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Feingold D, Gliksberg O, Brill S, Amit BH, Lev-Ran S, Kushnir T, Sznitman SR. Conceptualizing problematic use of medicinal Cannabis: Development and preliminary validation of a brief screening questionnaire. Addict Behav 2024; 158:108122. [PMID: 39128420 DOI: 10.1016/j.addbeh.2024.108122] [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: 01/28/2024] [Revised: 07/23/2024] [Accepted: 07/28/2024] [Indexed: 08/13/2024]
Abstract
The use of Medicinal Cannabis (MC) for treating chronic pain is increasing, globally, yet the definition of problematic MC use remains unclear. Defining problematic use of cannabis in medical and non-medical contexts may be fundamentally different since individuals prescribed MC often experience physical dependence, which do not necessarily imply pathology. We aimed to conceptualize problematic use of MC and develop a brief questionnaire for identifying and quantifying problematic MC use. Content validation used a broad definition of problematic substance use, adapting and compiling an initial list of 36 items from various sources: (a) screening tools for assessing problematic prescription opioid medication use; (b) screening tools for problematic recreational cannabis use and (c) qualitative interviews with MC patients. 390 American self-identified chronic pain patients holding a MC card rated each item from the initial list on a 5-point frequency scale and filled out questionnaires assessing various clinical outcomes. Following initial item titration, a multi-group measurement invariance comparison strategy, using two external indicators: alcohol-related problems and depression, resulted a final eight-item list that met fit quality in a baseline model, presented excellent internal consistency reliability (α = 0.929), and significantly correlated with anxiety and low quality of life. Items in the final list related predominantly to negative consequences of MC use. Problematic use of MC is characterized by negative physiological, social, emotional and functional consequences. The final eight-item list was named the Medicinal Cannabis Negative Consequences Scale (MCNCS), emerging as a brief measure for problematic MC use and demonstrating preliminary reliability and validity, which could aid clinicians and researchers.
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Affiliation(s)
| | - Or Gliksberg
- Department of Psychology, Ariel University, Ariel, Israel.
| | - Silviu Brill
- Pain Institute, Sourasky Medical Center, Tel Aviv, Israel.
| | - Ben H Amit
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Sourasky Medical Center, Tel Aviv, Israel.
| | - Shaul Lev-Ran
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Israel Center on Addiction, Netanya, Israel; Lev Hasharon Medical Center, Netanya, Israel.
| | - Talma Kushnir
- Department of Psychology, Ariel University, Ariel, Israel; Adelson School of Medicine, Ariel University, Israel.
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Jungwirth J, Bavato F, Quednow BB. [Psychedelic and dissociative agents in psychiatry: challenges in the treatment]. DER NERVENARZT 2024:10.1007/s00115-024-01727-0. [PMID: 39196383 DOI: 10.1007/s00115-024-01727-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/29/2024] [Indexed: 08/29/2024]
Abstract
With the discovery of the antidepressive effects of ketamine and the increasing withdrawal of the pharmaceutical industry from the development of new psychotropic drugs, the psychiatric research into the clinical application of hallucinogens in psychiatry has literally blossomed in the last two decades. Promising results for various treatment approaches with psychedelic agents, such lysergic acid diethylamide (LSD) and psilocybin, and dissociative agents, such as ketamine and esketamine, have raised great hopes among researchers, clinicians and patients in recent years, so that there was already talk of a new era in psychiatry. As one of the first of these substances, in December 2019 intranasal esketamine was approved in the USA and the EU for the treatment of treatment-resistant depression and Switzerland followed in 2020. Recently, psilocybin was approved in Australia, Canada and Switzerland for compassionate use in exceptional cases for the treatment of depression, while large approval studies with various psychedelic agents are currently ongoing worldwide. The medical application of psychedelic agents and ketamine/esketamine is considered to be safe; however, as with all new forms of treatment it is of crucial importance that, in addition to the hopes, the specific challenges of these new treatment approaches must also be carefully considered and assessed. Excessive expectations and an insufficient risk-benefit estimation are detrimental to the patients and the reputation of the treating physician. Although a possible paradigm shift in the care of mental health is already being discussed, this review article consciously concentrates on the possible risks of treatment and the methodological weaknesses of the studies carried out so far.
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Affiliation(s)
- Johannes Jungwirth
- AG Neurophänomenologie des Bewusstseins, Erwachsenenpsychiatrie und Psychotherapie, Psychiatrische Universitätsklinik Zürich, Universität Zürich, Zürich, Schweiz
| | - Francesco Bavato
- AG Experimentelle Pharmakopsychologie und psychologische Suchtforschung, Erwachsenenpsychiatrie und Psychotherapie, Psychiatrische Universitätsklinik Zürich, Universität Zürich, Zürich, Schweiz
| | - Boris B Quednow
- AG Experimentelle Pharmakopsychologie und psychologische Suchtforschung, Erwachsenenpsychiatrie und Psychotherapie, Psychiatrische Universitätsklinik Zürich, Universität Zürich, Zürich, Schweiz.
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Klosterhalfen S, Kotz D, Kastaun S. Smokers' perception of the comparative health risks of cigarettes, e-cigarettes and heated tobacco products: a survey among the German population. J Public Health (Oxf) 2024; 46:e400-e409. [PMID: 38741461 DOI: 10.1093/pubmed/fdae068] [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: 10/28/2023] [Revised: 04/04/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Tobacco cigarettes, e-cigarettes and heated tobacco products can pose different health risks (harm continuum). As current tobacco smokers could benefit from switching to less harmful products, we aimed to assess current smokers' perceived comparative health risks of these three products and to explore associations between risk perceptions and specific user characteristics. METHODS We analysed data from 11 waves (2019-2021; N = 5657 current tobacco smokers) of a representative, cross-sectional household survey conducted in Germany. Associations were assessed with multivariable logistic regression models. RESULTS 55.2% of smokers (95%CI = 53.8-56.5%) ranked cigarettes as the most harmful product. 36.1% of smokers (95%CI = 34.8-37.3%) perceived e-cigarettes and 33.8% (95%CI = 32.5-35.0%) heated tobacco products as more harmful than cigarettes. Misperceptions that e-cigarettes or heated tobacco products are more harmful to health than cigarettes increased over the 3-year study period and were more common among those with lower educational attainment. CONCLUSIONS Only half of current tobacco smokers in Germany perceive the comparative health risks of cigarettes adequately and such misperceptions have increased recently. As current smokers could benefit most from switching to less harmful products, educational campaigns are needed to inform this group about the health risks of tobacco smoking and the comparative health risks of the various nicotine and tobacco products along the harm continuum.
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Affiliation(s)
- Stephanie Klosterhalfen
- Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society (chs), Institute of General Practice (ifam), Medical Faculty of the Heinrich-Heine-University, 40225 Duesseldorf, Germany
| | - Daniel Kotz
- Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society (chs), Institute of General Practice (ifam), Medical Faculty of the Heinrich-Heine-University, 40225 Duesseldorf, Germany
- Department of Behavioural Science and Health, University College London, WC1E 7HB London, UK
| | - Sabrina Kastaun
- Addiction Research and Clinical Epidemiology Unit, Centre for Health and Society (chs), Institute of General Practice (ifam), Medical Faculty of the Heinrich-Heine-University, 40225 Duesseldorf, Germany
- Patient-Physician Communication Research Unit, Centre for Health and Society (chs), Institute of General Practice (ifam), Medical Faculty of the Heinrich-Heine-University, 40225 Duesseldorf, Germany
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Lin X, Wang H, Zou L, Yang B, Chen W, Rong X, Zhang X, He L, Li X, Peng Y. The NRF2 activator RTA-408 ameliorates chronic alcohol exposure-induced cognitive impairment and NLRP3 inflammasome activation by modulating impaired mitophagy initiation. Free Radic Biol Med 2024; 220:15-27. [PMID: 38679301 DOI: 10.1016/j.freeradbiomed.2024.04.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Chronic alcohol exposure induces cognitive impairment and NLRP3 inflammasome activation in the mPFC (medial prefrontal cortex). Mitophagy plays a crucial role in neuroinflammation, and dysregulated mitophagy is associated with behavioral deficits. However, the potential relationships among mitophagy, inflammation, and cognitive impairment in the context of alcohol exposure have not yet been studied. NRF2 promotes the process of mitophagy, while alcohol inhibits NRF2 expression. Whether NRF2 activation can ameliorate defective mitophagy and neuroinflammation in the presence of alcohol remains unknown. METHODS BV2 cells and primary microglia were treated with alcohol. C57BL/6J mice were repeatedly administered alcohol intragastrically. BNIP3-siRNA, PINK1-siRNA, CCCP and bafilomycin A1 were used to regulate mitophagy in BV2 cells. RTA-408 acted as an NRF2 activator. Mitochondrial dysfunction, mitophagy and NLRP3 inflammasome activation were assayed. Behavioral tests were used to assess cognition. RESULTS Chronic alcohol exposure impaired the initiation of both receptor-mediated mitophagy and PINK1-mediated mitophagy in the mPFC and in vitro microglial cells. Silencing BNIP3 or PINK1 induced mitochondrial dysfunction and aggravated alcohol-induced NLRP3 inflammasome activation in BV2 cells. In addition, alcohol exposure inhibited the NRF2 expression both in vivo and in vitro. NRF2 activation by RTA-408 ameliorated NLRP3 inflammasome activation and mitophagy downregulation in microglia, ultimately improving cognitive impairment in the presence of alcohol. CONCLUSION Chronic alcohol exposure-induced impaired mitophagy initiation contributed to NLRP3 inflammasome activation and cognitive deficits, which could be alleviated by NRF2 activation via RTA-408.
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Affiliation(s)
- Xinrou Lin
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China; Nanhai Translational Innovation Center of Precision Immunology, Sun Yat-Sen Memorial Hospital, Foshan, 528200, China
| | - Hongxuan Wang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Lubin Zou
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China; Nanhai Translational Innovation Center of Precision Immunology, Sun Yat-Sen Memorial Hospital, Foshan, 528200, China
| | - Biying Yang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China; Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510000, China
| | - Wanru Chen
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Xiaoming Rong
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Xiaoni Zhang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Lei He
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China
| | - Xiangpen Li
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China; Shenshan Medical Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Shanwei, 516400, China.
| | - Ying Peng
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China; Nanhai Translational Innovation Center of Precision Immunology, Sun Yat-Sen Memorial Hospital, Foshan, 528200, China; Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510000, China.
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Novin MH, Razaghi E, Farzadfar F, Tarokh MJ, Rouhifard M. Measuring The Harms Caused by Illicit Drugs. A New Methodology for Estimating Drug Harm Index. Subst Use Misuse 2024:1-9. [PMID: 39069745 DOI: 10.1080/10826084.2024.2383973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
BACKGROUND Substance use carries a wide range of negative consequences, impacting both the individual using the substances and others. In recent years, there have been multiple efforts to assess the harm caused by drugs and to rank them, with each taking a distinctive approach to the matter. Objectives: This study seeks to introduce a new model for assessing the harm index and ranking of drugs. Methods: This prospective study involved the evaluation of 277 male drug users, assessing substance use harm on four separate occasions throughout the span of 1 year. Various aspects of harm were quantified through the utilization of the Duke Health Profile (DUKE) and the Addiction Severity Index (ASI) questionnaire. The pharmaceutical properties of each drug were incorporated into the study. The relationship between the combined variables in a mixed statistical model was determined at a significance level of .05 using the Rsoftware. This procedure facilitated the establishment of models and the definition of harm index ranges for each substance. Result: The results indicated that heroin had the highest harm index at 71.2 (95% CI69.6-72.8), while pure methadone scored the lowest at 36.5 (95% CI31.7-41.7), along with methadone combined with methamphetamine, which scored 35 (95% CI33-37.1). Conclusion: The variables utilized in this study can help estimate the approximate harm index range for both traditional and novel substances. Furthermore, the harm model designed in this study has the capability to predict the extent of harm to a drug user.
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Affiliation(s)
- Mohammad Hassan Novin
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Emran Razaghi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Jafar Tarokh
- Industrial Engineering Department, K.T. Toosi University of Technology, Tehran, Iran
| | - Mahtab Rouhifard
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Gomez-Escolar A, Folch-Sanchez D, Stefaniuk J, Swithenbank Z, Nisa A, Braddick F, Idrees Chaudhary N, van der Meer PB, Batalla A. Current Perspectives on the Clinical Research and Medicalization of Psychedelic Drugs for Addiction Treatments: Safety, Efficacy, Limitations and Challenges. CNS Drugs 2024:10.1007/s40263-024-01101-3. [PMID: 39033264 DOI: 10.1007/s40263-024-01101-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2024] [Indexed: 07/23/2024]
Abstract
Mental health disorders and substance use disorders (SUDs) in particular, contribute greatly to the global burden of disease. Psychedelics, including entactogens and dissociative substances, are currently being explored for the treatment of SUDs, yet with less empirical clinical evidence than for other mental health disorders, such as depression or post-traumatic stress disorder (PTSD). In this narrative review, we discuss the current clinical research evidence, therapeutic potential and safety of psilocybin, lysergic acid diethylamide (LSD), ketamine, 3,4-methylenedioxymethamphetamine (MDMA) and ibogaine, particularly in the context of the SUD treatment. Our aim was to provide a balanced overview of the current research and findings on potential benefits and harms of psychedelics in clinical settings for SUD treatment. We highlight the need for more clinical research in this particular treatment area and point out some limitations and challenges to be addressed in future research.
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Affiliation(s)
- Anton Gomez-Escolar
- INAWE Institute, Calle Ciudad Real 28, 28223, Madrid, Spain.
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain.
- Energy Control, Asociación Bienestar y Desarrollo (ABD), Madrid, Spain.
