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Stogner J, Baldwin JM, Wiercioch A. 'Spice' Use Motivations, Experiences, and Repercussions among Veterans of the United States Armed Forces. Subst Use Misuse 2024; 59:1182-1189. [PMID: 38548662 DOI: 10.1080/10826084.2024.2330900] [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: 04/26/2024]
Abstract
BACKGROUND AND OBJECTIVES The potential for synthetic cannabinoids (SCs) to function as an alternative to marijuana without the same risk of a positive urinalyses led to claims of pervasive military SC use. Case studies confirm use among veterans, but no study has adequately explored SC use in the military using detailed interview data. METHODS Interviews (1-2 h) were conducted with 318 justice-involved veterans. Recruitment was attempted with all participants in eight veterans treatment courts in three U.S. states (54.9% of 579 eligible veterans). Interviews were transcribed and thematic analyses completed. RESULTS SC use was reported by 65 participants (21.3%). Major emergent themes indicated SCs were perceived as unpleasant, overly powerful, and a poor substitute for marijuana. Further, habitual use was rare as many chose not to reuse after initial negative experiences. Few indicated that the perception that SCs would not appear on routine military urinalyses enabled their use. Veterans were aware of the changing drug composition and feared "bad batches." CONCLUSIONS SCs were explicitly disliked both independently and relative to marijuana. Nine discussed avoiding positive military drug screens as a consideration, but negative initial experiences generally prevented progression to habitual use. Veterans did not view SCs as a suitable marijuana replacement. Fears that SCs are being used as a marijuana alternative among veterans subject to frequent drug testing appear unfounded. These interviews suggest that routine military drug testing did not motivate individuals to use SCs habitually as a marijuana replacement; however, veterans' negative interpretation of SC effects contributed to this outcome.
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Affiliation(s)
- John Stogner
- Department of Criminal Justice and Criminology, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, North Carolina
| | - Julie Marie Baldwin
- Department of Justice, Law & Criminology, American University, Washington, DC
| | - Amelia Wiercioch
- Department of Criminal Justice, University of Central Florida, 12494 University Blvd, Orlando, FL
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2
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Marandure BN, Mhizha S, Wilson A. " Spice Was Made, by the Devil Himself": A Thematic Analysis of the Experience of an Addiction to Synthetic Cannabinoids. J Psychoactive Drugs 2022:1-9. [PMID: 35640052 DOI: 10.1080/02791072.2022.2083534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Synthetic cannabinoids (SC) are the most common type of new psychoactive substances used predominantly as a replacement for cannabis. There is a wealth of literature on the negative effects experienced by users of SC. However, there is a paucity of research on the experience of addiction to SC from the users' perspectives. The present study qualitatively explored the experience of addiction to SC. Online blog entries detailing the experience of SC addiction were analyzed using thematic analysis. Users reported being stuck in a cycle of addiction which was composed of addiction hallmarks. They also experienced a range of significant physical, mental health and psychosocial problems. Suicidal ideation was also reported, with potential for its occurrence during withdrawal, due to shame of being addicted, and as the only way to stop the addiction cycle. Additionally, both psychotic and cognitive symptoms were reported to persist following cessation, enhancing current understanding of long-term SC effects. Therefore, users require both clinical and psychosocial support for these issues, most notably suicidal ideation.
