMA (ecstasy) is a relatively safe recreational drug and is currently considered for therapeutic use for the treatment of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), recreational MDMA use occasionally elicits hyperthermia and hyponatremia, sometimes with a fatal outcome. Specific risk factors for both adverse effects are profuse sweating while vigorously dancing under unfavorable conditions such as high ambient temperatures and insufficient fluid suppletion which result in dehydration. Concomitant use of MDMA and alcohol is highly prevalent, but adds to the existing risk, because alcohol facilitates the emergence of MDMA-induced adverse events, like hyperthermia, dehydration, and hyponatremia. Because of potential health-related consequences of concomitant use of MDMA and alcohol, it is important to identify the mechanisms of the interactions between alcohol and MDMA. This review summarizes the main drivers of MDMA-induced hyperthermia, dehydration, and hyponatremia and the role of concomitant alcohol use. It is shown that alcohol use has a profound negative impact by its interaction with most of these drivers, including poikilothermia, exposure to high ambient temperatures, heavy exercise (vigorous dancing), vasoconstriction, dehydration, and delayed initiation of sweating and diuresis. It is concluded that recreational and clinical MDMA-users should refrain from concomitant drinking of alcoholic beverages to reduce the risk for adverse health incidents when using MDMA.
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Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - Tibor M Brunt
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Mimi Pierce
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
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3
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Li X, Fu Q, Scherrer JF, Humphrey D, Leigh I. A temporal relationship between nonmedical opioid Use and major depression in the U.S.: A Prospective study from the National Epidemiological Survey on Alcohol and Related Conditions. J Affect Disord 2020; 273:298-303. [PMID: 32421616 DOI: 10.1016/j.jad.2020.04.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/18/2020] [Accepted: 04/27/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Given the existing strong cross-sectional relationship between nonmedical opioid use (NMOU) and major depressive disorder (MDD), this study focused on the temporal relationship between NMOU and major depression. METHODS Data sources were derived from Wave 1 and Wave 2 of the National Epidemiological Survey on Alcohol and Related Conditions. Logistic regression was applied to predicted NMOU at the follow-up survey based on baseline MDD diagnosis and symptoms of MDD among the sample without lifetime NMOU at baseline (N=32,982). In parallel, we examined the relationship between past year NMOU at baseline and new onset of MDD diagnosis (N=28,649) and between past year NMOU at baseline and new onset of symptoms of MDD (N=23,214) among people without major depression diagnosis or symptoms at baseline. RESULTS MDD diagnosis (aOR=1.68, 95% CI=1.43, 1.98) and symptoms of major depression (aOR=1.25, 95% CI=1.14, 1.38) at baseline were associated with higher odds of incident NMOU. The baseline NMOU was associated with lower odds incident MDD diagnosis (aOR=0.79, 95%CI=0.66, 0.94) in the adjusted model. However, the baseline NMOU was associated with higher odds of new onset of major depressive symptoms at wave 2 in the sample without baseline symptoms of MDD (aOR=1.42, 95%CI=1.23, 1.63). CONCLUSION Symptoms of MDD and MDD diagnosis increased the new onset of NMOU, while NMOU only increased the risks of new onset of symptoms of MDD.
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Affiliation(s)
- Xue Li
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Salus Center Suite 300, 3545 Lafayette Ave., St. Louis, Missouri, 63104, Saint Louis, Missouri, USA
| | - Qiang Fu
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Salus Center Suite 300, 3545 Lafayette Ave., St. Louis, Missouri, 63104, Saint Louis, Missouri, USA.