- Drogopedia, Madrid, Spain.
| | - Daniel Folch-Sanchez
- Addictions Research Group (GRAC), Clínic Foundation for Biomedical Research - Institut d'Investigacions Biomèdiques August Pi Sunyer (FRCB-IDIBAPS), Barcelona, Spain
| | | | - Zoe Swithenbank
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | | | - Fleur Braddick
- Addictions Research Group (GRAC), Clínic Foundation for Biomedical Research - Institut d'Investigacions Biomèdiques August Pi Sunyer (FRCB-IDIBAPS), Barcelona, Spain
| | | | - Pim B van der Meer
- Department of Neurology, University Medical Center, Leiden, The Netherlands
| | - Albert Batalla
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
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Ehlert A, Zimmermann J, Johann D, Ribeaud D, Eisner M, Baumgartner MR, Shanahan L, Rauhut H, Quednow BB. Substance use-related alterations of social decision-making in a longitudinal cohort of young adults. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00172-1. [PMID: 39009135 DOI: 10.1016/j.bpsc.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/24/2024] [Accepted: 06/28/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Substance use disorders (SUD) are associated with severe negative social and health-related outcomes. Evidence accumulates that chronic substance use is associated with alterations in social interaction behavior, which likely contributes to the vicious circle of SUD. However, little is known if these social problems originate from contextual factors only or also from the substance use itself - in other words, if they are predisposed or substance-induced. METHODS We study the causation behind behavioral alterations of substance users over a 9-year period (from age 11 to 20) in an urban age cohort (n=1,002) with high prevalence of substance use at age 20. We identify common substance use patterns using toxicological hair analysis, examine behavioral alterations with incentivized games, and use teacher assessments across different ages to determine the causes and effects behind substance use-related impairments in social interaction. RESULTS We find that opioid and stimulant users reveal reduced prosocial behavior compared to nonusers, particularly in interpersonal trust and perspective-taking (e.g., they are ∼50 percent less likely to trust others). Our longitudinal analyses suggest a causal relationship between the non-medical use of prescription opioids and impaired social behavior, whereas impairments among stimulant users seem to be partially predisposed. Moreover, women tend to be more severely affected by opioid use than men. However, no behavioral alterations were found among young adult cannabis or ecstasy users. CONCLUSION Highly addictive substances such as opioids can impair users' social behavior by undermining fundamental human interaction fueling a vicious circle of substance use and social isolation.
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Affiliation(s)
- Alexander Ehlert
- Institute of Sociology, University of Zurich, Andreasstrasse 15, 8050 Zürich, Switzerland
| | - Josua Zimmermann
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, 8032 Zurich, Switzerland; Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - David Johann
- Institute of Sociology, University of Zurich, Andreasstrasse 15, 8050 Zürich, Switzerland
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, 8050 Zurich, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, 8050 Zurich, Switzerland; Institute of Criminology, University of Cambridge, Cambridge, CB3 9DA, United Kingdom
| | - Markus R Baumgartner
- Center for Forensic Hair Analytics, Institute of Forensic Medicine, University of Zurich, 8057 Zurich, Switzerland
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, 8050 Zurich, Switzerland; Department of Psychology, University of Zurich, 8050 Zurich, Switzerland
| | - Heiko Rauhut
- Institute of Sociology, University of Zurich, Andreasstrasse 15, 8050 Zürich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, 8032 Zurich, Switzerland; Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland; Jacobs Center for Productive Youth Development, University of Zurich, 8050 Zurich, Switzerland.
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Heal DJ, Gosden J, Smith SL. A critical assessment of the abuse, dependence and associated safety risks of naturally occurring and synthetic cannabinoids. Front Psychiatry 2024; 15:1322434. [PMID: 38915848 PMCID: PMC11194422 DOI: 10.3389/fpsyt.2024.1322434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 05/27/2024] [Indexed: 06/26/2024] Open
Abstract
Various countries and US States have legalized cannabis, and the use of the psychoactive1 and non-psychoactive cannabinoids is steadily increasing. In this review, we have collated evidence from published non-clinical and clinical sources to evaluate the abuse, dependence and associated safety risks of the individual cannabinoids present in cannabis. As context, we also evaluated various synthetic cannabinoids. The evidence shows that delta-9 tetrahydrocannabinol (Δ9-THC) and other psychoactive cannabinoids in cannabis have moderate reinforcing effects. Although they rapidly induce pharmacological tolerance, the withdrawal syndrome produced by the psychoactive cannabinoids in cannabis is of moderate severity and lasts from 2 to 6 days. The evidence overwhelmingly shows that non-psychoactive cannabinoids do not produce intoxicating, cognitive or rewarding properties in humans. There has been much speculation whether cannabidiol (CBD) influences the psychoactive and potentially harmful effects of Δ9-THC. Although most non-clinical and clinical investigations have shown that CBD does not attenuate the CNS effects of Δ9-THC or synthetic psychoactive cannabinoids, there is sufficient uncertainty to warrant further research. Based on the analysis, our assessment is cannabis has moderate levels of abuse and dependence risk. While the risks and harms are substantially lower than those posed by many illegal and legal substances of abuse, including tobacco and alcohol, they are far from negligible. In contrast, potent synthetic cannabinoid (CB1/CB2) receptor agonists are more reinforcing and highly intoxicating and pose a substantial risk for abuse and harm. 1 "Psychoactive" is defined as a substance that when taken or administered affects mental processes, e.g., perception, consciousness, cognition or mood and emotions.
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Affiliation(s)
- David J. Heal
- DevelRx Limited, Nottingham, United Kingdom
- Department of Life Sciences, University of Bath, Bath, United Kingdom
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Gooding NB, Williams RJ. Are There Riskier Types of Gambling? J Gambl Stud 2024; 40:555-569. [PMID: 37355524 DOI: 10.1007/s10899-023-10231-0] [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] [Accepted: 06/18/2023] [Indexed: 06/26/2023]
Abstract
Gambling-related harm is a public health issue requiring market regulation and efforts aimed at prevention and treatment. An important consideration for the regulation of gambling is whether certain types of gambling are intrinsically more harmful than others. The present study was a comprehensive investigation of this issue in a nationwide sample of 10,199 Canadian adult gamblers that included 1346 individuals with problem gambling. We investigated (a) the univariate cross-sectional association between individual types of gambling and problem gambling; (b) the cross-sectional association between individual gambling types and problem gambling when controlling for breadth of gambling involvement; (c) the prospective/lagged relationship between participation in different gambling types and future problem gambling; and (d) the self-reports of people with gambling problems concerning the types and modalities they consider to be most problematic. Our collective results indicate that breadth of gambling involvement is a stronger predictor of gambling problems than involvement in any particular type, but that involvement in certain types (electronic gambling machines in particular, and casino table games and online gambling to a lesser extent) does confer additional risk.
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Affiliation(s)
- Nolan B Gooding
- Department of Psychology, University of Lethbridge, 4401 University Drive W, Lethbridge, AB, T1K 3M4, Canada.
| | - Robert J Williams
- Faculty of Health Sciences, University of Lethbridge, 4401 University Drive W, Lethbridge, AB, T1K 3M4, Canada
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Wilkes R, Roberts DM, Liknaitzky P, Brett J. The psychedelic call: analysis of Australian Poisons Information Centre calls associated with classic psychedelics. Clin Toxicol (Phila) 2024; 62:242-247. [PMID: 38753585 DOI: 10.1080/15563650.2024.2346612] [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: 11/27/2023] [Accepted: 04/18/2024] [Indexed: 05/18/2024]
Abstract
INTRODUCTION The global use of certain classical psychedelics has increased in recent years, but little is known about their spectrum of toxicity within Australia. We aim to describe calls to New South Wales Poisons Information Centre relating to exposures to classical psychedelics including lysergic acid diethylamide, psilocybin, N,N-dimethyltryptamine, ayahuasca, mescaline and ibogaine. METHODS This is a retrospective observational study of calls to New South Wales Poisons Information Centre between January 2014 and December 2022. We identified exposures to classical psychedelics within New South Wales Poisons Information Centre database and measured the annual number of exposures, source of call (hospital, health care worker, member of the public), co-ingested substances, clinical features and advice given. RESULTS There were 737 calls related to relevant psychedelic exposures; 352 (47.8 per cent) to lysergic acid diethylamide, 347 (47.0 per cent) to psilocybin, 28 (3.8 per cent) to N,N-dimethyltryptamine, 4 (0.5 per cent) to ayahuasca, 4 (0.5 per cent) to mescaline and 2 (0.3 per cent) to ibogaine. Cases were predominantly male (77.2 per cent) and aged between 20 and 74 years (65.6 per cent). Psychedelic calls more than doubled from 45 in 2014 to 105 in 2022 and 625 (85 per cent) of all calls were either from or referred to hospital. Co-ingestion of psychedelics with another substance occurred in 249 (33.8 per cent) of calls and the most frequent clinical features related to single substance psychedelic exposures were hallucinations (27.6 per cent), gastrointestinal symptoms (21.7 per cent) and tachycardia (18.1 per cent). Seizures occurred in 2.9 per cent of single substance psychedelic exposures. DISCUSSION Increasing incidence of psychedelic exposure calls, including those reporting significant toxicity, likely reflects increasing community use. This may in part be driven by increasing interest in psychedelic assisted psychotherapy trials subsequently increasing public awareness. CONCLUSION Relatively high poisoning severity contrasts with safety within clinical trials of psychedelic assisted psychotherapy that may relate to the uncontrolled nature of community use which is mitigated within clinical trial environments. Education about safe use may be useful.
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Affiliation(s)
- Rachael Wilkes
- Emergency Department, St. Vincent's Hospital, Sydney, Australia
| | - Darren M Roberts
- Edith Collins Centre, Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia
- New South Wales Poison's Information Centre, Sydney Children's Hospitals Network, Westmead, Sydney, Australia
- St. Vincent's Clinical School, University of New South Wales, Sydney, Australia
| | - Paul Liknaitzky
- Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Jonathan Brett
- New South Wales Poison's Information Centre, Sydney Children's Hospitals Network, Westmead, Sydney, Australia
- St. Vincent's Clinical School, University of New South Wales, Sydney, Australia
- Medicines Intelligence and Health, School of Population Health, University of New South Wales, Australia
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Hayden Griffin O, Leban L, Singh D, Webb M, Narayanan S. Deconstructing Differential Drug Coverage within a Malaysian Media Source. J Psychoactive Drugs 2024; 56:272-278. [PMID: 36864012 DOI: 10.1080/02791072.2023.2186287] [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: 09/23/2022] [Revised: 01/04/2023] [Accepted: 02/13/2023] [Indexed: 03/04/2023]
Abstract
Many researchers have noted that media coverage of drugs can be sensationalized and/or have questionable accuracy. Additionally, it has been alleged that the media often treats all drugs as harmful and can fail to differentiate between different types of drugs. Within this context, the researchers sought to deconstruct how media coverage was similar and/or different according to drug type within a national media outlet in Malaysia. Our sample comprised 487 news articles published over a two-year period. Articles were coded to reflect thematic differences in drug framing. We focus on five drugs widely used in Malaysia (amphetamines, opiates, cannabis, cocaine, and kratom) and assess the most frequent themes, crimes, and locations mentioned in reference to each drug. All drugs were primarily covered in a criminal justice context, and articles highlighted concern about the spread of these drugs and their abuse. Drug coverage varied, particularly in association with violent crimes, specific regions, and discussion of legality. We find evidence of both similarities and differences in how drugs were covered. Variation in coverage demonstrated that certain drugs were deemed a heightened threat, as well as reflected broader social/political processes shaping ongoing debates over treatment approaches and legality.
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Affiliation(s)
- O Hayden Griffin
- Department of Criminal Justice, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lindsay Leban
- Department of Criminal Justice, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Darshan Singh
- Centre for Drug Research, Universiti Sains Malaysia, Minden, Penang, Malaysia
| | - Megan Webb
- Department of Sociology, University of California, Riverside, CA, USA
| | - Suresh Narayanan
- School of Social Sciences, Universiti Sains Malaysia, Minden, Penang, Malaysia
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Lin X, Li X, Li C, Wang H, Zou L, Pan J, Zhang X, He L, Rong X, Peng Y. Activation of STING signaling aggravates chronic alcohol exposure-induced cognitive impairment by increasing neuroinflammation and mitochondrial apoptosis. CNS Neurosci Ther 2024; 30:e14689. [PMID: 38516831 PMCID: PMC10958405 DOI: 10.1111/cns.14689] [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: 11/21/2023] [Revised: 02/18/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024] Open
Abstract
AIMS Chronic alcohol exposure leads to persistent neurological disorders, which are mainly attributed to neuroinflammation and apoptosis. Stimulator of IFN genes (STING) is essential in the cytosolic DNA sensing pathway and is involved in inflammation and cellular death processes. This study was to examine the expression pattern and biological functions of STING signaling in alcohol use disorder (AUD). METHODS Cell-free DNA was extracted from human and mouse plasma. C57BL/6J mice were given alcohol by gavage for 28 days, and behavior tests were used to determine their mood and cognition. Cultured cells were treated with ethanol for 24 hours. The STING agonist DMXAA, STING inhibitor C-176, and STING-siRNA were used to intervene the STING. qPCR, western blot, and immunofluorescence staining were used to assess STING signaling, inflammation, and apoptosis. RESULTS Circulating cell-free mitochondrial DNA (mtDNA) was increased in individuals with AUD and mice chronically exposed to alcohol. Upregulation of STING signaling under alcohol exposure led to inflammatory responses in BV2 cells and mitochondrial apoptosis in PC12 cells. DMXAA exacerbated alcohol-induced cognitive impairment and increased the activation of microglia, neuroinflammation, and apoptosis in the medial prefrontal cortex (mPFC), while C-176 exerted neuroprotection. CONCLUSION Activation of STING signaling played an essential role in alcohol-induced inflammation and mitochondrial apoptosis in the mPFC. This study identifies STING as a promising therapeutic target for AUD.
