1
|
Bruzelius E, Palamar JJ, Fitzgerald ND, Cottler LB, Carr TC, Martins SS. Law enforcement fentanyl seizures and overdose mortality in US counties, 2013-2020. Drug Alcohol Depend 2024; 262:111400. [PMID: 39079225 DOI: 10.1016/j.drugalcdep.2024.111400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 07/02/2024] [Accepted: 07/10/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND The spread of illicitly manufactured fentanyl is driving steep increases in US overdose deaths. Fentanyl seizures are correlated with state-level opioid-related mortality; however, more granular seizure surveillance information has the potential to better inform overdose prevention and harm reduction efforts. METHODS Using data on fentanyl pill and powder seizures from High Intensity Drug Trafficking Areas (HIDTA), we tested associations between seizure prevalence and overdose mortality, from 2013 to 2020. The primary exposure-seizure burden-was constructed by identifying counties having high (above the median) prevalence of pill, powder, or combined pill/powder seizure burden per 100,000 population. Poisson models accounted for county demographic, law enforcement and time trends. RESULTS During the timeframe, there were 13,842 fentanyl seizures in 606 US counties. In adjusted models, counties with a high burden of pill or powder fentanyl seizures, or both (combined pills/powder) exhibited higher total overdose mortality than non-high burden counties (pills adjusted prevalence ratio [aPR]: 1.10 [95 % confidence interval [CI]: 1.08, 1.12]; powder aPR 1.12 [CI: 1.11, 1.13]; combined pills/powder aPR: 1.27 [CI: 1.25, 1.29]). A similar pattern of associations with fentanyl seizure burden was noted for overdose deaths involving synthetic opioids (pills [aPR]: 0.99 [CI: 0.96, 1.02]; powder aPR 1.29 [CI: 1.27, 1.30]; combined pills/powder aPR 1.55 [CI: 1.52, 1.58]). CONCLUSIONS Law enforcement data on fentanyl seizures predicts drug overdose mortality at the county-level. Integrating these data with more traditional epidemiologic surveillance approaches has the potential to inform community overdose response efforts.
Collapse
Affiliation(s)
- Emilie Bruzelius
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States.
| | - Joseph J Palamar
- Department of Population Health, NYU Langone Health, New York, NY, United States
| | - Nicole D Fitzgerald
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine University of Florida, Gainesville, FL, United States
| | - Linda B Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine University of Florida, Gainesville, FL, United States
| | - Thomas C Carr
- College of Public Affairs, Center for Drug Policy and Prevention, University of Baltimore, United States; Office of National Drug Control Policy, Washington-Baltimore High Intensity Drug Trafficking Areas Program, Center for Drug Policy and Prevention, University of Baltimore, United States
| | - Silvia S Martins
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
| |
Collapse
|
2
|
Palamar JJ, Fitzgerald ND, Goldberger BA, Cottler LB. Monitoring illicit pentobarbital availability in the United States: A National Drug Early Warning System briefing. Drug Alcohol Depend 2024; 263:112402. [PMID: 39173219 DOI: 10.1016/j.drugalcdep.2024.112402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/31/2024] [Accepted: 08/01/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Pentobarbital is a Schedule II/III short-acting barbiturate with limited medical use in humans. Veterinary professionals use pentobarbital to euthanize dogs, cats, and other companion animals. Pentobarbital is also utilized in capital punishment and small amounts are illegally shipped or diverted to assist in suicides. However, five kilograms of pentobarbital smuggled in from Mexico was recently seized by an organized crime drug enforcement task force (along with fentanyl, heroin, and cocaine), which may suggest a shift in illicit supply. We investigated potential indicators of illicit pentobarbital use or availability in the US to help determine whether this drug is becoming an emerging public health concern. METHODS The National Drug Early Warning System requested information on pentobarbital from its sentinel surveillance sites and collaborators and conducted a search of current literature. RESULTS In early 2024, multiple batches of counterfeit pills (e.g., pressed as "M30s" to represent oxycodone) confiscated near the Southwest border tested positive for pentobarbital plus combinations of fentanyl, fentanyl analogs, and xylazine. Other indicators suggest pentobarbital is being smuggled in powder form and possibly sold as another drug such as heroin. One national drug analysis program detected pentobarbital in 217 drug submissions from 2020 to 2023, and there were at least 12 fatal exposures linked to use from 2020 to 2022. CONCLUSION Continued monitoring of illicit use and availability is needed as pentobarbital may continue to appear on the illicit market. Unknown exposure can occur if the drug is mixed into counterfeit pills or sold in powder form represented to be another drug.
Collapse
Affiliation(s)
- Joseph J Palamar
- NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA.
| | - Nicole D Fitzgerald
- Columbia University Mailman School of Public Health, Department of Epidemiology, New York, NY, USA
| | - Bruce A Goldberger
- University of Florida College of Medicine, Department of Pathology, Immunology and Laboratory Medicine, Gainesville, FL, USA
| | - Linda B Cottler
- University of Florida, College of Public Health and Health Professions, College of Medicine Department of Epidemiology, USA
| |
Collapse
|
3
|
Starks TJ, Hillesheim JR, Castiblanco J, Cain D, Stephenson R. Drug use during the second year of the COVID-19 pandemic: observations from repeated cross-sectional surveys of sexual minority men in the US active on social networking applications. AIDS Care 2024; 36:145-153. [PMID: 38289592 PMCID: PMC11283985 DOI: 10.1080/09540121.2024.2308738] [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] [Received: 07/10/2023] [Accepted: 01/10/2024] [Indexed: 07/28/2024]
Abstract
Studies conducted early in the COVID-19 pandemic - before vaccines were widely available - indicated that drug use may have declined among sexual minority men (SMM). This study evaluated drug use trends in the second year of the pandemic. Cross-sectional responses from cisgender SMM living in the US and recruited online (n = 15,897) were grouped for analyses: Time 1: 3/1/2021-5/30/2021; Time 2: 6/1/2021-8/31/2021; Time 3: 9/1/2021-11/30/2021; and Time 4: 12/1 2021-2/28/2022. Results of multivariable models indicated that illicit drug use (excluding cannabis) increased at Times 2 (OR = 1.249, p < .001), 3 (OR = 1.668, p < .001), and 4 (OR = 1.674, p < .001) compared to Time 1. In contrast, cannabis use was relatively stable over time. Rates did not differ significantly among Times 1, 2, and 4. While rates of COVID-19 vaccination increased over time, illicit drug use was negatively associated with the odds of vaccination (OR = 0.361, p < .001). These findings highlight the need for ongoing attention to the risks drug use poses among SMM. Illicit drug use - a long-standing health disparity among SMM - increased significantly across the second year of the pandemic. Because they are less likely to be vaccinated, SMM who use illicit drugs may be at greater risk of COVID-19 infection or complications.