| | - Jeffrey F Scherrer
- Department of Family and Community Medicine, School of Medicine, Saint Louis University, St. Louis, Missouri, USA
| | - Daniel Humphrey
- Department of Communication, Boston College, Boston, MA, USA
| | - Isabella Leigh
- Department of Communication, Boston College, Boston, MA, USA
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4
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Traccis F, Frau R, Melis M. Gender Differences in the Outcome of Offspring Prenatally Exposed to Drugs of Abuse. Front Behav Neurosci 2020; 14:72. [PMID: 32581736 PMCID: PMC7291924 DOI: 10.3389/fnbeh.2020.00072] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 04/21/2020] [Indexed: 12/17/2022] Open
Abstract
Despite great efforts to warn pregnant women that drugs of abuse impact development of the embryo and the fetus, the use of legal and illegal drugs by childbearing women is still a major public health concern. In parallel with well-established teratogenic effects elicited by some drugs of abuse, epidemiological studies show that certain psychoactive substances do not induce birth defects but lead to subtle neurobehavioral alterations in the offspring that manifest as early as during infancy. Although gender differences in offspring susceptibility have not been fully investigated, a number of longitudinal studies indicate that male and female progeny exposed in utero to drugs of abuse show different vulnerabilities to deleterious effects of these substances in cognitive, executive, and behavioral domains. Here, we briefly review the existing literature focusing on gender differences in the neurobehavioral consequences of maternal exposure to drugs of abuse. Overall, the data strongly indicate that male exposed progeny are more susceptible than female to dysfunctions in cognitive processing and emotional regulation. However, insights into the mechanisms determining this natural phenomenon are not currently available. Our analysis prompts future investigations to implement clinical studies including the influence of gender/sex as a biological variable in the outcome of offspring prenatally exposed to drugs of abuse.
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Affiliation(s)
| | | | - Miriam Melis
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
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5
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Rougemont-Bücking A, Jungaberle H, Scheidegger M, Merlo MCG, Grazioli VS, Daeppen JB, Gmel G, Studer J. Comparing Mental Health across Distinct Groups of Users of Psychedelics, MDMA, Psychostimulants, and Cannabis. J Psychoactive Drugs 2019; 51:236-246. [PMID: 30836844 DOI: 10.1080/02791072.2019.1571258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Differences in mental health (MH) of users of distinct psychoactive substances have been shown. Both substance use (SU) and MH in users are influenced by stressful life events. This study compared MH parameters in distinct groups of substance users and evaluated the impact of stress factors on these outcomes. Data stem from the longitudinal Swiss Cohort Study on Substance Use Risk Factors (C-SURF) involving 4,475 young adult men. Distinct groups were created for the past 12 months' use of psychedelics, MDMA, psychostimulants, and cannabis. MH measurements (depressive symptoms, overall MH, perceived stress, life satisfaction) were used as outcome variables, while indicators of past family functioning and stressful life events served as covariates. The MH of psychedelics users was not significantly different from the no-drug-use group, whereas poorer MH was found in the other SU groups. Observed effects were influenced by the tested stress factors. The absence of association between use of psychedelics and worsening of MH deserves further investigation in male and female samples. Stressful life experiences must be considered when assessing the MH of users of illicit substances. These findings suggest that some men practice SU as self-medication to cope with life adversity.
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Affiliation(s)
- Ansgar Rougemont-Bücking
- a Faculty of Science and Medicine-Medicine Section, Department of Neurosciences and Movement Science (NMS), Psychiatry and Psychotherapy, University of Fribourg , Fribourg , Switzerland
| | - Henrik Jungaberle
- b FINDER Institute for Prevention Research , Berlin , Germany.,c MIND European Foundation for Psychedelic Science , Berlin , Germany
| | - Milan Scheidegger
- d Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich , Zurich , Switzerland
| | - Marco C G Merlo
- a Faculty of Science and Medicine-Medicine Section, Department of Neurosciences and Movement Science (NMS), Psychiatry and Psychotherapy, University of Fribourg , Fribourg , Switzerland
| | - Veronique S Grazioli
- e Addiction Medicine Center, Department of Psychiatry, Lausanne University Hospital , Lausanne , Switzerland
| | - Jean-Bernard Daeppen
- e Addiction Medicine Center, Department of Psychiatry, Lausanne University Hospital , Lausanne , Switzerland
| | - Gerhard Gmel
- e Addiction Medicine Center, Department of Psychiatry, Lausanne University Hospital , Lausanne , Switzerland.,f Addiction Switzerland, Research Department , Lausanne , Switzerland.,g Centre for Addiction and Mental Health, Institute for Mental Health Policy Research , Toronto , Ontario , Canada.,h University of the West of England, Faculty of Health and Social Science , Frenchay Campus, Bristol , UK
| | - Joseph Studer
- e Addiction Medicine Center, Department of Psychiatry, Lausanne University Hospital , Lausanne , Switzerland
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6
