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Basedow LA, Majić T, Hafiz NJ, Algharably EAE, Kreutz R, Riemer TG. Cognitive functioning associated with acute and subacute effects of classic psychedelics and MDMA - a systematic review and meta-analysis. Sci Rep 2024; 14:14782. [PMID: 38926480 PMCID: PMC11208433 DOI: 10.1038/s41598-024-65391-9] [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: 08/14/2023] [Accepted: 06/19/2024] [Indexed: 06/28/2024] Open
Abstract
Classic psychedelics and MDMA have a colorful history of recreational use, and both have recently been re-evaluated as tools for the treatment of psychiatric disorders. Several studies have been carried out to assess potential long-term effects of a regular use on cognition, delivering distinct results for psychedelics and MDMA. However, to date knowledge is scarce on cognitive performance during acute effects of those substances. In this systematic review and meta-analysis, we investigate how cognitive functioning is affected by psychedelics and MDMA during the acute drug effects and the sub-acute ("afterglow") window. Our quantitative analyses suggest that acute cognitive performance is differentially affected by psychedelics when compared to MDMA: psychedelics impair attention and executive function, whereas MDMA primarily affects memory, leaving executive functions and attention unaffected. Our qualitative analyses reveal that executive functioning and creativity may be increased during a window of at least 24 h after the acute effects of psychedelics have subsided, whereas no such results have been observed for MDMA. Our findings may contribute to inform recommendations on harm reduction for recreational settings and to help fostering differential approaches for the use of psychedelics and MDMA within a therapeutic framework.
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Affiliation(s)
- Lukas A Basedow
- Department of Psychology, Clinical Psychology and Psychotherapy, Philipps-Universität Marburg, Gutenbergstraße 18, 35037, Marburg, Germany.
| | - Tomislav Majić
- Psychedelic Substances Research Group, Department of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry und Neurosciences, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nicklas Jakob Hafiz
- Institute for Educational Quality Improvement (IQB), Humboldt-Universität zu Berlin, Berlin, Germany
| | - Engi A E Algharably
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Reinhold Kreutz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Thomas G Riemer
- Psychedelic Substances Research Group, Department of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
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2
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Whelan J, Ward RD, Noller G. A thematic analysis of MDMA-related harm and harm reduction experiences and knowledge in Aotearoa New Zealand. Harm Reduct J 2024; 21:100. [PMID: 38783300 PMCID: PMC11112856 DOI: 10.1186/s12954-024-01024-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Methylenedioxymethamphetamine (MDMA) is a popular drug worldwide and use is prevalent in Aotearoa New Zealand. Although associated with some significant harms, including fatalities, MDMA is ultimately less harmful than other commonly consumed drugs. We aimed to expand the understanding of MDMA harm and harm reduction strategies from a consumer perspective so that national harm reduction efforts can be better informed. METHODS We conducted 14 semi-structured focus group discussions including 60 people (aged 18-67, median = 21) who use MDMA in the Southern region of Aotearoa New Zealand to explore their thoughts and experiences regarding MDMA associated harm and harm reduction. Reflexive thematic analysis was conducted from a critical realist perspective. RESULTS Five themes were generated; (1) Mindset and setting matters; (2) Looking after your body and mind, not overdoing it; (3) Other substances increase risk and harm; (4) Trusted friends and peers are protective; and (5) Valid information is key for healthy self-determination; and one subtheme 5.1) Drug checking is essential harm reduction. CONCLUSIONS We discuss the implications for MDMA consumers and aim to inform national drug policy and the harm reduction practices of consumers and organisations, for the ultimate purpose of reducing MDMA-related harm in Aotearoa New Zealand.
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Affiliation(s)
- Jai Whelan
- Department of Psychology, University of Otago, William James Building, Level 1, 275 Leith Walk, Ōtepoti/Dunedin, Aotearoa, 9016, New Zealand.
| | - Ryan D Ward
- Department of Psychology, University of Otago, William James Building, Level 1, 275 Leith Walk, Ōtepoti/Dunedin, Aotearoa, 9016, New Zealand
| | - Geoff Noller
- Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Ōtepoti/Dunedin, Aotearoa, New Zealand
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3
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Winstock AR. Nitrous oxide: The label 'potentially addictive' may do more harm than good. Addiction 2024; 119:623-624. [PMID: 38183384 DOI: 10.1111/add.16426] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 01/08/2024]
Affiliation(s)
- Adam Rohan Winstock
- University College London, Institute of Epidemiology and Health Care, London, UK
- Global Drug Survey, London, UK
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4
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Cartágenes SDC, da Silveira CCSDM, Pinheiro BG, Fernandes LMP, Farias SV, Kobayashi NHC, de Souza PHFS, do Prado AF, Ferreira MKM, Lima RR, de Oliveira EHC, de Luna FCF, Burbano RMR, Fontes-Júnior EA, Maia CDSF. “K-Powder” Exposure during Adolescence Elicits Psychiatric Disturbances Associated with Oxidative Stress in Female Rats. Pharmaceuticals (Basel) 2022; 15:ph15111373. [PMID: 36355545 PMCID: PMC9698848 DOI: 10.3390/ph15111373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022] Open
Abstract
Ketamine, also called ‘K-powder’ by abusers, an analog of phencyclidine, primarily acts as an antagonist of N-methyl-D-aspartic acid (NMDA) receptors, therapeutically used as an anesthetic agent. Ketamine also stimulates the limbic system, inducing hallucinations and dissociative effects. At sub-anesthetic doses, ketamine also displays hallucinatory and dissociative properties, but not loss of consciousness. These behavioral consequences have elicited its recreational use worldwide, mainly at rave parties. Ketamine is generally a drug of choice among teenagers and young adults; however, the harmful consequences of its recreational use on adolescent central nervous systems are poorly explored. Thus, the aim of the present study was to characterize the behavioral and biochemical consequences induced by one binge-like cycle of ketamine during the early withdrawal period in adolescent female rats. Adolescent female Wistar rats (n = 20) received intraperitoneally administered ketamine (10 mg/kg/day) for 3 consecutive days. Twenty-four hours after the last administration of ketamine, animals were submitted to behavioral tests in an open field, elevated plus-maze, and forced swimming test. Then, animals were intranasally anesthetized with 2% isoflurane and euthanized to collect prefrontal cortex and hippocampus to assess lipid peroxidation, antioxidant capacity against peroxyl radicals, reactive oxygen species, reduced glutathione, and brain-derived neurotrophic factor (BDNF) levels. Our results found that 24 h after recreational ketamine use, emotional behavior disabilities, such as anxiety- and depression-like profiles, were detected. In addition, spontaneous ambulation was reduced. These negative behavioral phenotypes were associated with evidence of oxidative stress on the prefrontal cortex and hippocampus.
