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Wei SY, Su CC, Hu HY, Lin SY, Pan CH. Shedding light on the hidden methamphetamine abuse: a nation-wide 7-year post-mortem study in Taiwan. J Epidemiol 2024:JE20230263. [PMID: 38462530 DOI: 10.2188/jea.je20230263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND The number of methamphetamine-related deaths has been increasing in recent decades. However, current data primarily rely on a few large-scale national surveys, highlighting the need for diverse data sources. Post-mortem studies offer advantages that compensate for the limitations of cohort studies. In this study, we aimed to (1) examine mortality rates and years of potential life lost, (2) compare proportionate mortality with previous cohort studies, and (3) quantitatively investigate causes of death as potential risk factors associated with each manner of death. METHODS We analyzed 740 cases from 2013 to 2019 in Taiwan. RESULTS The mean age of cases was 38.4 years, with a notable loss of 30s years of potential life, and 79.6% were male. The crude mortality rate was 0.45 per 100,000 person-years. The proportionate mortality indicated that autopsy dataset, compared to cohort studies, provided more accurate estimations for accidental deaths, equivalent suicides, underestimated natural deaths, and overestimated homicides. Accidental deaths were evident in 67% of cases with 80% attributed to drug intoxication. Multiple substances were detected in 61% of cases, with psychiatric medications detected in 43% of cases. Higher methamphetamine concentrations and a greater proportion of multiple substances and benzodiazepines were detected in suicidal deaths. Among accidental deaths, traffic accidents (7.9%) were the second most common cause, particularly motorcycle riders. CONCLUSIONS Using autopsy dataset as a secondary source, we identified that over half of the cases involved accidental drug intoxication. The significant proportion of cases involving multiple substances, psychiatric medications, and drug-impaired driving raises concerning.
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Affiliation(s)
- Shyh-Yuh Wei
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University
| | - Chien-Chou Su
- Clinical Innovation and Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University
| | - Hsuan-Yun Hu
- Institute of Forensic Medicine, Ministry of Justice
| | - Szu-Yu Lin
- Institute of Forensic Medicine, Ministry of Justice
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2
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Fursman H, Finch E, Xiao L, Lefrançois E, Gupta A, Bartlett M, Latimer J, Chadwick S, Roux C, Morelato M. A snapshot of injecting drug consumption from the analysis of used syringes within the Medically Supervised Injecting Centre in Sydney, Australia. Drug Alcohol Rev 2024; 43:787-798. [PMID: 38145366 DOI: 10.1111/dar.13803] [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: 09/03/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION The administration of illicit drugs by injection is associated with considerable harm, including an increased risk of overdose. The chemical analysis of used syringes can enhance knowledge on injecting drug consumption beyond traditional data sources (self-report surveys). This additional information may be useful during significant global events like the COVID-19 pandemic. This study aimed to examine a snapshot of the drugs injected at the Medically Supervised Injecting Centre (MSIC) in Sydney, Australia, in 2019-2020. METHODS Used syringes were collected from MSIC across three periods throughout 2019 and 2020 (February 2019, March-April 2020 and June-September 2020). Drug residues were extracted from used syringes using methanol before detection by gas chromatography-mass spectrometry and ultra-performance liquid chromatography-tandem mass spectrometry. The chemical analysis results were compared to self-report data obtained from MSIC clients. RESULTS Heroin (46-53%), methamphetamine (24-34%) and pharmaceutical opioids (15-27%) were the most common drug residues detected. The chemically detected drugs had declining coherence with the drugs self-reported by MSIC clients across the time periods examined. DISCUSSION AND CONCLUSIONS There was no significant change in the drugs injected (heroin, methamphetamine and pharmaceutical opioids) across the three periods collected throughout varying COVID-19 lockdown restrictions. Changes in the frequency of other drugs injected and discrepancies between chemical analysis and self-report were potentially related to regulatory changes, degradation or misinformed sales. Routine chemical analysis of used syringes has provided an alternative information source to promote awareness of current drug trends and aid harm reduction.