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Affiliation(s)
- Xinrou Lin
- Department of Neurology, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen UniversityGuangzhouChina
- Nanhai Translational Innovation Center of Precision ImmunologySun Yat‐Sen Memorial HospitalFoshanChina
| | - Xiangpen Li
- Department of Neurology, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen UniversityGuangzhouChina
- Shenshan Medical Center, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityShanweiChina
| | - Chenguang Li
- Department of Neurology, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen UniversityGuangzhouChina
| | - Hongxuan Wang
- Department of Neurology, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen UniversityGuangzhouChina
| | - Lubin Zou
- Department of Neurology, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen UniversityGuangzhouChina
- Nanhai Translational Innovation Center of Precision ImmunologySun Yat‐Sen Memorial HospitalFoshanChina
| | - Jingrui Pan
- Department of Neurology, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen UniversityGuangzhouChina
- Shenshan Medical Center, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityShanweiChina
| | - Xiaoni Zhang
- Department of Neurology, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen UniversityGuangzhouChina
| | - Lei He
- Department of Neurology, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen UniversityGuangzhouChina
| | - Xiaoming Rong
- Department of Neurology, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen UniversityGuangzhouChina
| | - Ying Peng
- Department of Neurology, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen UniversityGuangzhouChina
- Nanhai Translational Innovation Center of Precision ImmunologySun Yat‐Sen Memorial HospitalFoshanChina
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat‐Sen Memorial HospitalSun Yat‐Sen UniversityGuangzhouChina
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Falchi-Carvalho M, Wießner I, Silva SRB, O Maia L, Barros H, Laborde S, Arichelle F, Tullman S, Silva-Costa N, Assunção A, Almeida R, Pantrigo ÉJ, Bolcont R, Costa-Macedo JV, Arcoverde E, Galvão-Coelho N, Araujo DB, Palhano-Fontes F. Safety and tolerability of inhaled N,N-Dimethyltryptamine (BMND01 candidate): A phase I clinical trial. Eur Neuropsychopharmacol 2024; 80:27-35. [PMID: 38141403 DOI: 10.1016/j.euroneuro.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 12/25/2023]
Abstract
Psychedelics are being increasingly examined for their therapeutic potential in mood disorders. While the acute effects of ayahuasca, psilocybin, and lysergic acid diethylamide (LSD) last over several hours, inhaled N,N-Dimethyltryptamine (DMT) effects last around 10 min, which might provide a cost- and time-effective alternative to the clinical application of oral psychedelics. We aimed at investigating the safety and tolerability of inhaled DMT (BMND01 candidate). We recruited 27 healthy volunteers to receive a first, lower dose and a second, higher dose (5/20 mg, 7.5/30 mg, 10/40 mg, 12.5/50 mg, or 15/60 mg) of inhaled DMT in an open-label, single-ascending, fixed-order, dose-response study design. We investigated subjective experiences (intensity, valence, and phenomenology), physiological effects (blood pressure, heart rate, respiratory rate, blood oxygen saturation, body temperature), biochemical markers (liver, kidney, and metabolic functions), and adverse events during the acute and post-acute effects of DMT. DMT dose-dependently increased intensity, valence and perceptual ratings. There was a mild, transient, and self-limited increase in blood pressure and heart rate. There were no changes in safety blood biomarkers and no serious adverse events. DMT dose-dependently enhanced subjective experiences and positive valence. Inhaled DMT might be an efficient, non-invasive, safe route of administration, which might simplify the clinical use of this substance. This is the first clinical trial to test the effects of inhaled DMT (BMND01 candidate).
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Affiliation(s)
- Marcelo Falchi-Carvalho
- Biomind Labs, Brookfield Place, 181 Bay Street, Suite 1800, Toronto, ON M5J 2T9, Canada; Department of Clinical Medicine, Health Science Center, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Isabel Wießner
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Sérgio Ruschi B Silva
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Lucas O Maia
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Handersson Barros
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Sophie Laborde
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Flávia Arichelle
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Sam Tullman
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Natan Silva-Costa
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Aline Assunção
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Raissa Almeida
- Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Érica J Pantrigo
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Raynara Bolcont
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Emerson Arcoverde
- University Hospital Onofre Lopes, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Nicole Galvão-Coelho
- Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Draulio B Araujo
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil; Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
| | - Fernanda Palhano-Fontes
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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La S, Beltrame J, Tavella R. Sex-specific and ethnicity-specific differences in MINOCA. Nat Rev Cardiol 2024; 21:192-202. [PMID: 37775559 DOI: 10.1038/s41569-023-00927-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/01/2023]
Abstract
Suspected myocardial infarction with non-obstructive coronary arteries (MINOCA) has received increasing attention over the past decade. Given the heterogeneity in the mechanisms underlying acute myocardial infarction in the absence of obstructive coronary arteries, the syndrome of MINOCA is considered a working diagnosis that requires further investigation after diagnostic angiography studies have been performed, including coronary magnetic resonance angiography and functional angiography. Although once considered an infrequent and low-risk form of myocardial infarction, recent data have shown that the prognosis of MINOCA is not as benign as previously assumed. However, despite increasing awareness of the condition, many questions remain regarding the diagnosis, risk stratification and treatment of MINOCA. Women seem to be more susceptible to MINOCA, but studies on the sex-specific differences of the disease are scarce. Similarly, ethnicity-specific factors might explain discrepancies in the observed prevalence or underlying pathophysiological mechanisms of MINOCA but data are also scarce. Therefore, in this Review, we provide an update on the latest evidence available on the sex-specific and ethnicity-specific differences in the clinical features, pathophysiological mechanisms, treatment and prognosis of MINOCA.
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Affiliation(s)
- Sarena La
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Cardiology, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia
- Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - John Beltrame
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Department of Cardiology, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia
- Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Rosanna Tavella
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.
- Department of Cardiology, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia.
- Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
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Maruta J, Cho C, Raphan T, Yakushin SB. Symptom reduction in mal de débarquement syndrome with attenuation of the velocity storage contribution in the central vestibular pathways. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1331135. [PMID: 38486679 PMCID: PMC10937418 DOI: 10.3389/fresc.2024.1331135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024]
Abstract
Background The velocity storage mechanism of the central vestibular system is closely associated with the vestibulo-ocular reflex (VOR), but also contributes to the sense of orientation in space and the perception of self-motion. We postulate that mal de débarquement syndrome (MdDS) is a consequence of inappropriate sensory adaptation of velocity storage. The premise that a maladapted velocity storage may be corrected by spatial readaptation of the VOR has recently been translated into the development of the first effective treatment for MdDS. However, this treatment's initial impact may be reversed by subsequent re-triggering events. Presently, we hypothesized that MdDS symptoms could alternatively be reduced by attenuating the velocity storage contribution in the central vestibular pathways. Methods Forty-three patients with MdDS (aged 47 ± 14 yo; 36 women) were randomly assigned to two treatment groups and followed for 6 months. The horizontal VOR was tested with chair rotation during laboratory visits, and the strength of velocity storage was quantified with model-based parameters-the time constant (Tc) and the gain of coupling from the vestibular primary afferent signals (g0). To attenuate velocity storage, Group 1 underwent a progressively intensifying series of low-frequency earth-vertical oscillatory rotation coupled to conflicting visual stimuli. Group 2 underwent an established protocol combining head tilts and visual stimulation, designed to correct maladapted spatial orientation but not change the velocity storage strength. The symptom severity was self-rated on an 11-point scale and reported before and up to 6 months after the treatment. Results In Group 1, velocity storage was modified through reduction of g0 (p < 0.001) but not Tc. The symptom rating was at least halved initially in 43% of Group 1 (p = 0.04), the majority of whom retained a similar level of improvement during the 6-month follow-up period. In Group 2, no systematic change was induced in the parameters of velocity storage strength, as expected. The symptom rating was at least halved initially in 80% of Group 2 (p < 0.001), but paralleling previous findings, symptoms often returned subsequently. Conclusion Attenuation of velocity storage shows promise as a lasting remedy for MdDS that can complement the VOR readaptation approach.
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Affiliation(s)
- Jun Maruta
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Catherine Cho
- Department of Neurology, NYU Langone Medical Center, New York, NY, United States
- Department of Otolaryngology, NYU Langone Medical Center, New York, NY, United States
| | - Theodore Raphan
- Department of Computer and Information Science, Brooklyn College, Institute for Neural and Intelligent Systems, New York, NY, United States
- The Graduate School and University Center of the City University of New York, New York, NY, United States
| | - Sergei B. Yakushin
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Manca F, Lewsey J. Previous psychiatric hospitalizations as risk factors for single and multiple future alcohol-related hospitalizations in patients with alcohol use disorders. Addiction 2024; 119:291-300. [PMID: 37750192 DOI: 10.1111/add.16352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 08/21/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND AND AIMS People with alcohol use disorder (AUD) often have co-occurring psychiatric conditions. The association between psychiatric conditions and AUD relapse has not yet been fully explored. This study aimed to quantify different psychiatric comorbidities as risk factors for first and multiple AUD rehospitalizations in patients already hospitalized once for AUD. METHODS We used a nation-wide routine health-care database in Scotland, UK, between 2010 and 2019. Individuals with a first hospitalization for AUD (codes F10.0-9 in the ICD-10 codes) were checked for previous hospitalizations where the main or co-occurring cause was a psychiatric condition (any other F0-F99 code in ICD-10). The final cohort included 23 529 patients, 18 620 of whom did not have a history of any other psychiatric comorbidity. First, individuals with a history of any previous psychiatric hospitalization were grouped and compared with those without on the basis of time to AUD rehospitalization. Then, individuals with different histories of psychiatric hospitalization were compared with each other. Cox and Prentice, Williams and Peterson gap-time models were used for single and multiple AUD rehospitalizations, respectively. RESULTS The AUD rehospitalization rate in individuals with a previous psychiatric hospitalization was 8% higher compared with those without [hazard ratio (HR) = 1.08, 95% confidence interval (CI) = 1.01-1.14]. The difference in rehospitalization rate reduced following the first rehospitalization (HR at second rehospitalization from first: 0.95, 95% CI = 0.87-1.04 and HR at third rehospitalization from second: 0.94, 95% CI = 0.84-1.07). Mood disorders and neurotic, stress-related and somatoform disorders were associated with a 54% (HR = 1.54, 95% CI = 1.38-1.72) and 39% (HR = 1.39, 95% CI = 1.17-1.66) increase in the risk of a first AUD rehospitalization. Other conditions, such as disorders due to psychoactive substance use or schizophrenia, were associated with decreases in future AUD rehospitalization (HR = 0.89, 95% CI = 0.82-0.97 and HR = 0.82, 95% CI = 0.58-1.16, respectively). CONCLUSIONS Patients with AUD appear to have different rates of AUD rehospitalization based on different co-occurring psychiatric conditions. Addiction-related characteristics may be more relevant risk indicators for multiple AUD readmission than psychiatric comorbidities.
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Affiliation(s)
- Francesco Manca
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jim Lewsey
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Chrenek C, Duong B, Khullar A, McRee C, Thomas R, Swainson J. Use of ketamine for treatment resistant depression: updated review of literature and practical applications to a community ketamine program in Edmonton, Alberta, Canada. Front Psychiatry 2024; 14:1283733. [PMID: 38260793 PMCID: PMC10801061 DOI: 10.3389/fpsyt.2023.1283733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024] Open
Abstract
Background Though intravenous (IV) ketamine and intranasal (IN) esketamine are noted to be efficacious for treatment-resistant depression (TRD), access to each of these treatments within healthcare systems is limited due to cost, availability, and/or monitoring requirements. IV ketamine has been offered at two public hospital sites in Edmonton, Canada since 2015. Since then, demand for maintenance ketamine treatments has grown. This has required creative solutions for safe, accessible, evidence-based patient care. Objectives Aims of this paper are twofold. First, we will provide a synthesis of current knowledge with regards to the clinical use of ketamine for TRD. Consideration will be given regarding; off-label racemic ketamine uses versus FDA-approved intranasal esketamine, populations treated, inclusion/exclusion criteria, dosing, assessing clinical response, concomitant medications, and tolerability/safety. Second, this paper will describe our experience as a community case study in applying evidence-based treatment. We will describe application of the literature review to our clinical programming, and in particular focus on cost-effective maintenance treatments, long-term safety concerns, routes of ketamine administration other than via intravenous, and cautious prescribing of ketamine outside of clinically monitored settings. Methodology We conducted a literature review of the on the use of ketamine for TRD up to June 30, 2023. Key findings are reviewed, and we describe their application to our ketamine program. Conclusion Evidence for the use of ketamine in resistant depression has grown in recent years, with evolving data to support and direct its clinical use. There is an increasing body of evidence to guide judicious use of ketamine in various clinical circumstances, for a population of patients with a high burden of suffering and morbidity. While large-scale, randomized controlled trials, comparative studies, and longer-term treatment outcomes is lacking, this community case study illustrates that currently available evidence can be applied to real-world clinical settings with complex patients. As cost is often a significant barrier to accessing initial and/or maintenance IV or esketamine treatments, public ketamine programs may incorporate SL or IN ketamine to support a sustainable and accessible treatment model. Three of such models are described.
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Affiliation(s)
- Carson Chrenek
- Department of Psychiatry, Misericordia Community Hospital, University of Alberta, Edmonton, AB, Canada
| | - Bryan Duong
- Department of Psychiatry, University of Alberta Hospital, University of Alberta, Edmonton, AB, Canada
| | - Atul Khullar
- Department of Psychiatry, Grey Nuns Community Hospital, University of Alberta, Edmonton, AB, Canada
| | - Chris McRee
- Grey Nuns Community Hospital, Edmonton, AB, Canada
| | - Rejish Thomas
- Department of Psychiatry, Grey Nuns Community Hospital, University of Alberta, Edmonton, AB, Canada
| | - Jennifer Swainson
- Department of Psychiatry, Misericordia Community Hospital, University of Alberta, Edmonton, AB, Canada
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Wojtas A, Gołembiowska K. Molecular and Medical Aspects of Psychedelics. Int J Mol Sci 2023; 25:241. [PMID: 38203411 PMCID: PMC10778977 DOI: 10.3390/ijms25010241] [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: 11/17/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Psychedelics belong to the oldest psychoactive drugs. They arouse recent interest due to their therapeutic applications in the treatment of major depressive disorder, substance use disorder, end-of-life anxiety,= and anxiety symptoms, and obsessive-compulsive disorder. In this review, the current state of preclinical research on the mechanism of action, neurotoxicity, and behavioral impact of psychedelics is summarized. The effect of selective 5-HT2A receptor agonists, 25I- and 25B-NBOMe, after acute and repeated administration is characterized and compared with the effects of a less selective drug, psilocybin. The data show a significant effect of NBOMes on glutamatergic, dopaminergic, serotonergic, and cholinergic neurotransmission in the frontal cortex, striatum, and nucleus accumbens. The increases in extracellular levels of neurotransmitters were not dose-dependent, which most likely resulted from the stimulation of the 5-HT2A receptor and subsequent activation of the 5-HT2C receptors. This effect was also observed in the wet dog shake test and locomotor activity. Chronic administration of NBOMes elicited rapid development of tolerance, genotoxicity, and activation of microglia. Acute treatment with psilocybin affected monoaminergic and aminoacidic neurotransmitters in the frontal cortex, nucleus accumbens, and hippocampus but not in the amygdala. Psilocybin exhibited anxiolytic properties resulting from intensification of GABAergic neurotransmission. The data indicate that NBOMes as selective 5-HT2A agonists exert a significant effect on neurotransmission and behavior of rats while also inducing oxidative DNA damage. In contrast to NBOMes, the effects induced by psilocybin suggest a broader therapeutic index of this drug.