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Affiliation(s)
- Sabrina de Carvalho Cartágenes
- Laboratory of Pharmacology of Inflammation and Behavior, Health Sciences Institute, Pharmacy College, Federal University of Pará, Belém 66075-900, PA, Brazil
| | | | - Bruno Gonçalves Pinheiro
- Laboratory of Pharmacology of Inflammation and Behavior, Health Sciences Institute, Pharmacy College, Federal University of Pará, Belém 66075-900, PA, Brazil
| | - Luanna Melo Pereira Fernandes
- Laboratory of Pharmacology of Inflammation and Behavior, Health Sciences Institute, Pharmacy College, Federal University of Pará, Belém 66075-900, PA, Brazil
- Physiological and Morphological Sciences Department, Biological and Health Science Centre, State University of Pará, Belém 66087-662, PA, Brazil
| | - Sarah Viana Farias
- Laboratory of Pharmacology of Inflammation and Behavior, Health Sciences Institute, Pharmacy College, Federal University of Pará, Belém 66075-900, PA, Brazil
| | - Natália Harumi Correa Kobayashi
- Laboratory of Pharmacology of Inflammation and Behavior, Health Sciences Institute, Pharmacy College, Federal University of Pará, Belém 66075-900, PA, Brazil
| | - Pablo Henrique Franco Santos de Souza
- Laboratory of Pharmacology of Inflammation and Behavior, Health Sciences Institute, Pharmacy College, Federal University of Pará, Belém 66075-900, PA, Brazil
| | - Alejandro Ferraz do Prado
- Laboratory of Pharmacology and Toxicology of Cardiovascular System, Institute of Biological Science, Federal University of Pará, Belém 66075-900, PA, Brazil
| | - Maria Karolina Martins Ferreira
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-900, PA, Brazil
| | - Rafael Rodrigues Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Federal University of Pará, Belém 66075-900, PA, Brazil
| | - Edivaldo Herculano Correa de Oliveira
- Laboratory of Cytogenomics and Environmental Mutagenesis, Environment Section (SAMAM), Evandro Chagas Institute (IEC), Ananindeua 67030-000, PA, Brazil
| | - Francisco Canindé Ferreira de Luna
- Laboratory of Cytogenomics and Environmental Mutagenesis, Environment Section (SAMAM), Evandro Chagas Institute (IEC), Ananindeua 67030-000, PA, Brazil
| | | | - Enéas Andrade Fontes-Júnior
- Laboratory of Pharmacology of Inflammation and Behavior, Health Sciences Institute, Pharmacy College, Federal University of Pará, Belém 66075-900, PA, Brazil
| | - Cristiane do Socorro Ferraz Maia
- Laboratory of Pharmacology of Inflammation and Behavior, Health Sciences Institute, Pharmacy College, Federal University of Pará, Belém 66075-900, PA, Brazil
- Correspondence:
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Tang H, Tang W, An X, Lu Z, Jia Z. Tracking the Trend of Ketamine Use in China During 2010–2015: a Retrospective Observational Study. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00741-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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6
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Fitzgerald ND, Striley CW, Palamar JJ, Copeland J, Kurtz S, Cottler LB. Test-retest reliability and cross-cultural applicability of DSM-5 adopted diagnostic criteria for ketamine use disorders. Drug Alcohol Depend 2021; 228:109056. [PMID: 34592704 PMCID: PMC8678918 DOI: 10.1016/j.drugalcdep.2021.109056] [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: 08/11/2021] [Revised: 09/10/2021] [Accepted: 09/11/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite increasing prevalence of nonmedical ketamine use globally, data on ketamine use disorders, which are classified in the DSM-5 under criteria for phencyclidine, are limited. This study assessed the reliability and applicability of DSM-based diagnostic criteria for ketamine use disorder. METHODS Participants who used ecstasy were recruited through the Tri-City Study of Club Drug Use, Abuse, and Dependence in St. Louis, Miami, and Sydney. Those who reported using ketamine (lifetime use >5 times) were included in these analyses (n = 205). Participants were interviewed using the computerized Substance Abuse Module for Club Drugs (CD-SAM) at baseline and 7 days later for the reliability of diagnoses and individual diagnostic criteria. RESULTS Overall, 29.3% met DSM-5 adopted criteria for ketamine use disorder at Time 1. Moderate to excellent test-retest reliability was observed consistently across study sites for any ketamine use disorder (κ = 0.57, Y = 0.61) and severe ketamine use disorder (κ = 0.62, Y = 0.79). Continued use of ketamine despite knowledge of physical or psychological problems was the most frequently endorsed individual criterion (59.0%), followed by reported withdrawal (30.2%) and physically hazardous use (29.8%). All individual criteria had acceptable reliability estimates (κ ≥ 0.41). CONCLUSIONS Diagnoses of ketamine use disorder can be reliably evaluated using this fully structured diagnostic instrument's questions and algorithm. Ketamine-related withdrawal among people who use ketamine should be re-evaluated. Considering that after-effects of this dissociative anesthetic can last for many hours, it is important to explore a different timeframe for possible withdrawal effects.
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Affiliation(s)
- Nicole D Fitzgerald
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, PO Box 100231, Gainesville, FL 32610, USA.
| | - Catherine W Striley
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, PO Box 100231, Gainesville, FL 32610, USA
| | - Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY 10016, USA
| | - Jan Copeland
- National Drug and Alcohol Research Centre, University of New South Wales, NDW 2052, Australia
| | - Steven Kurtz
- Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Miami, FL 33138, USA
| | - Linda B Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, PO Box 100231, Gainesville, FL 32610, USA
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7
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Corkery JM, Hung WC, Claridge H, Goodair C, Copeland CS, Schifano F. Recreational ketamine-related deaths notified to the National Programme on Substance Abuse Deaths, England, 1997-2019. J Psychopharmacol 2021; 35:1324-1348. [PMID: 34092131 PMCID: PMC8600594 DOI: 10.1177/02698811211021588] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Ketamine is a phencyclidine derivative with dissociative anaesthetic properties. Increasing numbers of individuals in England take ketamine recreationally. Information on deaths arising from such use in England is presented. METHODS Cases were extracted on 31 January 2020 from the National Programme on Substance Abuse Deaths database, based on text searches of the cause of death, coroner's verdict and positive toxicology results for the terms 'ketamine' or 'norketamine'. FINDINGS During 1997-2005, there were <5 deaths p.a. in which ketamine was implicated. Numbers increased until 2009 (21), plateauing until 2016; thereafter, deaths have risen to about 30 p.a. Decedents' characteristics (N = 283): male 84.1%, mean age 31.2 (SD 10.0) years, employed 56.5%, drug use history 79.6% and living with others 60.3%. Ketamine was detected with other substances in most cases. Main (74.6%) underlying cause of death was accidental poisoning. Ketamine may have impaired judgement in other cases. CONCLUSIONS Although controlled, recreational ketamine use and related fatalities continue to increase. Consumers need to be more aware of the potentially fatal risks they face.
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Affiliation(s)
- John Martin Corkery
- Psychopharmacology, Drug Misuse and
Novel Psychoactive Substances Research Unit, Department of Clinical, Pharmaceutical
and Biological Sciences, University of Hertfordshire, Hatfield, Hertfordshire,
UK
- John Martin Corkery, Psychopharmacology,
Drug Misuse and Novel Psychoactive Substances Research Unit, Department of
Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire,
Room 2F419, Health Research Building, College Lane Campus, Hatfield, Herts AL10
9AB, UK.
| | - Wan-Chu Hung
- Institute of Pharmaceutical Sciences,
King’s College London, London, UK
| | - Hugh Claridge
- National Programme on Substance Abuse
Deaths, St George’s, University of London, London, UK
- Population Health Research Institute,
St George’s, University of London, London, UK
| | - Christine Goodair
- National Programme on Substance Abuse
Deaths, St George’s, University of London, London, UK
- Population Health Research Institute,
St George’s, University of London, London, UK
| | - Caroline S Copeland
- Institute of Pharmaceutical Sciences,
King’s College London, London, UK
- National Programme on Substance Abuse
Deaths, St George’s, University of London, London, UK
- Population Health Research Institute,
St George’s, University of London, London, UK
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and
Novel Psychoactive Substances Research Unit, Department of Clinical, Pharmaceutical
and Biological Sciences, University of Hertfordshire, Hatfield, Hertfordshire,
UK
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8
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Docherty JR, Alsufyani HA. Pharmacology of Drugs Used as Stimulants. J Clin Pharmacol 2021; 61 Suppl 2:S53-S69. [PMID: 34396557 DOI: 10.1002/jcph.1918] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/22/2021] [Indexed: 12/21/2022]
Abstract
Psychostimulant, cardiovascular, and temperature actions of stimulants involve adrenergic (norepinephrine), dopaminergic (dopamine), and serotonergic (serotonin) pathways. Stimulants such as amphetamine, 3,4-methylenedioxymethamphetamine (MDMA), or mephedrone can act on the neuronal membrane monoamine transporters NET, DAT, and SERT and/or the vesicular monoamine transporter 2 to inhibit reuptake of neurotransmitter or cause release by reverse transport. Stimulants may have additional effects involving pre- and postsynaptic/junctional receptors for norepinephrine, dopamine, and serotonin and other receptors. As a result, stimulants may have a wide range of possible actions. Agents with cocaine or MDMA-like actions can induce serious and potentially fatal adverse events via thermodysregulatory, cardiovascular, or other mechanisms. MDMA-like stimulants may cause hyperthermia that can be life threathening. Recreational users of stimulants should be aware of the dangers of hyperthermia in a rave/club environment.
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Affiliation(s)
| | - Hadeel A Alsufyani
- Department of Physiology, King Abdulaziz University, Jeddah, Saudi Arabia
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9
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Pan WH, Wu KCC, Chen CY, Chu YR, Wu SC, Jou S, Lu TP, Tung YC, Hsu J, Chen WJ. First-time offenders for recreational ketamine use under a new penalty system in Taiwan: incidence, recidivism and mortality in national cohorts from 2009 to 2017. Addiction 2021; 116:1770-1781. [PMID: 33197101 DOI: 10.1111/add.15337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/22/2020] [Accepted: 11/06/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND AIMS Ketamine has become a new recreational drug of choice among young people in parts of Asia. Using national databases in Taiwan, this study aimed to (1) examine the yearly trend in the ketamine offence rate over time; (2) estimate the 3-year risk of drug-related re-offence and its correlates among the first-time offenders; and (3) estimate the 3-year standardized mortality ratio (SMR) among the first-time offenders. DESIGN, SETTING AND PARTICIPANTS Retrospective cohort studies of offenders for recreational ketamine use in a penalty system initiated in 2009. Offenders for recreational ketamine use were identified from the Administrative Penalty System for Schedule III/IV Substances database from 2009 to 2017, and the re-offence rate and mortality among first-time offenders were assessed via record-linkage within the database as well as with both the criminal drug offence database and the national mortality database. The cohort from 2009 to 2016 (n = 39 178) was used for the recidivism analysis and the cohort from 2009 to 2013 (n = 25 357) was used for the 3-year SMR analysis. MEASUREMENTS Recidivism was estimated using survival analysis of the event as re-arrest for using ketamine, more serious illicit drugs (Schedules I/II), or any illicit drugs (ketamine or Schedules I/II). SMRs were estimated for overall and cause-specific death within 3 years after the first offence for ketamine use. FINDINGS The age-standardized rates for both prevalent (1.38 per 1000) and first-time offenders (0.65 per 1000) peaked in 2013 and then decreased steadily. The 3-year risk of re-offence was 33.85% [95% confidence interval (CI) = 33.23-34.47%) for ketamine use and 39.52% (95% CI = 39.00-40.04%) for any illicit drug use. These first-time offenders had an SMR of 4.9 (95% CI = 4.3-5.4) for overall mortality, 2.1 (95% CI = 1.6-2.7) for natural deaths and 7.6 (95% CI = 6.7-8.6) for unnatural deaths. CONCLUSIONS Recreational ketamine use in Taiwan appears to lead not only to high risk for drug-related re-offence but also to excess mortality.
