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Mian MN, Altman BR, Low F, Earleywine M. Development of the Protective Strategies for Psychedelics Scale: A novel inventory to assess safety strategies in the context of psychedelics. J Psychopharmacol 2024; 38:101-109. [PMID: 38050326 PMCID: PMC10851634 DOI: 10.1177/02698811231214060] [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] [Indexed: 12/06/2023]
Abstract
BACKGROUND Individuals who use psychedelics take efforts to mitigate unintended consequences. Despite the demonstrated utility of analogous protective behavioral strategies (PBS) assessments for other substances, no standardized scale exists to capture these protective strategies for psychedelic use. OBJECTIVE The present study addresses a notable gap concerning the assessment of psychedelic use, specifically by developing a scale measuring the protective strategies employed around use, called the Protective Strategies for Psychedelics Scale (PSPS). METHODS A sample (Mage = 36.85 years old, standard deviation = 10.3; male = 61.9%; White = 85.2%) of 434 adults with lifetime use of psychedelics reported on initial qualitatively developed items for the PSPS, PBS scales for cannabis and alcohol, and use of alcohol, cannabis, and psychedelics. RESULTS Iterative principal components analyses began with 37 items and yielded a 32-item two-factor solution demonstrating excellent internal reliability (Cronbach's α = .95) and accounted for 51.3% of the variance. Nineteen items loaded on PSPS factor 1, which focused on long-term preparation, emphasizing strategies focused on mood/intentions, preparing the substance, environment, and scheduling episode of use; 13 items loaded on factor 2, which focused on short-term preparation, highlighting strategies surrounding social context, health, and other substances. The PSPS demonstrated convergent validity with validated PBS scales for cannabis and alcohol (r = 0.71-0.79, p < 0.001), and was moderately associated with lifetime psychedelic use (r = 0.28, p < 0.001). CONCLUSION The PSPS demonstrates promising psychometric properties, and future work validating the scale for diverse samples across research and clinical settings is warranted.
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Affiliation(s)
- Maha N Mian
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Brianna R Altman
- Department of Psychology, Rutgers University, New Brunswick, NJ, USA
| | - Fiona Low
- University at Albany, SUNY, Albany, NY, USA
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2
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Milshteyn Y, Bensimon M. Exploring the subjective experience of rave party participants in Israel who consume psychedelic drugs: a qualitative inquiry. Harm Reduct J 2023; 20:176. [PMID: 38057811 DOI: 10.1186/s12954-023-00908-5] [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: 08/03/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Rave music parties (RMP) are a world-wide socio-cultural phenomenon, where people listen to rave music while frequently consuming psychedelic drugs. Epidemiological studies have emphasized the hazardous consequences following the consumption of psychedelic drugs at RMP, and qualitative studies have shown social and psycho-spiritual experiences. Yet, phenomenological inquiry into subjective experiences of attendees is scant. This study aimed to examine physical, emotional, perceptual and social experiences of RMP participants in Israel, and their view on Israel's policy toward rave events. In addition, the study aimed to contribute useful information for policymakers and society on rave music and psychedelic drugs experiences at RMP. METHOD Interpretative phenomenological analysis was used to analyze transcriptions of semi-structured interviews with 27 individuals attending RMP regularly and consume psychedelic drugs. RESULTS Analysis revealed four significant themes: the first theme, the impact of Israel's drug policy on participants' sense of safety, relates to participants' sense of insecurity and anxiety at Israeli RMP due to government drug ban policy. The second theme, the stigma on rave culture, relates to participants' perception regarding the stigma on rave culture in law enforcement agencies and in society in general. The third theme, negative experiences, describes short-term experiences after consuming psychedelics at RMP, including hallucinations and disorientation. The fourth theme, positive experiences, describes positive sensory, emotional and self/world attitudinal aspects after consuming psychedelics at RMP. Sensory experiences included intensified auditory, visual and tactile experiences; emotional experiences included positive feelings toward others, reduced stress and ability to vent difficult emotions; self/world attitudinal aspects included self-acceptance, higher appreciation of life and connectedness to nature. CONCLUSIONS The study highlights RMP participants' sense of insecurity due to Israel's strict drug policy and absence of harm reduction strategies at rave scenes. The study also notes participants' experience of stigmatization as drug addicts by society and law enforcement agencies. Reducing police presence and adopting harm reduction policies at rave scenes in Israel may increase participants' sense of security, reduce stigmatization and decrease overdose risk. Hence, the findings may contribute to new knowledge useful for policymakers and society concerning RMP and the use of psychedelics.
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Affiliation(s)
- Yula Milshteyn
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
| | - Moshe Bensimon
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel.