Collapse
Affiliation(s)
- Tyrel J. Starks
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
- Doctoral Program in Health Psychology and Clinical Science, Graduate Center of the City University of New York, New York, NY, USA
| | - Joseph R. Hillesheim
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
| | - Juan Castiblanco
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
| | - Demetria Cain
- Department of Psychology, Hunter College of the City University of New York, New York, NY, USA
| | - Rob Stephenson
- The Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
4
|
Manthey J, Gobiņa I, Isajeva L, Neneman J, Reile R, Štelemėkas M, Rehm J. The Impact of Raising Alcohol Taxes on Government Tax Revenue: Insights from Five European Countries. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:363-374. [PMID: 38386271 PMCID: PMC11021250 DOI: 10.1007/s40258-024-00873-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Reducing the affordability of alcoholic beverages by increasing alcohol excise taxation can lead to a reduction in alcohol consumption but the impact on government alcohol excise tax revenue is poorly understood. This study aimed to (a) describe cross-country tax revenue variations and (b) investigate how changes in taxation were related to changes in government tax revenue, using data from Estonia, Germany, Latvia, Lithuania and Poland. METHODS For the population aged 15 years or older, we calculated the annual per capita alcohol excise tax revenue, total tax revenue, gross domestic product and alcohol consumption. In addition to descriptive analyses, joinpoint regressions were performed to identify whether changes in alcohol excise taxation were linked to changes in alcohol excise revenue since 1999. RESULTS In 2022, the per capita alcohol excise tax revenue was lowest in Germany (€44.2) and highest in Estonia (€218.4). In all countries, the alcohol excise tax revenue was mostly determined by spirit sales (57-72% of total alcohol tax revenue). During 2010-20, inflation-adjusted per capita alcohol excise tax revenues have declined in Germany (- 22.9%), Poland (- 19.1%) and Estonia (- 4.2%) and increased in Latvia (+ 56.8%) and Lithuania (+ 49.3%). In periods of policy non-action, alcohol consumption and tax revenue showed similar trends, but tax level increases were accompanied by increased revenue and stagnant or decreased consumption. CONCLUSIONS Increasing alcohol taxation was not linked to decreased but increased government revenue. Policymakers can increase revenue and reduce alcohol consumption and harm by increasing alcohol taxes.
Collapse
Affiliation(s)
- Jakob Manthey
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany.
| | - Inese Gobiņa
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Laura Isajeva
- Department of Public Health and Epidemiology, Riga Stradiņš University, Riga, Latvia
- Institute of Public Health, Riga Stradiņš University, Riga, Latvia
| | - Jarosław Neneman
- Institute of Economics, Faculty of Economics and Sociology, University of Lodz, Lodz, Poland
| | - Rainer Reile
- Department for Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Mindaugas Štelemėkas
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Preventive Medicine, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jürgen Rehm
- Department of Psychiatry and Psychotherapy, Center for Interdisciplinary Addiction Research (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program on Substance Abuse, Program on Substance Abuse and WHO CC, Public Health Agency of Catalonia, Barcelona, Spain
| |
Collapse
|
5
|
Palamar JJ, Fitzgerald ND, Carr TH, Rutherford C, Keyes KM, Cottler LB. National and regional trends in seizures of shrooms (psilocybin) in the United States, 2017-2022. Drug Alcohol Depend 2024; 258:111086. [PMID: 38326175 PMCID: PMC11088526 DOI: 10.1016/j.drugalcdep.2024.111086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/17/2023] [Accepted: 12/23/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Psilocybin, the principle psychoactive component in "shrooms", is regaining acceptance in therapeutic settings, leading to media coverage of medical benefits associated with use. Possession is also becoming increasingly decriminalized throughout the United States. There is a lack of data on prevalence of shroom use, but trends in law enforcement seizure data can provide one indicator of shroom availability in US communities. We determined whether seizures of shrooms have shifted between 2017 and 2022. METHODS This study examined national and regional trends in counts and total weight of shroom seizures reported to High Intensity Drug Trafficking Areas in the US between 2017 and 2022 (N=4526). RESULTS There were 402 seizures in 2017 compared to 1396 in 2022 with the plurality occurring in the Midwest (36.0%), followed by the West (33.5%). Between 2017 Quarter 1 (Q1) and 2022 Quarter 4 (Q4), the number of seizures increased by 368.9% (AQPC=7.0; 95 CI: 5.9-8.1) and there were significant increases in all four regions. In terms of weight, 226.0kg was seized in 2017 vs. 844.0kg in 2022, and the greatest total weight in seizures was in the West (1864.2kg, 42.6%), followed by the South (1831.9kg, 41.8%). Between 2017 Q1 and 2022 Q4, the total weight seized in the US increased by 2749.7% (AQPC=6.2, 95% CI: 0.3-12.4) and there were significant increases in all four regions. CONCLUSIONS Seizures of shrooms have increased, suggesting that availability may be escalating; thus, increases in prevention efforts and harm reduction education are warranted.
Collapse
Affiliation(s)
- Joseph J Palamar
- NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA.
| | - Nicole D Fitzgerald
- University of Florida, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, United States; NDEWS, University of Florida, USA
| | - Thomas H Carr
- Office of National Drug Control Policy, Washington-Baltimore High Intensity Drug Trafficking Areas Program; College of Public Affairs, Center for Drug Policy and Prevention, University of Baltimore, USA
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Linda B Cottler
- University of Florida, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, United States; NDEWS, University of Florida, USA
| |
Collapse
|
6
|
Kennedy MC, Dong H, Tobias S, Buxton JA, Lysyshyn M, Tupper KW, Ti L. Fentanyl Concentration in Drug Checking Samples and Risk of Overdose Death in Vancouver, Canada. Am J Prev Med 2024; 66:10-17. [PMID: 37633426 DOI: 10.1016/j.amepre.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
INTRODUCTION The proliferation of fentanyl and its analogs in illegal, unregulated drug markets remains a major driver of the overdose crisis in North America. Drug checking services have been implemented as a harm reduction strategy to address the crisis. However, little is known about their potential utility as a mechanism for monitoring population-level risk of overdose stemming from changing fentanyl concentration in unregulated drugs over time. Therefore, this study assessed the relationship between median fentanyl concentration in expected opioid drug checking samples and the death rate due to illicit drug toxicity over time in Vancouver, Canada. METHODS Monthly population-based rates of death due to illicit drug toxicity were drawn from provincial coroner records. Monthly median percent fentanyl concentration was calculated using a validated quantification model from point-of-care Fourier-transform infrared spectra among expected opioid samples that tested positive for fentanyl at community drug checking services. A time-series analysis using generalized additive modeling was conducted to examine the association between monthly median fentanyl concentration and monthly death rate due to illicit drug toxicity, controlling for calendar month. Analyses were conducted in 2021-2022. RESULTS Between January 2019 and October 2020, 577 deaths due to illicit drug toxicity occurred in Vancouver, and the observed monthly rate ranged from 1.75 to 7.65 deaths per 100,000 population. A significant, positive association was observed between monthly median fentanyl concentration and monthly death rate due to illicit drug toxicity, adjusting for calendar month (chi-square=52.21, p<0.001). CONCLUSIONS Findings suggest a role for point-of-care drug checking as a tool for monitoring evolving overdose risk at the population level.
Collapse
Affiliation(s)
- Mary Clare Kennedy
- School of Social Work, Faculty of Health and Social Development, The University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada; British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada.
| | - Huiru Dong
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada; Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Boston, Massachusetts
| | - Samuel Tobias
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada; School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jane A Buxton
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - Mark Lysyshyn
- Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Kenneth W Tupper
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada; School of Child and Youth Care, Faculty of Human and Social Development, University of Victoria, Victoria, British Columbia, Canada
| | - Lianping Ti
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada; Department of Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
7
|
Shover CL, Friedman JR, Romero R, Buhr R, Chu B, Tang A, Medina JA, Wisk L, Lucas J, Goodman-Meza D. Longitudinal changes in co-involved drugs, comorbidities, and demographics of methamphetamine-related deaths in Los Angeles County. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 151:209101. [PMID: 37315796 PMCID: PMC10623547 DOI: 10.1016/j.josat.2023.209101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION We conducted a population-based observational study of all medical examiner cases in Los Angeles County from January 2012 through June 2021 in which methamphetamine was listed as a cause of or contributing factor to death (n = 6125). We aimed to characterize demographics, comorbidities, and co-involved substances in methamphetamine-related deaths longitudinally in Los Angeles County, California. METHODS We used detailed death record data to manually classify fatalities by involvement of each organ system, opioids, alcohol, cocaine, other drugs or medications, and external/traumatic causes. Primary outcomes included: the number of methamphetamine-involved deaths, demographics of decedents, percentage of methamphetamine deaths also involving other drugs, and percentage of methamphetamine deaths involving different organ systems. We performed Mann Kendall tests of trends to identify statistically significant longitudinal changes. RESULTS During the study period, the percentage of methamphetamine-related deaths involving opioids significantly increased from 16 % in 2012 to 54 % in 2021 (p < 0.001). Concurrently, the percentage involving cardiovascular causes significantly decreased from 47 % to 26 % (p < 0.05). Methamphetamine-related deaths in LAC increasingly affected people experiencing homelessness, for whom the percentage tripled from 13 % in 2012 to 35 % in 2021. The share of decedents under 40 years old increased from 33 % to 41 %. The percentage of Black or African American decedents increased over five-fold from 3 % to 17 %. CONCLUSIONS Methamphetamine-related deaths involving opioids more than tripled in Los Angeles County from 2012 to 2021, reflecting the drug supply's shift to illicit fentanyl. More than a quarter involved cardiovascular causes. These findings have implications for treatment and prevention, including scaling up contingency management, distributing naloxone to people who primarily use stimulants, and including cardiovascular care alongside these interventions directly targeted to reduce harms of methamphetamine use.