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Affiliation(s)
- Wen-Hsuan Pan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Kevin Chien-Chang Wu
- Department of Psychiatry, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.,Department of Medical Education and Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chi-Ya Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Roo Chu
- Division of Controlled Drugs, Taiwan Food and Drug Administration, Ministry of Health and Welfare, Executive Yuan, Taipei, Taiwan
| | - Shang-Chi Wu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Susyan Jou
- Graduate School of Criminology, National Taipei University, New Taipei, Taiwan
| | - Tzu-Pin Lu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Chi Tung
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.,Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Jui Hsu
- Division of Controlled Drugs, Taiwan Food and Drug Administration, Ministry of Health and Welfare, Executive Yuan, Taipei, Taiwan
| | - Wei J Chen
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Psychiatry, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
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10
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Van Amsterdam J, Van Den Brink W. Harm related to recreational ketamine use and its relevance for the clinical use of ketamine. A systematic review and comparison study. Expert Opin Drug Saf 2021; 21:83-94. [PMID: 34176409 DOI: 10.1080/14740338.2021.1949454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUNDS Ketamine is a dissociative anesthetic that is currently considered for several new indications. AIM To deduce the safety of long-term ketamine treatment using the harm of heavy recreational (non-medical) ketamine use as a proxy for maximal possible harm of ketamine treatment. METHODS Systematic literature review according to PRISMA guidelines to identify controlled studies on ketamine-related harm in heavy recreational ketamine users. Results were compared with serious adverse events (SAEs) in patients treated with ketamine according to three systematic reviews considering dosing regimen and cumulative dose. RESULTS The systematic search yielded 25 studies. Heavy recreational ketamine use can escalate to ketamine dependency and was often dose-dependently associated with other SAEs, including cognitive and mental disorders, and gastrointestinal and urinary tract symptoms, which disappeared upon marked reduction of ketamine use. Heavy ketamine users have a much higher cumulative exposure to ketamine than ketamine treated patients (>90 times), which may explain why SAEs in the clinical context are mostly mild and reversible and why ketamine dependence was not reported in these patients. CONCLUSION Treatment of patients with ketamine is not associated with ketamine dependency or SAEs. However, caution is needed since data on long-term clinical ketamine use with a long-term follow-up is lacking.
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Affiliation(s)
- Jan Van Amsterdam
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Wim Van Den Brink
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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11
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Edland-Gryt M. Cocaine Rituals in Club Culture: Intensifying and Controlling Alcohol Intoxication. JOURNAL OF DRUG ISSUES 2021. [DOI: 10.1177/0022042620986514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Clubbing is an important part of the nighttime economy, and cocaine use is, for some young people, an essential part of this clubbing culture. However, the interaction rituals around the use of powder cocaine in this context remain understudied. This study is based on qualitative interviews with young adult recreational cocaine users ( n = 28) and explores how they use cocaine in club settings, in relation to rituals and drinking culture. The analysis identified three main explanations for using cocaine: (a) unity with friends because of shared transgression, (b) the high as a “collective effervescence,” and (c) the possibility to control, extend, and intensify drinking to intoxication. These three explanations illustrate how cocaine rituals were deeply integrated in drinking-to-intoxication rituals, and how the illegality of cocaine use reinforced feelings of unity with friends. In the nighttime economy, cocaine use and its related rituals are used to intensify and control alcohol-fuelled partying.
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Affiliation(s)
- Marit Edland-Gryt
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
- Department of Sociology and Human Geography, University of Oslo, Norway
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12
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Individual differences in distress, impulsivity, and coping motives for use as predictors of problematic ecstasy use. Addict Behav 2020; 108:106397. [PMID: 32353691 DOI: 10.1016/j.addbeh.2020.106397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 02/16/2020] [Accepted: 03/14/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Ecstasy users who report problematic use of ecstasy experience adverse social, psychological, and health-related consequences not reported by non-problem users. Relatively little is known about the risk factors for the development of problematic ecstasy use. Such information would be valuable for targeted intervention, prevention, and education AIMS: The current study aimed to fill this gap by investigating several hypothesised risk factors for problematic use and the relationships between them. METHODS Self-reported impulsivity, psychological distress, sex, and coping motives for ecstasy use were investigated as predictors of problematic ecstasy use in a cross-sectional online survey. RESULTS The sample consisted of 483 individuals (60.5% male, 38.3% female, 1.2% other) aged 18-62 years, reporting ecstasy use on an average of 59.7 occasions (SD = 167.8). Both higher self-reported impulsivity and psychological distress predicted problem ecstasy use, and both these relationships were partially mediated by coping motives. When these variables were examined in a combined mediation model accounting for their covariance, psychological distress still predicted problematic use partially via an effect on coping motives, while impulsivity showed only a direct effect on problem use. No sex differences in problem ecstasy use were observed. CONCLUSIONS Increased trait impulsivity and psychological distress appear to confer greater risk of problematic ecstasy use. Targeting these factors, as well as coping motives for ecstasy use, may be useful in efforts to prevent and reduce problematic ecstasy use among those who use the drug.
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Aguilar MA, García-Pardo MP, Parrott AC. Of mice and men on MDMA: A translational comparison of the neuropsychobiological effects of 3,4-methylenedioxymethamphetamine ('Ecstasy'). Brain Res 2020; 1727:146556. [PMID: 31734398 DOI: 10.1016/j.brainres.2019.146556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 11/09/2019] [Accepted: 11/12/2019] [Indexed: 11/19/2022]
Abstract
MDMA (3,4-methylendioxymethamphetamine), also known as Ecstasy, is a stimulant drug recreationally used by young adults usually in dance clubs and raves. Acute MDMA administration increases serotonin, dopamine and noradrenaline by reversing the action of the monoamine transporters. In this work, we review the studies carried out over the last 30 years on the neuropsychobiological effects of MDMA in humans and mice and summarise the current knowledge. The two species differ with respect to the neurochemical consequences of chronic MDMA, since it preferentially induces serotonergic dysfunction in humans and dopaminergic neurotoxicity in mice. However, MDMA alters brain structure and function and induces hormonal, psychomotor, neurocognitive, psychosocial and psychiatric outcomes in both species, as well as physically damaging and teratogen effects. Pharmacological and genetic studies in mice have increased our knowledge of the neurochemical substrate of the multiple effects of MDMA. Future work in this area may contribute to developing pharmacological treatments for MDMA-related disorders.
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Affiliation(s)
- Maria A Aguilar
- Department of Psychobiology, Faculty of Psychology, Valencia University, Valencia, Spain.
| | | | - Andrew C Parrott
- Department of Psychology, Swansea University, Swansea, United Kingdom; Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
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Heradstveit O, Skogen JC, Edland-Gryt M, Hesse M, Vallentin-Holbech L, Lønning KJ, Sivertsen B. Self-Reported Illicit Drug Use Among Norwegian University and College Students. Associations With Age, Gender, and Geography. Front Psychiatry 2020; 11:543507. [PMID: 33362594 PMCID: PMC7758438 DOI: 10.3389/fpsyt.2020.543507] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 11/16/2020] [Indexed: 11/17/2022] Open
Abstract
Background and Aims: Several studies have pointed to relatively high levels of illicit drug use among students in higher education compared to the general population. The aim of the present study was to provide an updated examination of self-reported illicit drug use among Norwegian University and college students. Methods: Data stem from the SHoT study (Students' Health and Well-being Study), a nationwide cross-sectional survey for higher education in Norway including Norwegian full-time students aged 18-35. Self-reported illicit drug use across a range of specified drugs comprised the outcome variables. Information on gender, age, and study location (geographical area) was also collected and used as stratification variables. The SHoT-survey from 2018 (N = 50,054) was used for the analyses of associations between demographical variables and illicit drug use, while trends in illicit drug use were estimated by comparing the 2018-results with data from the SHoT-surveys conducted in 2010 and 2014. Results: The proportion of students reporting having ever tried illicit drugs increased from 2014 to 2018, for both males (30.8 vs. 36.7%) and females (17.5 vs. 24.0%, both p < 0.001), while only minimal changes occurred between 2010 and 2014. The most commonly used illicit drugs during the past 12 months in 2018 were cannabis (15.2%), followed by MDMA (4.0%), cocaine (3.0%), and LSD/psilocybin (2.1%). Illicit drug use showed both linear increase with age, and inverted U-shaped relationships that peaked in the age span from 23 to 28 years of age. Males reported higher illicit drug use compared with females for all drugs. Proportions of illicit drug use varied across geographical areas within the country, with the highest use being reported in the Oslo area (the largest city and capital of Norway). Conclusions: The present study reports an increase from 2010 to 2018 among Norwegian University and college students in the proportion of those reporting to have tried illicit drugs. Despite varying proportions of use across type of drug, age, gender, and geographical location, the overall high levels of illicit drug use past 12 months confirm the need to address illicit drug use in this population.