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Affiliation(s)
| | - Krystyna Gołembiowska
- Unit II, Department of Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, 12 Smętna Street, 31-343 Kraków, Poland;
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Mauries S, Bertrand L, Frija-Masson J, Benzaquen H, Kalamarides S, Sauvage K, Lejoyeux M, d’Ortho MP, Geoffroy PA. Effects of smoking on sleep architecture and ventilatory parameters including apneas: Results of the Tab-OSA study. Sleep Med X 2023; 6:100085. [PMID: 37736106 PMCID: PMC10509708 DOI: 10.1016/j.sleepx.2023.100085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 09/06/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023] Open
Abstract
Background The interaction between smoking and sleep seems appears to be bidirectional, but few studies evaluated the impact of smoking and its cessation on objective sleep parameters. In this context, this new study aimed to assess the impact of smoking and its cessation on sleep architecture and on ventilatory sleep parameters, particularly the presence of sleep apnea syndrome (apnea-hypopnea index (AHI)≥15). Methods: Patients hospitalized for polysomnographic sleep exploration were compared according to their smoking status: active smokers (AS), former smokers (FS), non-smokers (NoNi). Psychiatric and non-psychiatric co-morbidities and treatment or substance use were taken into account in the analyses. Results A total of 170 participants were included (N = 37 FS, 39 AS, 86 NoNi). A significant decrease in the mean nocturnal O2 saturation was observed for FS and AS compared to NoNi. No differences were found regarding AHI. Regarding sleep architecture, we observed a significant decrease in the slow wave sleep duration for AS compared to NoNi, and interestingly not between FS and NoNi. Conclusion This study suggests that current smokers suffer from alterations in both sleep architecture and ventilatory parameters, the later appears to persist even after smoking cessation.
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Affiliation(s)
- Sibylle Mauries
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Léa Bertrand
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Justine Frija-Masson
- Université de Paris, NeuroDiderot, Inserm, U1141, 48 boulevard Sérurier, 75019, Paris, France
- Explorations Fonctionnelles et Centre du Sommeil- Département de Physiologie Clinique, Assistance Publique des Hôpitaux de Paris, GHU Paris Nord, DMU DREAM, Hôpital Bichat, 46 rue Henri Huchard, 75018, Paris, France
| | - Hélène Benzaquen
- Explorations Fonctionnelles et Centre du Sommeil- Département de Physiologie Clinique, Assistance Publique des Hôpitaux de Paris, GHU Paris Nord, DMU DREAM, Hôpital Bichat, 46 rue Henri Huchard, 75018, Paris, France
| | - Sophie Kalamarides
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Beaujon, 100 boulevard Général Leclerc, 92110, Clichy, France
| | - Karine Sauvage
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
| | - Michel Lejoyeux
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
- GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
| | - Marie-Pia d’Ortho
- Université de Paris, NeuroDiderot, Inserm, U1141, 48 boulevard Sérurier, 75019, Paris, France
- Explorations Fonctionnelles et Centre du Sommeil- Département de Physiologie Clinique, Assistance Publique des Hôpitaux de Paris, GHU Paris Nord, DMU DREAM, Hôpital Bichat, 46 rue Henri Huchard, 75018, Paris, France
| | - Pierre A. Geoffroy
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, 46 rue Henri Huchard, 75018, Paris, France
- GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France
- Université de Paris, NeuroDiderot, Inserm, U1141, 48 boulevard Sérurier, 75019, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 5 rue Blaise Pascal, 67000, Strasbourg, France
- Département de Psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Beaujon, 100 boulevard Général Leclerc, 92110, Clichy, France
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Wilds KM, Riddell JR. Cannabis Policy and Consumption: Taking into account Substitution Effects. Subst Use Misuse 2023; 59:97-109. [PMID: 37781770 DOI: 10.1080/10826084.2023.2262012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
Background: Previous studies examining the cannabis-alcohol substitution effect have found that medical cannabis policies may result in substituting the use of cannabis in place of alcohol use. Objectives: This study adds to the literature on cannabis-alcohol substitution by analyzing the effect of decriminalization, medicinal cannabis, and adult-use legalization cannabis policies (2002-2019) on cannabis and alcohol use and substance substitution for all 50 states and the District of Columbia (N=867). Results: Results support the notion that liberalized cannabis policies can increase the prevalence of cannabis use. An adult-use legalization specific analysis yielded findings suggesting a complex and heterogenous effect of such laws on cannabis-alcohol complementation. Conclusion: Given the lack of clarity and heterogenous effects of cannabis laws, policy makers should carefully take into consideration the benefits of medical cannabis laws, along with the risks of decriminalization and adult-use legalization.
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Affiliation(s)
- Katherine M Wilds
- Department of Criminology and Criminal Justice, The University of Texas at Dallas, Richardson, United States
| | - Jordan R Riddell
- School of Criminology and Criminal Justice, Missouri State University, Springfield, United States
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21
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Carton L, Bastien A, Chérot N, Caron C, Deheul S, Cottencin O, Gautier S, Moreau-Crépeaux S, Dondaine T, Bordet R. An overview of the use of psychoactive substances among students at the University of Lille during the COVID-19 health crisis: Results of the PETRA study. DIALOGUES IN CLINICAL NEUROSCIENCE 2023; 25:101-111. [PMID: 37837439 PMCID: PMC10578082 DOI: 10.1080/19585969.2023.2268063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 10/03/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVES Students represent a population at risk for substance abuse. That risk may have been exacerbated by the COVID-19 pandemic. We aimed to describe substance abuse among students and to compare consumption according to the university field. METHODS A self-administered questionnaire was sent by email to all students at the University of Lille, France, between March and July 2021. This anonymous questionnaire included questions about sociodemographic characteristics, university courses and the use of psychoactive substances (frequency, reasons, routes of administration) since the first university year. RESULTS Among the 4431 students who responded (response rate 6.1%), eighty percent declared having used alcohol since the first university year, 34% cannabis, 15.4% benzodiazepines, 14.7% opioid drugs, 7.5% cocaine, 6.8% nitrous oxide and 6.5% MDMA. More than 20% of the users of cannabis, benzodiazepines, amphetamines and cocaine reported having already felt dependent. Recreational use was described by more than 10% of benzodiazepine or opioid drug users. Nitrous oxide use was significantly more frequent in the health and sport field (p < 0.001). Tobacco, benzodiazepine, cannabis and MDMA uses were significantly more frequent in the humanities and social sciences/art, language and literature fields (p < 0.001). CONCLUSION Prevention measures focusing on alcohol, cannabis, illicit psychostimulants, nitrous oxide and prescription drugs are required in the student population.
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Affiliation(s)
- Louise Carton
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
| | - Axel Bastien
- Department of Psychiatry and Addiction Medicine, CHU Lille, Lille, France
| | - Nathalie Chérot
- Department of Occupational Health, Univ. Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483, IMP ECS - IMPact de l‘Environnement Chimique sur la Santé humaine, Lille, France
| | - Clément Caron
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
- Department of Psychiatry and Addiction Medicine, CHU Lille, Lille, France
| | - Sylvie Deheul
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
| | - Olivier Cottencin
- Department of Psychiatry and Addiction Medicine, Univ Lille, CHU Lille, INSERM U-1172, Plasticity & SubjectivitY (P SY) team, Lille Neuroscience & Cognition Centre (LiNC), Lille, France
| | - Sophie Gautier
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
| | | | - Thibaut Dondaine
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
| | - Régis Bordet
- Pharmacology Department, Pharmacovigilance and Addictovigilance center, Univ. Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
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22
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Unlu A, Hupli A. Twitter activity surrounding the Finnish green party's cannabis legalisation proposal: A mixed-methods analysis. NORDIC STUDIES ON ALCOHOL AND DRUGS 2023; 40:625-645. [PMID: 38045011 PMCID: PMC10688398 DOI: 10.1177/14550725231171022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 04/05/2023] [Indexed: 12/05/2023] Open
Abstract
Background: In September 2021, a Finnish political party, the Greens, voted to include cannabis policy reform in their party programme, which would legalise the use, possession, manufacture and sale of cannabis. A rapid public discussion has emerged on different social media platforms, including Twitter. Methods: We downloaded 10 days of Twitter data and prepared it for further text analysis, including sentiment, topic modelling and thematic content analysis. Results: Before the proposal, the average daily number of tweets was approximately 140. However, during the week of the proposal, there was a significant increase in tweet volume, reaching a peak of 6,600 tweets on a single day, with a daily average of over 2,700 tweets. Sentiment analysis showed that during the public discussion, the sentiment scores of the tweets were more likely to be positive. Through topic modelling analysis, we obtained the weight of the topic for each tweet, which enabled us to identify the most representative tweets in our corpus. To narrow the sample size for content analysis, we selected tweets that had a topic percentage distribution of over 0.95 (N=188) for closer thematic content analysis. Several positive and negative themes emerged, which were then categorised under broader topics. Similar themes were identified in the most retweeted, liked and commented tweets, which came mainly from known public figures, including politicians, health experts and NGO leaders. Conclusion: Our results show that the discussion was not limited to cannabis legalisation, but instead covered a variety of topics related to drug policy.
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Affiliation(s)
- Ali Unlu
- Finnish Institute for Health and Welfare (THL), Alcohol, Drugs and Tobacco Unit, Mannerheimintie, Helsinki, Finland; and Department of Computer Science, Aalto University, Espoo, Finland
| | - Aleksi Hupli
- Emerging Technologies Lab, Faculty of Social Sciences, Tampere University, Aalto, Finland
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23
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Wolfgang AS, Hoge CW. Psychedelic-Assisted Therapy in Military and Veterans Healthcare Systems: Clinical, Legal, and Implementation Considerations. Curr Psychiatry Rep 2023; 25:513-532. [PMID: 37682446 DOI: 10.1007/s11920-023-01446-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE OF REVIEW This review discusses the current and projected landscape of psychedelic-assisted therapy (PAT), with a focus on clinical, legal, and implementation considerations in Department of Defense (DoD) and Department of Veterans Affairs (VA) healthcare systems. RECENT FINDINGS 3,4-Methylenedioxymethamphetamine (MDMA)- and psilocybin-assisted therapy have shown promising outcomes in efficacy, safety, tolerability, and durability for PTSD and depression, respectively. MDMA-assisted therapy is already approved by the Food and Drug Administration (FDA) on an Expanded Access ("compassionate use") basis for PTSD, with full approval projected for 2024. Psilocybin-assisted therapy is projected to be FDA-approved for depression soon thereafter. Other psychedelics are in earlier stages of development. The VA is currently conducting PAT clinical trials. Although there are clear legal pathways for the VA and DoD to conduct PAT trials, a number of implementation barriers exist, such as the very high number of clinical hours necessary to treat each patient, resource requirements to support treatment infrastructure, military-specific considerations, and the high level of evidence necessary for PAT to be recommended in clinical practice guidelines. Ongoing considerations are whether and how PAT will be made available to VA and DoD beneficiaries, feasibility and cost-effectiveness, and ethical safeguards that must be implemented to prioritize access to PAT given the likelihood of extremely limited initial availability. However, with imminent FDA approval of PATs and considerable national interest in these treatments, DoD and VA policymakers must be prepared with clearly delineated policies and plans for how these healthcare systems will approach PAT.
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Affiliation(s)
- Aaron S Wolfgang
- Walter Reed National Military Medical Center, 4494 Palmer Rd N, Bethesda, MD, 20814, USA.
- Uniformed Services University, Bethesda, MD, USA.
- Yale University School of Medicine, New Haven, CT, USA.
| | - Charles W Hoge
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
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24
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Hwang SB, Lee JG, Lee Y, Kook WA, Kim SK, Donio AL, Min HW, Kim YJ, Lee SY, Jang CG. Adinazolam, a Benzodiazepine-Type New Psychoactive Substance, Has Abuse Potential and Induces Withdrawal Symptoms in Rodents. ACS Chem Neurosci 2023; 14:3487-3498. [PMID: 37695876 DOI: 10.1021/acschemneuro.3c00346] [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] [Indexed: 09/13/2023] Open
Abstract
Adinazolam (ADZ) is a benzodiazepine-type new psychoactive substance (NPS) with anxiolytic, anticonvulsant, and antidepressant effects. High ADZ doses have been reported to impair psychomotor performance and memory; however, the abuse potential and drug dependence of ADZ have not yet been fully investigated. In this study, we evaluated whether ADZ has abuse potential and leads to drug dependence and withdrawal symptoms. The intravenous self-administration (IVSA) test revealed that ADZ (0.01, 0.03, and 0.1 mg/kg/infusion) was self-administered significantly above vehicle levels, suggesting the reinforcing effect of ADZ. Furthermore, we revealed that treatment discontinuation following chronic ADZ administration (3 and 6 mg/kg) caused several somatic withdrawal symptoms in mice, including body tremor. Moreover, it induced motivational withdrawal signs, such as anxiety-related behavior in the elevated plus maze (EPM) test and memory deficits in the Y-maze test. After the IVSA test, an enzyme-linked immunosorbent assay (ELISA) showed that ADZ administration significantly increased the dopamine contents in the thalamus, nucleus accumbens (NAc), and ventral tegmental area (VTA). This finding was also supported by the results of the Western blot. Taken together, our results suggest that ADZ has abuse potential and can lead to drug dependence and withdrawal syndrome.
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Affiliation(s)
- Su-Bin Hwang
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Jae-Gyeong Lee
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Youyoung Lee
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Wun-A Kook
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Seon-Kyung Kim
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Audrey Lynn Donio
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Hee-Won Min
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Young-Jung Kim
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Seok-Yong Lee
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Choon-Gon Jang
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
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25
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Crossin R, Cleland L, Wilkins C, Rychert M, Adamson S, Potiki T, Pomerleau AC, MacDonald B, Faletanoai D, Hutton F, Noller G, Lambie I, Sheridan JL, George J, Mercier K, Maynard K, Leonard L, Walsh P, Ponton R, Bagshaw S, Muthukumaraswamy S, McIntosh T, Poot E, Gordon P, Sharry P, Nutt D, Boden J. The New Zealand drug harms ranking study: A multi-criteria decision analysis. J Psychopharmacol 2023; 37:891-903. [PMID: 37353972 PMCID: PMC10481626 DOI: 10.1177/02698811231182012] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/25/2023]
Abstract
AIMS The harms arising from psychoactive drug use are complex, and harm reduction strategies should be informed by a detailed understanding of the extent and nature of that harm. Drug harm is also context specific, and so any comprehensive assessment of drug harm should be relevant to the characteristics of the population in question. This study aimed to evaluate and rank drug harms within Aotearoa New Zealand using a multi-criteria decision analysis (MCDA) framework, and to separately consider harm within the total population, and among youth. METHODS Two facilitated workshops involved the separate ranking of harm for the total population, and then for youth aged 12-17, by two expert panels. In the total population workshop, 23 drugs were scored against 17 harm criteria, and those criteria were then evaluated using a swing weighting process. Scoring and weighting were subsequently updated during the youth-specific workshop. All results were recorded and analysed using specialised MCDA software. RESULTS When considering overall harm, the MCDA modelling results indicated that alcohol, methamphetamine and synthetic cannabinoids were the most harmful to both the overall population and the youth, followed by tobacco in the total population. Alcohol remained the most harmful drug for the total population when separately considering harm to those who use it, and harm to others. CONCLUSIONS The results provide detailed and context-specific insight into the harm associated with psychoactive drugs use within Aotearoa New Zealand. The findings also demonstrate the value of separately considering harm for different countries, and for different population subgroups.