Collapse
Affiliation(s)
- Chelsea L Shover
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA.
| | | | - Ruby Romero
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
| | - Russell Buhr
- Division of Pulmonary and Critical Care, University of California, Los Angeles, CA, USA
| | - Brian Chu
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Amber Tang
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Jesus A Medina
- UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Lauren Wisk
- Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, CA, USA
| | - Jonathan Lucas
- Department of Medical Examiner-Coroner, Los Angeles County, Los Angeles, CA, USA
| | - David Goodman-Meza
- Division of Infectious Diseases, University of California, Los Angeles, CA, USA
| |
Collapse
|
8
|
Price O, Man N, Sutherland R, Bruno R, Dietze P, Salom C, Agramunt S, Grigg J, Degenhardt L, Peacock A. Disruption to Australian heroin, methamphetamine, cocaine and ecstasy markets with the COVID-19 pandemic and associated restrictions. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 113:103976. [PMID: 36822010 PMCID: PMC9932690 DOI: 10.1016/j.drugpo.2023.103976] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND Changes to drug markets can affect drug use and related harms. We aimed to describe market trends of heroin, methamphetamine, cocaine and ecstasy in Australia following the introduction of COVID-19 pandemic-associated restrictions. METHODS Australians residing in capital cities who regularly inject drugs (n ∼= 900 each year) or regularly use ecstasy and/or other illicit stimulants (n ∼= 800 each year) participated in annual interviews 2014-2022. We used self-reported market indicators (price, availability, and purity) for heroin, crystal methamphetamine, cocaine, and ecstasy crystal to estimate generalised additive models. Observations from the 2014-2019 surveys were used to establish the pre-pandemic trend; 2020, 2021 and 2022 observations were considered immediate, short-term and longer-term changes since the introduction of pandemic restrictions. RESULTS Immediate impacts on market indicators were observed for heroin and methamphetamine in 2020 relative to the 2014-2019 trend; price per cap/point increased (β: A$9.69, 95% confidence interval [CI]: 2.25-17.1 and β: A$40.3, 95% CI: 33.1-47.5, respectively), while perceived availability (adjusted odds ratio [aOR] for 'easy'/'very easy' to obtain: 0.38, 95% CI: 0.24-0.59 and aOR: 0.08, 95% CI: 0.03-0.25, respectively) and perceived purity (aOR for 'high' purity: 0.36, 95% CI: 0.23-0.54 and aOR: 0.33, 95% CI: 0.20-0.54, respectively) decreased. There was no longer evidence for change in 2021 or 2022 relative to the 2014-2019 trend. Changes to ecstasy and cocaine markets were most evident in 2022 relative to the pre-pandemic trend: price per gram increased (β: A$92.8, 95% CI: 61.6-124 and β: A$24.3, 95% CI: 7.93-40.6, respectively) and perceived purity decreased (aOR for 'high purity': 0.18, 95% CI: 0.09-0.35 and 0.57, 95% CI: 0.36-0.90, respectively), while ecstasy was also perceived as less easy to obtain (aOR: 0.18, 95% CI: 0.09-0.35). CONCLUSION There were distinct disruptions to illicit drug markets in Australia after the COVID-19 pandemic began; the timing and magnitude varied by drug.
Collapse
Affiliation(s)
- Olivia Price
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
| | - Nicola Man
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Rachel Sutherland
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia; School of Psychological Sciences, University of Tasmania, Hobart, Australia
| | - Paul Dietze
- Behaviours and Health Risks, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne Australia; National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Caroline Salom
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia; Institute for Social Science Research, The University of Queensland, Brisbane, Australia
| | - Seraina Agramunt
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Jodie Grigg
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia; School of Psychological Sciences, University of Tasmania, Hobart, Australia
| |
Collapse
|
9
|
Smart R, Kim JY, Kennedy S, Tang L, Allen L, Crane D, Mack A, Mohamoud S, Pauly N, Perez R, Donohue J. Association of polysubstance use disorder with treatment quality among Medicaid beneficiaries with opioid use disorder. J Subst Abuse Treat 2023; 144:108921. [PMID: 36327615 PMCID: PMC10664516 DOI: 10.1016/j.jsat.2022.108921] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 08/22/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The opioid crisis is transitioning to a polydrug crisis, and individuals with co-occurring substance use disorder (SUDs) often have unique clinical characteristics and contextual barriers that influence treatment needs, engagement in treatment, complexity of treatment planning, and treatment retention. METHODS Using Medicaid data for 2017-2018 from four states participating in a distributed research network, this retrospective cohort study documents the prevalence of specific types of co-occurring SUD among Medicaid enrollees with an opioid use disorder (OUD) diagnosis, and assesses the extent to which different SUD presentations are associated with differential patterns of MOUD and psychosocial treatments. RESULTS We find that more than half of enrollees with OUD had a co-occurring SUD, and the most prevalent co-occurring SUD was for "other psychoactive substances", indicated among about one-quarter of enrollees with OUD in each state. We also find some substantial gaps in MOUD treatment receipt and engagement for individuals with OUD and a co-occurring SUD, a group representing more than half of individuals with OUD. In most states, enrollees with OUD and alcohol, cannabis, or amphetamine use disorder are significantly less likely to receive MOUD compared to enrollees with OUD only. In contrast, enrollees with OUD and other psychoactive SUD were significantly more likely to receive MOUD treatment. Conditional on MOUD receipt, enrollees with co-occurring SUDs had 10 % to 50 % lower odds of having a 180-day period of continuous MOUD treatment, an important predictor of better patient outcomes. Associations with concurrent receipt of MOUD and behavioral counseling were mixed across states and varied depending on co-occurring SUD type. CONCLUSIONS Overall, ongoing progress toward increasing access to and quality of evidence-based treatment for OUD requires further efforts to ensure that individuals with co-occurring SUDs are engaged and retained in effective treatment. As the opioid crisis evolves, continued changes in drug use patterns and populations experiencing harms may necessitate new policy approaches that more fully address the complex needs of a growing population of individuals with OUD and other types of SUD.