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Affiliation(s)
- Ove Heradstveit
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway.,Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Jens Christoffer Skogen
- Center for Alcohol & Drug Research, Stavanger University Hospital, Stavanger, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Marit Edland-Gryt
- Department of Alcohol, Tobacco, and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Morten Hesse
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Lotte Vallentin-Holbech
- Centre for Alcohol and Drug Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
| | - Kari-Jussie Lønning
- Norwegian Medical Association, Oslo, Norway.,The Student Welfare Association of Oslo and Akershus (SiO), Oslo, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway.,Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
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15
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Lappin JM, Sara GE. Psychostimulant use and the brain. Addiction 2019; 114:2065-2077. [PMID: 31321819 DOI: 10.1111/add.14708] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/01/2019] [Accepted: 06/03/2019] [Indexed: 12/18/2022]
Abstract
Psychostimulant users are typically young adults. We have conducted a narrative review of neuropsychiatric harms associated with the psychostimulants methamphetamine/amphetamine, cocaine and 3,4-methylenedioxymethamphetamine (MDMA), focusing on epidemiological factors, common clinical presentations, underlying causal mechanisms and treatment options. The major neuropsychiatric harms of psychostimulant use are stroke, neurocognitive impairment, Parkinson's disease, seizures and psychotic illness. These arise through a combination of acute monoamine release, longer-term neurotransmitter effects and indirect effects. These effects are moderated by factors in the individual and in the pattern of substance use. Neuropsychiatric harms associated with psychostimulant use can thus lead to severe long-term impairment.
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Affiliation(s)
- Julia M Lappin
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Grant E Sara
- InforMH, NSW Ministry of Health, North Ryde, NSW, Australia.,Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
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16
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Vera B, Vidal Giné C, Lozano O, Fernández Calderón F. Harm reduction behaviors among polysubstance users who consume ecstasy: can they reduce the negative consequences? An exploratory study. DRUGS: EDUCATION, PREVENTION AND POLICY 2018. [DOI: 10.1080/09687637.2018.1544225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Belén Vera
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentin
- Instituto de Investigaciones Psicológicas, IIPSI, UNC-CONICET, Córdoba, Argentina
| | | | - Oscar Lozano
- Departamento de Psicología Clínica y Experimental, Facultad de Educación, Universidad de Huelva, Huelva, Spain
- Research Center on Natural Resources, Health and the Environment, Universidad de Huelva, Huelva, Spain
| | - Fermín Fernández Calderón
- Departamento de Psicología Clínica y Experimental, Facultad de Educación, Universidad de Huelva, Huelva, Spain
- Research Center on Natural Resources, Health and the Environment, Universidad de Huelva, Huelva, Spain
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17
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Abstract
BACKGROUND For a number of mental health disorders, including posttraumatic stress disorders (PTSD), there are not many available treatment options. Recently, there has been renewed interest in the potential of methylenedioxymethamphetamine (MDMA) to restore function for patients with these disorders. The primary hypothesis is that MDMA, via prosocial effects, increases the ability of patients to address the underlying psychopathology of the disorder. However, the use of MDMA poses potential problems of neurotoxicity, in addition to its own potential for misuse. METHODS In this article, the proposed potential of MDMA as an adjunct to psychotherapy for PTSD is evaluated. The rationale for the use of MDMA and the positive results of studies that have administered MDMA in the treatment of PTSD are provided (pros). A description of potential adverse effects of treatment is also presented (cons). An overview of MDMA pharmacology and pharmacokinetics and a description of potential adverse effects of treatments are also presented. Methylenedioxymethamphetamine-produced oxytocin release and decreased expression of fear conditioning as well as one of the MDMA enantiomers (the n R- entaniomer) are suggested as potential mechanisms for the beneficial effects of MDMA in PTSD (suggestions). RESULTS There is some evidence that MDMA facilitates recovery of PTSD. However, the significant adverse effects of MDMA raise concern for its adoption as a pharmacotherapy. Alternative potential treatments with less adverse effects and that are based on the ubiquitous pharmacology of MDMA are presented. CONCLUSIONS We suggest that additional research investigating the basis for the putative beneficial effects of MDMA might reveal an effective treatment with fewer adverse effects. Suggestions of alternative treatments based on the behavioral pharmacology and toxicology of MDMA and its enantiomers are presented.
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Seto WK, Mak SK, Chiu K, Vardhanabhuti V, Wong HF, Leong HT, Lee PSF, Ho YC, Lee CK, Cheung KS, Yuen MF, Leung WK. Magnetic resonance cholangiogram patterns and clinical profiles of ketamine-related cholangiopathy in drug users. J Hepatol 2018; 69:121-128. [PMID: 29551711 DOI: 10.1016/j.jhep.2018.03.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/05/2018] [Accepted: 03/03/2018] [Indexed: 12/04/2022]
Abstract
BACKGROUND & AIMS Recreational ketamine use has emerged as an important health and social issue worldwide. Although ketamine is associated with biliary tract damage, the clinical and radiological profiles of ketamine-related cholangiopathy have not been well described. METHODS Chinese individuals who had used ketamine recreationally at least twice per month for six months in the previous two years via a territory-wide community network of charitable organizations tackling substance abuse were recruited. Magnetic resonance cholangiography (MRC) was performed, and the findings were interpreted independently by two radiologists, with the findings analysed in association with clinical characteristics. RESULTS Among the 343 ketamine users referred, 257 (74.9%) were recruited. The mean age and ketamine exposure duration were 28.7 (±5.8) and 10.5 (±3.7) years, respectively. A total of 159 (61.9%) had biliary tract anomalies on MRC, categorized as diffuse extrahepatic dilatation (n = 73), fusiform extrahepatic dilatation (n = 64), and intrahepatic ductal changes (n = 22) with no extrahepatic involvement. Serum alkaline phosphatase (ALP) level (odds ratio [OR] 1.007; 95% CI 1.002-1.102), lack of concomitant recreational drug use (OR 1.99; 95% CI 1.11-3.58), and prior emergency attendance for urinary symptoms (OR 1.95; 95% CI 1.03-3.70) had high predictive values for biliary anomalies on MRC. Among sole ketamine users, ALP level had an AUC of 0.800 in predicting biliary anomalies, with an optimal level of ≥113 U/L having a positive predictive value of 85.4%. Cholangiographic anomalies were reversible after ketamine abstinence, whereas decompensated cirrhosis and death were possible after prolonged exposure. CONCLUSIONS We have identified distinctive MRC patterns in a large cohort of ketamine users. ALP level and lack of concomitant drug use predicted biliary anomalies, which were reversible after abstinence. The study findings may aid public health efforts in combating the growing epidemic of ketamine abuse. LAY SUMMARY Recreational inhalation of ketamine is currently an important substance abuse issue worldwide, and can result in anomalies of the biliary system as demonstrated by magnetic resonance imaging. Although prolonged exposure may lead to further clinical deterioration, such biliary system anomalies might be reversible after ketamine abstinence. Clinical trial number: NCT02165488.
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Affiliation(s)
- Wai-Kay Seto
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
| | - Siu-King Mak
- Department of Surgery, North District Hospital, Hong Kong
| | - Keith Chiu
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong
| | | | - Ho-Fai Wong
- Department of Surgery, North District Hospital, Hong Kong
| | - Heng-Tat Leong
- Department of Surgery, North District Hospital, Hong Kong
| | - Paul S F Lee
- Department of Radiology, North District Hospital, Hong Kong
| | - Y C Ho
- Department of Radiology, Queen Mary Hospital, Hong Kong
| | - Chi-Kei Lee
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
| | - Ka-Shing Cheung
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Man-Fung Yuen
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
| | - Wai K Leung
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
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19
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Pharmacokinetic Interaction Study of Ketamine and Rhynchophylline in Rat Plasma by Ultra-Performance Liquid Chromatography Tandem Mass Spectrometry. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6562309. [PMID: 29951541 PMCID: PMC5989277 DOI: 10.1155/2018/6562309] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 04/11/2018] [Indexed: 12/16/2022]
Abstract
Eighteen Sprague-Dawley rats were randomly divided into three groups: ketamine group, rhynchophylline group, and ketamine combined with rhynchophylline group (n = 6). The rats of two groups received a single intraperitoneal administration of 30 mg/kg ketamine and 30 mg/kg rhynchophylline, respectively, and the third group received combined intraperitoneal administration of 30 mg/kg ketamine and 30 mg/kg rhynchophylline together. After blood sampling at different time points and processing, the concentrations of ketamine and rhynchophylline in rat plasma were determined by the established ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) method. Chromatographic separation was achieved using a UPLC BEH C18 column (2.1 mm × 50 mm, 1.7 μm) with carbamazepine as an internal standard (IS). The initial mobile phase consisted of acetonitrile and water (containing 0.1% formic acid) with gradient elution. Multiple reaction monitoring (MRM) modes of m/z 238.1 → 179.1 for ketamine, m/z 385.3 → 159.8 for rhynchophylline, and m/z 237.3 → 194.3 for carbamazepine (IS) were utilized to conduct quantitative analysis. Calibration curve of ketamine and rhynchophylline in rat plasma demonstrated good linearity in the range of 1-1000 ng/mL (r > 0.995), and the lower limit of quantification (LLOQ) was 1 ng/mL. Moreover, the intra- and interday precision relative standard deviation (RSD) of ketamine and rhynchophylline were less than 11% and 14%, respectively. This sensitive, rapid, and selective UPLC-MS/MS method was successfully applied to pharmacokinetic interaction study of ketamine and rhynchophylline after intraperitoneal administration. The results showed that there may be a reciprocal inhibition between ketamine and rhynchophylline.