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Ballard AM, Falk D, Greenwood H, Gugerty P, Feinberg J, Friedmann PD, Go VF, Jenkins WD, Korthuis PT, Miller WC, Pho MT, Seal DW, Smith GS, Stopka TJ, Westergaard RP, Zule WA, Young AM, Cooper HLF. Houselessness and syringe service program utilization among people who inject drugs in eight rural areas across the USA: a cross-sectional analysis. Harm Reduct J 2023; 20:157. [PMID: 37880724 PMCID: PMC10601138 DOI: 10.1186/s12954-023-00892-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Research conducted in urban areas has highlighted the impact of housing instability on people who inject drugs (PWID), revealing that it exacerbates vulnerability to drug-related harms and impedes syringe service program (SSP) use. However, few studies have explored the effects of houselessness on SSP use among rural PWID. This study examines the relationship between houselessness and SSP utilization among PWID in eight rural areas across 10 states. METHODS PWID were recruited using respondent-driven sampling for a cross-sectional survey that queried self-reported drug use and SSP utilization in the prior 30 days, houselessness in the prior 6 months and sociodemographic characteristics. Using binomial logistic regression, we examined the relationship between experiencing houselessness and any SSP use. To assess the relationship between houselessness and the frequency of SSP use, we conducted multinomial logistic regression analyses among participants reporting any past 30-day SSP use. RESULTS Among 2394 rural PWID, 56.5% had experienced houselessness in the prior 6 months, and 43.5% reported past 30-day SSP use. PWID who had experienced houselessness were more likely to report using an SSP compared to their housed counterparts (adjusted odds ratio [aOR] = 1.24 [95% confidence intervals [CI] 1.01, 1.52]). Among those who had used an SSP at least once (n = 972), those who experienced houselessness were just as likely to report SSP use two (aOR = 0.90 [95% CI 0.60, 1.36]) and three times (aOR = 1.18 [95% CI 0.77, 1.98]) compared to once. However, they were less likely to visit an SSP four or more times compared to once in the prior 30 days (aOR = 0.59 [95% CI 0.40, 0.85]). CONCLUSION This study provides evidence that rural PWID who experience houselessness utilize SSPs at similar or higher rates as their housed counterparts. However, housing instability may pose barriers to more frequent SSP use. These findings are significant as people who experience houselessness are at increased risk for drug-related harms and encounter additional challenges when attempting to access SSPs.
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Affiliation(s)
- April M Ballard
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA.
- School of Public Health, Georgia State University, 140 Decatur Street SE, Atlanta, GA, 30303, USA.
| | - Dylan Falk
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Harris Greenwood
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Paige Gugerty
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
| | - Judith Feinberg
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Peter D Friedmann
- Office of Research, University of Massachusetts Chan Medical School-Baystate, Springfield, MA, USA
| | - Vivian F Go
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Wiley D Jenkins
- School of Medicine, Southern Illinois University, Carbondale, IL, USA
| | - P Todd Korthuis
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - William C Miller
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Mai T Pho
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - David W Seal
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Gordon S Smith
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | | | - Ryan P Westergaard
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | - April M Young
- College of Public Health, University of Kentucky, 111 Washington Avenue, Lexington, KY, 40536, USA
| | - Hannah L F Cooper
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA
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4
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Greń J, Richards DK, Pearson MR, Ostaszewski K. Development and validation of the Substance Use Protective Strategies Scale (SUPSS) among Polish young adults using various psychoactive substances. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023:104216. [PMID: 37802721 DOI: 10.1016/j.drugpo.2023.104216] [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: 06/13/2023] [Revised: 09/19/2023] [Accepted: 09/23/2023] [Indexed: 10/08/2023]
Abstract
Research supports protective behavioral strategies (PBS) as effective in reducing substance use, intoxication, and/or related risks/harms. However, despite the predominance of polysubstance use and common co-occurrence of different substance use disorders (SUDs), previous PBS research has been limited in terms of substance-specific measurement. This study sought to develop and validate a measure of PBS that is not substance-specific. Building from initial pilot work, we tested the psychometric properties of the Substance Use Protective Strategies Scale (SUPSS) in a large sample of young adults (N = 7325, aged 18-30), who reported using multiple psychoactive substances (other than alcohol and nicotine), recruited via social media in Poland. By splitting the sample, we conducted exploratory (n = 3709) and confirmatory factor analysis (n = 3614), which supported a 4-factor structure with 19 items (7 items dropped): Preparation for use (α = 0.66), Manner of use (α = 0.85), Additional concerns (α = 0.74), and Setting (α = 0.62). Configural, metric and scalar invariance were supported across sex, age, and user status for most substance types (cannabis, dissociatives, etc.). Further, the SUPSS factors were strongly associated with substance-related harms (R-squared = 0.495) and SUD symptoms (DUDIT, R-squared = 0.570). Our model fit was adequate (but not excellent), and two subscales had low internal consistency, highlighting the need for further improvement of the SUPSS. Despite its limitations, we found the SUPSS to have strong psychometric properties and it holds promise to enhance PBS research and harm reduction-oriented interventions.