Collapse
Affiliation(s)
- Rosanna Smart
- Drug Policy Research Center, RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, United States of America.
| | - Joo Yeon Kim
- Department of Health Policy and Management, University of Pittsburgh, 130 DeSoto Street, Crabtree Hall A635, Pittsburgh, PA 15261, United States of America.
| | - Susan Kennedy
- AcademyHealth, 1666 K Street NW, Suite 1100, Washington, DC 20006, United States of America.
| | - Lu Tang
- Department of Biostatistics, University of Pittsburgh, 130 DeSoto Street, Pittsburgh, PA 15261, United States of America.
| | - Lindsay Allen
- Department of Emergency Medicine, Buehler Center for Health Policy & Economics, Northwestern University, 750 N. Lake Shore Drive, Evanston, IL 60611, United States of America.
| | - Dushka Crane
- Government Resource Center, The Ohio State University, 150 Pressey Hall, 1070 Carmack Road, Columbus, OH 43210, United States of America.
| | - Aimee Mack
- Government Resource Center, The Ohio State University, 150 Pressey Hall, 1070 Carmack Road, Columbus, OH 43210, United States of America.
| | - Shamis Mohamoud
- The Hilltop Institute, University of Maryland Baltimore County, Sondheim Hall, Third Floor, 1000 Hilltop Circle, Baltimore, MD 21250, United States of America.
| | - Nathan Pauly
- Manatt Health Strategies, 151 N Franklin Street, Suite 2600, Chicago, IL 60606, United States of America.
| | - Rosa Perez
- The Hilltop Institute, University of Maryland Baltimore County, Sondheim Hall, Third Floor, 1000 Hilltop Circle, Baltimore, MD 21250, United States of America.
| | - Julie Donohue
- Department of Health Policy and Management, University of Pittsburgh, 130 DeSoto Street, Crabtree Hall A635, Pittsburgh, PA 15261, United States of America.
| |
Collapse
|
10
|
Lowder EM, Zhou W, Peppard L, Bates R, Carr T. Supply-side predictors of fatal drug overdose in the Washington/Baltimore HIDTA region: 2016-2020. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 110:103902. [PMID: 36343432 DOI: 10.1016/j.drugpo.2022.103902] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/05/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Rising rates of fentanyl- and polydrug-involved drug overdose deaths have prompted inquiry into the role of drug supply in fatal overdose outcomes in the United States. To date, however, there have been few empirical investigations of drug enforcement strategies on fatal overdose rates, despite knowledge that both drug use and supply are often geographically distributed. To address this limitation, we examined measures of drug enforcement as predictors of next-year fatal overdose rates in the Washington/Baltimore High Intensity Drug Trafficking Area (W/B HIDTA). METHODS We conducted mixed-effects models to examine the role of drug seizures and disruption in drug trafficking organizations (DTOs) and money laundering organizations (MLOs) on fatal overdose rates over a 5-year period (2016-2020) across 45 local jurisdictions in the W/B HIDTA region. Outcomes included any, opioid-involved, and fentanyl-involved fatal overdose. RESULTS Adjusting for covariates, both the total number of drug seizures and amount of cocaine seized (in dosage units per capita) positively predicted next-year opioid- and fentanyl-involved fatal overdose rates. Disruption to DTO and MLO operations did not significantly predict next-year fatal overdose rates for any outcome. CONCLUSION Supply-side enforcement activities alone may have limited impact on reducing fatal overdose rates, but may serve as important markers to identify communities at high risk of fatal overdose and facilitate targeted intervention. Our findings underscore the importance of comprehensive law enforcement approaches that extend beyond drug enforcement to integrate prevention, linkage to treatment, and harm reduction strategies as needed to address the overdose epidemic.
Collapse
Affiliation(s)
- Evan M Lowder
- Department of Criminology, Law and Society, George Mason University, 4400 University Dr, Enterprise Hall 308, Fairfax, VA 22030, USA.
| | - Weiyu Zhou
- Department of Statistics, School of Computing, George Mason University, 4511 Patriot Cir, Fairfax, VA 22030, USA
| | - Lora Peppard
- Center for Drug Policy and Prevention, University of Baltimore, 1800 Alexander Bell Drive, Suite 300, Reston, VA 20191, USA
| | - Rebecca Bates
- Center for Drug Policy and Prevention, University of Baltimore, 1800 Alexander Bell Drive, Suite 300, Reston, VA 20191, USA
| | - Thomas Carr
- Center for Drug Policy and Prevention, University of Baltimore, 1800 Alexander Bell Drive, Suite 300, Reston, VA 20191, USA
| |
Collapse
|
11
|
Ghadimi K, Heidari Z, Kheradmand M, Najafi MA, Chitsaz A, Khorvash F, Fahim M, Najafi MR. Prevalence, clinical, imaging, electroencephalography and laboratory characteristics of seizures in COVID-19. AMERICAN JOURNAL OF NEURODEGENERATIVE DISEASE 2022; 11:46-54. [PMID: 36419954 PMCID: PMC9678745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND COVID-19 is the cause of the recent pandemic. Viral infections could increase the risks of neurological impairments, including seizures. Here, we aimed to evaluate the prevalence, clinical, imaging, electroencephalography and laboratory characteristics of seizures in COVID-19. METHODS This retrospective cross-sectional study was performed on cases of COVID-19 infection and seizure. The prevalence of seizures in patients with COVID-19 was calculated using the incidence of seizures in all patients. The collected data were age, sex, history of previous illnesses, the severity of COVID-19 disease, patients' medications, hospitalization, and the presence of electrolyte disorders in patients' tests and other tests such as blood gas. Those patients with their first seizure episodes were also divided into two groups of cases with COVID-19 associated seizures (N=38) and non-COVID-19 associated seizures (N=37) and the mentioned data were compared between the two groups. RESULTS We assessed data of 60 patients with COVID-19-associated seizures (group 1), 40 patients with seizures not related to COVID-19 (group 2) and 60 patients with COVID-19 infection and no seizures (group 3). The prevalence of hypertension and diabetes mellitus were significantly higher in group 3 compared to group 1 (P=0.044 and P=0.009, respectively). Still, patients in group 1 had a higher prevalence of cerebrovascular accidents (CVA) compared to group 3 (P=0.008). The prevalence of abnormal EEG was significantly higher in cases with COVID-19 infection compared to the other group (P<0.001). Cases with their first seizure episode associated with COVID-19 had significantly higher creatinine levels (P=0.035), lower blood pH (P=0.023), lower blood HCO3 (P=0.001), higher ALT (P=0.004), higher blood urea nitrogen (BUN) (P=0.001), lower hemoglobin (Hb) (P=0.017), higher ESR (P=0.001), higher CRP (P<0.001) and higher mortality rates (P=0.004). CONCLUSION Patients with COVID-19 infection and seizure have higher mortality rates and disturbed laboratory data.
Collapse
Affiliation(s)
- Keyvan Ghadimi
- School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Zohreh Heidari
- Department of Neurology, School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Mohsen Kheradmand
- Department of Neurology, School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Mohammad Amin Najafi
- Department of Neurology, School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Ahmad Chitsaz
- Department of Neurology, School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Fariborz Khorvash
- Department of Neurology, School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Maryam Fahim
- School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Mohammad Reza Najafi
- Department of Neurology, School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| |
Collapse
|
12
|
Foltin RW, Zale S, Sykes KA, Nagaraj N, Scranton RE, Comer SD. A novel long-acting formulation of oral buprenorphine/naloxone produces prolonged decreases in fentanyl self-administration by rhesus monkeys. Drug Alcohol Depend 2022; 239:109599. [PMID: 35963210 DOI: 10.1016/j.drugalcdep.2022.109599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Due to the poor oral bioavailability of buprenorphine, an oral formulation has not been thought possible. Lyndra Therapeutics is developing a once-weekly long-acting oral product containing buprenorphine. We evaluated the efficacy of this formulation in reducing intravenous (i.v.) fentanyl self-administration by three male and three female rhesus monkeys. METHODS Buprenorphine HCl and naloxone HCl were co-formulated using an 11:1 ratio of buprenorphine:naloxone in a controlled-release gastric residence formulation administered in an oral capsule (LYN-013). Naloxone was included to determine the feasibility of combining naloxone with buprenorphine in the formulation as an abuse deterrent. Complete fentanyl dose-response functions were determined during each session. The efficacy of single doses of 56/5, 112/10 and 168/15 mg buprenorphine/naloxone in reducing fentanyl self-administration was examined over 13 days. RESULTS LYN-013 significantly decreased the rate of responding for fentanyl for 3 days and significantly reduced total intake of fentanyl for 8 days. Time to maximal buprenorphine levels (Tmax) ranged between 56 and 68 h for all 3 doses. The maximal buprenorphine level (Cmax) following 168 mg was 2.3 ng/ml which was significantly greater that those observed for 56 mg (1.22 ng/ml) and 112 mg (1.35 ng/ml). Finally, the area-under-curves (AUCtau) were buprenorphine dose-dependently increased from 88 to 127-265 h*ng/ml. There were no signs of non-specific changes in behavior. CONCLUSIONS A once-weekly oral buprenorphine/naloxone formulation produced sustained suppression of fentanyl self-administration in monkeys suggesting that oral delivery of buprenorphine with this formulation could provide a new opportunity to treat opioid use disorders (OUD).