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20
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Ma J, Sun XJ, Wang RJ, Wang TY, Su MF, Liu MX, Li SX, Han Y, Meng SQ, Wu P, Shi J, Bao YP, Lu L. Profile of psychiatric symptoms in methamphetamine users in China: Greater risk of psychiatric symptoms with a longer duration of use. Psychiatry Res 2018; 262:184-192. [PMID: 29453037 DOI: 10.1016/j.psychres.2018.02.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 10/31/2017] [Accepted: 02/02/2018] [Indexed: 11/17/2022]
Abstract
Chronic methamphetamine (MA) use is associated with psychiatric symptoms. This study explored pattern of co-occurring psychiatric symptoms in MA users and their relationship to duration of MA use. A cross-sectional study was conducted among MA users at the Shenzhen Compulsory Drug Detoxification Center from April 2012 to October 2015. The Positive and Negative Syndrome Scale, Hamilton Anxiety Scale, and Beck Depression Inventory were used to assess psychiatric symptoms. Among 1277 MA users, 57.6% participants had any type of psychiatric symptoms including depressive, anxiety and psychotic symptoms. A dose-response relationship was found between duration of MA use and risk of psychiatric symptoms. The odds ratios (OR) of depressive symptoms increased with the duration of MA use (1-5 years vs. < 1 year: 1.74 [95% CI, 1.24-2.42]; ≥ 5 years vs. < 1 year: 2.07 [1.19-3.61]), so did the ORs of co-occurring anxiety and depressive symptoms (1-5 years: 1.74 [1.20-2.51]; ≥ 5 years: 3.09 [1.76-5.40]). Methamphetamine-dependent individuals were four-times more likely to experience any type of psychiatric symptoms than non-dependent users. The prevalence of psychiatric symptoms was high in chronic MA users and increased with MA use duration. Early prevention and treatment strategies targeting both MA use and associated psychiatric symptoms are needed.
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Affiliation(s)
- Jun Ma
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Xin-Jun Sun
- Shenzhen Compulsory Drug Rehabilitation Center, Shenzhen, Guangdong 518019, China
| | - Ru-Jia Wang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Tong-Yu Wang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Meng-Fan Su
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Mo-Xuan Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; School of Public Health, Peking University, Beijing 100191, China
| | - Su-Xia Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Ying Han
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Shi-Qiu Meng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, 2052, Australia.
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China; Peking University Sixth Hospital, Peking University Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Peking University, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China.
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21
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Evaluating the abuse potential of psychedelic drugs as part of the safety pharmacology assessment for medical use in humans. Neuropharmacology 2018; 142:89-115. [PMID: 29427652 DOI: 10.1016/j.neuropharm.2018.01.049] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/07/2018] [Accepted: 01/31/2018] [Indexed: 11/21/2022]
Abstract
Psychedelics comprise drugs come from various pharmacological classes including 5-HT2A agonists, indirect 5-HT agonists, e.g., MDMA, NMDA antagonists and κ-opioid receptor agonists. There is resurgence in developing psychedelics to treat psychiatric disorders with high unmet clinical need. Many, but not all, psychedelics are schedule 1 controlled drugs (CDs), i.e., no approved medical use. For existing psychedelics in development, regulatory approval will require a move from schedule 1 to a CD schedule for drugs with medical use, i.e., schedules 2-5. Although abuse of the psychedelics is well documented, a systematic preclinical and clinical evaluation of the risks they pose in a medical-use setting does not exist. We describe the non-clinical tests required for a regulatory evaluation of abuse/dependence risks, i.e., drug-discrimination, intravenous self-administration and physical dependence liability. A synopsis of the existing data for the various types of psychedelics is provided and we describe our findings with psychedelic drugs in these models. FDA recently issued its guidance on abuse/dependence evaluation of drug-candidates (CDER/FDA, 2017). We critically review the guidance, discuss the impact this document will have on non-clinical abuse/dependence testing, and offer advice on how non-clinical abuse/dependence experiments can be designed to meet not only the expectations of FDA, but also other regulatory agencies. Finally, we offer views on how these non-clinical tests can be refined to provide more meaningful information to aid the assessment of the risks posed by CNS drug-candidates for abuse and physical dependence. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.
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Su MF, Liu MX, Li JQ, Lappin JM, Li SX, Wu P, Liu ZM, Shi J, Lu L, Bao Y. Epidemiological Characteristics and Risk Factors of Methamphetamine-Associated Psychotic Symptoms. Front Psychiatry 2018; 9:489. [PMID: 30369888 PMCID: PMC6194209 DOI: 10.3389/fpsyt.2018.00489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 09/19/2018] [Indexed: 11/29/2022] Open
Abstract
Objective: To explore the epidemiological characteristics and the risk factors for methamphetamine (MA)-associated psychotic symptoms among MA users in China. Methods: A cross-sectional study was conducted between April, 2012 and October, 2015 among individuals for whom MA was the principal drug of use in a Compulsory Drug Detoxification Center in Beijing, Guangdong Province. Demographic, drug use and psychological characteristics were examined using a specifically-designed questionnaire, the Positive and Negative Syndrome Scale, Barratt Impulsive Scale, Hamilton Anxiety Scale and Beck Depression Inventory. Logistic regression was performed to explore the risk factors for MA-associated psychotic symptoms. Results: A total of 1685 participants were included. Participants were predominantly aged 30 or above, unemployed, and were unmarried Han Chinese men, with limited education. The duration of MA use was more than 3 months in 72.3%. 47.8% reported that the dose of MA use was ≥ 0.2 g per occasion of use. 11.5% had used two or more synthetic drugs. The prevalence of MA-associated psychotic symptoms was 17.0% among MA users during periods of abstinence. Multiple logistic regression analyses showed that a higher dose (≥0.2 g per time), a longer duration of MA use (>3 months) a history of heroin use and a history of tobacco use were associated with MA-associated psychotic symptoms, with adjusted odds ratios (ORs) of 1.96 (95% confidence interval [CI]: 1.40-2.76), 1.98 (95% CI: 1.33-2.96) and 2.45 (95% CI: 1.67-3.60), 1.78 (95% CI: 1.27-2.49) respectively. MA-associated psychotic symptoms were less common among married/cohabitating than unmarried (OR = 0.56; 95% CI: 0.39-0.81), and unemployed than employed (OR = 0.65; 95% CI: 0.47-0.92) individuals. MA users with anxiety and depression symptoms had significantly greater risk for MA-associated psychotic symptoms by 9.70 (6.92-13.59) and 1.90 (1.36-2.65) times respectively. Individuals with higher impulsivity were more likely to have MA-associated psychotic symptoms than those with lower (OR = 2.19; CI:1.50-3.20). Conclusion: MA-associated psychotic symptoms occurred frequently among MA users in China. The efforts that facilitate drug users' attempts to reduce MA use, abstain from poly-drug use, and control associated psychiatric symptoms and impulsivity should be supported because of their potential contribution to MA-associated psychotic symptoms in this population.
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Affiliation(s)
- Meng-Fan Su
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Mo-Xuan Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Jin-Qiao Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Julia M Lappin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Su-Xia Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,School of Public Health, Peking University, Beijing, China
| | - Zhi-Min Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Lin Lu
- Key Laboratory of Mental Health and Peking University Sixth Hospital, National Clinical Research Center for Mental Disorders, Institute of Mental Health, Peking University, Beijing, China.,Peking-Tsinghua Center for Life Sciences and IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Yanping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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23
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Edland-Gryt M, Sandberg S, Pedersen W. From ecstasy to MDMA: Recreational drug use, symbolic boundaries, and drug trends. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 50:1-8. [PMID: 28869878 DOI: 10.1016/j.drugpo.2017.07.030] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 07/18/2017] [Accepted: 07/26/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND Ecstasy pills with MDMA as the main ingredient were introduced in many European countries in the 1980s, and were often linked to the rave and club scenes. However, use gradually levelled off, in part as a response to increased concerns about possible mental health consequences and fatalities. Extensive use of MDMA now seems to be re-emerging in many countries. In this study, we investigated the cultural and social meaning associated with MDMA use in Oslo, Norway, with an emphasis on how users distinguish MDMA crystals and powder from "old ecstasy pills". METHODS Qualitative in-depth interviews (n=31, 61,3% males) were conducted with young adult party-goers and recreational MDMA/ecstasy users (20-34 years old, mean age 26.2 years). RESULTS Research participants emphasised three important perceived differences between the MDMA crystals and ecstasy pills: (i) The effects of MDMA were described as better than ecstasy; (ii) MDMA was regarded as a safer drug; (iii) Users of MDMA crystals were described as more distinct from and less anchored in out-of-fashion rave culture than those using ecstasy. These differences were an important part of the symbolic boundary work MDMA users engaged in when justifying their drug use. CONCLUSION MDMA has re-emerged as an important psychoactive substance in Oslo's club scene. One important reason for this re-emergence seems to be its perceived differentiation from ecstasy pills, even though the active ingredient in both drugs is MDMA. This perceived distinction between MDMA and ecstasy reveals the importance of social and symbolic meanings in relation to psychoactive substance use. Insights from this study can be important in terms of understanding how trends in drug use develop and how certain drugs gain or lose popularity.