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Grigsby TJ, Forster M, Tsai J, Rohrbach LA, Sussman S. Negative Substance Use Consequences Associated With Noncondom Use Among Male, but Not Female, Alternative High School Students. THE JOURNAL OF SCHOOL HEALTH 2018; 88:531-537. [PMID: 29864204 PMCID: PMC5992488 DOI: 10.1111/josh.12640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 09/19/2017] [Accepted: 09/19/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND Alternative (or continuation) high schools are institutions designed for students at risk for not graduating due to behavioral, educational, or medical problems. The present study explored the relationship between negative substance use consequences (eg, having trouble at school or work) and noncondom use in this at-risk population and whether these associations varied by sex. METHODS Participants (N = 1101; 62.9% Hispanic; Mage = 16.85) were sampled from 24 alternative high schools in California, and data were analyzed using cross-sectional multivariate logistic regression models. RESULTS We observed a relationship between the number of negative substance use consequences and probability of noncondom use at the last sexual encounter for boys (p < .001) but not girls (p > .05). There were significant associations between specific social consequences (missing school/work) and dependence symptoms (selling personal items to get alcohol or drugs) with noncondom use for boys only. There was a similar association between substance use frequency and noncondom use for boys. CONCLUSIONS These findings suggest that substance use consequences may be a useful and advantageous indicator of risky sexual behaviors such as noncondom use for boys, but not girls, in alternative high school settings. Future research and intervention programming recommendations are discussed.
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Affiliation(s)
- Timothy J Grigsby
- Department of Kinesiology, Health, and Nutrition, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249
| | - Myriam Forster
- Department of Health Sciences, University of California, Northridge, 18111 Nordhoff St, Northridge, CA 91330
| | - Jennifer Tsai
- Department of Preventive Medicine, University of Southern California, 2001 North Soto Street, 3rd Floor, Los Angeles, CA 90032
| | - Louise A Rohrbach
- Department of Preventive Medicine, University of Southern California, 2001 North Soto Street, 3rd Floor, Los Angeles, CA 90032
| | - Steve Sussman
- Department of Preventive Medicine, University of Southern California, 2001 North Soto Street, 3rd Floor, Los Angeles, CA 90032
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7
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Lai TJ, Su MH, Lee TSH, Yang HJ. Mental Health Problems in Recently Incarcerated Male Adult Drug Users in Taiwan: Patterns, Rates, and Implications for Treatment. Int J Ment Health Addict 2017. [DOI: 10.1007/s11469-016-9663-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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8
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Kazour F, Soufia M, Rohayem J, Richa S. Suicide Risk of Heroin Dependent Subjects in Lebanon. Community Ment Health J 2016; 52:589-96. [PMID: 26424734 DOI: 10.1007/s10597-015-9952-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 09/23/2015] [Indexed: 11/30/2022]
Abstract
The aim is to determine the frequency of suicidal behavior and associated factors among heroin dependent inpatients. 61 heroin dependent inpatients (vs. 61 controls) were assessed on their pattern of substance use, impulsivity, depression and suicidal behavior. 37.7 % of patients had a personal history of suicidal attempt (SA), 14.8 % had current suicidal ideation. SA was associated to younger age at first substance use and to higher rates of depression and impulsivity. IV heroin overdose was the most frequent mode of SA (47.8 %). Long duration, multiple drug use, and family history of suicide were associated with higher risk of suicide among lebanese patients.
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Affiliation(s)
- François Kazour
- Department of Psychiatry, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon. .,Psychiatric Hospital of the Cross, Jalledib, 60096, Lebanon.
| | - Michel Soufia
- Department of Psychiatry, Faculty of Medicine, Université Saint-Esprit de Kaslik, Beirut, Lebanon
| | - Jihane Rohayem
- Department of Psychiatry, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.,Hotel-Dieu de France Hospital, Beirut, Lebanon
| | - Sami Richa
- Department of Psychiatry, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.,Hotel-Dieu de France Hospital, Beirut, Lebanon
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Abstract
Alcohol consumption with psychostimulants is very common among drug addicts. There is little known about the possible pharmacological interactions between alcohol and psychostimulants. Among most commonly co-abused psychostimulants with alcohol are methamphetamine, cocaine, 3,4-methylenedioxymethamphetaminen, and nicotine. Co-abuse of alcohol with psychostimulants can lead to several neurophysiological dysfunctions such as decrease in brain antioxidant enzymes, disruption of learning and memory processes, cerebral hypo-perfusion, neurotransmitters depletion as well as potentiation of drug seeking behaviour. Moreover, co-abuse of alcohol and psychostimulants can lead to increase in heart rate, blood pressure, myocardial oxygen consumption and cellular stress, and the risk of developing different types of cancer. Co-abuse of alcohol with psychostimulants during pregnancy can lead to fetal brain abnormalities. Further studies are needed to investigate the pharmacokinetics, pharmacodynamics, and neurochemical changes on co-abuse of alcohol and psychostimulants.