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Affiliation(s)
- Harrison Fursman
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Eleanor Finch
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Linda Xiao
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Elodie Lefrançois
- School of Criminal Justice, Faculty of Law, Criminal Justice and Public Administration, University of Lausanne, Lausanne, Switzerland
| | - Anjali Gupta
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Mark Bartlett
- Uniting Medically Supervised Injecting Centre, Sydney, Australia
| | - Julie Latimer
- Uniting Medically Supervised Injecting Centre, Sydney, Australia
| | - Scott Chadwick
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Claude Roux
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Marie Morelato
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
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3
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Giommoni L. How to improve the surveillance of the Taliban ban's impact on European drug markets. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 124:104320. [PMID: 38219675 DOI: 10.1016/j.drugpo.2024.104320] [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: 07/31/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 01/16/2024]
Abstract
In April 2023, the Taliban banned poppy cultivation and the trade of all narcotics. This caused a 95% reduction in opium production. Usually, that would be good news. But there is a substantial worry: synthetic opioids might fill the void left by heroin. This is concerning because these drugs have led to health emergencies in areas where they are prevalent. This paper highlights the limitations of the current drug surveillance system in Europe and proposes improvements. It argues that reliance on secondary data is insufficient. Instead, we need to interview a sentinel group of people who inject drugs and adjust city-level sentinel systems, such as wastewater analysis, to specifically track the spread of synthetic opioids. Without these proactive steps, we risk only noticing a transition from heroin to synthetic opioids after it has occurred, with its harmful impacts already in place.
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Affiliation(s)
- Luca Giommoni
- School of Social Sciences, Cardiff University, Cardiff, United Kingdom.
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4
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Caulkins JP, Tallaksen A, Taylor J, Kilmer B, Reuter P. The Baltic and Nordic responses to the first Taliban poppy ban: Implications for Europe & synthetic opioids today. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 124:104314. [PMID: 38183860 DOI: 10.1016/j.drugpo.2023.104314] [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: 10/09/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024]
Abstract
The 2000-2001 and the 2022-2023 Taliban opium bans were and could be two of the largest ever disruptions to a major illegal drug market. To help understand potential implications of the current ban for Europe, this paper analyzes how opioid markets in seven Baltic and Nordic countries responded to the earlier ban, using literature review, key informant interviews, and secondary data analysis. The seven nations' markets responded in diverse ways, including rebounding with the same drug (heroin in Norway), substitution to a more potent opioid (fentanyl replacing heroin in Estonia), and substitution to one with lower risk of overdose (buprenorphine replacing heroin in Finland). The responses were not instantaneous, but rather evolved, sometimes over several years. This variety suggests that it can be hard to predict how drug markets will respond to disruptions, but two extreme views can be challenged. It would be naive to imagine that drug markets will not adapt to shocks, but also unduly nihilistic to presume that they will always just bounce back with no lasting effects. Substitution to another way of meeting demand is possible, but that does not always negate fully the benefits of disrupting the original market. Nonetheless, there is historical precedent for a European country's opioid market switching to synthetic opioids when heroin supplies were disrupted. Given how much that switch has increased overdose rates in Canada and the United States, that is a serious concern for Europe at present. A period of reduced opioid supply may be a particularly propitious time to expand treatment services (as Norway did in the early 2000s).
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Affiliation(s)
- Jonathan P Caulkins
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA.