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Affiliation(s)
- Marit Edland-Gryt
- Department of Substance Use, Norwegian Institute of Public Health, Norway.
| | - Sveinung Sandberg
- Department of Substance Use, Norwegian Institute of Public Health, Norway; Department of Criminology and Sociology of Law, University of Oslo, Norway
| | - Willy Pedersen
- Department of Sociology and Human Geography, University of Oslo, Norway; Norwegian Social Research, Oslo and Akershus University College of Applied Sciences, Norway
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Cadoni C, Pisanu A, Simola N, Frau L, Porceddu PF, Corongiu S, Dessì C, Sil A, Plumitallo A, Wardas J, Di Chiara G. Widespread reduction of dopamine cell bodies and terminals in adult rats exposed to a low dose regimen of MDMA during adolescence. Neuropharmacology 2017; 123:385-394. [DOI: 10.1016/j.neuropharm.2017.06.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 06/01/2017] [Accepted: 06/07/2017] [Indexed: 11/16/2022]
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Massaro LT, Abdalla RR, Laranjeira R, Caetano R, Pinsky I, Madruga CS. Amphetamine-type stimulant use and conditional paths of consumption: data from the Second Brazilian National Alcohol and Drugs Survey. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2017; 39:201-207. [PMID: 28700012 PMCID: PMC7111376 DOI: 10.1590/1516-4446-2015-1894] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/22/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: The aim of this study was to estimate nationally representative prevalence rates of amphetamine-type stimulant (ATS) use and to identify consumption-associated factors, proposing a conditional model of direct and indirect consumption paths. METHOD: Using data from the Second Brazilian National Alcohol and Drugs Survey, this cross-sectional study analyzed a subsample of 3,828 participants between 15 and 64 years old, gathering information on the use of psychoactive substances in a probabilistic sample of the Brazilian household population. RESULTS: Rates of lifetime and last-year ATS use were, respectively, 4.1 and 1.6%. Economically privileged individuals and users of other substances were more at risk for using ATS. The results suggest that higher education decreases the chances of ATS consumption. The conditional model showed that higher income increased ATS use, higher education lowered the odds of such an increase, and cocaine use cancelled that associative effect. CONCLUSION: Brazil presents high rates of ATS use. Prevention and treatment strategies should focus on the protective effect of higher education levels and should target polydrug use. Knowledge of ATS-associated factors and user profiles is the starting point for developing effective treatments and tailored prevention strategies.
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Affiliation(s)
- Luciana T.S. Massaro
- Instituto Nacional de Ciência e Tecnologia para Políticas Públicas do Álcool e Outras Drogas (INPAD), São Paulo, SP, Brazil
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Renata R. Abdalla
- Instituto Nacional de Ciência e Tecnologia para Políticas Públicas do Álcool e Outras Drogas (INPAD), São Paulo, SP, Brazil
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ronaldo Laranjeira
- Instituto Nacional de Ciência e Tecnologia para Políticas Públicas do Álcool e Outras Drogas (INPAD), São Paulo, SP, Brazil
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Raul Caetano
- Prevention Research Center, Oakland, CA, United States
| | - Ilana Pinsky
- Instituto Nacional de Ciência e Tecnologia para Políticas Públicas do Álcool e Outras Drogas (INPAD), São Paulo, SP, Brazil
| | - Clarice S. Madruga
- Instituto Nacional de Ciência e Tecnologia para Políticas Públicas do Álcool e Outras Drogas (INPAD), São Paulo, SP, Brazil
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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García-Pardo M, Rodríguez-Arias M, Miñarro J, Aguilar M. Role of nitric oxide pathway in the conditioned rewarding effects of MDMA in mice. Behav Brain Res 2017; 330:75-77. [DOI: 10.1016/j.bbr.2017.05.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/27/2017] [Accepted: 05/03/2017] [Indexed: 12/11/2022]
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Mdege ND, Meader N, Lloyd C, Parrott S, McCambridge J. The Novel Psychoactive Substances in the UK Project: empirical and conceptual review work to produce research recommendations. PUBLIC HEALTH RESEARCH 2017. [DOI: 10.3310/phr05040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BackgroundAlthough illegal drug use has largely been declining in the UK over the past decade, this period has witnessed the emergence of a range of novel psychoactive substances (NPS) (‘legal highs’). These are new, mostly synthetic, substances that mimic the effects of existing drugs). Despite there being many causes for concern in relation to NPS, there has been little prior study of the burden associated with their use in public health terms. Clarity is lacking on research priorities in this rapidly developing literature.ObjectivesTo inform the development of public health intervention research on NPS by reviewing existing data on their use, associated problems and potential responses to such problems.DesignA scoping review and narrative synthesis of selected bodies of evidence was undertaken to summarise and evaluate what is known about NPS use and the related harms of, and responses to, such use. Relevant literature was identified from electronic databases (covering January 2006 to June 2016 inclusive), Google (Google Inc., Mountain View, CA, USA), relevant websites and online drug forums and by contacting experts. Articles were included if they were primary studies, secondary studies involving the analysis and interpretation of primary research or discussion papers. A conceptual framework postulating an evidence-informed public health approach to NPS use in the UK was developed through a pragmatic literature review, the iterative development of concepts and finalisation in light of the results from the empirical review work. The process also involved feedback from various stakeholders. Research recommendations were developed from both strands of work.ResultsA total of 995 articles were included in the scoping review, the majority of which related to individual-level health-related adverse effects attributable to NPS use. The prevalence of lifetime NPS use varied widely between (e.g. with higher prevalence in young males) and within population subgroups. The most commonly reported adverse effects were psychiatric/other neurological, cardiovascular, renal and gastrointestinal manifestations, and there is limited evidence available on responses. In these and other respects, available evidence is at an early stage of development. Initial evidence challenges the view that NPS should be treated differently from other illicit drugs. The conceptual framework indicated that much of the evidence that would be useful to inform public health responses does not yet exist. We propose a systems-based prevention approach that develops existing responses, is multilevel and life course informed in character, and emphasises commonalities between NPS and other legal and illegal drug use. We make 20 recommendations for research, including nine key recommendations.LimitationsScoping reviews do not interrogate evidence in depth, and the disjunction between the scoping review and the conceptual framework findings is worthy of careful attention.ConclusionsKey research recommendations build on those that have previously been made and offer more evidence-based justification and detail, as previous recommendations have not yet been acted on. The case for decision-making on commissioning new research based on these recommendations is both strong and urgent.Future workThe validity of recommendations generated through this project could be enhanced via further work with research commissioners, policy-makers, researchers and the public.Study registrationThe systematic review element of this study is registered as PROSPERO CRD42016026415.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Noreen D Mdege
- Department of Health Sciences, University of York, York, UK
| | - Nick Meader
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Charlie Lloyd
- Department of Health Sciences, University of York, York, UK
| | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
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Effective active vaccination against methamphetamine in female rats. Drug Alcohol Depend 2017; 175:179-186. [PMID: 28437722 PMCID: PMC5484075 DOI: 10.1016/j.drugalcdep.2017.03.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 02/28/2017] [Accepted: 03/18/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Immunotherapies directed against methamphetamine (MA) abuse have shown success in rodent models, however only a limited number of studies have investigated active vaccination in female mice and none in female rats. It is critical to determine if potential immunotherapeutic strategies generalize across sex, particularly for drugs that may produce significant sex-differences on behavioral or physiological endpoints. METHODS Female Wistar rats were initially vaccinated with keyhole-limpet hemocyanin (KLH) or an anti-methamphetamine-KLH conjugate (MH6-KLH) three times over five weeks and implanted with radiotelemetry devices to assess locomotor activity and body temperature responses to MA. Rats were first exposed to MA via vapor inhalation (100mg/mL in propylene glycol) and then by injection (0.25-1.0mg/kg, i.p.) and vapor after a final vaccine boost. RESULTS The MH6-KLH vaccine generated an increase in antibody titers across the initial 6-week, 3 immunization protocol and a restoration of titer after a week 14 booster. Locomotor stimulation induced by 0.25mg/kg MA, i.p, in the KLH group was prevented in the MH6-KLH group. MH6-KLH animals also exhibited an attenuated locomotor stimulation produced by 0.5mg/kg MA, i.p. No group differences in locomotion induced by vapor inhalation of MA were observed and body temperature was not differentially affected by MA across the groups, most likely because vapor inhalation of MA that produced similar locomotor stimulation resulted in ∼10-fold higher plasma MA levels. CONCLUSIONS This study confirms the efficacy of the MH6-KLH vaccine in attenuating the effects of MA in female rats.