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Affiliation(s)
- Blessing N Marandure
- Institute of Psychological Science, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Samson Mhizha
- Department of Psychology, Faculty of Social Studies, University of Zimbabwe, Harare, Zimbabwe
| | - Amanda Wilson
- Institute of Psychological Science, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
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Pintori N, Castelli MP, Miliano C, Simola N, Fadda P, Fattore L, Scherma M, Ennas MG, Mostallino R, Flore G, De Felice M, Sagheddu C, Pistis M, Di Chiara G, De Luca MA. Repeated exposure to JWH-018 induces adaptive changes in the mesolimbic and mesocortical dopaminergic pathways, glial cells alterations, and behavioural correlates. Br J Pharmacol 2021; 178:3476-3497. [PMID: 33837969 PMCID: PMC8457172 DOI: 10.1111/bph.15494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 12/13/2022] Open
Abstract
Background and Purpose Spice/K2 herbal mixtures, containing synthetic cannabinoids such as JWH‐018, have been marketed as marijuana surrogates since 2004. JWH‐018 has cannabinoid CB1 receptor‐dependent reinforcing properties and acutely increases dopaminergic transmission selectively in the NAc shell. Here, we tested the hypothesis that repeated administration of JWH‐018 (i) modulates behaviour, (ii) affects dopaminergic transmission and its responsiveness to motivational stimuli, and (iii) is associated with a neuroinflammatory phenotype. Experimental Approach Rats were administered with JWH‐018 once a day for 14 consecutive days. We then performed behavioural, electrophysiological, and neurochemical evaluation at multiple time points after drug discontinuation. Key Results Repeated JWH‐018 exposure (i) induced anxious and aversive behaviours, transitory attentional deficits, and withdrawal signs; (ii) decreased spontaneous activity and number of dopamine neurons in the VTA; and (iii) reduced stimulation of dopaminergic transmission in the NAc shell while potentiating that in the NAc core, in response to acute JWH‐018 challenge. Moreover, (iv) we observed a decreased dopamine sensitivity in the NAc shell and core, but not in the mPFC, to a first chocolate exposure; conversely, after a second exposure, dialysate dopamine fully increased in the NAc shell and core but not in the mPFC. Finally, selected dopamine brain areas showed (v) astrogliosis (mPFC, NAc shell and core, VTA), microgliosis (NAc shell and core), and downregulation of CB1 receptors (mPFC, NAc shell and core). Conclusion and Implications Repeated exposure to JWH‐018 may provide a useful model to clarify the detrimental effects of recurring use of Spice/K2 drugs.
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Affiliation(s)
- Nicholas Pintori
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | | | - Cristina Miliano
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Nicola Simola
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Paola Fadda
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,Institute of Neuroscience-Cagliari, National Research Council, Rome, Italy
| | - Liana Fattore
- Institute of Neuroscience-Cagliari, National Research Council, Rome, Italy
| | - Maria Scherma
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Maria Grazia Ennas
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Rafaela Mostallino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Giovanna Flore
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Marta De Felice
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Claudia Sagheddu
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Marco Pistis
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,Institute of Neuroscience-Cagliari, National Research Council, Rome, Italy
| | - Gaetano Di Chiara
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,Institute of Neuroscience-Cagliari, National Research Council, Rome, Italy
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4
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The e-psychonaut drugs' psychopharmacology. Curr Opin Pharmacol 2021; 57:165-174. [PMID: 33774473 DOI: 10.1016/j.coph.2021.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 01/31/2023]
Abstract
The focus here was on the pharmacological and clinical pharmacological issues pertaining to the vast range of drugs (e.g. synthetic cannabimimetics, synthetic opioids, novel stimulants, novel psychedelics, PCP/ketamine-like compounds, prescribed medicinal compounds and popular psychotropic herbs/plants) discussed by Internet-based enthusiasts of new/novel psychoactive substances (NPS), 'e-psychonauts'. Currently ongoing related in silico studies, followed by further in vitro and in vivo/preclinical studies, will hopefully provide important findings in terms of which molecules within each given NPS class may present with higher levels of receptor affinities, and hence clinical potency. Understanding the pharmacological characteristics/potency of those novel recreational molecules will hopefully help in predicting related NPS diffusion, morbidity and possible lethality data.