Collapse
Affiliation(s)
- Richard W Foltin
- Division on Substance Use Disorders, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Stephen Zale
- Lyndra Therapeutics, Inc., 65 Grove St, Watertown, MA 02472, USA
| | - Kristine A Sykes
- Lyndra Therapeutics, Inc., 65 Grove St, Watertown, MA 02472, USA
| | - Nayana Nagaraj
- Lyndra Therapeutics, Inc., 65 Grove St, Watertown, MA 02472, USA
| | | | - Sandra D Comer
- Division on Substance Use Disorders, New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032, USA
| |
Collapse
|
13
|
Abstract
Rates of stimulant use, including misuse of prescription stimulants and use of cocaine and methamphetamine, are rising rapidly among adolescents and young adults ("youth"). Stimulant misuse is associated with overdose, polysubstance use, substance use disorders, and other medical harms. Substance use is often initiated during adolescence and young adulthood, and interventions during these crucial years have the potential to impact the lifetime risk of stimulant use disorder and associated harms. In this narrative review, we review recent data on prescription and illicit stimulant use in youth. We describe the rising contribution of stimulants to polysubstance use involving opioids and other substances and to overdose, as well as ways to minimize harm. We also discuss prescription stimulant misuse, which is especially prevalent among youth relative to other age groups, and the limited evidence on potential pathways from prescription stimulant use to illicit stimulant use. Last, we assess potential strategies for the prevention and treatment of stimulant use disorder in youth.
Collapse
Affiliation(s)
- Natalie J LaBossier
- Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, United States.
| | - Scott E Hadland
- Division of Adolescent and Young Adult Medicine, Mass General for Children, 175 Cambridge St., 5th Floor, Boston, MA 02114, United States; Department of Pediatrics, Harvard Medical School, 25 Shattuck St., Boston, MA 02115, United States
| |
Collapse
|
14
|
Delcher C, Harris DR, Anthony N, Mir M. Opioid Overdoses Increase at Home During the COVID-19 Stay-At-Home Order Period in Cook County, Illinois. AJPM FOCUS 2022; 1:100007. [PMID: 36942018 PMCID: PMC9213020 DOI: 10.1016/j.focus.2022.100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction Stay-at-home orders during the COVID-19 pandemic decreased population mobility to reduce SARS-CoV-2 infection rates. We empirically tested the hypothesis that this public health measure was associated with a higher likelihood of opioid- and stimulant-involved deaths occurring in homes located in Cook County, Illinois. Methods The stay-at-home period was from March 21, 2020 to May 30, 2020. We analyzed overdose data from the Cook County Medical Examiner's Office using a death location description from case investigations categorized as home, medical, motel, scene, and other. Two groups of decedents were defined as either having an opioid or stimulant listed in the primary cause of death field. We modeled a weekly time series to detect changes in deaths (number) and trends during segmented time periods. Chi-square or Fisher's exact and adjusted logistic regression was used for testing the differences between the stay-at-home and a 13-week preceding period. Results There were 4,169 and 2,012 opioid- and stimulant-involved deaths, respectively, from 2018 to 2020. Both groups were demographically similar: 75% male, 52% White, and aged 45 years (mean). In the 13 weeks before stay-at-home orders, 51% of opioid-involved deaths occurred in homes, which increased to 59% (p<0.0001) during the 10 weeks of the order and decreased back to 51% in the 18 weeks after the order expired. For stimulant-involved deaths, 51% were residential immediately before the orders, with a nonsignificant increase to 52% during the stay-at-home period. Before the pandemic, there were 20 deaths/week, increasing to 37 deaths/week (p<0.0001) during stay-at-home enactment. Deaths involving fentanyl among the opioid-involved group increased from 76% to 89%, whereas those involving heroin decreased from 55% to 37%. The adjusted OR for opioid-involved fatal overdoses occurring at home during this period compared with that occurring the 13 weeks before was 1.37 (95% CI=1.05, 1.79). Conclusions The likelihood of a death occurring at home, especially for people using opioids, increased during the stay-at-home order period. Findings have implications for mitigating overdose risks during social isolation.
Collapse
Affiliation(s)
- Chris Delcher
- Institute for Pharmaceutical Outcomes and Policy, UK College of Pharmacy, University of Kentucky, Lexington, Kentucky
- Department of Pharmacy Practice and Science, UK College of Pharmacy, University of Kentucky, Lexington, Kentucky
| | - Daniel R Harris
- Institute for Pharmaceutical Outcomes and Policy, UK College of Pharmacy, University of Kentucky, Lexington, Kentucky
- Department of Pharmacy Practice and Science, UK College of Pharmacy, University of Kentucky, Lexington, Kentucky
| | - Nicholas Anthony
- Institute for Pharmaceutical Outcomes and Policy, UK College of Pharmacy, University of Kentucky, Lexington, Kentucky
- Department of Pharmacy Practice and Science, UK College of Pharmacy, University of Kentucky, Lexington, Kentucky
| | - Mojde Mir
- Cook County Medical Examiner's Office, Chicago, Illinois
| |
Collapse
|
15
|
Carfora A, Petrella R, Ambrosio G, Fracassi I, Festinese S, Feola A, Campobasso CP. Toxicological Analysis of Illicit Drugs Seized in Naples (Italy) and First Detection of Synthetic Cannabinoids during COVID-19 Pandemic. Healthcare (Basel) 2022; 10:healthcare10081488. [PMID: 36011145 PMCID: PMC9408475 DOI: 10.3390/healthcare10081488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/31/2022] [Accepted: 08/04/2022] [Indexed: 11/18/2022] Open
Abstract
The COVID-19 pandemic has consistently raised the number of drug seizures, in United States as in Europe. The COVID-19 pandemic has also changed the typology of seizures from “more traditional” drugs to New Psychoactive Substances (NPSs), depending on geographical area. In Europe, the most frequent NPSs are synthetic cannabinoids (SCs) and cathinones, nonetheless synthetic opioids and phenethylamines are widely used. The aim of the study is the detection of NPS and other substances of abuse available in the black market, by quali/quantitative methods in LC-MS/MS and GC-MS. From 2018 to 2021, 268 seizures occurred in total and were analyzed by the Forensic Toxicology Laboratory (FTL) of Naples (Italy). The distribution of analyzed seizures over the years is the following: 53 in 2018, 61 in 2019, 89 in 2020 and 65 during the first semester of 2021. Cannabis was the most detected drug both in hashish and marijuana seizures, followed by cocaine > heroine > prescribed drugs > ketamine−amphetamine MDMA. No NPSs were seized until June 2021, when NPSs were found in two different seizures: Case #1 showed a bar of Cannabis resin containing a low level of Δ9THC = 0.57% associated to SC AB-FUBINACA in 4.5%; Case #2 showed a vegetal resinous substance (Δ9THC = 0.27%) with SC 5F-APINACA (4.1%) associated with methadone (1.0%). The detection of NPSs is alarming evidence that can lead to an increase in the risk of overdose or other negative and unpredictable consequences, such as violent or self-harming behavior in unaware users of cannabis derivatives considered of “natural” origin.