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García-Pardo M, Roger-Sánchez C, Rodríguez-Arias M, Miñarro J, Aguilar M. Cognitive and behavioural effects induced by social stress plus MDMA administration in mice. Behav Brain Res 2017; 319:63-72. [DOI: 10.1016/j.bbr.2016.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/25/2016] [Accepted: 11/07/2016] [Indexed: 12/22/2022]
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Aarde SM, Taffe MA. Predicting the Abuse Liability of Entactogen-Class, New and Emerging Psychoactive Substances via Preclinical Models of Drug Self-administration. Curr Top Behav Neurosci 2017; 32:145-164. [PMID: 27909988 DOI: 10.1007/7854_2016_54] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Animal models of drug self-administration are currently the gold standard for making predictions regarding the relative likelihood that a recreational drug substance will lead to continued use and addiction. Such models have been found to have high predictive accuracy and discriminative validity for a number of drug classes including ethanol, nicotine, opioids, and psychostimulants such as cocaine and methamphetamine. Members of the entactogen class of psychostimulants (drugs that produce an "open mind state" including feelings of interpersonal closeness, intimacy and empathy) have been less frequently studied in self-administration models. The prototypical entactogen 3,4-methylenedioxymethamphetamine (MDMA; "Ecstasy") supports self-administration but not with the same consistency nor with the same efficacy as structurally related drugs amphetamine or methamphetamine. Consistent with these observations, MDMA use is more episodic in the majority of those who use it frequently. Nevertheless, substantial numbers of MDMA users will meet the criteria for substance dependence at some point in their use history. This review examines the currently available evidence from rodent self-administration studies of MDMA and two of the new and emerging psychoactive substances (NPS) that produce entactogen type neuropharmacological responses - mephedrone (4-methylmethcathinone; 4MMC; "meow meow") and methylone (3,4-methylenedioxymethcathinone). Overall, the current evidence predicts that these NPS entactogens have enhanced abuse liability compared with MDMA.
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Affiliation(s)
- Shawn M Aarde
- Committee on the Neurobiology of Addictive Disorders Mailcode SP30-2400, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA, 92037, USA
| | - Michael A Taffe
- Committee on the Neurobiology of Addictive Disorders Mailcode SP30-2400, The Scripps Research Institute, 10550 North Torrey Pines Road, La Jolla, CA, 92037, USA.
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Papaseit E, Moltó J, Muga R, Torrens M, de la Torre R, Farré M. Clinical Pharmacology of the Synthetic Cathinone Mephedrone. Curr Top Behav Neurosci 2017; 32:313-331. [PMID: 28012094 DOI: 10.1007/7854_2016_61] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
4-Methyl-N-methylcathinone (mephedrone) is a popular new psychoactive substance (NPS) that is structurally related to the parent compound cathinone, the β-keto analogue of amphetamine. Mephedrone appeared on the street drug market as a substitute for 3,4-methylenedioxy-N-methylamphetamine (MDMA, ecstasy) and was subsequently banned due to the potential health risks associated with its use. Nevertheless, mephedrone continues to be widely consumed among specific populations, with unique patterns of misuse. To date, most information about the biological effects of mephedrone comes from user experiences, epidemiological data, clinical cases, toxicological findings, and animal studies, whilst there are very few data regarding its human pharmacodynamics and pharmacokinetics. This chapter reviews the available published data on patterns of mephedrone use, its acute and chronic effects, and its pharmacokinetic properties. More human research is needed to elucidate the safety, toxicity, and addiction potential of mephedrone and related NPS.
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Affiliation(s)
- Esther Papaseit
- Hospital Universitari Germans Trias i Pujol (IGTP), Badalona, Spain
- Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - José Moltó
- Hospital Universitari Germans Trias i Pujol (IGTP), Badalona, Spain
- Fundació Lluita contra la Sida, Badalona, Spain
| | - Robert Muga
- Hospital Universitari Germans Trias i Pujol (IGTP), Badalona, Spain
- Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
| | - Marta Torrens
- Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain
- IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
- Institut de Neuropsiquiatria i Adiccions, Barcelona, Spain
| | - Rafael de la Torre
- IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Magí Farré
- Hospital Universitari Germans Trias i Pujol (IGTP), Badalona, Spain.
- Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallés, Spain.
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Neurochemical substrates of the rewarding effects of MDMA: implications for the development of pharmacotherapies to MDMA dependence. Behav Pharmacol 2016; 27:116-32. [PMID: 26650254 DOI: 10.1097/fbp.0000000000000210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In recent years, studies with animal models of reward, such as the intracranial self-stimulation, self-administration, and conditioned place preference paradigms, have increased our knowledge on the neurochemical substrates of the rewarding effects of 3,4-methylenedioxymetamphetamine (MDMA) in rodents. However, pharmacological and neuroimaging studies with human participants are scarce. Serotonin [5-hydroxytryptamine (5-HT)], dopamine (DA), endocannabinoids, and endogenous opiates are the main neurotransmitter systems involved in the rewarding effects of MDMA in rodents, but other neurotransmitters such as glutamate, acetylcholine, adenosine, and neurotensin are also involved. The most important finding of recent research is the demonstration of differential involvement of specific neurotransmitter receptor subtypes (5-HT2, 5-HT3, DA D1, DA D2, CB1, μ and δ opioid, etc.) and extracellular proteins (DA and 5-HT transporters) in the acquisition, expression, extinction, and reinstatement of MDMA self-administration and conditioned place preference. It is important to extend the research on the effects of different compounds acting on these receptors/transporters in animal models of reward, especially in priming-induced, cue-induced, and stress-induced reinstatement. Increase in knowledge of the neurochemical substrates of the rewarding effects of MDMA may contribute to the design of new pharmacological treatments for individuals who develop MDMA dependence.
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Matthews A, Sutherland R, Peacock A, Van Buskirk J, Whittaker E, Burns L, Bruno R. I like the old stuff better than the new stuff? Subjective experiences of new psychoactive substances. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 40:44-49. [PMID: 27939599 DOI: 10.1016/j.drugpo.2016.11.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 10/28/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Over the past decade, monitoring systems have identified the rapid emergence of new psychoactive substances (NPS). While the use of many NPS is minimal and transitory, little is known about which products have potential for capturing the attention of significant proportions of the drug consuming market. The aim of this study was to explore self-reported experiences of three commonly used NPS classes within the Australian context (synthetic cathinones, hallucinogenic phenethylamines and hallucinogenic tryptamines) relative to traditional illicit drug counterparts. METHODS Frequent psychostimulant consumers interviewed for the Australian Ecstasy and related Drugs Reporting System (EDRS) (n=1208) provided subjective ratings of the pleasurable and negative (acute and longer-term) effects of substances used in the last six months on the last occasion of use, and the likelihood of future use. RESULTS Stimulant-type NPS (e.g., mephedrone, methylone) were rated less favourably than ecstasy and cocaine in terms of pleasurable effects and likelihood of future use. DMT (a hallucinogenic tryptamine) showed a similar profile to LSD in terms of pleasurable effects and the likelihood of future use, but negative effects (acute and comedown) were rated lower. Hallucinogenic phenethylamines (e.g., 2C-B) showed a similar negative profile to LSD, but were rated as less pleasurable and less likely to be used again. CONCLUSION The potential for expanded use of stimulant-type NPS may be lower compared to commonly used stimulants such as ecstasy and cocaine. In contrast, the potential of DMT may be higher relative to LSD given the comparative absence of negative effects.
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Affiliation(s)
- Allison Matthews
- School of Medicine (Psychology), University of Tasmania, Private Bag 30, Hobart, Tasmania 7001, Australia.
| | - Rachel Sutherland
- National Drug and Alcohol Research Centre, UNSW Australia, 22-32 King St, Randwick, NSW, 2052, Australia
| | - Amy Peacock
- School of Medicine (Psychology), University of Tasmania, Private Bag 30, Hobart, Tasmania 7001, Australia; National Drug and Alcohol Research Centre, UNSW Australia, 22-32 King St, Randwick, NSW, 2052, Australia
| | - Joe Van Buskirk
- National Drug and Alcohol Research Centre, UNSW Australia, 22-32 King St, Randwick, NSW, 2052, Australia
| | - Elizabeth Whittaker
- National Drug and Alcohol Research Centre, UNSW Australia, 22-32 King St, Randwick, NSW, 2052, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, UNSW Australia, 22-32 King St, Randwick, NSW, 2052, Australia
| | - Raimondo Bruno
- School of Medicine (Psychology), University of Tasmania, Private Bag 30, Hobart, Tasmania 7001, Australia
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Jones L, Reed P, Parrott A. Mephedrone and 3,4-methylenedioxy-methamphetamine: Comparative psychobiological effects as reported by recreational polydrug users. J Psychopharmacol 2016; 30:1313-1320. [PMID: 27371497 DOI: 10.1177/0269881116653106] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS The purpose of this study was to compare the effects of mephedrone and 3,4-methylenedioxy-methamphetamine (MDMA), as reported by young recreational polydrug users. METHODS 152 MDMA users and 81 mephedrone users were recruited through snowballing on social network sites. They completed a standard online questionnaire for either mephedrone or MDMA. The questions covered the average amount taken per session, the longest duration of usage in the last 12-months, subjective effects while on-drug, and recovery effects in the days afterwards. RESULTS Mephedrone users reported a significantly longer maximum session of use than MDMA users. Mephedrone users also reported a significantly greater average amount used per session. The majority of on-drug subjective ratings did not differ between drugs, with similar increases in entactogenic effects. Although mephedrone users did report significantly more frequent issues with sleeping, anger and anxiety. In relation to recovery, mephedrone users reported more frequent craving, nasal irritation, paranoia, and relationship difficulties. Mephedrone users also rated general recovery effects as more severe over the seven-day period following use, taking more days to feel normal. CONCLUSIONS The acute effects of MDMA and mephedrone were broadly similar. However, the recovery period for mephedrone was more enduring, possibly due to the longer duration of acute session usage.