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Cohen K, Rosenzweig S, Rosca P, Pinhasov A, Weizman A, Weinstein A. Personality Traits and Psychotic Proneness Among Chronic Synthetic Cannabinoid Users. Front Psychiatry 2020; 11:355. [PMID: 32477173 PMCID: PMC7242629 DOI: 10.3389/fpsyt.2020.00355] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 04/07/2020] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Chronic use of synthetic cannabinoids (SCs) has been associated with a wide range of negative consequences for health including psychotic and affective disturbances. Accumulating evidence indicates that cannabinoids use may be a risk factor for schizophrenia, and chronic natural cannabis users score higher than non-users on measures of schizotypal personality traits. However, little is known regarding the personality characteristics of SC users, especially in comparison with recreational cannabis users and healthy individuals. This study aimed to examine the differences in personality characteristics and schizotypy between SC users, regular cannabis users, and non-users and to compare these measures between groups. METHODS Forty-two chronic SC users, 39 natural cannabis users, and 47 non-using control participants, without history of mental disorder, or current substance use diagnosis (mean age 26± 4.47 years; 23 females, 105 males), completed the Big-Five Factor Inventory (BFI), the Schizotypal Personality Questionnaire-Brief (SPQ-B), substance use history, rating scales of depression and anxiety, and a demographic questionnaire. RESULTS On the BFI, SC users scored higher than natural cannabis users and non-users on neuroticism, but lower on agreeableness and extraversion, and endorsed greater schizotypal symptoms on the SPQ-B. In addition, SC users had lower scores on conscientiousness than non-users, and natural cannabis users were more extroverted than non-users. Higher openness and lower conscientiousness predicted schizotypy for both SC and natural cannabis users. Finally, greater neuroticism predicted schizotypy for natural cannabis users, and introversion predicted schizotypy for non-users. CONCLUSIONS These results show that chronic SC users differ from natural cannabis users and non-users on dimensions of specific personality traits and schizotypy that may indicate psychotic proneness.
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Affiliation(s)
- Koby Cohen
- Department of Behavioral Science, Ariel University, Ariel, Israel
| | - Shiri Rosenzweig
- Department of Behavioral Science, Ariel University, Ariel, Israel
| | - Paola Rosca
- Ministry of Health (Israel), Jerusalem, Israel
| | - Albert Pinhasov
- Adelson School of Medicine, Ariel University, Ariel, Israel
- Department of Molecular Biology, Ariel University, Ariel, Israel
| | | | - Aviv Weinstein
- Department of Behavioral Science, Ariel University, Ariel, Israel
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6
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Zangani C, Schifano F, Napoletano F, Arillotta D, Gilgar L, Guirguis A, Corkery JM, Gambini O, Vento A. The e-Psychonauts' 'Spiced' World; Assessment of the Synthetic Cannabinoids' Information Available Online. Curr Neuropharmacol 2020; 18:966-1051. [PMID: 32116194 PMCID: PMC7709145 DOI: 10.2174/1570159x18666200302125146] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/10/2020] [Accepted: 02/28/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND A wide range of novel psychoactive substances (NPS) is regularly searched and discussed online by web-based drug enthusiasts (i.e. the e-psychonauts). Among NPS, the range of synthetic cannabinoids (SC; 'Spice') currently represents a challenge for governments and clinicians. METHODS Using a web crawler (i.e. the NPS.Finder®), the present study aimed at assessing psychonauts' fora/platforms to better understand the online mentions of SC. RESULTS The open-web crawling/navigating software identified here some 1,103 synthetic cannabinoids. Of these, 863 molecules were not listed in either the international or the European NPS databases. CONCLUSION A web crawling approach helped here in identifying a large range of unknown SC likely to possess a misuse potential. Most of these novel/emerging molecules are still relatively unknown. This is a reason for concern; each of these analogues potentially presents different toxicodynamic profiles and there is a lack of docking, preclinical, and clinical observations. Strengthening multidisciplinary collaboration between clinicians and bioinformatics may prove useful in better assessing SC-associated public health risks.
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Affiliation(s)
| | - Fabrizio Schifano
- Address correspondence to this author at the Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; E-mail:
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8
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Place C, Scally A, Gow L, Wade A, Barrowcliff R, Nasim I, Nyamuchiwa M. Spice boys: an exploratory study around novel psychoactive substance use on a male acute ward. ADVANCES IN DUAL DIAGNOSIS 2017. [DOI: 10.1108/add-10-2016-0018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Novel psychoactive substances (NPS) – often known as “legal highs” – are a varied group of substances that are causing concern due to their possible effects on mental health. Particular concerns have been raised about synthetic cannabinoid receptor agonists often known as “Spice”. The purpose of this paper is to identify the prevalence of NPS use and explore any association with acute psychological disturbance.
Design/methodology/approach
The authors reviewed the case notes for 153 admissions to a male acute inpatient ward. Prevalence of reported NPS use and admissions to psychiatric intensive care unit (PICU) were recorded.
Findings
In total, 18.9 per cent of individuals admitted to acute inpatient care were reported to have used NPS. NPS users were almost ten times as likely as their non-NPS using peers to require care in PICU. This result was statistically significant (Fisher exact test: p<0.001). Although caution is required given the limitations of this study, the data and clinical experience suggest that synthetic cannabinoids may be the specific type of NPS that is being used by this group.