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Affiliation(s)
- Yusuf S Althobaiti
- University of Toledo, College of Pharmacy and Pharmaceutical Sciences, Department of Pharmacology and Experimental Therapeutics, Toledo, OH, USA
| | - Youssef Sari
- University of Toledo, College of Pharmacy and Pharmaceutical Sciences, Department of Pharmacology and Experimental Therapeutics, Toledo, OH, USA
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10
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Hasin DS, Grant BF. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings. Soc Psychiatry Psychiatr Epidemiol 2015; 50:1609-40. [PMID: 26210739 PMCID: PMC4618096 DOI: 10.1007/s00127-015-1088-0] [Citation(s) in RCA: 274] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 06/28/2015] [Indexed: 01/12/2023]
Abstract
PURPOSE The NESARC, a "third-generation" psychiatric epidemiologic survey that integrated detailed measures of alcohol and drug use and problems has been the data source for over >850 publications. A comprehensive review of NESARC findings and their implications is lacking. METHOD NESARC was a survey of 43,093 participants that covered alcohol, drug and psychiatric disorders, risk factors, and consequences. Wave 1 of the NESARC was conducted in 2001-2002. Three years later, Wave 2 follow-up re-interviews were conducted with 34,653 of the original participants. Scopus and Pubmed were used to search for NESARC papers, which were sorted into topic areas and summarized. RESULT The most common disorders were alcohol and posttraumatic stress disorders, and major depression. Females had more internalizing disorders and males had more externalizing disorders, although the preponderance of males with alcohol disorders (the "gender gap") was less pronounced than it was in previous decades. A race/ethnic "paradox" (lower risk among disadvantaged minorities than whites) remains unexplained. Younger participants had higher risk for substance and personality disorders, but not unipolar depressive or anxiety disorders. Psychiatric comorbidity was extensive and often formed latent trans-diagnostic domains. Since 1991-1992, risk for marijuana and prescription drug disorders increased, while smoking decreased, although smoking decreases were less pronounced among those with comorbidity. A nexus of comorbidity, social support, and stress predicted transitions in diagnostic status between Waves 1 and 2. Childhood maltreatment predicted psychopathology. Alcohol and drug use disorders were seldom treated; attitudinal barriers (little perceived need, perceived alcoholism stigma, pessimism about efficacy) were more important in predicting non-treatment than financial barriers. CONCLUSIONS Understanding comorbidity and the effects of early stressors will require research incorporating biologic components, e.g., genetic variants and brain imaging. The lack of treatment for alcohol and drug disorders, predicted by attitudinal rather than financial variables, suggests an urgent need for public and professional education to reduce the stigma associated with these disorders and increase knowledge of treatment options.
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Affiliation(s)
- Deborah S Hasin
- Department of Psychiatry, College of Physicians and Surgeons, New York, NY, 10032, USA
- Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Bridget F Grant
- Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, 5635 Fishers Lane, Room 3077, Rockville, MD, 20852, USA.
