Toward a typology of hallucinogen users in the United States

Driving under the influence of cannabis and alcohol: Evidence from a national sample of young drivers

OBJECTIVE

Driving under the influence (DUI) of psychoactive substances is an important public health and criminal justice issue, impacting the lives of millions of Americans. Although recent research provides up-to-date information regarding DUI among adults, there is a pressing need for research that focuses specifically on younger/underage drivers. We draw from a large, nationally-representative sample to provide up-to-date evidence as to the prevalence and key criminal justice, substance use, and behavioral health correlates of DUI of cannabis and alcohol among drivers ages 16 to 20 in the United States.

METHODS

We used data from the 2020 and 2021 National Survey on Drug Use and Health (young drivers ages 16-20; N=12,863). All analyses-survey adjusted prevalence estimates, logistic regression-were conducted using Stata SE 17.0 and weighted to account for the study's stratified cluster sampling design.

RESULTS

The prevalence of DUI-cannabis for the full sample-including those not endorsing past-year use-was 6.3%. Among youth endorsing past-year cannabis use, 24.5% reported DUI of cannabis. In the full sample and among cannabis users, DUI-cannabis risk was elevated among older and male youth. The prevalence of DUI-alcohol was 2.6% among all youth and 6.1% among youth reporting past-year alcohol consumption.

CONCLUSIONS

Estimates indicate that more than one million young drivers each year are placing their lives and those of others at risk by operating motor vehicles after consuming cannabis and/or alcohol. Findings underscore the importance of prevention efforts targeting underaged cannabis and alcohol-impaired driving.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Matrix-assisted laser-desorption/ionization-mass spectrometric imaging of psilocybin and its analogues in psychedelic mushrooms using a cesium chloride-coated target plate

Fungi with hallucinogenic properties and neurotoxicity have been listed as prohibited drugs in recent years, but there is a lack of in situ quantification of psilocybin and analogues in these samples to avoid the decomposition of these psychoactive tryptamines in time-consuming sample preparation. In this study, matrix-assisted laser-desorption/ionization (MALDI)-Fourier transform ion cyclotron resonance (FT ICR) mass spectrometric imaging (MSI) was used to analyze the distribution of psilocybin and its analogues in hallucinogenic Psilocybe mushrooms. A cesium chloride (CsCl)-coated target plate was prepared to improve the detection sensitivity and reduce the interference of other compounds or decomposition products with very similar m/z values in MALDI-FT ICR MS analysis. Psilocybin and other tryptamines with structurally similar compounds, including psilocin, baeocystin, tryptophan, tryptamine, and aeruginascin, were identified and imaged in the psilocybe tissue section; the semiquantitative analysis of the distribution of psilocybin was also investigated using a homemade 75-well CsCl-coated plate; and the target plate can be placed on the mass spectrometry target carrier along with the indium-tin oxide (ITO) conductive slide, which can simultaneously carry out matrix vapor deposition, thus ensuring the parallelism between the standards and samples in the pretreatment experiment and MSI. The contents of psilocybin and its analogues in the psilocybe tissue section can be evaluated from the color changes corresponding to different concentration standard curves. Furthermore, a comprehensive comparison between MALDI-FT ICR MS and ultra-performance liquid chromatography-quadrupole time of flight mass spectrometry (UPLC-Q/TOF MS) analysis was performed for quantification and validation. This study reduces the decomposition in time-consuming sample pretreatment and provides a powerful tool for drug abuse control and forensic analysis.

Heads, Seekers, Psychonauts, and One-Timers: Patterns in Stories of Psychedelic Consumption

Psychedelics are psychoactive substances that alter ordinary states of consciousness. The U.S. criminalized ingestion of these drugs approximately 60 years ago and use remains punishable by law. Prior to this time, the substances were differentially declared spiritual sacraments, medicines, and/or party drugs. (Auto)Ethnographies and other research often indicate psychedelic-induced experiences as remarkably personal, necessitating subjective interpretation. Empirical studies exploring patterns across psychedelic encounters are rare, but among the few that exist, users tend to be identified as either pursuing psycho-spiritual enlightenment or self-indulgent amusement. The present paper utilizes narratives collected through 37 in-depth interviews with adults from diverse social backgrounds who report a history of psychedelic consumption in non-clinical settings. The data suggest a potential 4-part categorization based on five factors: named forms of psychedelic substances used, reported frequency of psychedelic ingestions, stated reasons for consumption and desistance, self-imposed rules surrounding use, and descriptions of drug effects and experiences.

Past-year hallucinogen use in relation to psychological distress, depression, and suicidality among US adults

BACKGROUND

There is renewed interest in the clinical application of hallucinogenic substances to treat a range of psychiatric conditions. However, there is mixed evidence regarding how use of such substances outside of medical settings relates to psychological distress, depression, and suicidality.

METHODS

We examined data from a US representative sample of noninstitutionalized adults from the 2015-2020 National Survey on Drug Use and Health (N = 241,675). We evaluated whether past-year use of specific hallucinogens (i.e., LSD, DMT/AMT/Foxy, salvia divinorum, ecstasy [MDMA/Molly], ketamine) is associated with reporting past-year serious psychological distress (SPD), major depressive episode (MDE), and suicidality. Generalized linear models using Poisson and log link were used to estimate adjusted prevalence ratios (aPRs), controlling for sociodemographic characteristics and past-year use of various other illegal drugs.

RESULTS

LSD use was associated with an increased likelihood of MDE (aPR = 1.23, 95% CI: 1.10-1.37) and suicidal thinking (aPR = 1.21, 95% CI: 1.09-1.34). Similar associations were observed between salvia divinorum use and suicidal thinking (aPR = 1.41, 95% CI: 1.00-1.97) and between DMT/AMT/Foxy use and suicidal planning (aPR = 1.81 95% CI: 1.17-2.81). On the other hand, ecstasy use was associated with a decreased likelihood of SPD (aPR = 0.83, 95% CI: 0.77-0.89), MDE (aPR = 0.91, 95% CI: 0.83-1.00), and suicidal thinking (aPR = 0.86, 95% CI: 0.75-0.99).

CONCLUSION

Findings suggest there are differences among specific hallucinogens with respect to depression and suicidality. More research is warranted to understand consequences of and risk factors for hallucinogen use outside of medical settings among adults experiencing depression or suicidality.