Practical implications
Mental health professionals can expect to care for people using NPS in acute inpatient environments, and so they need to understand the nature and effects of these substances. It is possible that NPS use may be associated with sustained acute psychological disturbance.
Originality/value
There have been few studies on the prevalence of NPS use in inpatient environments and none of them have published that explore the association with PICU admission. Despite the limitations of this study, it has significant value by identifying an urgent need for comprehensive research in this area.
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9
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Orsolini L, Papanti D, Corkery J, Schifano F. An insight into the deep web; why it matters for addiction psychiatry? Hum Psychopharmacol 2017; 32. [PMID: 28657187 DOI: 10.1002/hup.2573] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 01/07/2017] [Accepted: 01/13/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Nowadays, the web is rapidly spreading, playing a significant role in the marketing or sale or distribution of "quasi" legal drugs, hence facilitating continuous changes in drug scenarios. The easily renewable and anarchic online drug-market is gradually transforming indeed the drug market itself, from a "street" to a "virtual" one, with customers being able to shop with a relative anonymity in a 24-hr marketplace. The hidden "deep web" is facilitating this phenomenon. The paper aims at providing an overview to mental health's and addiction's professionals on current knowledge about prodrug activities on the deep web. METHODS A nonparticipant netnographic qualitative study of a list of prodrug websites (blogs, fora, and drug marketplaces) located into the surface web was here carried out. A systematic Internet search was conducted on Duckduckgo® and Google® whilst including the following keywords: "drugs" or "legal highs" or "Novel Psychoactive Substances" or "NPS" combined with the word deep web. RESULTS Four themes (e.g., "How to access into the deepweb"; "Darknet and the online drug trading sites"; "Grams-search engine for the deep web"; and "Cryptocurrencies") and 14 categories were here generated and properly discussed. CONCLUSIONS This paper represents a complete or systematical guideline about the deep web, specifically focusing on practical information on online drug marketplaces, useful for addiction's professionals.
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Affiliation(s)
- Laura Orsolini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, College Lane Campus, University of Hertfordshire, Hatfield, Herts, UK.,Villa San Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy.,Polyedra Research, Teramo, Italy
| | - Duccio Papanti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, College Lane Campus, University of Hertfordshire, Hatfield, Herts, UK
| | - John Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, College Lane Campus, University of Hertfordshire, Hatfield, Herts, UK
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, College Lane Campus, University of Hertfordshire, Hatfield, Herts, UK
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10
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Orsolini L, Papanti GD, De Berardis D, Guirguis A, Corkery JM, Schifano F. The "Endless Trip" among the NPS Users: Psychopathology and Psychopharmacology in the Hallucinogen-Persisting Perception Disorder. A Systematic Review. Front Psychiatry 2017; 8:240. [PMID: 29209235 PMCID: PMC5701998 DOI: 10.3389/fpsyt.2017.00240] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 11/03/2017] [Indexed: 12/21/2022] Open
Abstract
Hallucinogen-persisting perception disorder (HPPD) is a syndrome characterized by prolonged or reoccurring perceptual symptoms, reminiscent of acute hallucinogen effects. HPPD was associated with a broader range of LSD (lysergic acid diethylamide)-like substances, cannabis, methylenedioxymethamphetamine (MDMA), psilocybin, mescaline, and psychostimulants. The recent emergence of novel psychoactive substances (NPS) posed a critical concern regarding the new onset of psychiatric symptoms/syndromes, including cases of HPPD. Symptomatology mainly comprises visual disorders (i.e., geometric pseudo-hallucinations, haloes, flashes of colors/lights, motion-perception deficits, afterimages, micropsia, more acute awareness of floaters, etc.), even though depressive symptoms and thought disorders may be comorbidly present. Although HPPD was first described in 1954, it was just established as a fully syndrome in 2000, with the revised fourth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR). HPPD neural substrates, risk factors, and aetiopathogenesys still largely remain unknown and under investigation, and many questions about its pharmacological targets remain unanswered too. A critical mini review on psychopathological bases, etiological hypothesis, and psychopharmacological approaches toward HPPD, including the association with some novel substances, are provided here, by means of a literature search on PubMed/Medline, Google Scholar, and Scopus databases without time restrictions, by using a specific set of keywords. Pharmacological and clinical issues are considered, and practical psychopharmacological recommendations and clinical guidelines are suggested.