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11
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Price JS, Shear P, Lisdahl KM. Ecstasy exposure & gender: examining components of verbal memory functioning. PLoS One 2014; 9:e115645. [PMID: 25545890 PMCID: PMC4278706 DOI: 10.1371/journal.pone.0115645] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 11/25/2014] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Studies have demonstrated verbal memory deficits associated with past year ecstasy use, although specific underlying components of these deficits are less understood. Further, prior research suggests potential gender differences in ecstasy-induced serotonergic changes. Therefore, the current study investigated whether gender moderated the relationship between ecstasy exposure and components of verbal memory after controlling for polydrug use and confounding variables. METHOD Data were collected from 65 polydrug users with a wide range of ecstasy exposure (ages 18-35; 48 ecstasy and 17 marijuana users; 0-2310 ecstasy tablets). Participants completed a verbal learning and memory task, psychological questionnaires, and a drug use interview. RESULTS Increased past year ecstasy exposure predicted poorer short and long delayed free and cued recalls, retention, and recall discrimination. Male ecstasy users were more susceptible to dose-dependent deficits in retention than female users. CONCLUSION Past year ecstasy consumption was associated with verbal memory retrieval, retention, and discrimination deficits in a dose-dependent manner in a sample of healthy young adult polydrug users. Male ecstasy users were at particular risk for deficits in retention following a long delay. Gender difference may be reflective of different patterns of polydrug use as well as increased hippocampal sensitivity. Future research examining neuronal correlates of verbal memory deficits in ecstasy users are needed.
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Affiliation(s)
- Jenessa S. Price
- McLean Hospital – Harvard Medical School, Belmont, Massachusetts, United States of America
| | - Paula Shear
- Department of Psychology, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States of America
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12
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Keyes KM, Cerdá M, Brady JE, Havens JR, Galea S. Understanding the rural-urban differences in nonmedical prescription opioid use and abuse in the United States. Am J Public Health 2014; 104:e52-9. [PMID: 24328642 PMCID: PMC3935688 DOI: 10.2105/ajph.2013.301709] [Citation(s) in RCA: 295] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2013] [Indexed: 11/04/2022]
Abstract
Nonmedical prescription opioid misuse remains a growing public problem in need of action and is concentrated in areas of US states with large rural populations such as Kentucky, West Virginia, Alaska, and Oklahoma. We developed hypotheses regarding the influence of 4 factors: (1) greater opioid prescription in rural areas, creating availability from which illegal markets can arise; (2) an out-migration of young adults; (3) greater rural social and kinship network connections, which may facilitate drug diversion and distribution; and (4) economic stressors that may create vulnerability to drug use more generally. A systematic consideration of the contexts that create differences in availability, access, and preferences is critical to understanding how drug use context varies across geography.
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Affiliation(s)
- Katherine M Keyes
- Katherine M. Keyes, Magdalena Cerdá, and Sandro Galea are with the Department of Epidemiology, Columbia University, New York, NY. Joanne E. Brady is with the Department of Epidemiology and the Department of Anesthesiology, Columbia University. Jennifer R. Havens is with the Department of Behavioral Science, Center on Drug and Alcohol Research, University of Kentucky College of Medicine, Lexington
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Abstract
The aim of the present study was to report independent correlates of ecstasy use in the Swedish general population. Data were drawn from a Swedish national household survey conducted in 2008-2009 on a random, stratified sample of 58,000 inhabitants of Sweden, aged 15 to 64. The response rate was 38.3%. Logistic regression analysis was used to identify correlates of recent (past-year) and former ecstasy use. Results are discussed and limitations of the study are noted.