| | - Amund Tallaksen
- The Council of State Governments Justice Center, 22 Cortland St., Floor 22, New York, NY 10007, USA
| | - Jirka Taylor
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Beau Kilmer
- RAND Drug Policy Research Center, 1776 Main St., Santa Monica, CA 90401, USA
| | - Peter Reuter
- University of Maryland, 7251 Preinkert Drive, College Park, MD 20742, USA
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5
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Verhagen R, Kaserzon SL, Thomas KV, Mueller JF, Tscharke BJ. Exploring drug consumption patterns across varying levels of remoteness in Australia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 903:166163. [PMID: 37574069 DOI: 10.1016/j.scitotenv.2023.166163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/21/2023] [Accepted: 08/07/2023] [Indexed: 08/15/2023]
Abstract
Wastewater-based epidemiology (WBE) relies on representative sampling that is typically achieved with autosamplers that collect time, flow, or volume proportional samples. The expense, resources and operational know-how associated with autosampler operation means they are only typically available at major wastewater treatment plants (WWTPs). This results in a lack of data on consumption levels in regional and remote areas, or in countries that lack the financial means. The aim of this study was to estimate and investigate trends in drug consumption across varying levels of remoteness in Australia. Field-calibrated, microporous polyethylene passive samplers were deployed over 2 periods (Aug/Sept 2019 and 2020) at 43 treatment plants covering all five categories of remoteness, as per Australian Bureau of Statistics definitions (Major cities, Inner regional, Outer regional, Remote, and Very remote). The per capita consumption of cocaine, methylamphetamine, nicotine, oxycodone and MDMA were estimated. No spatial trends between remoteness and drug consumption were observed, except for cocaine, where Major cities had a 5-to-10-fold higher consumption compared to the other levels of remoteness in 2019 and 2020, respectively. Outer regional sites had the highest and lowest methylamphetamine consumption. The variance in drug use among sites was much higher in Remote (and Inner/Outer regional) sites when compared with Major cities. A significant and consistent decrease in oxycodone consumption was observed at all sites between 2019 and 2020, possibly related to regulatory changes and the COVID-19 pandemic where elective surgeries were suspended. The majority of sites experienced a decrease in cocaine and methylamphetamine consumption, possibly due to border restrictions or changes in supply and demand dynamics. This was the first extensive passive sampling study to assess drug consumption in urban, regional, and remote locations, demonstrating that passive samplers can facilitate extension of wastewater-based drug monitoring programs to sites where other representative sampling options are very difficult to implement.
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Affiliation(s)
- Rory Verhagen
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia..
| | - Sarit L Kaserzon
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Benjamin J Tscharke
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
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Palamar JJ, Salomone A, Massano M, Cleland CM. Trends in reported and biologically confirmed drug use among people who use ecstasy in the nightclub/festival-attending population, 2016-2022. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 9:100198. [PMID: 38023341 PMCID: PMC10665664 DOI: 10.1016/j.dadr.2023.100198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023]
Abstract
Background Nightclub/festival attendees are a population with high rates of party drug use, but research is needed to determine whether there have been shifts in unintended drug exposure in this population (e.g., via adulterants) to inform prevention and harm reduction efforts. Methods Adults entering nightclubs and festivals in New York City were asked about past-year drug use in 2016 through 2022, with a subset providing a hair sample for testing. We focused on the 1943 who reported ecstasy use (of which 247 had a hair sample analyzed) and compared trends in self-reported drug use, drug positivity, and adjusted prevalence (adjusting for unreported use). Results MDMA positivity decreased from 74.4 % to 42.3 %, and decreases occurred regarding detection of synthetic cathinones ("bath salts"; a 100.0 % decrease), MDA (a 76.9 % decrease), amphetamine (an 81.3 % decrease), methamphetamine (a 64.2 % decrease), and ketamine (a 33.4 % decrease) (ps < .05). Although prevalence of MDA and synthetic cathinone use was comparable between self-report and adjusted report in 2022, gaps in prevalence were wider in 2016 (ps < .01). Adjusted prevalence of synthetic cathinone use decreased more across time than prevalence based on self-report (a 79.4 % vs. 69.1 % decrease) and adjusted report for MDA use decreased more than prevalence based on self-report (a 50.6 % vs. 38.9 % decrease). Conclusions Combining self-report and toxicology tests helped us determine that decreases in drug use/exposure were steeper regarding adjusted prevalence. Underreported drug exposure-possibly due to exposure to adulterants-appears to have had less of an effect on prevalence in 2022 than it did in 2016.