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Affiliation(s)
- Laura Orsolini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Neomesia Mental Health, Villa Jolanda Hospital, Jesi, Italy.,Polyedra, Teramo, Italy
| | - Gabriele Duccio Papanti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Domenico De Berardis
- Polyedra, Teramo, Italy.,NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy.,Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University "G. D'Annunzio", Chieti, Italy
| | - Amira Guirguis
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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Schifano F, Orsolini L, Papanti D, Corkery J. NPS: Medical Consequences Associated with Their Intake. Curr Top Behav Neurosci 2017; 32:351-380. [PMID: 27272067 DOI: 10.1007/7854_2016_15] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Over the last decade, the 'traditional' drug scene has been supplemented - but not replaced - by the emergence of a range of novel psychoactive substances (NPS), which are either newly created or existing drugs, including medications, now being used in novel ways. By the end of 2014, in excess of 500 NPS had been reported by a large number of countries in the world. Most recent data show, however, that synthetic cathinones, synthetic cannabinoids, and psychedelics/phenethylamines account for the largest number of NPS.The present chapter aims at providing an overview of the clinical and pharmacological issues relating to these most popular NPS categories. Given the vast range of medical and psychopathological issues associated with the molecules here described, it is crucial for health professionals to be aware of the effects and toxicity of NPS. A general overview of the acute management of NPS adverse events is provided as well, although further studies are required to identify a range of evidence-based, index molecule-focused, treatment strategies. The rapid pace of change in the NPS online market constitutes a major challenge to the provision of current and reliable scientific knowledge on these substances.
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Affiliation(s)
- Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, Herts, AL10 9AB, UK.
| | - Laura Orsolini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, Herts, AL10 9AB, UK
| | - Duccio Papanti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, Herts, AL10 9AB, UK
| | - John Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, Herts, AL10 9AB, UK
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12
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Adamowicz P, Gieroń J. Acute intoxication of four individuals following use of the synthetic cannabinoid MAB-CHMINACA. Clin Toxicol (Phila) 2016; 54:650-4. [DOI: 10.1080/15563650.2016.1190016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Schifano F, Papanti GD, Orsolini L, Corkery JM. Novel psychoactive substances: the pharmacology of stimulants and hallucinogens. Expert Rev Clin Pharmacol 2016; 9:943-54. [PMID: 26985969 DOI: 10.1586/17512433.2016.1167597] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
There are increasing levels of concern relating to the rapidly evolving novel psychoactive substances/NPS and web markets' scenarios. The paper aims at providing an overview of the clinical pharmacological issues related to some of the most popular NPS categories, e.g. stimulants and hallucinogens. NPS intake is typically associated with the imbalance of a complex range of neurotransmitter pathways/receptors, namely: dopamine; cannabinoid/CB1; and 5-HT2A. The intake is almost invariably undetectable with standard screening tests. Hence, it may frequently occur that the acute management of NPS misusers will need to focus on decreasing levels of both self/outward-directed aggression and agitation. Benzodiazepines may be considered as first line treatment. Alternatively, propofol and/or antipsychotics can be administered. Focus will be as well on treatment of possible rhabdomyolysis and hyperthermia. Indeed, future studies should inform better tailored management/treatment strategies.