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Affiliation(s)
- Tove Abrahamsson
- Division of Psychiatry, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
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14
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Zhang Y, Lu C, Zhang J, Hu L, Song H, Li J, Kang L. Gender differences in abusers of amphetamine-type stimulants and ketamine in southwestern China. Addict Behav 2013; 38:1424-30. [PMID: 23006246 DOI: 10.1016/j.addbeh.2012.06.024] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2012] [Revised: 05/21/2012] [Accepted: 06/19/2012] [Indexed: 10/28/2022]
Abstract
The objective of this study was to investigate abuse conditions of new-type drugs for users who are seeking treatment, gender differences, and differences between the amphetamine-type stimulants (ATS) users and mixed amphetamine-type stimulants and ketamine (ATS+K) poly-drug users. A retrospective analysis was conducted of patients with a final diagnosis of the substance use disorder according to the Diagnoses and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV) who underwent treatment for exposure to new-type drugs at the mental health center of the West China Hospital from March 2009 to May 2011. A questionnaire was used to collect information about socio-demographics, drug abuse conditions and psychiatric co-morbidities. Male subjects were older (p=0.026), had low level education (p=0.003), were less previously married (p<0.001), were more likely to be employed and to hold higher status jobs (p=0.007); 77.1% of subjects had a psychotic disorder, 28.0% of subjects had a mood disorder, 39.7% had an anxiety disorder, and 45.0% had a cognitive impairment disorder. More men used methamphetamine MA (p<0.001), tobacco (p=0.014) and more than one drug substance (p=0.004) compared to women; women were more vulnerable to mood disorders (p=0.034) than men. For the males, the ATS+K patients were more likely to use 3, 4-methylenedioxymethamphetamine MDMA (p<0.001) and develop more psychotic disorders (p=0.04) than the ATS patients; for females, the ATS+K patients were more likely to use MDMA (p=0.002), alcohol (p=0.014) and develop more cognitive impairment disorder (p=0.034). The present study found that the new-type drug patients have a high degree of psychiatric morbidities; more men were using MA, tobacco and multi-substance and more women patients experience mood disorder in the gender differences. For the males, the ATS+K patients were more likely to use MDMA (3, 4-methylenedioxymethamphetamine) and develop more psychotic disorders than the ATS patients; for females, the ATS+K patients were more likely to use MDMA, alcohol and develop more cognitive impairment disorder. These results suggested that the psychiatrists should focus on the mood disorder among females, psychotic disorders among males who abuse ATS and ketamine, and cognitive impairment disorder for the females who abuse ATS and ketamine.
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Hittner JB, Schachne ER. Meta-analysis of the association between ecstasy use and risky sexual behavior. Addict Behav 2012; 37:790-6. [PMID: 22424824 DOI: 10.1016/j.addbeh.2012.02.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Revised: 02/08/2012] [Accepted: 02/27/2012] [Indexed: 11/19/2022]
Abstract
A random-effects meta-analysis was conducted to examine the association between ecstasy use and risky sexual behavior. Analysis of 17 studies revealed a small to moderate sized effect (mean weighted r=0.211, 95% CI: 0.085-0.336). Random-effects homogeneity testing was non-significant, thus formal moderator analyses were not performed. Moreover, numerical and visual diagnostics suggested that publication bias was not a concern. It is hoped that the present meta-analytic findings and recommendations will encourage investigators to broaden their research methodologies and will stimulate new insights into the association between ecstasy use and risky sexual behavior.
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Affiliation(s)
- James B Hittner
- Department of Psychology, College of Charleston, SC 29424, USA.
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16
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Kim J, Fan B, Liu X, Kerner N, Wu P. Ecstasy use and suicidal behavior among adolescents: findings from a national survey. Suicide Life Threat Behav 2011; 41:435-44. [PMID: 21631573 PMCID: PMC3152632 DOI: 10.1111/j.1943-278x.2011.00043.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The relationship between ecstasy use and suicidal behavior among adolescents in the United States was examined. Data from the adolescent subsample (ages 12-17, N = 19,301) of the 2000 National Household Survey on Drug Abuse were used in the analyses. Information on adolescent substance use, suicidal behaviors, and related sociodemographic, family, and individual factors was obtained in the survey. The rate of past year suicide attempt among adolescents with lifetime ecstasy use was almost double that of adolescents who had used other drugs only, and nine times that of adolescents with no history of illicit drug use. In multinomial logistic regression analyses controlling for related factors, the effect of ecstasy use remained significant. Adolescent ecstasy users may require enhanced suicide prevention and intervention efforts.
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Affiliation(s)
- Jueun Kim
- College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
| | - Bin Fan
- New York State Psychiatric Institute, New York, NY, 10032, USA
| | - Xinhua Liu
- Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Nancy Kerner
- College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
| | - Ping Wu
- College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA, New York State Psychiatric Institute, New York, NY, 10032, USA, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA,Corresponding author at: Departments of Psychiatry and Epidemiology, Columbia University, 1051 Riverside Drive, Unit 43, New York, NY, 10032, USA. Tel: (212) 543-5190; Fax: (212) 781-6050;
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17
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Pechansky F, Remy L, Surratt HL, Kurtz SP, Rocha TBM, Von Diemen L, Bumaguin DB, Inciardi J. Age of Sexual Initiation, Psychiatric Symptoms, and Sexual Risk Behavior among Ecstasy and LSD Users in Porto Alegre, Brazil: A Preliminary Analysis. JOURNAL OF DRUG ISSUES 2011; 41:217. [PMID: 22287797 PMCID: PMC3266349 DOI: 10.1177/002204261104100204] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Ecstasy and LSD use is widespread in large Brazilian cities, but there is limited information on their use among young, middle-class, club goers in Brazil. We conducted standardized face-to-face interviews with 200 male and female ecstasy and/or LSD users, focusing on drug use and sexual history, current risk behaviors, and psychiatric symptomatology. Participants with early sexual debut (before 14) were more likely to report lifetime use of marijuana and powder and crack cocaine than those with later sexual initiation. Early sexual debut was associated with past year sexual risk behaviors, including having sex while high (Prevalence Ratio (PR)=1.3), having two or more sex partners (PR=1.3), as well as history of sexual abuse (PR=13.6). Depression and anxiety scores were similar by age of sexual initiation. The implications of these findings are discussed.