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Affiliation(s)
- Lewis Jones
- Psychology Department, Swansea University, Swansea, UK
| | - Phil Reed
- Psychology Department, Swansea University, Swansea, UK
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Fernández-Calderón F, Vidal-Giné C, López-Guerrero J, Lozano-Rojas ÓM. Reliability, convergent and structural validity and cut-off score of the Severity of Dependence Scale for recreational ketamine users. Addict Behav 2016; 60:1-7. [PMID: 27082261 DOI: 10.1016/j.addbeh.2016.03.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 01/27/2016] [Accepted: 03/29/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS There is a lack of instruments for measuring ketamine substance use disorders. The aims were (i) to estimate the reliability and provide evidence of validity of the Severity of Dependence Scale (SDS) in a sample of recreational users, and (ii) propose a cut-off point to determine the presence of dependence. METHODS We conducted a web-based cross-sectional survey with recreational users who accessed webs related to recreational drug use and harm reduction. 264 recreational ketamine users who had taken it in the past month participated in the study. The Spanish version of the SDS was used. Information on ketamine use-related problems and ketamine use patterns was also collected. RESULTS The reliability estimation calculated by the Cronbach's alpha coefficient was 0.776. SDS showed evidence of convergent validity based on relationships with other variables. Two comparisons were made in this study to analyze the Receiver Operating Characteristic Curve. For frequency of use in the last month the area under curve (AUC) was 0.835 (CI=0.775-0.895) with optimal discrimination at an SDS score of 3. For having been in treatment for decreasing or quitting ketamine use the AUC was 0.902 (CI=0.840-0.963) and the cut-off point was 4. Confirmatory factor analysis showed a one-dimensional structure when Items 3 and 4 were correlated. CONCLUSIONS This study has provided evidence of reliability and validity of the ketamine version of the SDS for recreational users. Considering that ketamine use is linked to young people and its strong potential for causing serious impairment, a cut-off of 3 is proposed as indicative of dependence.
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Vidal Giné C, Fernández Calderón F, López Guerrero J. Patterns of use, harm reduction strategies, and their relation to risk behavior and harm in recreational ketamine users. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 42:358-69. [DOI: 10.3109/00952990.2016.1141211] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Self-reported use of novel psychoactive substances in a US nationally representative survey: Prevalence, correlates, and a call for new survey methods to prevent underreporting. Drug Alcohol Depend 2015; 156:112-119. [PMID: 26377051 PMCID: PMC4633323 DOI: 10.1016/j.drugalcdep.2015.08.028] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 08/26/2015] [Accepted: 08/28/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND In recent years, there has been an increase in emergence and use of novel psychoactive substances (NPS) in the US and worldwide. However, there is little published epidemiological survey data estimating the prevalence of use in the US. METHOD Data on self-reported NPS use came from the National Survey of Drug Use and Health (2009-2013), a national representative sample of non-institutionalized individuals in the US. Subjects were asked to provide names of (non-traditional) drugs they used that they were not specifically asked about. We examined lifetime prevalence and sociodemographic correlates of self-reported use of new and uncommon synthetic drugs (NPS) among subjects ages 12-34-years-old. RESULTS 1.2% of subjects self-reported any use of the 57 NPS we examined. Use of psychedelic tryptamines (primarily DMT) was most common, followed by psychedelic phenethylamines (e.g., 2C series) and synthetic cannabinoids. Prevalence of self-reported use of NPS increased from 2009 to 2013 and use was most common among males, whites, older subjects, those of lower income, and among those residing in cities. Lifetime use of various other illicit drugs (e.g., LSD, cocaine, ecstasy/MDMA) was highly prevalent among NPS users. CONCLUSION This the first study reporting on use of a variety of NPS in a nationally representative US sample; however, use appears to be underreported as other national data suggest higher rates of NPS (e.g., synthetic cannabinoid) use. Developing more adaptable survey tools and systematically assessing NPS use would allow researchers to ask about hundreds of NPS and improve reporting as new drugs continue to rapidly emerge.
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Kamilar-Britt P, Bedi G. The prosocial effects of 3,4-methylenedioxymethamphetamine (MDMA): Controlled studies in humans and laboratory animals. Neurosci Biobehav Rev 2015; 57:433-46. [PMID: 26408071 DOI: 10.1016/j.neubiorev.2015.08.016] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/26/2015] [Accepted: 08/28/2015] [Indexed: 02/03/2023]
Abstract
Users of ±3,4-methylenedioxymethamphetamine (MDMA; 'ecstasy') report prosocial effects such as sociability and empathy. Supporting these apparently unique social effects, data from controlled laboratory studies indicate that MDMA alters social feelings, information processing, and behavior in humans, and social behavior in rodents. Here, we review this growing body of evidence. In rodents, MDMA increases passive prosocial behavior (adjacent lying) and social reward while decreasing aggression, effects that may involve serotonin 1A receptor mediated oxytocin release interacting with vasopressin receptor 1A. In humans, MDMA increases plasma oxytocin and produces feelings of social affiliation. It decreases identification of negative facial expressions (cognitive empathy) and blunts responses to social rejection, while enhancing responses to others' positive emotions (emotional empathy) and increasing social approach. Thus, consistent with drug folklore, laboratory administration of MDMA robustly alters social processing in humans and increases social approach in humans and animals. Effects are consistent with increased sociability, with mixed evidence about enhanced empathy. These neurobiologically-complex prosocial effects likely motivate recreational ecstasy use.
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Affiliation(s)
- Philip Kamilar-Britt
- Division on Substance Abuse, New York State Psychiatric Institute, 1051 Riverside Drive, MC 120, New York, NY 10032, United States.
| | - Gillinder Bedi
- Division on Substance Abuse, New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, MC 120, New York, NY 10032, United States.
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Abstract
Psychostimulants are a diverse group of substances with their main psychomotor effects resembling those of amphetamine, methamphetamine, cocaine, or cathinone. Due to their potential as drugs of abuse, recreational use of most of these substances is illegal since 1971 Convention on Psychotropic Substances. In recent years, new psychoactive substances have emerged mainly as synthetic cathinones with new molecules frequently complementing the list. Psychostimulant related movement disorders are a known entity often seen in emergency rooms around the world. These admissions are becoming more frequent as are fatalities associated with drug abuse. Still the legal constraints of the novel synthetic molecules are bypassed. At the same time, chronic and permanent movement disorders are much less frequently encountered. These disorders frequently manifest as a combination of movement disorders. The more common symptoms include agitation, tremor, hyperkinetic and stereotypical movements, cognitive impairment, and also hyperthermia and cardiovascular dysfunction. The pathophysiological mechanisms behind the clinical manifestations have been researched for decades. The common denominator is the monoaminergic signaling. Dopamine has received the most attention but further research has demonstrated involvement of other pathways. Common mechanisms linking psychostimulant use and several movement disorders exist.
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Affiliation(s)
- Andres Asser
- Department of Neurology and Neurosurgery, University of Tartu , Tartu , Estonia
| | - Pille Taba
- Department of Neurology and Neurosurgery, University of Tartu , Tartu , Estonia
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McCreary AC, Müller CP, Filip M. Psychostimulants: Basic and Clinical Pharmacology. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2015; 120:41-83. [PMID: 26070753 DOI: 10.1016/bs.irn.2015.02.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Substance use disorder, and particularly psychostimulant use disorder, has considerable socioeconomic burden globally. The psychostimulants include several chemical classes, being derivatives of benzoylecgonine, phenethylamine, phenylpropanolamine, or aminoaryloxazoline. Psychostimulant drugs activate the brain reward pathways of the mesoaccumbal system, and continued use leads to persistent neuroplastic and dysfunctional changes of a variety of structures involved in learning and memory, habit-forming learning, salience attribution, and inhibitory control. There are a variety of neurochemical and neurobehavioral changes in psychostimulant addiction, for example, dopaminergic, glutamatergic, serotonergic (5-HT-ergic), and γ-amino butyric acid (GABA) changes have all noted. In this chapter, we will review pharmacological changes associated with psychostimulant use and abuse in humans and animals, and on the basis of the best characterized and most widely abused psychostimulants (amphetamines, cocaine) discuss why use transitions into abuse and review basic science and clinical strategies that might assist in treating psychostimulant abuse.
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Affiliation(s)
| | - Christian P Müller
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen, Germany
| | - Małgorzata Filip
- Laboratory of Drug Addiction Pharmacology, Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland; Department of Toxicology, Faculty of Pharmacy, Jagiellonian University, Krakow, Poland.
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