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Affiliation(s)
- Fabrizio Schifano
- a 'Psychopharmacology; drug misuse; and novel psychoactive substances' Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , Herts , UK
| | - G Duccio Papanti
- a 'Psychopharmacology; drug misuse; and novel psychoactive substances' Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , Herts , UK
| | - Laura Orsolini
- a 'Psychopharmacology; drug misuse; and novel psychoactive substances' Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , Herts , UK
| | - John M Corkery
- a 'Psychopharmacology; drug misuse; and novel psychoactive substances' Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , Herts , UK
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14
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Fattore L. Synthetic Cannabinoids-Further Evidence Supporting the Relationship Between Cannabinoids and Psychosis. Biol Psychiatry 2016; 79:539-48. [PMID: 26970364 DOI: 10.1016/j.biopsych.2016.02.001] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 12/26/2022]
Abstract
Consumption of synthetic mind-altering compounds, also known as "new psychoactive substances," is increasing globally at an alarming rate. Synthetic cannabinoids (SCs) are among the most commonly used new psychoactive substances. They are usually purchased as marijuana-like drugs, marketed as herbal blends and perceived as risk-free by inexperienced users. Yet, contrary to Δ(9)-tetrahydrocannabinol, SCs may lead to severe health consequences, including anxiety, tachycardia, hallucinations, violent behavior, and psychosis. This review focuses on the latest (2010-2015) evidence of psychotic symptoms induced by ingestion of products containing SCs. Reports suggesting that SCs may either exacerbate previously stable psychotic symptoms (in vulnerable individuals) or trigger new-onset psychosis (in individuals with no previous history of psychosis) are reviewed. Pharmacology and toxicology of these compounds are discussed, with particular reference to their psychoactive effects.
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Affiliation(s)
- Liana Fattore
- CNR Neuroscience Institute, National Research Council (Italy), and Centre of Excellence "Neurobiology of Dependence," Department of Biomedical Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, Cagliari, Sardinia, Italy.
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15
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De Luca MA, Castelli MP, Loi B, Porcu A, Martorelli M, Miliano C, Kellett K, Davidson C, Stair JL, Schifano F, Di Chiara G. Native CB1 receptor affinity, intrinsic activity and accumbens shell dopamine stimulant properties of third generation SPICE/K2 cannabinoids: BB-22, 5F-PB-22, 5F-AKB-48 and STS-135. Neuropharmacology 2015; 105:630-638. [PMID: 26686391 DOI: 10.1016/j.neuropharm.2015.11.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 11/18/2015] [Accepted: 11/19/2015] [Indexed: 01/07/2023]
Abstract
In order to investigate the in vivo dopamine (DA) stimulant properties of selected 3rd generation Spice/K2 cannabinoids, BB-22, 5F-PB-22, 5F-AKB-48 and STS-135, their in vitro affinity and agonist potency at native rat and mice CB1 receptors was studied. The compounds bind with high affinity to CB1 receptors in rat cerebral cortex homogenates and stimulate CB1-induced [(35)S]GTPγS binding with high potency and efficacy. BB-22 and 5F-PB-22 showed the lowest Ki of binding to CB1 receptors (0.11 and 0.13 nM), i.e., 30 and 26 times lower respectively than that of JWH-018 (3.38 nM), and a potency (EC50, 2.9 and 3.7 nM, respectively) and efficacy (Emax, 217% and 203%, respectively) as CB1 agonists higher than JWH-018 (EC50, 20.2 nM; Emax, 163%). 5F-AKB-48 and STS-135 had higher Ki for CB1 binding, higher EC50 and lower Emax as CB1 agonists than BB-22 and 5F-PB-22 but still comparatively more favourable than JWH-018. The agonist properties of all the compounds were abolished or drastically reduced by the CB1 antagonist/inverse agonist AM251 (0.1 μM). No activation of G-protein was observed in CB1-KO mice. BB-22 (0.003-0.01 mg/kg i.v.) increased dialysate DA in the accumbens shell but not in the core or in the medial prefrontal cortex, with a bell shaped dose-response curve and an effect at 0.01 mg/kg and a biphasic time-course. Systemic AM251 (1.0 mg/kg i.p.) completely prevented the stimulant effect of BB-22 on dialysate DA in the NAc shell. All the other compounds increased dialysate DA in the NAc shell at doses consistent with their in vitro affinity for CB1 receptors (5F-PB-22, 0.01 mg/kg; 5F-AKB-48, 0.1 mg/kg; STS-135, 0.15 mg/kg i.v.). 3rd generation cannabinoids can be even more potent and super-high CB1 receptor agonists compared to JWH-018. Future research will try to establish if these properties can explain the high toxicity and lethality associated with these compounds.
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Affiliation(s)
| | - M Paola Castelli
- Department of Biomedical Sciences, University of Cagliari, Italy
| | - Barbara Loi
- School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Alessandra Porcu
- Department of Biomedical Sciences, University of Cagliari, Italy
| | | | - Cristina Miliano
- Department of Biomedical Sciences, University of Cagliari, Italy
| | - Kathryn Kellett
- School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Colin Davidson
- Pharmacology and Cell Physiology, Division of Biomedical Science, St George's University of London, London, UK
| | | | - Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, UK
| | - Gaetano Di Chiara
- Department of Biomedical Sciences, University of Cagliari, Italy; CNR Institute of Neuroscience, Cagliari Section, University of Cagliari, Italy.