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18
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Schenk S. MDMA ("ecstasy") abuse as an example of dopamine neuroplasticity. Neurosci Biobehav Rev 2010; 35:1203-18. [PMID: 21184779 DOI: 10.1016/j.neubiorev.2010.12.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 12/12/2010] [Accepted: 12/15/2010] [Indexed: 01/12/2023]
Abstract
A number of reviews have focused on the short- and long-term effects of MDMA and, in particular, on the persistent deficits in serotonin neurotransmission that accompany some exposure regimens. The mechanisms underlying the serotonin deficits and their relevance to various behavioral and cognitive consequences of MDMA use are still being debated. It has become clear, however, that some individuals develop compulsive and uncontrolled drug-taking that is consistent with abuse. For other drugs of abuse, this transition has been attributed to neuroadaptations in central dopamine mechanisms that occur as a function of repeated drug exposure. A question remains as to whether similar neuroadaptations occur as a function of exposure to MDMA and the impact of serotonin neurotoxicity in the transition from use to abuse. This review focuses specifically on this issue by first providing an overview of human studies and then reviewing the animal literature with specific emphasis on paradigms that measure subjective effects of drugs and self-administration as indices of abuse liability. It is suggested that serotonin deficits resulting from repeated exposure to MDMA self-administration lead to a sensitized dopaminergic response to the drug and that this sensitized response renders MDMA comparable to other drugs of abuse.
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Affiliation(s)
- Susan Schenk
- Victoria University of Wellington, School of Psychology, Kelburn Pde, Easterfield Bldg Rm 702, Wellington, New Zealand.
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19
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Niv N, Warda U, Grella CE, Moore AA, Sarkisyan D, Karno MP. Substance use disorders and treatment utilization among MDMA users: Results from The National Epidemiologic Survey on Alcohol and Related Conditions. JOURNAL OF DRUG ISSUES 2010; 40:537-551. [PMID: 24198439 DOI: 10.1177/002204261004000301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study examined the prevalence and correlates of substance use disorders and treatment utilization among lifetime MDMA users. Secondary analyses were conducted on data from the 2001-2002 NESARC, a nationally representative survey of adults in the United States. Lifetime MDMA use was assessed, and MDMA users (n = 562) were compared to a matched sample of non-MDMA users. Substance use diagnoses were made using the AUDADIS - DSM-IV, and data on treatment utilization were collected. MDMA use was significantly related to lifetime and past year substance use disorders as well as treatment utilization in bivariate analyses. Multivariate analysis, however, showed that MDMA use was not related to lifetime substance use diagnosis or to treatment utilization. MDMA use still had the strongest association with past year substance use disorders.