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Affiliation(s)
- Rose Crossin
- Department of Population Health, University of Otago, Christchurch, New Zealand
| | - Lana Cleland
- Department of Population Health, University of Otago, Christchurch, New Zealand
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Chris Wilkins
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Marta Rychert
- SHORE & Whāriki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Simon Adamson
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Tuari Potiki
- Office of Māori Development, University of Otago, Dunedin, New Zealand
| | - Adam C Pomerleau
- National Poisons Centre, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Blair MacDonald
- National Drug Intelligence Bureau, New Zealand Police, Wellington, New Zealand
| | - Dwaine Faletanoai
- Pacific Mental Health and Addictions Services (Takanga a Fohe), Waitemata District Health Board, Takapuna, New Zealand
| | - Fiona Hutton
- Institute of Criminology, Victoria University of Wellington, Wellington, New Zealand
| | - Geoff Noller
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
- New Zealand Needle Exchange Programme, National Office, Christchurch, New Zealand
| | - Ian Lambie
- Department of Psychology, University of Auckland, Auckland, New Zealand
| | - Jane L Sheridan
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jason George
- New Zealand Needle Exchange Programme, National Office, Christchurch, New Zealand
| | - Kali Mercier
- New Zealand Drug Foundation, Wellington, New Zealand
| | | | - Louise Leonard
- Community and Other Drug Service, Waikato District Health Board, Waikato, New Zealand
| | | | - Rhys Ponton
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Sue Bagshaw
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Suresh Muthukumaraswamy
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tracey McIntosh
- School of Māori Studies and Pacific Studies, Faculty of Arts, University of Auckland, Auckland, New Zealand
- Ministry of Social Development, Wellington, New Zealand
| | | | | | - Patrick Sharry
- People and Decisions, Sydney, Australia
- Australian Graduate School of Management, University of New South Wales, Sydney, Australia
| | - David Nutt
- Centre for Neuropsychopharmacology, Imperial College, London, UK
| | - Joseph Boden
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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26
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Palamar JJ. Adverse drug effects as a deterrent against willingness to use in the future among nightclub/festival attendees. Drug Alcohol Rev 2023; 42:1547-1552. [PMID: 37102194 PMCID: PMC10524187 DOI: 10.1111/dar.13673] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 04/04/2023] [Accepted: 04/09/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION It is largely unknown whether adverse effects experienced from recreational drug use affect willingness to use again. This study determined whether adverse effects from select party drugs affect reported willingness to use again in the next month among a high-risk population-people who attend electronic dance music parties at nightclubs or dance festivals. METHODS Adults (age ≥ 18) entering nightclubs/festivals were surveyed in New York City in 2018-2022 (n = 2981). Participants were asked about past-month use of common party drugs (cocaine, ecstasy, lysergic acid diethylamide [LSD] and ketamine), whether they had experienced a harmful or very unpleasant effect after use in the past 30 days, and whether they intend to use again in the next 30 days if offered by a friend. The relationship between having experienced an adverse outcome and willingness to use again was examined in a bivariable and multivariable manner. RESULTS Experiencing an adverse effect after past-month cocaine (adjusted prevalence ratio [aPR] = 0.58, 95% confidence interval [CI] 0.35-0.95) or ecstasy use (aPR = 0.45, 95% CI 0.25-0.80) was associated with lower risk for willingness to use again. Adverse effects related to LSD use were related to lower risk of being willing to use again in the bivariable model, but in multivariable models, risk was not attenuated for willingness to use LSD or ketamine again. DISCUSSION AND CONCLUSIONS Personally experienced adverse effects can deter willingness to use certain party drugs again in this high-risk population. Interventions targeting cessation of recreational party drug use can likely benefit from focusing on deleterious effects of use that have been experienced.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University Langone Medical Center, New York, USA
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27
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Feng R, Ching THW, Bartlett AC, La Torre JT, Williams MT. Healing Words: Effects of Psychoeducation on Likelihood to Seek and Refer Psychedelic-Assisted Psychotherapy Among BIPOC Individuals. J Psychoactive Drugs 2023:1-13. [PMID: 37652035 DOI: 10.1080/02791072.2023.2253535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 07/03/2023] [Accepted: 08/20/2023] [Indexed: 09/02/2023]
Abstract
Psychedelic-assisted psychotherapy (PAP) is gaining renewed interest as a treatment for various mental disorders. However, there has been limited Black, Indigenous, and People of Color (BIPOC) representation in PAP clinical trials, signaling the need for culturally consonant communication about the efficacy and safety of PAP. We randomly assigned 321 BIPOC and 301 non-Hispanic White participants to four different modes of psychoeducation (didactic, visual, narrative, hope-based) and tested effects on likelihood of seeking and referring others to PAP using ANCOVAS. The influences of different psychoeducation components on these likelihoods were also tested using hierarchical regression modeling. Regardless of psychoeducation mode, BIPOC participants were more likely to seek PAP than non-Hispanic White participants after psychoeducation. Further, information on physical safety and success rate of PAP uniquely predicted BIPOC participants' likelihood of seeking and referring others to PAP after psychoeducation. Our findings suggest that once provided psychoeducation, BIPOC participants are receptive to seeking or referring others to PAP. BIPOC participants also appear to prioritize physical safety and rate of success of PAP in these decisions. Stigma against PAP is likely not the primary barrier to recruitment of BIPOC individuals into PAP trials. Instead, researchers should conduct more psychoeducational outreach to diversify future trials.
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Affiliation(s)
- Raymond Feng
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Terence H W Ching
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Amy C Bartlett
- Department of Religious Studies, University of Ottawa, Ottawa, ON, Canada
| | - Joseph T La Torre
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Monnica T Williams
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
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28
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Palamar JJ, Rutherford C, Le A, Keyes KM. Seasonal Variation of Use of Common Psychedelics and Party Drugs Among Nightclub/Festival Attendees in New York City. J Psychoactive Drugs 2023:1-8. [PMID: 37605471 PMCID: PMC10879452 DOI: 10.1080/02791072.2023.2240322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/29/2023] [Indexed: 08/23/2023]
Abstract
Few epidemiological studies have focused on seasonal variation in the use of common psychedelics and party drugs among nightclub and festival attendees, typically those who attend electronic dance music (EDM) events. We sought to determine whether the use of different drug types varies seasonally within this population. Across 15 seasons from summer 2017 through fall 2022, we surveyed 3,935 adults entering randomly selected nightclubs and festivals in New York City regarding their past-month use of cocaine, MDMA (3,4-methylenedioxymethamphetamine, commonly known as ecstasy), lysergic acid diethylamide (LSD), psilocybin (shrooms), and ketamine. Multivariable models were used to compare adjusted odds ratios for drug use within each season with the grand mean of combined seasons. Summer was associated with higher odds for use of LSD (aOR 2.72; 95% CI, 1.88-3.93) and psilocybin (aOR 1.65; CI, 1.12-2.43), independent of increases in psilocybin use over time (p < .001). A significant increase in use of ketamine (p = .014) and significant decreases in use of cocaine (p = .002) and ecstasy (p = .002) were found across time, but multivariable models did not detect seasonal variations. Summer is a risk factor for use of common psychedelics among people who attend EDM events. Therefore, the summer months may be the best time to disseminate information about harm reduction for psychedelic drug users.
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Affiliation(s)
- Joseph J. Palamar
- New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, New York, NY
| | - Caroline Rutherford
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY
| | - Austin Le
- New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, New York, NY
- New York University College of Dentistry, New York, NY
| | - Katherine M. Keyes
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY
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29
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van Ruitenbeek P, Franzen L, Mason NL, Stiers P, Ramaekers JG. Methylphenidate as a treatment option for substance use disorder: a transdiagnostic perspective. Front Psychiatry 2023; 14:1208120. [PMID: 37599874 PMCID: PMC10435872 DOI: 10.3389/fpsyt.2023.1208120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/14/2023] [Indexed: 08/22/2023] Open
Abstract
A transition in viewing mental disorders from conditions defined as a set of unique characteristics to one of the quantitative variations on a collection of dimensions allows overlap between disorders. The overlap can be utilized to extend to treatment approaches. Here, we consider the overlap between attention-deficit/hyperactivity disorder and substance use disorder to probe the suitability to use methylphenidate as a treatment for substance use disorder. Both disorders are characterized by maladaptive goal-directed behavior, impaired cognitive control, hyperactive phasic dopaminergic neurotransmission in the striatum, prefrontal hypoactivation, and reduced frontal cortex gray matter volume/density. In addition, methylphenidate has been shown to improve cognitive control and normalize associated brain activation in substance use disorder patients and clinical trials have found methylphenidate to improve clinical outcomes. Despite the theoretical basis and promising, but preliminary, outcomes, many questions remain unanswered. Most prominent is whether all patients who are addicted to different substances may equally profit from methylphenidate treatment.
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Affiliation(s)
- Peter van Ruitenbeek
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
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30
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Perino J, Ramaroson H, Ong N, Bezin J, Gilleron V, Daveluy A, Tournier M. General hospital admissions in young and middle-aged people who use psychoactive substances: Impact of Covid-19 lockdowns. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 118:104082. [PMID: 37336071 PMCID: PMC10247883 DOI: 10.1016/j.drugpo.2023.104082] [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: 01/19/2023] [Revised: 05/15/2023] [Accepted: 05/29/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUNDS The Covid-19 pandemic offered a unique opportunity to investigate trends in hospitalizations related to psychoactive substance intoxication, since the usual health burden of social use at parties and gatherings was likely to be decreased during lockdowns and curfew periods. Since young adults are the main users of psychoactive substances for experimental and recreational purposes, this study identified and compared hospitalization trends in young adults and adults over 30 years old. METHODS This national cohort study was conducted using the French hospital discharge database. An interrupted time-series analysis for the period between 2014 and 2020 was performed in two groups: young (age 18-29) and other adults (30+) to ascertain the trends in the monthly incidence of hospitalization related to psychoactive substance intoxication (opiates, cocaine, benzodiazepines, psychostimulants, alcohol and cannabis). Hospitalization characteristics during the first and second lockdown and the period between them were compared to the reference period (from 01/01/2014 to 29/02/2020). RESULTS Among 1,358,007 stays associated with psychoactive substance intoxication, 215,430 concerned young adults. Compared with adults 30+, hospitalization trends in young adults showed a greater decrease in the number of stays during lockdown, with a maximum decrease of -39% during the first lockdown (1,566 vs. 2,576; CI95%: 2,285-2,868) versus -20% (10,212 vs. 12,894; CI95%: 12,001-13,787) in the second lockdown. Presentations for alcohol intoxication decreased throughout the pandemic, particularly during the second lockdown, while admissions for benzodiazepine intoxication increased during both lockdowns. Admissions for cannabis intoxication increased throughout the entire period. CONCLUSIONS Lockdowns were associated with fewer hospitalizations related to psychoactive substance intoxication in both age groups, especially among young adults, which might reflect a decrease in social use. Recreational use might therefore be an important target for prevention and risk minimization.
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Affiliation(s)
- J Perino
- University hospital of Bordeaux, Centre d'addictovigilance de Bordeaux, Department of medical pharmacology, Bordeaux F-33000, France; Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux F-33000, France; CHU de Bordeaux, Bordeaux, France.