Collapse
|
16
|
Vo AT, Patton T, Peacock A, Larney S, Borquez A. Illicit Substance Use and the COVID-19 Pandemic in the United States: A Scoping Review and Characterization of Research Evidence in Unprecedented Times. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148883. [PMID: 35886734 PMCID: PMC9317093 DOI: 10.3390/ijerph19148883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 02/01/2023]
Abstract
We carried out a scoping review to characterize the primary quantitative evidence addressing changes in key individual/structural determinants of substance use risks and health outcomes over the first two waves of the COVID-19 pandemic in the United States (US). We systematically queried the LitCovid database for US-only studies without date restrictions (up to 6 August 2021). We extracted quantitative data from articles addressing changes in: (a) illicit substance use frequency/contexts/behaviors, (b) illicit drug market dynamics, (c) access to treatment and harm reduction services, and (d) illicit substance use-related health outcomes/harms. The majority of 37 selected articles were conducted within metropolitan locations and leveraged historical timeseries medical records data. Limited available evidence supported changes in frequency/behaviors/contexts of substance use. Few studies point to increases in fentanyl and reductions in heroin availability. Policy-driven interventions to lower drug use treatment thresholds conferred increased access within localized settings but did not seem to significantly prevent broader disruptions nationwide. Substance use-related emergency medical services’ presentations and fatal overdose data showed a worsening situation. Improved study designs/data sources, backed by enhanced routine monitoring of illicit substance use trends, are needed to characterize substance use-related risks and inform effective responses during public health emergencies.
Collapse
Affiliation(s)
- Anh Truc Vo
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Correspondence:
| | - Thomas Patton
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, San Diego, CA 92093, USA; (T.P.); (A.B.)
| | - Amy Peacock
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia;
| | - Sarah Larney
- Department of Family Medicine and Emergency Medicine, University of Montreal, Montreal, QC H3C 3J7, Canada;
| | - Annick Borquez
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, San Diego, CA 92093, USA; (T.P.); (A.B.)
| |
Collapse
|
17
|
Rossato DR, Rosa HZ, Rosa JLO, Milanesi LH, Metz VG, D'Àvila LF, Burger ME. Tactile Stimulation in Adult Rats Modulates Dopaminergic Molecular Parameters in the Nucleus accumbens Preventing Amphetamine Relapse. Mol Neurobiol 2022; 59:5564-5573. [PMID: 35732868 PMCID: PMC9217176 DOI: 10.1007/s12035-022-02927-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/14/2022] [Indexed: 11/28/2022]
Abstract
Amphetamine (AMPH) is a psychostimulant drug frequently related to addiction, which is characterized by functional and molecular changes in the brain reward system, favoring relapse development, and pharmacotherapies have shown low effectiveness. Considering the beneficial influences of tactile stimulation (TS) in different diseases that affect the central nervous system (CNS), here we evaluated if TS applied in adult rats could prevent or minimize the AMPH-relapse behavior also accessing molecular neuroadaptations in the nucleus accumbens (NAc). Following AMPH conditioning in the conditioned place preference (CPP) paradigm, male rats were submitted to TS (15-min session, 3 times a day, for 8 days) during the drug abstinence period, which were re-exposed to the drug in the CPP paradigm for additional 3 days for relapse observation and molecular assessment. Our findings showed that besides AMPH relapse, TS prevented the dopamine transporter (DAT), dopamine 1 receptor (D1R), tyrosine hydroxylase (TH), mu opioid receptor (MOR) increase, and AMPH-induced delta FosB (ΔFosB). Based on these outcomes, we propose TS as a useful tool to treat psychostimulant addiction, which is subsequent to clinical studies; it could be included in detoxification programs together with pharmacotherapies and psychological treatments already conventionally established.
Collapse
Affiliation(s)
- D R Rossato
- Graduation Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - H Z Rosa
- Graduation Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - J L O Rosa
- Graduation Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - L H Milanesi
- Department of Physiology and Pharmacology (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - V G Metz
- Graduation Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - L F D'Àvila
- Graduation Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil
| | - M E Burger
- Graduation Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil. .,Department of Physiology and Pharmacology (UFSM), Santa Maria, Rio Grande do Sul, Brazil.
| |
Collapse
|
18
|
Boogaerts T, Quireyns M, De Prins M, Pussig B, De Loof H, Matheï C, Aertgeerts B, Van Coppenolle V, Fransen E, Covaci A, van Nuijs ALN. Temporal monitoring of stimulants during the COVID-19 pandemic in Belgium through the analysis of influent wastewater. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 104:103679. [PMID: 35427945 PMCID: PMC8977453 DOI: 10.1016/j.drugpo.2022.103679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Wastewater-based epidemiology (WBE) is a complementary epidemiological data source to monitor stimulant consumption. The aims were to: (i) study intra- and inter-year temporal changes in stimulant use in Belgium during the first wave of the COVID-19 pandemic; and (ii) evaluate the effect of COVID-19 restrictive measures on stimulant consumption. METHODS The study population corresponded to the catchments of four wastewater treatment plants corresponding with four Belgian cities (i.e., Antwerp-Zuid, Boom, Brussels, Leuven). Daily 24-h composite influent wastewater samples collected over one week in September 2019 and March through June 2020 during the first wave of the COVID-19 pandemic were analyzed for biomarkers of amphetamine, cocaine, methamphetamine and 3,4-methylenedioxymethamphetamine (MDMA). Measured concentrations were converted to population-normalized mass loads by considering the daily flow rate and the catchment population size. Mobile network data was used to accurately capture population movements in the different catchment areas. Temporal changes were assessed with multiple linear regression models, and the effect of the COVID-19 interventions on stimulant consumption were investigated. RESULTS An increase in amphetamine use was observed in three cities during governmental restrictions, with highest consumption predominantly during lockdown. Similarly, cocaine consumption was higher after the pandemic started, with highest consumption noted during the lockdown period in Boom and Leuven. Consumption of MDMA was similar in Antwerp-Zuid, Brussels and Leuven throughout the entire sampled period. In Boom, the highest consumption was observed during the full lockdown period. CONCLUSIONS The present study shows the potential of WBE to assess the impact of stringent lockdown measures on stimulant use in Belgium. This paper shows that strong restrictive measures did not have a profound effect on stimulant consumption.
Collapse
Affiliation(s)
- Tim Boogaerts
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Maarten Quireyns
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Maarten De Prins
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Bram Pussig
- Academisch Centrum voor Huisartsengeneeskunde, Department of Public Health and primary Care, KU Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Hans De Loof
- Laboratory of Physiopharmacology, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Catharina Matheï
- Academisch Centrum voor Huisartsengeneeskunde, Department of Public Health and primary Care, KU Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Bert Aertgeerts
- Academisch Centrum voor Huisartsengeneeskunde, Department of Public Health and primary Care, KU Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | | | - Erik Fransen
- StatUa Core facility, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | | |
Collapse
|
19
|
Palamar JJ, Ciccarone D, Rutherford C, Keyes KM, Carr TH, Cottler LB. Trends in seizures of powders and pills containing illicit fentanyl in the United States, 2018 through 2021. Drug Alcohol Depend 2022; 234:109398. [PMID: 35370014 PMCID: PMC9027012 DOI: 10.1016/j.drugalcdep.2022.109398] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prevalence of fentanyl-laced counterfeit prescription pills has been increasing in the US, possibly placing a wider population at risk for unintentional exposure. We aimed to determine whether there have been shifts in the number of fentanyl seizures and in the form of fentanyl seized in the US. METHODS We examined quarterly national seizure data from High Intensity Drug Trafficking Areas to determine the number of drug seizures in the US containing fentanyl from January 2018 through December 2021. Generalized additive models were used to estimate trends in the number and weight of pill and powder seizures containing fentanyl. RESULTS There was an increase both in the number of fentanyl-containing powder seizures (from 424 in 2018 Quarter 1 [Q1] to 1539 in 2021 Quarter 4 [Q4], β = 0.94, p < 0.001) and in the number of pill seizures (from 68 to 635, β = 0.96, p < 0.01). The proportion of pills to total seizures more than doubled from 13.8% in 2018 Q1 to 29.2% in 2021 Q4 (β = 0.92, p < 0.001). Weight of powder fentanyl seizures increased from 298.2 kg in 2018 Q1 to 2416.0 kg in 2021 Q4 (β = 1.12, p = 0.01); the number of pills seized increased from 42,202 in 2018 Q1 to 2,089,186 in 2021 Q4 (β = 0.90, p < 0.001). CONCLUSIONS Seizures of drugs containing fentanyl have been increasing in the US. Given that over a quarter of fentanyl seizures are now in pill form, people who obtain counterfeit pills such as those disguised as oxycodone or alprazolam are at risk for unintentional exposure to fentanyl.