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Affiliation(s)
- Joseph J. Palamar
- NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA
| | - Alberto Salomone
- Department of Chemistry, University of Turin, Turin, Italy
- Centro Regionale Antidoping, Orbassano (TO), Italy
| | - Marta Massano
- Department of Chemistry, University of Turin, Turin, Italy
| | - Charles M. Cleland
- NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA
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Meyer M, Westenberg JN, Jang KL, Choi F, Schreiter S, Mathew N, King C, Lang UE, Vogel M, Krausz RM. Shifting drug markets in North America - a global crisis in the making? Int J Ment Health Syst 2023; 17:36. [PMID: 37880722 PMCID: PMC10598952 DOI: 10.1186/s13033-023-00601-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023] Open
Abstract
Understanding drug market dynamics and their underlying driving factors is paramount to developing effective responses to the overdose crisis in North America. This paper summarises the distinct drug market trends observed locally and internationally over the past decade to extrapolate future drug market trajectories. The emergence of fentanyl on North American street markets from 2014 onwards led to a shift of street drug use patterns. Previously perceived as contaminants, novel synthetic opioids became the drugs of choice and a trend towards higher potency was observed across various substance classes. The diversification of distribution strategies as well as the regionalisation and industrialisation of production followed basic economic principles that were heavily influenced by prosecution and policy makers. Particularly, the trend towards higher potency is likely most indicative of what to expect from future illicit drug market developments. Nitazenes and fentanyl-analogues, several times more potent than fentanyl itself, are increasingly detected in toxicological testing and have the potential of becoming the drugs of choice in the future. The dynamic of drug import and local production is less clear and influenced by a multitude of factors like precursor availability, know-how, infrastructure, and the success of local drug enforcement strategies. Drug market dynamics and the current trajectory towards ultrapotent opioids need to be recognised by legislation, enforcement, and the health care system to prepare effective responses. Without significant improvements in treatment access, the implementation of preventative approaches and early warning systems, the mortality rate will continue to increase. Furthermore, there is no mechanism in place preventing the currently North American focused overdose crisis to spread to other parts of the globe, particularly Europe. A system of oversight, research, and treatment is needed to address mortality rates of historic proportions and prevent further harm.
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Affiliation(s)
- Maximilian Meyer
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada.
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland.
| | - Jean N Westenberg
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Kerry L Jang
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Fiona Choi
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Stefanie Schreiter
- Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nickie Mathew
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Conor King
- Victoria Police Department, Victoria, Canada
| | - Undine E Lang
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Marc Vogel
- University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - R Michael Krausz
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
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8
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Sekeris A, Algahtani T, Aldabergenov D, Rock KL, Auwal F, Aldewaissan F, Williams BD, Kalk NJ, Copeland CS. Trends in deaths following drug use in England before, during, and after the COVID-19 lockdowns. Front Public Health 2023; 11:1232593. [PMID: 37841731 PMCID: PMC10570433 DOI: 10.3389/fpubh.2023.1232593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/18/2023] [Indexed: 10/17/2023] Open
Abstract
Aim This research aimed to describe how the characteristics of deaths following drug use changed during the COVID-19 pandemic in England, and how this can inform future strategy to support the health and social care of people who use drugs in future emergency scenarios. Method All deaths reported to the National Programme on Substance Abuse Deaths which occurred between January 2018 and December 2021 inclusive were extracted for analysis. Exponential smoothing models were constructed to determine any differences between forecasted vs. actual trends. Key results Following the first lockdown period in England there were significant increases in the proportion of people who died at home beyond the 95% confidence bounds of the exponential smoothing model and concurrent decreases in the proportion of people who died in hospital. Whilst the overall proportion of deaths attributable to opioids did not significantly deviate from the forecasted trend, there were significant increases in methadone-related deaths and decreases in heroin/morphine-related death beyond the 95% confidence bounds. The proportion of deaths concluded as suicide increased, as did those implicating antidepressant use. There were no changes in the proportion of deaths following use of other drug classes, alcohol use in combination with psychoactive drugs, or on decedent demographics (gender, age, and drug user status). A small number of deaths due to drug use had COVID-19 infection itself listed as a cause of death (n = 23). Conclusion For people who use drugs, the impact of the restrictions due to the COVID-19 pandemic was greater than that of infection from the virus itself. The health and social care strategy for these people needs to be pre-emptively adapted to mitigate against the specific risk factors for fatal drug overdose associated with future emergency scenarios.