| | - H Ramaroson
- Unité de Coordination et d'Analyse de l'Information Médicale, Département d'Information Médicale (Ucaim-DIM), Service D'information Médicale, Chu De Bordeaux, FR, France
| | - N Ong
- Unité de Coordination et d'Analyse de l'Information Médicale, Département d'Information Médicale (Ucaim-DIM), Service D'information Médicale, Chu De Bordeaux, FR, France
| | - J Bezin
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux F-33000, France; CHU de Bordeaux, Bordeaux, France
| | - V Gilleron
- Unité de Coordination et d'Analyse de l'Information Médicale, Département d'Information Médicale (Ucaim-DIM), Service D'information Médicale, Chu De Bordeaux, FR, France
| | - A Daveluy
- University hospital of Bordeaux, Centre d'addictovigilance de Bordeaux, Department of medical pharmacology, Bordeaux F-33000, France; Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux F-33000, France
| | - M Tournier
- Univ. Bordeaux, INSERM, BPH, U1219, Bordeaux F-33000, France; Hospital Charles Perrens, Bordeaux F-33000, France
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Palamar JJ, Fitzgerald ND, Grundy DJ, Black JC, Jewell JS, Cottler LB. Characteristics of poisonings involving ketamine in the United States, 2019-2021. J Psychopharmacol 2023; 37:802-808. [PMID: 36475433 PMCID: PMC10244478 DOI: 10.1177/02698811221140006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The use of ketamine, a controlled dissociative anesthetic, has become more widespread in recent years with recreational/nonmedical use increasing and ketamine becoming more widely available in clinics to treat depression. AIMS We examined recent trends in adverse effects related to ketamine use. METHODS US National Poison Control data were examined, focusing on ketamine exposures among those aged ⩾13 between 2019 and 2021 (n = 758). We examined quarterly trends in exposure and delineated correlates of patients experiencing a major adverse effect or death. RESULTS The number of reported exposures increased 81.1% from 2019 Quarter 1 through 2021 Quarter 4, from 37 to 67 (p = 0.018). The majority of patients were male (57.1%), and the plurality of cases involved intentional misuse or "abuse" (39.5%), followed by suspected suicide attempt (19.7%) and unintentional exposure (18.9%). A fifth (19.6%) experienced a major adverse effect or death. A third (33.4%) co-used other drugs; the drugs most commonly co-used were benzodiazepines (14.6%), alcohol (10.3%), and opioids (8.7%). Co-use of gamma-hydroxybutyrate (GHB; adjusted prevalence ratio (aPR) = 3.43, 95% confidence interval (CI): 1.57-7.46) and opioids (aPR = 2.44, 95% CI: 1.46-4.08) was associated with increased risk for a major adverse effect or death, as was injection-only administration (aPR = 2.68, 95% CI: 1.21-5.92). CONCLUSIONS Although still rare, poisonings involving ketamine have increased in recent years. Polydrug use-particularly with opioids or GHB-appears to be a particular risk factor for more serious adverse effects. As prevalence of use increases, it is important to monitor adverse effects and co-occurring behaviors to inform timely prevention and harm reduction as needed.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Nicole D. Fitzgerald
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - David J. Grundy
- A Division of Denver Health, Rocky Mountain Poison & Drug Safety (RMPDS), Denver, CO, USA
| | - Joshua C. Black
- A Division of Denver Health, Rocky Mountain Poison & Drug Safety (RMPDS), Denver, CO, USA
| | - Jennifer S. Jewell
- A Division of Denver Health, Rocky Mountain Poison & Drug Safety (RMPDS), Denver, CO, USA
| | - Linda B. Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
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Daly FP, O'Donnell K, Davoren MP, Noone C, Weatherburn P, Quinlan M, Foley B, Lyons F, Igoe D, Barrett P. Recreational and sexualised drug use among gay, bisexual, and other men who have sex with men (gbMSM) in Ireland-Findings from the European MSM internet survey (EMIS) 2017. PLoS One 2023; 18:e0288171. [PMID: 37506129 PMCID: PMC10381075 DOI: 10.1371/journal.pone.0288171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Gay, bisexual, and other men who have sex with men (gbMSM) report a higher prevalence of drug use in comparison to the general male population. However, in Ireland, there is a paucity of literature regarding the prevalence of drug use and its determinants among gbMSM. AIMS/OBJECTIVES To quantify the prevalence of (i) recreational drug use (RDU) and (ii) sexualised drug use (SDU) among gbMSM in Ireland, and to identify the factors associated with these drug use practices. METHODS The European MSM Internet Survey (EMIS) 2017 was an online, anonymous, internationally-promoted questionnaire. Two binary outcomes were included in our analyses: (1) RDU and (2) SDU in the previous year. Multivariable-adjusted logistic regression explored factors associated with these outcomes, and all independent covariates were adjusted for one another. RESULTS Among gbMSM without HIV (n = 1,898), 40.9% and 13.1% engaged in RDU and SDU in the previous year, respectively. Among diagnosed-positive gbMSM (n = 141), the past-year respective prevalence estimates were 51.8% and 26.2%. Increased odds of RDU were observed among gbMSM who were younger (vs. 40+ years) (18-24 years; AOR 2.96, 95% CI 2.05-4.28, 25-39 years; AOR 1.66, 95% CI 1.27-2.16), lived in Dublin (vs. elsewhere) (AOR 1.47, 95% CI 1.17-1.83), and engaged in condomless anal intercourse (CAI) in the previous year (vs. none) (1-2 partners; AOR 1.79, 95% CI 1.34-2.38, 6+ partners; AOR 1.79, 95% CI 1.18-2.71). Greater odds of SDU were identified among those who lived in Dublin (vs. elsewhere) (AOR 1.50, 95% CI 1.07-2.10), and engaged in CAI (vs. none) (1-2 partners; AOR 3.16, 95% CI 2.05-4.88, 3-5 partners; AOR 2.50, 95% CI 1.47-4.26, and 6+ partners; AOR 3.79, 95% CI 2.23-6.43). CONCLUSION GbMSM report a high prevalence of drug use in Ireland. Targeted interventions, including harm reduction campaigns, may be needed to support healthier drug use choices among this community.
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Affiliation(s)
- Fionn P Daly
- School of Medicine and Health, University College Cork, Cork, Ireland
- School of Public Health, University College Cork, Cork, Ireland
| | - Kate O'Donnell
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | - Martin P Davoren
- School of Public Health, University College Cork, Cork, Ireland
- Sexual Health Centre, Cork, Ireland
| | - Chris Noone
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Peter Weatherburn
- Sigma Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | | | - Fiona Lyons
- St. James's Hospital, James St, Saint James' (part of Phoenix Park), Dublin 8, Dublin, Ireland
| | - Derval Igoe
- HSE Health Protection Surveillance Centre, Dublin, Ireland
| | - Peter Barrett
- School of Public Health, University College Cork, Cork, Ireland
- Department of Public Health HSE-South, St. Finbarr's Hospital, Cork, Ireland
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Lohner V, McNeill A, Schneider S, Vollstädt-Klein S, Andreas M, Szafran D, Grundinger N, Demjén T, Fernandez E, Przewozniak K, Tountas Y, Trofor A, Zatonski W, Willemsen MC, Vardavas C, Fong GT, Mons U. Understanding perceived addiction to and addictiveness of electronic cigarettes among electronic cigarette users: a cross-sectional analysis of the International Tobacco Control Smoking and Vaping (ITC 4CV) England Survey. Addiction 2023; 118:1359-1369. [PMID: 36772958 PMCID: PMC10357132 DOI: 10.1111/add.16162] [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: 08/11/2022] [Accepted: 01/25/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND AND AIMS The addictive potential of electronic cigarettes (e-cigarettes) remains to be fully understood. We identified patterns and correlates of perceived addiction to e-cigarettes and perceived addictiveness of e-cigarettes relative to tobacco cigarettes (relative addictiveness) in dual users as well as exclusive e-cigarette users. DESIGN, SETTING AND PARTICIPANTS Observational study using cross-sectional survey data from England (2016) from the International Tobacco Control Project (ITC) Four Country Smoking and Vaping (4CV) survey. The study comprised 832 current e-cigarette users who had been vaping for at least 4 months. MEASUREMENTS Perceived addiction to e-cigarettes and relative addictiveness of e-cigarettes were examined. Socio-demographic factors were age, gender and education; markers of addiction included urge to vape, time to first vape after waking and nicotine strength used; vaping and smoking characteristics included frequency and duration of e-cigarette use, intention to quit, adjustable power or temperature, enjoyment, satisfaction relative to tobacco cigarettes and tobacco cigarette smoking status. FINDINGS A total of 17% of participants reported feeling very addicted to e-cigarettes, while 40% considered e-cigarettes equally/more addictive than tobacco cigarettes. Those who felt very addicted had higher odds of regarding e-cigarettes as more addictive than tobacco cigarettes (odds ratio 3.4, 95% confidence interval 2.3-5.1). All markers of addiction, daily use and enjoyment were associated with higher perceived addiction, whereas time to first vape after waking, daily vaping and perceiving vaping as less satisfying than smoking were associated with relative addictiveness. CONCLUSIONS Markers of addiction to e-cigarettes appear to correspond with perceived addiction to e-cigarettes, suggesting that self-reported perceived addiction might serve as an indicator of addiction. Prevalence both of markers of addiction and perceived addiction were comparatively low overall, suggesting a limited but relevant addictive potential of e-cigarettes. Additionally, positive and negative reinforcement, reflected here by enjoyment and relative satisfaction, might play a role in e-cigarette addiction.
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Affiliation(s)
- Valerie Lohner
- Cardiovascular Epidemiology of Aging, Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
| | - Ann McNeill
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Shaping public health policies to reduce inequalities & harm (SPECTRUM), UK
| | - Sven Schneider
- Center for Preventive Medicine and Digital Health Baden-Württemberg, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Sabine Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Mannheim Center for Translational Neurosciences (MCTN), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Marike Andreas
- Center for Preventive Medicine and Digital Health Baden-Württemberg, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Daria Szafran
- Center for Preventive Medicine and Digital Health Baden-Württemberg, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Nadja Grundinger
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tibor Demjén
- Smoking or Health Hungarian Foundation, Budapest, Hungary
| | - Esteve Fernandez
- Tobacco Control Unit and WHO Collaborating Center for Tobacco Control, Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat, Spain
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain
- School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Consortium for Biomedical Research in Respiratory Diseases (CIBERES), Madrid, Spain
| | - Krzysztof Przewozniak
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- Collegium Civitas, Warsaw, Poland
- Health Promotion Foundation, Warsaw, Poland
| | - Yannis Tountas
- Center for Health Services Research, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Antigona Trofor
- University of Medicine and Pharmacy "Grigore T. Popa" Iasi, Iasi, Romania
- Aer Pur Romania, Bucharest, Romania
| | - Witold Zatonski
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
- European Observatory of Health Inequalities, President Stanisław Wojciechowski State University of Applied Sciences, Kalisz, Poland
| | - Marc C. Willemsen
- Maastricht University, Department of Health Promotion (CAPHRI), Maastricht, The Netherlands
- Trimbos Institute, Netherlands Expertise Centre for Tobacco Control, Utrecht, The Netherlands
| | - Constantine Vardavas
- School of Medicine, University of Crete, Crete, Greece
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON
- School of Public Health Sciences, University of Waterloo, Waterloo, ON
- Ontario Institute for Cancer Research, Toronto, ON
| | - Ute Mons
- Cardiovascular Epidemiology of Aging, Department of Cardiology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Germany
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Cheung K, Patch K, Earp BD, Yaden DB. Psychedelics, Meaningfulness, and the "Proper Scope" of Medicine: Continuing the Conversation. Camb Q Healthc Ethics 2023:1-7. [PMID: 37366110 DOI: 10.1017/s0963180123000270] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Psychedelics such as psilocybin reliably produce significantly altered states of consciousness with a variety of subjectively experienced effects. These include certain changes to perception, cognition, and affect,1 which we refer to here as the acute subjective effects of psychedelics. In recent years, psychedelics such as psilocybin have also shown considerable promise as therapeutic agents when combined with talk therapy, for example, in the treatment of major depression or substance use disorder.2 However, it is currently unclear whether the aforementioned acute subjective effects are necessary to bring about the observed therapeutic effects of psilocybin and other psychedelics. This uncertainty has sparked a lively-though still largely hypothetical-debate on whether psychedelics without subjective effects ("nonsubjective psychedelics" or "non-hallucinogenic psychedelics") could still have the same therapeutic impact, or whether the acute subjective effects are in fact necessary for this impact to be fully realized.3,4,5.
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Affiliation(s)
| | - Kyle Patch
- Department of Bioethics, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | - Brian D Earp
- Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
| | - David B Yaden
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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King LA, Nutt DJ, Nichols DE. Remove barriers to clinical research for schedule 1 drugs with therapeutic potential. BMJ 2023; 381:981. [PMID: 37130596 DOI: 10.1136/bmj.p981] [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: 05/04/2023]
Affiliation(s)
| | - David J Nutt
- Centre for Psychedelic Research Division of Psychiatry, Imperial College London, Hammersmith Hospital, London W12 0NN, UK
| | - David E Nichols
- Department of Chemical Biology and Medicinal Chemistry, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
- Purdue University School of Pharmacy, West Lafayette, IN, USA
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Mitek AE, Keating S, Weir WB, McMichael MM, Forsythe L, McNeil L, Seals C, Boozell G, Fuson H, Xiu Y, Hague DW. Veterinary Education's Role in the Opioid Epidemic: Integration of an Online Safe Opioid Prescribing Course into the Core Curriculum. JOURNAL OF VETERINARY MEDICAL EDUCATION 2023; 50:162-166. [PMID: 35324420 DOI: 10.3138/jvme-2021-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
As the COVID-19 pandemic continues, the opioid epidemic has worsened. Opioid-related deaths continue to rise, and many of these deaths can be traced to a prescription opioid. Because veterinarians prescribe opioids, many organizations and federal agencies have called for increased veterinary education on the topic. In this teaching tip, we review the current literature surrounding the veterinary profession's link to the opioid epidemic and one potential way that educational institutions can successfully and efficiently incorporate safe opioid prescribing training into the curriculum using an online course.
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Affiliation(s)
- Ashley E Mitek
- Veterinary Clinical Medicine, University of Illinois, College of Veterinary Medicine, 1008 W. Hazelwood Dr., Urbana, IL 61802 USA
| | - Stephanie Keating
- University of Illinois, College of Veterinary Medicine, 1008 W. Hazelwood Dr., Urbana, IL 61802 USA
| | - William B Weir
- Carle Illinois College of Medicine, 807 S. Wright St., Urbana, IL 61820 USA
| | | | - Lauren Forsythe
- University of Illinois, College of Veterinary Medicine, 1008 W. Hazelwood Dr., Urbana, IL 61802 USA
| | - Leslie McNeil
- Clinical Skills Learning Center, University of Illinois, College of Veterinary Medicine, 1008 W. Hazelwood Dr., Urbana, IL 61802 USA
| | - Christopher Seals
- University of Illinois, College of Veterinary Medicine, 1008 W. Hazelwood Dr., Urbana, IL 61802 USA
| | - Greg Boozell
- University of Illinois, College of Veterinary Medicine, 1008 W. Hazelwood Dr., Urbana, IL 61802 USA
| | - Holly Fuson
- University of Illinois, College of Veterinary Medicine, 1008 W. Hazelwood Dr., Urbana, IL 61802 USA
| | - Ying Xiu
- University of Illinois, College of Veterinary Medicine, 1008 W. Hazelwood Dr., Urbana, IL 61802 USA
| | - Devon W Hague
- University of Illinois, College of Veterinary Medicine, 1008 W. Hazelwood Dr., Urbana, IL 61802 USA
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Ku YC, Chung HP, Hsu CY, Cheng YH, Hsu FIC, Tsai YC, Chao E, Lee TSH. Recidivism of Individuals Who Completed Schedule I Drugs Deferred Prosecution Treatment: A Population-Based Follow-Up Study from 2008 to 2020 in Taiwan. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01034-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
AbstractDeferred Prosecution with Condition to Complete the Addiction Treatment (DPCCAT) is a judicial diversion program in Taiwan that shifts people who use drugs away from the label drug offender and toward the label patient. However, little is known about the effectiveness of completing a DPCCAT program on people who use drugs. Using a nationwide population-based retrospective panel data from 2008 to 2020, recidivism is defined as a person was caught urine positive and charged by a prosecutor after their completion of DPCCAT. After controlled gender, age, and region, comparisons of recidivism rates and time to relapse between Schedule I drug use only, Schedule I & II drug use, and heterogeneous group were examined. Of 24,248 participants with DPCCAT, 11,141 (46%) completed the one-year treatment program. Of completers, the five-year recidivism rates are significantly lower for the Schedule I drug use only (26%) than Schedule I & II drugs use (52%) and heterogeneous group (47%). Results from Cox regression indicated that the duration of recidivate to drug use is significantly longer for the Schedule I drug only than the other two groups after controlling for demographics. The main findings support that completion of a DPCCAT program only reduces the risk of recidivism for people who use Schedule I drug only and is less effective for polydrug users and heterogeneous group. We suggest that characteristics of people who use drugs and other criminal offenses should be taken into consideration for triage when DPCCAT is offered.