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16
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Baumeister D, Tojo LM, Tracy DK. Legal highs: staying on top of the flood of novel psychoactive substances. Ther Adv Psychopharmacol 2015; 5:97-132. [PMID: 26240749 PMCID: PMC4521440 DOI: 10.1177/2045125314559539] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
There has been growing clinical, public, and media awareness and concern about the availability and potential harmfulness of so-called 'legal highs', which are more appropriately called new or novel psychoactive substances (NPS). A cat-and-mouse process has emerged wherein unknown chemists and laboratories are producing new, and as yet nonproscribed, compounds for human consumption; and as soon as they are banned, which they inevitably are, slightly modified analogues are produced to circumvent new laws. This rapidly changing environment, 81 new substances were identified in 2013 alone, has led to confusion for clinicians, psychopharmacologists, and the public at large. Our difficulties in keeping up with the process has had a two-fold negative effect: the danger of ignoring what is confusing; and the problem that some of the newer synthesized compounds appear ever more potent. This review aims to circumscribe a quick moving and growing field, and to categorize NPS into five major groups based upon their 'parent' compounds: stimulants similar to cocaine, amphetamines and ecstasy; cannabinoids; benzodiazepine based drugs; dissociatives similar to ketamine and phencyclidine (PCP); and those modelled after classic hallucinogens such as LSD and psilocybin. Pharmacodynamic actions, subjective and physical effects, harmfulness, risk of dependency and, where appropriate, putative clinical potentials are described for each class. Clinicians might encounter NPS in various ways: anecdotal reportage; acute intoxication; as part of a substance misuse profile; and as a precipitant or perpetuating factor for longer-term physical and psychological ill health. Current data are overall limited, and much of our knowledge and treatment strategies are based upon those of the 'parent' compound. There is a critical need for more research in this field, and for professionals to make themselves more aware of this growing issue and how it might affect those we see clinically and try to help: a brave new world of so-called 'psychonauts' consuming NPS will also need informed 'psychotherapeutonauts'. The paper should serve as a primer for clinicians and interested readers, as well as provide a framework into which to place the new substances that will inevitably be synthesized in the future.
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Affiliation(s)
- David Baumeister
- Department of Psychology, Institute of Psychiatry, King's College, London, UK
| | - Luis M Tojo
- Stress, Psychiatry and Immunology Lab, Department of Psychological Medicine, Institute of Psychiatry, King's College, London, UK
| | - Derek K Tracy
- Consultant Psychiatrist and Associate Clinical Director, Oxleas NHS Foundation Trust, Princess Royal University Hospital, and Cognition, Schizophrenia and Imaging Laboratory, Department of Psychosis Studies, Institute of Psychiatry, King's College, London BR6 8NY, UK
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Schifano F, Orsolini L, Duccio Papanti G, Corkery JM. Novel psychoactive substances of interest for psychiatry. World Psychiatry 2015; 14:15-26. [PMID: 25655145 PMCID: PMC4329884 DOI: 10.1002/wps.20174] [Citation(s) in RCA: 236] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Novel psychoactive substances include synthetic cannabinoids, cathinone derivatives, psychedelic phenethylamines, novel stimulants, synthetic opioids, tryptamine derivatives, phencyclidine-like dissociatives, piperazines, GABA-A/B receptor agonists, a range of prescribed medications, psychoactive plants/herbs, and a large series of performance and image enhancing drugs. Users are typically attracted by these substances due to their intense psychoactive effects and likely lack of detection in routine drug screenings. This paper aims at providing psychiatrists with updated knowledge of the clinical pharmacology and psychopathological consequences of the use of these substances. Indeed, these drugs act on a range of neurotransmitter pathways/receptors whose imbalance has been associated with psychopathological conditions, including dopamine, cannabinoid CB1, GABA-A/B, 5-HT2A, glutamate, and k opioid receptors. An overall approach in terms of clinical management is briefly discussed.
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Affiliation(s)
- Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, UK
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