Collapse
Affiliation(s)
- Joseph J. Palamar
- New York University Grossman School of Medicine, Department of Population Health, New York, NY, USA,Correspondence to: New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, Room 1752, New York, NY 10016, USA. (J.J. Palamar)
| | - Daniel Ciccarone
- University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA, USA
| | - Caroline Rutherford
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
| | - Katherine M. Keyes
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
| | - Thomas H. Carr
- College of Public Affairs, Center for Drug Policy and Prevention, University of Baltimore, United States,Office of National Drug Control Policy, Washington, Baltimore High Intensity Drug Trafficking Areas Program, United States, Center for Drug Policy and Prevention, University of Baltimore, United States
| | - Linda B. Cottler
- NDEWS, University of Florida, United States,University of Florida, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, United States
| |
Collapse
|
20
|
Mezaache S, Donadille C, Martin V, Le Brun Gadelius M, Appel L, Spire B, Briand Madrid L, Bastien M, Roux P. Changes in cannabis use and associated correlates during France's first COVID-19 lockdown in daily cannabis users: results from a large community-based online survey. Harm Reduct J 2022; 19:26. [PMID: 35292040 PMCID: PMC8922077 DOI: 10.1186/s12954-022-00611-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/04/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Lockdown measures during the first wave of the COVID-19 pandemic in France led to serious public health concerns over people who use illicit drugs, especially in terms of mental health. We assessed changes in cannabis use during the first lockdown in France among daily cannabis users and associated correlates. METHODS CANNAVID is a French, national, cross-sectional web-based survey, conducted from 17 April to 11 May 2020. Daily cannabis users aged ≥ 18 years and living in France were invited to participate through advertisements. Respondents completed an ad hoc questionnaire on a dedicated online platform. We analyzed changes in cannabis use during the first lockdown (i.e., stopped, decreased, unchanged, or increased) and performed a multinomial logistic regression analysis to evaluate correlates of these changes. RESULTS Of the 4019 participants, 74.0% were men. Median age was 27 years (interquartile range: 22-37). With regard to cannabis use, 293 (7.3%) persons stopped, 1153 (28.7%) decreased, 1146 (28.5%) did not change, and 1427 (35.5%) increased their use during the lockdown. A multinomial logistic regression model revealed several sociodemographic, behavioral and health-related factors associated with changes in cannabis use. Compared with participants with an unchanged level of cannabis use during the lockdown, those who increased and those who stopped cannabis use were more likely to have increased tobacco and alcohol use and to have experienced depression and sleep disorders intensification. Those who stopped cannabis use were also more likely to have increased benzodiazepine use and to have experienced pain increase during lockdown. CONCLUSIONS France's first COVID-19-related lockdown had a differential impact on daily cannabis users' consumption patterns. Most study respondents reported changes to their cannabis consumption pattern. Those who reported a stable cannabis use were more likely to report fewer negative changes. Specific interventions are needed for this population, as well as research to assess the long-term impacts of these changes.
Collapse
Affiliation(s)
- Salim Mezaache
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Cécile Donadille
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | | | | | | | - Bruno Spire
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Laelia Briand Madrid
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Martin Bastien
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Perrine Roux
- Sciences économiques & sociales de la santé & traitement de l'information médicale, Aix-Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France. .,Faculté de médecine, INSERM U1252 SESSTIM, 27 bd Jean Moulin, Marseille, France.
| |
Collapse
|
21
|
Humphreys K, Shover CL, Andrews CM, Bohnert ASB, Brandeau ML, Caulkins JP, Chen JH, Cuéllar MF, Hurd YL, Juurlink DN, Koh HK, Krebs EE, Lembke A, Mackey SC, Larrimore Ouellette L, Suffoletto B, Timko C. Responding to the opioid crisis in North America and beyond: recommendations of the Stanford-Lancet Commission. Lancet 2022; 399:555-604. [PMID: 35122753 PMCID: PMC9261968 DOI: 10.1016/s0140-6736(21)02252-2] [Citation(s) in RCA: 184] [Impact Index Per Article: 92.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 08/01/2021] [Accepted: 10/06/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Keith Humphreys
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
| | - Chelsea L Shover
- Division of General Internal Medicine and Health Services Research, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA
| | - Christina M Andrews
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Amy S B Bohnert
- Department of Psychiatry and Department of Anesthesiology, University of Michigan Health System, Ann Arbor, MI, USA; Veterans Affairs Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Margaret L Brandeau
- Department of Management Science and Engineering, Huang Engineering Center, Stanford University, Stanford, CA USA
| | | | - Jonathan H Chen
- Stanford Center for Biomedical Informatics Research, Stanford University School of Medicine, Stanford, CA, USA; Division of Hospital Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Yasmin L Hurd
- Addiction Institute, Icahn School of Medicine, New York, NY, USA
| | - David N Juurlink
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Howard K Koh
- Department of Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Erin E Krebs
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA; Center for Care Delivery and Outcomes Research, Veterans Affairs Minneapolis Health Care System, Minneapolis, MN, USA
| | - Anna Lembke
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Sean C Mackey
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | | | - Brian Suffoletto
- Department of Emergency Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Christine Timko
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| |
Collapse
|
22
|
Jones CM, Houry D, Han B, Baldwin G, Vivolo-Kantor A, Compton WM. Methamphetamine use in the United States: epidemiological update and implications for prevention, treatment, and harm reduction. Ann N Y Acad Sci 2022; 1508:3-22. [PMID: 34561865 PMCID: PMC9097961 DOI: 10.1111/nyas.14688] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 08/04/2021] [Accepted: 08/19/2021] [Indexed: 02/03/2023]
Abstract
Recent attention has focused on the growing role of psychostimulants, such as methamphetamine in overdose deaths. Methamphetamine is an addictive and potent stimulant, and its use is associated with a range of physical and mental health harms, overdose, and mortality. Adding to the complexity of this resurgent methamphetamine threat is the reality that the increases in methamphetamine availability and harms are occurring in the midst of and intertwined with the ongoing opioid overdose crisis. Opioid involvement in psychostimulant-involved overdose deaths increased from 34.5% of overdose deaths in 2010 to 53.5% in 2019-an increase of more than 50%. This latest evolution of the nation's overdose epidemic poses novel challenges for prevention, treatment, and harm reduction. This narrative review synthesizes what is known about changing patterns of methamphetamine use with and without opioids in the United States, other characteristics associated with methamphetamine use, the contributions of the changing illicit drug supply to use patterns and overdose risk, motivations for couse of methamphetamine and opioids, and awareness of exposure to opioids via the illicit methamphetamine supply. Finally, the review summarizes illustrative community and health system strategies and research opportunities to advance prevention, treatment, and harm reduction policies, programs, and practices.