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Willson C. Misadventures in Toxicology: Concentration Matters for Testosterone-Induced Neurotoxicity. TOXICS 2023; 11:258. [PMID: 36977023 PMCID: PMC10057866 DOI: 10.3390/toxics11030258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
Testosterone is the predominant androgen in men and has important physiological functions. Due to declining testosterone levels from a variety of causes, testosterone replacement therapy (TRT) is increasingly utilized, while testosterone is also abused for aesthetic and performance-enhancing purposes. It has been increasingly speculated that aside from more well-established side effects, testosterone may cause neurological damage. However, the in vitro data utilized to support such claims is limited due to the high concentrations used, lack of consideration of tissue distribution, and species differences in sensitivity to testosterone. In most cases, the concentrations studied in vitro are unlikely to be reached in the human brain. Observational data in humans concerning the potential for deleterious changes in brain structure and function are limited by their inherent design as well as significant potential confounders. More research is needed as the currently available data are limited; however, what is available provides rather weak evidence to suggest that testosterone use or abuse has neurotoxic potential in humans.
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Affiliation(s)
- Cyril Willson
- EuSci LLC, 1309 S 204th St, #293, Elkhorn, NE 68022, USA
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Najman JM, Bell S, Williams GM, Clavarino AM, Scott JG, McGee TR, Mamun AA. Do tobacco and cannabis use and co-use predict lung function: A longitudinal study. Respir Med 2023; 208:107124. [PMID: 36682602 DOI: 10.1016/j.rmed.2023.107124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Use of tobacco and cannabis is common and has been reported to predict lung function. Less is known about co-use of tobacco and cannabis and their impact on changes in lung function to early adulthood. RESEARCH QUESTION The study examines whether cigarette smoking or cannabis use and co-use are each associated with lung function in a population sample of young adults. STUDY DESIGN AND METHODS Data are from a prospective cohort study of cigarette smoking, cannabis use and co-use at 21 and 30 years of age and lung function (FVC, FEV1, FEV1/FVC) measured at 30 years. Lung function results are transformed using Global Lung Function Formulae. Subjects are the children of pregnant women who were recruited into the cohort study over the period 1981-3. Respondents were administered a spirometry assessment at 21 and 30 years of age. These respondents completed a smoking and cannabis use questionnaire at 21- and 30-year follow-ups. RESULTS Cigarette smoking (with or without cannabis use) is associated with reduced airflow. There is no consistent association between cannabis use and measures of lung function. The co-use of tobacco and cannabis appears to entail no additional risk to lung function beyond the risks associated with tobacco use alone. INTERPRETATION Persistent cigarette smoking is associated with reduced airflow even in young adults. Cannabis use does not appear to be related to lung function even after years of use.
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Affiliation(s)
- Jake M Najman
- School of Public Health, Faculty of Medicine, The University of Queensland, 266 Herston Road, Herston, Qld, 4006, Australia.
| | - Scott Bell
- Children's Health Research Centre, Faculty of Medicine, University of Queensland, Graham Road, South Brisbane, Qld, 4101, Australia
| | - Gail M Williams
- School of Public Health, Faculty of Medicine, The University of Queensland, 266 Herston Road, Herston, Qld, 4006, Australia
| | - Alexandra M Clavarino
- School of Public Health, Faculty of Medicine, The University of Queensland, 266 Herston Road, Herston, Qld, 4006, Australia
| | - James G Scott
- Child & Youth Mental Health, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, Qld, 4006, Australia
| | - Tara R McGee
- School of Criminology and Criminal Justice, Griffith University, 176 Messines Ridge Road, Mount Gravatt, Qld, 4122, Australia
| | - Abdullah A Mamun
- UQ Poche Centre for Indigenous Health, The University of Queensland, 74 High Street, Toowong, Qld, 4066, Australia
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Alharbi FF, Alqahtani TM, Alzamil AM, Alharbi NH, Masud N. Knowledge, perception, and beliefs of Saudi physicians at King Abdulaziz Medical City, Riyadh related to medical cannabis: Literature review and a cross-sectional survey. J Family Med Prim Care 2023; 12:536-544. [PMID: 37122648 PMCID: PMC10131962 DOI: 10.4103/jfmpc.jfmpc_1856_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/03/2022] [Accepted: 12/12/2022] [Indexed: 05/02/2023] Open
Abstract
Cannabis is an herbaceous flowering plant, originally an indigenous plant in Eastern Asia, which later spread globally due to widespread agricultural practices. Cannabis was used medicinally until the early twentieth century, but subsequently prohibited due to the psychoactive effects. Aims To explore the medical cannabis-related level of knowledge of physicians at King Abdulaziz Medical City, including patient needs, perceptions of therapeutic effects, potential harm, and the willingness to prescribe if legalized in future. Methodology The study was a cross-sectional questionnaire-based survey. It was conducted at King Abdulaziz Medical City in Riyadh from February 2020 to February 2021. All physicians from the different specialties, who consented to participate, were included in this study. Statistical Analysis Descriptive statistics are presented as mean and standard deviation and proportions. An ANOVA test was applied to measure the association of the beliefs regarding the right to prescribe with overall knowledge. All tests were considered significant at P < 0.05. Results A total of 249 physicians participated with the majority (70%) male. The sample was similar regardless of the physician's position in the medical hierarchy, with a mean work experience of 8 years. Almost half of the participants indicated that they do not have good knowledge regarding the effects of MC products and more than half that they are unaware of the different MC products and formulations currently available. Conclusion The majority of the sample lacked knowledge about the medicinal use of cannabis for specific indications and felt uncomfortable to discuss the medicinal use of cannabis with their patients.
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Affiliation(s)
- Fares F Alharbi
- Department of Mental Health, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Research Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Taif M Alqahtani
- Department of Family Medicine, Second Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
- Bachelor of Medicine and Bachelor of Surgery, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Research Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Address for correspondence: Dr. Taif M Alqahtani, Department of Family Medicine, Second Health Cluster, Ministry of Health, Riyadh, Saudi Arabia. E-mail:
| | - Alaa M Alzamil
- Bachelor of Medicine and Bachelor of Surgery, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Research Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Nouf H Alharbi
- Bachelor of Medicine and Bachelor of Surgery, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Research Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Nazish Masud
- Member of Research Unit, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- Research Center, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Ding X, Li X, Xu M, He Z, Jiang H. The effect of repetitive transcranial magnetic stimulation on electroencephalography microstates of patients with heroin-addiction. Psychiatry Res Neuroimaging 2023; 329:111594. [PMID: 36724624 DOI: 10.1016/j.pscychresns.2023.111594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/28/2022] [Accepted: 01/10/2023] [Indexed: 01/30/2023]
Abstract
The effects of transcranial magnetic stimulation in treating substance use disorders are gaining attention; however, most existing studies used subjective measures to examine the treatment effects. Objective electroencephalography (EEG)-based microstate analysis is important for measuring the efficacy of transcranial magnetic stimulation in patients with heroin addiction. We investigated dynamic brain activity changes in individuals with heroin addiction after transcranial magnetic stimulation using microstate indicators. Thirty-two patients received intermittent theta-burst stimulation (iTBS) over the left dorsolateral prefrontal cortex. Resting-state EEG data were collected pre-intervention and 10 days post-intervention. The feature values of the significantly different microstate classes were computed using a K-means clustering algorithm. Four EEG microstate classes (A-D) were noted. There were significant increases in the duration, occurrence, and contribution of microstate class A after the iTBS intervention. K-means classification accuracy reached 81.5%. The EEG microstate is an effective improvement indicator in patients with heroin addiction treated with iTBS. Microstates were examined using machine learning; this method effectively classified the pre- and post-intervention cohorts among patients with heroin addiction and healthy individuals. Using EEG microstate to measure heroin addiction and further exploring the effect of iTBS in patients with heroin addiction merit clinical investigation.
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Affiliation(s)
- Xiaobin Ding
- School of Psychology, Northwest Normal University, Lanzhou 730000, China
| | - Xiaoyan Li
- School of Psychology, Northwest Normal University, Lanzhou 730000, China.
| | - Ming Xu
- School of Psychology, Northwest Normal University, Lanzhou 730000, China
| | - Zijing He
- School of Psychology, Northwest Normal University, Lanzhou 730000, China
| | - Heng Jiang
- School of Psychology, Northwest Normal University, Lanzhou 730000, China
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New approach for barbiturates, phenytoin, methyprylon and glutethimide determination and fragmentation (UHPLC-MS/MS). J Pharm Biomed Anal 2023; 228:115318. [PMID: 36868027 DOI: 10.1016/j.jpba.2023.115318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/15/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023]
Abstract
Barbiturates which are old pharmaceutical drugs are still widely used in medical treatment of epilepsy and for general anesthesia. To date, more than 2500 different barbituric acid analogs have been synthesized, and 50 of them were introduced into medical use over the last century. Due to their highly addictive properties, pharmaceuticals containing barbiturates are under strict control in many countries. However, by considering the worldwide problem with new psychoactive substances (NPS) the introduction of new designer barbiturate analogs into the dark market might serve a serious public health problem in the near future. For this reason there is an increasing need for application methods for barbiturates monitoring in biological samples. The UHPLC-QqQ-MS/MS method for determination of 15 barbiturates, phenytoin, methyprylon and glutethimide was developed and fully validated. The biological sample volume was reduced to only 50 µL. A simple LLE (pH 3 with ethyl acetate) was successfully applied. The lower LOQ was 10 ng/mL. The method enables differentiation of structural isomers: hexobarbital and cyclobarbital; as well as amobarbital and pentobarbital. Chromatographic separation was achieved with the use of the alkaline mobile phase (pH 9) and Acquity UPLC BEH C18 column. Furthermore, the novel fragmentation mechanism of barbiturates was proposed, which may have a great impact in identification of novel barbiturates analogs introduced to illegal marketplaces. The presented technique has a great potential to be applied in forensic, clinical and veterinary toxicological laboratories, as was evidenced by the positive results of international proficiency tests.
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Substances from unregulated drug markets - A retrospective data analysis of customer-provided samples from a decade of drug checking service in Zurich (Switzerland). THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 114:103972. [PMID: 36841217 DOI: 10.1016/j.drugpo.2023.103972] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 02/07/2023] [Accepted: 02/11/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Drug checking services (DCS) are harm reduction interventions for people who consume illicit substances. Unregulated drug markets lead to samples with unexpected and variable contents. A retrospective data analysis of Zurich's DCS was performed to determine the nature of these samples. METHODS This study aims to investigate the qualitative and quantitative properties of 16,815 customer-provided psychoactive drug samples analyzed chemically through the DCS in Zurich from 1st January 2011 to 31st December 2021. The main analytical method utilized for characterizing these substances was high-performance liquid chromatography and gas chromatography-mass spectrometry. Data sets are summarized using descriptive statistics. RESULTS There was a 2.5-fold increase in the number of tested samples over the past decade. An overall proportion of 57.9% (weighted mean) of samples within our database demonstrates unexpected analytical findings and additional low sample contents during the observation period. Substantial differences in quality and quantity between substance groups were detected and an increase of sample quality and content over time was demonstrated. CONCLUSIONS Chemical analysis reveals that over half of substances acquired from unregulated drug markets analyzed through DCS in Zurich are with low qualitative and quantitative properties, which may expose users to risks. Based on longitudinal analyses over a decade, this study contributes to the body of evidence that DCS may potentially manipulate unregulated drug markets towards providing better quality substances, as well as may stabilize these markets over time. The necessity for drug policy changes to make this service accessible in further settings was highlighted, as DCS still often take place in legal grey zones. FUNDING None to declare.
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Bielecka-Papierz G, Serefko A, Szopa A, Talarek S, Wróbel A, Szewczyk B, Radziwoń-Zaleska M, Kołtun-Jasion M, Poleszak E. The role of the L-arginine-NO-cGMP-dependent pathway in the development of sensitization to mephedrone effects on the locomotor activity in mice. Behav Brain Res 2023; 437:114103. [PMID: 36089098 DOI: 10.1016/j.bbr.2022.114103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 10/14/2022]
Abstract
Mephedrone, a popular psychostimulating substance widely used illegally in recreational purposes, exerts in rodents that regularly and intermittently were exposed to it a sensitized response to the drug. Behavioral sensitization is one of experimental models of drug dependency/abuse liability. In the present study we evaluated a potential involvement of the L-arginine-NO-cGMP pathway in the development of sensitization to the mephedrone-induced hyperlocomotion. Locomotor activity was measured automatically and experiments were performed on male Albino Swiss mice. We demonstrated that a 5-day administration of 7-nitroindazole (10 or 20 mg/kg/day) and L-NAME (50 mg/kg/day) suppressed the development of sensitization to the mephedrone-induced hyperlocomotion. As for L-arginine (125 or 250 mg/kg/day) and methylene blue (5 or 10 mg/kg/day) the obtained outcomes are inconclusive. Furthermore, the lower dose of L-NAME (25 mg/kg/day) surprisingly potentiated the development of sensitization to the mephedrone-induced effects on the spontaneous locomotor activity in mice. In conclusion, our data demonstrated that modulators of the L-arginine-NO-cGMP pathway may differently affect the development of sensitization to the locomotor stimulant effects of mephedrone. Inhibition of neuronal nitric oxide synthase (NOS) seems to prevent this process quite profoundly, non-selective inhibition of NOS may have a dual effect, whereas inhibition of soluble guanylate cyclase may only partially suppress the development of sensitization to the mephedrone-induced effects.
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Affiliation(s)
- Gabriela Bielecka-Papierz
- Chair and Department of Applied and Social Pharmacy, Medical University of Lublin, 1 Chodźki Street, 20-093 Lublin, Poland.
| | - Anna Serefko
- Laboratory of Preclinical Testing, Chair and Department of Applied and Social Pharmacy, Medical University of Lublin, 1 Chodźki Street, 20-093 Lublin, Poland.
| | - Aleksandra Szopa
- Laboratory of Preclinical Testing, Chair and Department of Applied and Social Pharmacy, Medical University of Lublin, 1 Chodźki Street, 20-093 Lublin, Poland
| | - Sylwia Talarek
- Department of Pharmacology and Pharmacodynamics, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland
| | - Andrzej Wróbel
- Second Department of Gynecology, Medical University of Lublin, 8 Jaczewskiego Street, 20-090 Lublin, Poland
| | - Bernadeta Szewczyk
- Department of Neurobiology, Polish Academy of Sciences, Maj Institute of Pharmacology, 12 Smętna Street, 31-343 Kraków, Poland
| | - Maria Radziwoń-Zaleska
- Department of Psychiatry, Medical University of Warsaw, 27 Nowowiejska Street, 00-665 Warsaw, Poland
| | - Małgorzata Kołtun-Jasion
- Department of Pharmacognosy and Molecular Basis of Phytotherapy, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Ewa Poleszak
- Laboratory of Preclinical Testing, Chair and Department of Applied and Social Pharmacy, Medical University of Lublin, 1 Chodźki Street, 20-093 Lublin, Poland.