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Affiliation(s)
- Athanasios Sekeris
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Thikra Algahtani
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Daniyar Aldabergenov
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Kirsten L. Rock
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Fatima Auwal
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Farah Aldewaissan
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
| | - Bryn D. Williams
- Department of Anaesthetics, Royal Free Hospital NHS Foundation Trust, London, United Kingdom
| | - Nicola J. Kalk
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Caroline S. Copeland
- Centre for Pharmaceutical Medicine Research, Institute of Pharmaceutical Science, King’s College London, London, United Kingdom
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9
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Ezell JM. Climate Change and the Opioid Epidemic. J Addict Med 2023; 17:500-502. [PMID: 37788599 DOI: 10.1097/adm.0000000000001201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
ABSTRACT Ongoing assessments by climate scientists, including a recent report from the United Nations' Intergovernmental Panel on Climate Change, punctuate the pronounced effect that climate change is poised to have in the near future on the health and well-being of humans-particularly those with low socioeconomic status-throughout the world. To this end, to date, very limited scholarly attention has been placed on the effects that climate change may have on people who use drugs (PWUDs), in particular those with opioid use disorder, and assessed their structural and social determinants of climate change vulnerability. Since COVID-19, which has key lessons to offer on climate change's potential effects on PWUDs, the opioid epidemic has been rapidly accelerating in terms of its socioeconomic, racial, and geographic reach. The opioid epidemic has been further deepened by increasing fentanyl contamination and co-use with stimulants such as methamphetamine and (crack) cocaine, spurring a heavy increase in overdose deaths. These trends highlight a looming confrontation between the world's complex overdose crisis and its equally intensifying climate emergency. This piece contextualizes the specter of harms that climate change is likely to cultivate against PWUDs and offers strategies for mitigation.
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Affiliation(s)
- Jerel M Ezell
- From the University of California, Berkeley School of Public Health Community Health Sciences, Berkeley, CA
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10
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Palamar JJ, Le A, Cleland CM, Keyes KM. Trends in drug use among nightclub and festival attendees in New York City, 2017-2022. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 115:104001. [PMID: 36934660 PMCID: PMC10164102 DOI: 10.1016/j.drugpo.2023.104001] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Drug use is prevalent among people who attend electronic dance music (EDM) parties at nightclubs or festivals. This population can serve as a sentinel population to monitor trends in use of party drugs and new psychoactive substances (NPS) that may diffuse through larger segments of the population. METHODS We surveyed adults entering randomly selected EDM parties at nightclubs and dance festivals in New York City about their drug use in 2017 (n=954), 2018 (n=1,029), 2019 (n=606), 2021 (n=229), and 2022 (n=419). We estimated trends in past-year and past-month use of 22 drugs or drug classes based on self-report from 2017-2022 and examined whether there were shifts pre- vs. post-COVID (2017-2019 vs. 2021-2022). RESULTS Between 2017 and 2022, there were increases in past-year and past-month use of shrooms (psilocybin), ketamine, poppers (amyl/butyl nitrites), synthetic cathinones ("bath salts"), and novel psychedelics (lysergamides and DOx series), increases in past-year cannabis use, and increases in past-month use of 2C series drugs. Between 2017 and 2022, there were decreases in past-year heroin use and decreases in past-month cocaine use, novel stimulant use, and nonmedical benzodiazepine use. The odds of use of shrooms, poppers, and 2C series drugs significantly increased after COVID, and the odds of use of cocaine, ecstasy, heroin, methamphetamine, novel stimulants, and prescription opioids (nonmedical use) decreased post-COVID. CONCLUSIONS We estimate shifts in prevalence of various drugs among this sentinel population, which can inform ongoing surveillance efforts and public health response in this and the general populations.
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Affiliation(s)
- Joseph J Palamar
- New York University Grossman School of Medicine, Department of Population Health, New York, NY, USA; Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA.
| | - Austin Le
- New York University Grossman School of Medicine, Department of Population Health, New York, NY, USA; New York University College of Dentistry, New York, NY, USA
| | - Charles M Cleland
- New York University Grossman School of Medicine, Department of Population Health, New York, NY, USA; Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA
| | - Katherine M Keyes
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
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