Collapse
Affiliation(s)
- Christopher M. Jones
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Debra Houry
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Beth Han
- National Institute on Drug Abuse, National Institutes of Health, Rockville, Maryland
| | - Grant Baldwin
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Alana Vivolo-Kantor
- Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Wilson M. Compton
- National Institute on Drug Abuse, National Institutes of Health, Rockville, Maryland
| |
Collapse
|
23
|
Wang Y, Zuo J, Wang L, Wang Q, Wang X, Yang Q, Wu HE, Goodman CB, Wang D, Liu T, Zhang X. The Association of Drug-Use Characteristics and Active Coping Styles With Positive Affect in Patients With Heroin-Use Disorder and Methamphetamine-Use Disorder During the COVID-19 Pandemic. Front Public Health 2021; 9:739068. [PMID: 34926370 PMCID: PMC8677928 DOI: 10.3389/fpubh.2021.739068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 10/25/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Positive affect (PA) is crucial for individuals to cope with the current pandemic and buffer the lingering fears after it, especially for patients with substance-use disorders (SUDs). The current study aimed to explore PA and its related factors during the COVID-19 pandemic in male patients with the heroin-use disorder (HUD) and patients with the methamphetamine-use disorder (MAUD), respectively. Methods: A total of 325 male patients with SUDs (106 with HUD and 219 with MAUD, all were single-substance users) in a compulsory rehabilitation center underwent semi-structured interviews during the pandemic. The demographic information, drug-use characteristics, active coping styles (ACSs, by Simple Coping Style Questionnaire), and PA (by the Positive and Negative Affect Scale) of participants were collected and recorded. Results: There were significant differences between the two groups in age, the proportion of full-time workers before the epidemic, duration of drug use, the proportion of patients with long-term withdrawal during the epidemic, cravings, ACS, and PA. Correlation and multiple linear regression analysis showed that duration of drug use, ACS, and stable jobs were significant predictive factors for PA in patients with HUD, while long-term withdrawal, ACS, and stable jobs during the epidemic were significant predictive factors for PA in patients with MAUD. Conclusions: Our study demonstrated the factors for PA in patients with HUD and MAUD during the pandemic. The results provided a basis for the comprehensive understanding of the PA of patients with SUDs and the development of targeted treatments.
Collapse
Affiliation(s)
- Yingying Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jinsong Zuo
- School of Life Science and Chemistry, Hunan University of Technology, Zhuzhou, China
| | - Long Wang
- Sanming Taijiang Hospital, Sanming, China
| | - Qianjin Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xin Wang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qian Yang
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hanjing Emily Wu
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Colin B Goodman
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Tieqiao Liu
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.,National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
24
|
Dunn M, Piatkowski T. Investigating the impact of COVID-19 on performance and image enhancing drug use. Harm Reduct J 2021; 18:124. [PMID: 34863199 PMCID: PMC8642842 DOI: 10.1186/s12954-021-00571-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/15/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Emerging research has suggested that the COVID-19 pandemic has had some impact on substance use patterns. The aim of the study was to conduct a rapid survey to assess the impact of COVID-19 on performance and image enhancing drug (PIED) use and training, and any subsequent negative physical or mental health outcomes. METHODS During 2020, a convenience sample of 60 PIED consumers (mean age = 26.69; 68.3% located outside Australia) completed a quantitative anonymous online survey exploring how the coronavirus pandemic impacted patterns of PIED use and associated exercise habits. The survey was administered via the Qualtrics platform and distributed online through PIED forums as well as through the investigators' networks. Participants were asked about their PIED use and exercise habits prior to and during restricted movement 'lockdowns'. RESULTS During pre-COVID, the majority of the sample opted to 'blast-cruise' (an initial high dose, followed by a lower maintenance dose; 71.7%, n = 43). During lockdown, 45% (n = 27) reported a change in PIED use as a result of the restrictions. In light of health concerns during COVID-19, a majority of men (60%, n = 36) did not take any extra precautions relating to their PIED use. A subgroup of men ceased using PIEDs completely (16.7%, n = 10) with the majority (80%, n = 8) of that subgroup following post-cycle therapy (PCT) of some kind. Only a small proportion of the sample reported negative mental health issues as a result of PCT access issues. CONCLUSIONS This study contributes to the emerging literature of the impact of the COVID-19 pandemic on substance use, specifically PIED use among men. The results suggest that the pandemic did influence the choice of PIEDs that participants consumed, although there was little disruption to patterns of exercise, an important aspect of PIED use. Of the men who did cease use completely, the majority reported little issue with PCT access; those who reported difficulty accessing PCT compounds indicated experience some mental health concerns related to ceasing their PIED use. Clinicians and those who come into contact with this group should be alert for any negative physical or mental health concerns resulting from disrupted or ceased PIED use.
Collapse
Affiliation(s)
- Matthew Dunn
- School of Health and Social Development, Deakin University, Geelong Waterfront Campus, Locked Bag 20000, Geelong, VIC, 3220, Australia.
| | | |
Collapse
|
25
|
Buil-Gil D, Zeng Y, Kemp S. Offline crime bounces back to pre-COVID levels, cyber stays high: interrupted time-series analysis in Northern Ireland. CRIME SCIENCE 2021; 10:26. [PMID: 34777938 PMCID: PMC8579416 DOI: 10.1186/s40163-021-00162-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/02/2021] [Indexed: 05/28/2023]
Abstract
Much research has shown that the first lockdowns imposed in response to the COVID-19 pandemic were associated with changes in routine activities and, therefore, changes in crime. While several types of violent and property crime decreased immediately after the first lockdown, online crime rates increased. Nevertheless, little research has explored the relationship between multiple lockdowns and crime in the mid-term. Furthermore, few studies have analysed potentially contrasting trends in offline and online crimes using the same dataset. To fill these gaps in research, the present article employs interrupted time-series analysis to examine the effects on offline and online crime of the three lockdown orders implemented in Northern Ireland. We analyse crime data recorded by the police between April 2015 and May 2021. Results show that many types of traditional offline crime decreased after the lockdowns but that they subsequently bounced back to pre-pandemic levels. In contrast, results appear to indicate that cyber-enabled fraud and cyber-dependent crime rose alongside lockdown-induced changes in online habits and remained higher than before COVID-19. It is likely that the pandemic accelerated the long-term upward trend in online crime. We also find that lockdowns with stay-at-home orders had a clearer impact on crime than those without. Our results contribute to understanding how responses to pandemics can influence crime trends in the mid-term as well as helping identify the potential long-term effects of the pandemic on crime, which can strengthen the evidence base for policy and practice.
Collapse
Affiliation(s)
- David Buil-Gil
- Department of Criminology, School of Social Sciences, University of Manchester, 2.17 Williamson Building, Oxford Road, Manchester, M15 6FH UK
| | - Yongyu Zeng
- Law School, Lancaster University, Lancaster, UK
| | - Steven Kemp
- Department of Criminology, School of Social Sciences, University of Manchester, 2.17 Williamson Building, Oxford Road, Manchester, M15 6FH UK
- Department of Law, Pompeu Fabra University, Barcelona, Spain
| |
Collapse
|
26
|
Abstract
PURPOSE OF REVIEW This review provides an update on recently published literature on the rise of illicit fentanyls, risks for overdose, combinations with other substances, e.g. stimulants, consequences, and treatment. RECENT FINDINGS Overdose due to illicit synthetic opioids (e.g. fentanyl and fentanyl analogs) continues to rise in the US both preceding and during the COVID-19 pandemic. Fentanyl-related overdose is rising in new geographic areas e.g. the western USA. Stimulant-related overdose is also increasing nationwide driven by methamphetamine and cocaine. Polysubstance use, e.g. the use of a stimulant along with an opioid is driving stimulant-related overdose. Other medical consequences of injection drug use are rising including HIV and hepatitis C infections. Medication approaches to treating opioid use disorder remain the standard of care and there are new promising pharmacological approaches to treating methamphetamine use disorder. SUMMARY A 'fourth wave' of high mortality involving methamphetamine and cocaine use has been gathering force in the USA. Availability and use of illicit fentanyls are still the major drivers of overdose deaths and the current rise in stimulant-related deaths appears entwined with the ongoing opioid epidemic.
Collapse
Affiliation(s)
- Daniel Ciccarone
- Department of Family and Community Medicine, University of California, San Francisco, California, USA
| |
Collapse
|