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Gaudreault PO, King SG, Malaker P, Alia-Klein N, Goldstein RZ. Whole-brain white matter abnormalities in human cocaine and heroin use disorders: association with craving, recency, and cumulative use. Mol Psychiatry 2023; 28:780-791. [PMID: 36369361 PMCID: PMC9911401 DOI: 10.1038/s41380-022-01833-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 11/13/2022]
Abstract
Neuroimaging studies in substance use disorder have shown widespread impairments in white matter (WM) microstructure suggesting demyelination and axonal damage. However, substantially fewer studies explored the generalized vs. the acute and/or specific drug effects on WM. Our study assessed whole-brain WM integrity in three subgroups of individuals addicted to drugs, encompassing those with cocaine (CUD) or heroin (HUD) use disorder, compared to healthy controls (CTL). Diffusion MRI was acquired in 58 CTL, 28 current cocaine users/CUD+, 32 abstinent cocaine users/CUD-, and 30 individuals with HUD (urine was positive for cocaine in CUD+ and opiates used for treatment in HUD). Tract-Based Spatial Statistics allowed voxelwise analyses of diffusion metrics [fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD)]. Permutation statistics (p-corrected < 0.05) were used for between-group t-tests. Compared to CTL, all individuals with addiction showed widespread decreases in FA, and increases in MD, RD, and AD (19-57% of WM skeleton, p < 0.05). The HUD group showed the most impairments, followed by the CUD+, with only minor FA reductions in CUD- (<0.2% of WM skeleton, p = 0.05). Longer periods of regular use were associated with decreased FA and AD, and higher subjective craving was associated with increased MD, RD, and AD, across all individuals with drug addiction (p < 0.05). These findings demonstrate extensive WM impairments in individuals with drug addiction characterized by decreased anisotropy and increased diffusivity, thought to reflect demyelination and lower axonal packing. Extensive abnormalities in both groups with positive urine status (CUD+ and HUD), and correlations with craving, suggest greater WM impairments with more recent use. Results in CUD-, and correlations with regular use, further imply cumulative and/or persistent WM damage.
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Affiliation(s)
- Pierre-Olivier Gaudreault
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Sarah G King
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Pias Malaker
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Nelly Alia-Klein
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Rita Z Goldstein
- Psychiatry and Neuroscience Departments, Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
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Black E, Mammen K, Deacon RM, Ezard N, Mills L, Dunlop AJ, Montebello M, Reid D, Childs S, Bruno R, Shakeshaft A, Siefried KJ, Farrell M, Holmes J, Lintzeris N. Health and social characteristics of clients reporting amphetamine type substance use at entry to public alcohol and other drug services in New South Wales, Australia, 2016-2019. Drug Alcohol Rev 2023; 42:389-400. [PMID: 36524444 PMCID: PMC10107800 DOI: 10.1111/dar.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Amphetamine type substances (ATS) are commonly used by Australian alcohol and other drug service entrants. We describe demographic characteristics, patterns of ATS and other substance use, health and social conditions among clients entering New South Wales (NSW) public alcohol and other drug services. METHODS Retrospective cohort of 13,864 records across six health districts (2016-2019) for clients seeking substance use treatment. These districts service approximately 44% of the NSW population aged 15 years and over. Multivariate analysis was conducted on a subsample for whom full data were available (N = 9981). Data included NSW Minimum Data Set for drug and alcohol treatment services and Australian Treatment Outcomes Profile items. RESULTS Over the preceding 4 weeks, 77% (n = 10,610) of clients (N = 13,864) reported no recent ATS use, 15% (n = 2109) reported 'low frequency' (1-12 days) and 8% (n = 1145) 'high frequency' (13-28 days) use. ATS use was most common among people attending for ATS or opioids as primary drug of concern. A multinomial regression (N = 9981) identified that clients reporting recent arrest (aOR 1.74, 95% CI 1.36, 2.24), higher cannabis use frequency (aOR 1.01, 95% CI 1.00, 1.02), lower opioid use frequency (aOR 0.98, 95% CI 0.97, 0.99) and poorer quality of life (aOR 0.91, 95% CI 0.86, 0.97) were more likely to report 'high frequency' rather than 'low frequency' ATS use. DISCUSSION AND CONCLUSIONS People who use ATS experience health and social issues that may require targeted responses. These should be integrated across all services, not only for clients with ATS as principal drug of concern.
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Affiliation(s)
- Emma Black
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Kristie Mammen
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
| | - Rachel M. Deacon
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
| | - Nadine Ezard
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- Alcohol and Drug Service, St Vincent's HospitalSydneyAustralia
- National Centre for Clinical Research on Emerging DrugsSydneyAustralia
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
| | - Llewellyn Mills
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Adrian J. Dunlop
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Clinical Services, Hunter New England Local Health DistrictNewcastleAustralia
- School of Medicine and Public HealthCollege of Health & Wellbeing, University of NewcastleNewcastleAustralia
- HMRI Healthcare Transformation Research ProgramNewcastleAustralia
| | - Mark Montebello
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, North Sydney Local Health DistrictSydneyAustralia
| | - David Reid
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, Illawarra and Shoalhaven Local Health DistrictWollongongAustralia
| | - Steven Childs
- NSW Drug and Alcohol Clinical Research and Improvement Network, NSW Ministry of HealthSydneyAustralia
- Drug and Alcohol Services, Central Coast Local Health DistrictGosfordAustralia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- School of Psychological SciencesUniversity of TasmaniaHobartAustralia
| | | | - Krista J. Siefried
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
- Alcohol and Drug Service, St Vincent's HospitalSydneyAustralia
- National Centre for Clinical Research on Emerging DrugsSydneyAustralia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW SydneySydneyAustralia
| | - Jennifer Holmes
- Centre for Alcohol and other Drugs, NSW Ministry of HealthSydneyAustralia
| | - Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health DistrictSydneyAustralia
- Specialty of Addiction MedicineThe University of SydneySydneyAustralia
- Drug and Alcohol Services, Illawarra and Shoalhaven Local Health DistrictWollongongAustralia
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Rosenblat JD, Husain MI, Lee Y, McIntyre RS, Mansur RB, Castle D, Offman H, Parikh SV, Frey BN, Schaffer A, Greenway KT, Garel N, Beaulieu S, Kennedy SH, Lam RW, Milev R, Ravindran AV, Tourjman V, Ameringen MV, Yatham LN, Taylor V. The Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Report: Serotonergic Psychedelic Treatments for Major Depressive Disorder. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:5-21. [PMID: 35975555 PMCID: PMC9720483 DOI: 10.1177/07067437221111371] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Serotonergic psychedelics are re-emerging as potential novel treatments for several psychiatric disorders including major depressive disorder. The Canadian Network for Mood and Anxiety Treatments (CANMAT) convened a task force to review the evidence and provide a consensus recommendation for the clinical use of psychedelic treatments for major depressive disorder. METHODS A systematic review was conducted to identify contemporary clinical trials of serotonergic psychedelics for the treatment of major depressive disorder and cancer-related depression. Studies published between January 1990 and July 2021 were identified using combinations of search terms, inspection of bibliographies and review of other psychedelic reviews and consensus statements. The levels of evidence for efficacy were graded according to the Canadian Network for Mood and Anxiety Treatments criteria. RESULTS Only psilocybin and ayahuasca have contemporary clinical trials evaluating antidepressant effects. Two pilot studies showed preliminary positive effects of single-dose ayahuasca for treatment-resistant depression (Level 3 evidence). Small randomized controlled trials of psilocybin combined with psychotherapy showed superiority to waitlist controls and comparable efficacy and safety to an active comparator (escitalopram with supportive psychotherapy) in major depressive disorder, with additional randomized controlled trials showing efficacy specifically in cancer-related depression (Level 3 evidence). There was only one open-label trial of psilocybin in treatment-resistant unipolar depression (Level 4 evidence). Small sample sizes and functional unblinding were major limitations in all studies. Adverse events associated with psychedelics, including psychological (e.g., psychotomimetic effects) and physical (e.g., nausea, emesis and headaches) effects, were generally transient. CONCLUSIONS There is currently only low-level evidence to support the efficacy and safety of psychedelics for major depressive disorder. In Canada, as of 2022, psilocybin remains an experimental option that is only available through clinical trials or the special access program. As such, Canadian Network for Mood and Anxiety Treatments considers psilocybin an experimental treatment and recommends its use primarily within clinical trials, or, less commonly, through the special access program in rare, special circumstances.
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Affiliation(s)
- Joshua D. Rosenblat
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Mood Disorders Psychopharmacology Unit,
University Health Network, Toronto, Ontario, Canada
| | - M. Ishrat Husain
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental
Health Research Institute Toronto, Ontario, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit,
University Health Network, Toronto, Ontario, Canada
| | - Roger S. McIntyre
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Mood Disorders Psychopharmacology Unit,
University Health Network, Toronto, Ontario, Canada
| | - Rodrigo B. Mansur
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Mood Disorders Psychopharmacology Unit,
University Health Network, Toronto, Ontario, Canada
| | - David Castle
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental
Health Research Institute Toronto, Ontario, Canada
| | - Hilary Offman
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Sagar V. Parikh
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Depression Program, Michigan Medicine, University of Michigan, Ann
Arbor, USA
| | - Benicio N. Frey
- Mood Disorders Program, St. Joseph's Healthcare Hamilton, McMaster
University, Psychiatry & Behavioural Neurosciences, Hamilton, Ontario,
Canada
| | - Ayal Schaffer
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre,
Toronto, Ontario, Canada
| | | | - Nicolas Garel
- McGill University, Psychiatry, Montreal, Quebec, Canada
| | | | - Sidney H. Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Mood Disorders Psychopharmacology Unit,
University Health Network, Toronto, Ontario, Canada
| | - Raymond W. Lam
- Department of Psychiatry, University of British Columbia, Vancouver,
British Columbia, Canada
| | - Roumen Milev
- Department of Psychiatry, Providence Care, Queen's University,
Kingston, ON, Canada
| | - Arun V. Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental
Health Research Institute Toronto, Ontario, Canada
| | - Valerie Tourjman
- Institut universitaire en santé mentale de Montréal, Psychiatry,
Montreal, Quebec, Canada
| | - Michael Van Ameringen
- McMaster University Medical Centre, Anxiety Disorders Clinic,
Hamilton, Ontario, Canada
| | - Lakshmi N. Yatham
- Department of Psychiatry, University of British Columbia, Vancouver,
British Columbia, Canada
| | - Valerie Taylor
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Mood Disorders Psychopharmacology Unit,
University Health Network, Toronto, Ontario, Canada
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Herrijgers C, Platteau T, Vandebosch H, Poels K, Florence E. Using Intervention Mapping to Develop an mHealth Intervention to Support Men Who Have Sex With Men Engaging in Chemsex (Budd): Development and Usability Study. JMIR Res Protoc 2022; 11:e39678. [PMID: 36542451 DOI: 10.2196/39678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/25/2022] [Accepted: 10/25/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Chemsex refers to the intentional use of drugs before or during sex among men who have sex with men (MSM). Engaging in chemsex has been linked to significant negative impacts on physical, psychological, and social well-being. However, no evidence-based support tools have addressed either these harms or the care needs of MSM who engage in chemsex. OBJECTIVE The purpose of this paper was to describe the development of a mobile health intervention (named Budd) using the intervention mapping protocol (IMP). Budd aims to support and inform MSM who participate in chemsex, reduce the negative impacts associated with chemsex, and encourage more reasoned participation. METHODS The IMP consists of 6 steps to develop, implement, and evaluate evidence-based health interventions. A needs assessment was carried out between September 2, 2019, and March 31, 2020, by conducting a literature study and in-depth interviews. Change objectives were selected based on these findings, after which theory-based intervention methods were selected. The first version of the intervention was developed in December 2020 and pilot-tested between February 1, 2021, and April 30, 2021. Adjustments were made based on the findings from this study. A separate article will be dedicated to the effectiveness study, conducted between October 15, 2021, and February 24, 2022, and implementation of the intervention. The Budd app went live in April 2022. RESULTS Budd aims to address individual factors and support chemsex participants in applying harm reduction measures when taking drugs (drug information, drug combination tool, and notebook), preparing for participation in a chemsex session (articles on chemsex, preparation tool, and event-specific checklist), planning sufficient time after a chemsex session to recover (planning tool), seeking support for their chemsex participation (overview of existing local health care and peer support services, reflection, personal statistics, and user testimonials), taking HIV medication or pre-exposure prophylaxis in a timely manner during a chemsex session (preparation tool), and contacting emergency services in case of an emergency and giving first aid to others (emergency information and personal buddy). CONCLUSIONS The IMP proved to be a valuable tool in the planning and development of the Budd app. This study provides researchers and practitioners with valuable information that may help them to set up their own health interventions. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/39678.
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Affiliation(s)
- Corinne Herrijgers
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Tom Platteau
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Heidi Vandebosch
- Department of Communication Studies, University of Antwerp, Antwerpen, Belgium
| | - Karolien Poels
- Department of Communication Studies, University of Antwerp, Antwerpen, Belgium
| | - Eric Florence
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerpen, Belgium
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Sagioglou C, Greitemeyer T. Motives Linking Subclinical Psychopathy and Benign Masochism to Recreational Drug use. JOURNAL OF DRUG ISSUES 2022. [DOI: 10.1177/00220426221145024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
As the use of some psychoactive substances continues to be a global health risk, it is important to understand why people use them. We compared the predictive power of psychopathy and masochism with regard to lifetime recreational drug use and tested the underlying motives in a sample of 415 US-based adults. Psychopathy predicted use of illicit drugs, cannabis, and nicotine, while masochism predicted cannabis, alcohol, and caffeine use. Both traits were related to most motives, but the motives differentially predicted substance use. Expansion motivation was the sole motive for illicit drug use, whereas cannabis was predicted mainly by expansion and enhancement. Alcohol, nicotine, and caffeine were used to escape daily worries, and alcohol was further used for social reasons. Benign masochism is a newly identified predictor of popular drug use. Future research could investigate masochism and expansion motivation as predictors of potentially harmful substance use.
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50
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Barber G, Nemeroff CB, Siegel S. A Case of Prolonged Mania, Psychosis, and Severe Depression After Psilocybin Use: Implications of Increased Psychedelic Drug Availability. Am J Psychiatry 2022; 179:892-896. [PMID: 36453037 DOI: 10.1176/appi.ajp.22010073] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Gregory Barber
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Barber); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles (Siegel)
| | - Charles B Nemeroff
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Barber); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles (Siegel)
| | - Steven Siegel
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore (Barber); Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin (Nemeroff); Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles (Siegel)
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