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Affiliation(s)
- N Niv
- University of California, Los Angeles (UCLA) Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior
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20
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Wu LT, Parrott AC, Ringwalt CL, Yang C, Blazer DG. The variety of ecstasy/MDMA users: results from the National Epidemiologic Survey on alcohol and related conditions. Am J Addict 2010; 18:452-61. [PMID: 19874166 DOI: 10.3109/10550490903206049] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
This study investigates the potential heterogeneity of ecstasy or MDMA (3,4-methylenedioxy-N-methylamphetamine) users. Data came from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Latent class analysis (LCA) and multinomial logistic regression procedures were used to identify subtypes of ecstasy users. Approximately 1.6% (n = 562) of adult participants (N = 43,093) reported lifetime ecstasy use. LCA identified three subtypes of ecstasy users. Class 1 exhibited pervasive use of most drug classes (ecstasy-polydrug users, 37%). Class 2 reported a high rate of use of marijuana and cocaine and a moderate use of amphetamines (ecstasy-marijuana-stimulant users, 29%). Class 3 was characterized by a high rate of use of marijuana and a low use of primarily prescription-type drugs (ecstasy-marijuana users, 34%). Subtypes were distinguished by family income, history of substance abuse treatment, and familial substance abuse. Class 1 exhibited the highest prevalence of disorders related to the use of marijuana (77%), tobacco (66%), amphetamines (36%), opioids (35%), sedatives (31%), and tranquilizers (30%). The recent resurgence in ecstasy use among adults underscores the need to monitor trends in its use.
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Affiliation(s)
- Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina 27710, USA.
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21
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Martín-Santos R, Torrens M, Poudevida S, Langohr K, Cuyás E, Pacifici R, Farré M, Pichini S, de la Torre R. 5-HTTLPR polymorphism, mood disorders and MDMA use in a 3-year follow-up study. Addict Biol 2010; 15:15-22. [PMID: 19878141 DOI: 10.1111/j.1369-1600.2009.00180.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A 3-year longitudinal prospective study was conducted to compare the incidence of substance use disorders (SUD) and non-substance use disorders (NSUD) among ecstasy users and two control groups: one of cannabis users and the other of non-drug users. The 5-HTTLPR polymorphism related to NSUD was also studied. A total of 94 subjects were included: 37 ecstasy users, 23 cannabis users and 34 non-drug users. SUD and NSUD disorders were diagnosed according to the fourth edition of the Diagnostic and Statistical Manual of Mental Health Disorders criteria using the Psychiatric Research Interview for Substance and Mental Disorders. Incidence Rates (IR) are presented. The 5-HTTLPR polymorphism was analyzed. Hardy-Weinberg equilibrium was studied. The results of the study showed that the highest IR of SUD was cannabis abuse/dependence in both the ecstasy (IR: 48.6/100 person-year) and cannabis (IR: 2.5/100 person-year) groups. There were no new cases of SUD in non-drug users at follow-up. The highest IR of NSUD was primary mood disorder in both the ecstasy (IR: 4.2/100 person-year) and in the non-drug (IR: 1.3/100 person-year) groups (P < 0.282). There were no new cases of NSUD in the cannabis group at follow-up. 5-HTTLPR polymorphism was associated with lifetime of primary mood disorders in ecstasy group (P = 0.018). Ecstasy use was associated with a higher rate of cannabis abuse/dependence disorders and mood disorders than cannabis use. In the ecstasy users, 5-HTTLPR polymorphism may result in a high vulnerability to primary mood disorders.
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Affiliation(s)
- Rocío Martín-Santos
- Human Pharmacology and Clinical Neurosciences Research Group, Institut Municipal d'Investigació Mèdica (IMIM-Hospital del Mar), Dr Aiguader 88, Barcelona, Spain.
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Wu P, Goodwin RD, Fuller C, Liu X, Comer JS, Cohen P, Hoven CW. The relationship between anxiety disorders and substance use among adolescents in the community: specificity and gender differences. J Youth Adolesc 2009; 39:177-88. [PMID: 20084563 DOI: 10.1007/s10964-008-9385-5] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2008] [Accepted: 12/23/2008] [Indexed: 10/21/2022]
Abstract
Using a sample of 781 adolescents (ages 13-17, 52.8% male) from a community survey, this study examined gender differences in the co-occurrence of specific anxiety disorders with substance use in adolescents. The associations between anxiety disorders and substance use differed according to the particular anxiety disorders and forms of substance use being examined, as well as by gender. Social phobia was associated with cigarette smoking among boys only. For girls, social phobia appeared to be negatively associated with drug use. For the other anxiety disorders, the associations with substance use tended to be stronger among girls. These findings highlight the need to improve clinical recognition of the anxiety disorders and to improve treatment access for afflicted adolescents. Future studies based on longitudinal data could further elucidate the relationships among anxiety disorders, gender, and substance use.
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Affiliation(s)
- Ping Wu
- Mailman School of Public Health, Columbia University, New York, NY, USA.
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