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Affiliation(s)
- Jakub Greń
- Public Health Department, Institute of Psychiatry and Neurology in Warsaw, Poland; Center of Alcohol, Substance use, And Addictions (CASAA), University of New Mexico, USA.
| | - Dylan K Richards
- Center of Alcohol, Substance use, And Addictions (CASAA), University of New Mexico, USA
| | - Matthew R Pearson
- Center of Alcohol, Substance use, And Addictions (CASAA), University of New Mexico, USA
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5
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Falcon A, Halstead VA, McCabe BE. College students' experiences with substance use at electronic music events: A qualitative study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:686-694. [PMID: 33830897 DOI: 10.1080/07448481.2021.1904953] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Objective: To understand college students' experiences with substance use at electronic music events (EME), including harm-reduction strategies and receptivity to educational intervention.Participants: A purposeful sample of undergraduate students at a private Southeastern university was recruited from April 2019 to May 2019 using online advertising and in-person tabling.Methods: A qualitative, descriptive research design utilizing semistructured focus groups.Results: Five focus groups were conducted (n = 18). A thematic analysis revealed three main themes: substance use is commonplace; substance use and protective behaviors; and universities' role in substance education. Additional categories and subcategories were identified within each theme.Conclusion: Substance use at EME is a common experience for college students. Several challenges and opportunities exist for universities working to promote harm reduction practices. Prevention efforts should be event-specific, incorporate student input to engage learning more effectively, and work to reduce barriers that deter students from taking safety precautions when using substances.
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Affiliation(s)
- Ashley Falcon
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Valerie A Halstead
- School of Nursing and Health Studies, University of Miami, Coral Gables, Florida, USA
| | - Brian E McCabe
- Department of Special Education, Rehabilitation, and Counseling, Auburn University, Auburn, Alabama, USA
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Abstract
Although many of the tenets of harm reduction have been around for centuries and more traditional harm reduction services such as syringe services programs have been in existence for decades, there has been a recent increase in interest and acceptance of harm reduction as an essential component of a public health approach to substance use. This article provides an overview of harm reduction and its application to alcohol, tobacco, and drug use. It discusses the importance of integrating harm reduction principles and services with traditional psychiatric, medical, and addiction treatment programs.
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Affiliation(s)
- Avinash Ramprashad
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 701 W Pratt St, 2nd Floor Suite 289, Baltimore, MD 21201, USA
| | - Gregory Malik Burnett
- Center for Addiction Medicine, University of Maryland Midtown Campus, 827 Linden Avenue 4th Floor, Suite 405, Baltimore MD 21201 USA; Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 22 S. Greene Street S-1-D-04, Baltimore, MD 21201, USA.
| | - Christopher Welsh
- Division of Addiction Research and Treatment, Department of Psychiatry, University of Maryland School of Medicine, 22 S. Greene Street S-1-D-04, Baltimore, MD 21201, USA
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Jakub G, Krzysztof O, Katarzyna D, Łukasz W. "It'll Never Be Safe, But You Can Limit the Harms". Exploring Adolescents' Strategies to Reduce Harms Associated with Psychoactive Substance Use. Subst Use Misuse 2022; 57:380-391. [PMID: 34895030 DOI: 10.1080/10826084.2021.2012694] [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: 10/19/2022]
Abstract
Introduction: Harm reduction strategies are behaviors that may be applied in order to reduce adverse consequences associated with psychoactive substance use. Adolescents who use substances make up a large population that may benefit from applying such strategies. However, previous research in this area has focused on adults. Therefore, the purpose of this qualitative study was to describe and examine harm reduction strategies among adolescents who use psychoactive substances. Methods: Semi-structured individual interviews were conducted with 72 adolescents of equal sex distribution (aged 17-18 years) who had used various substances at least three times in the past 12 months and had no history of substance use disorders (SUD) treatment. Data were transcribed and then analyzed thematically based on the Consensual Qualitative Research approach. Findings: Adolescents who use substances described the harm reduction strategies they use. According to the meaning youth attributed to these strategies, five themes were developed, that included approaches to risk, substance use safety conditions, preparation for use, manner of use, and controlled use. Most of the identified strategies correspond to those found in studies on adults. The main source of adolescents' knowledge about these strategies was the Internet. Peers appeared to play an important role in reducing substance-related risks. Conclusions: Despite risk-taking, adolescents in our study showed active engagement in reducing their substance-related risks and harms. Practical implications are provided, including supporting harm reduction strategies, enhancing the active role of peers and the Internet as communication channels in preventing SUDs as well as other substance-related problems among adolescents.
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Affiliation(s)
- Greń Jakub
- Department of Public Health, Institute of Psychiatry and Neurology, Warsaw, Poland
| | | | - Dąbrowska Katarzyna
- Department of Studies on Alcoholism and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Wieczorek Łukasz
- Department of Studies on Alcoholism and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland
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8
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Healey A, Siefried KJ, Harrod ME, Franklin E, Peacock A, Barratt MJ, Brett J. Correlates of higher-risk drug-related behaviours at music festivals in New South Wales, Australia. Drug Alcohol Rev 2021; 41:320-329. [PMID: 34793619 DOI: 10.1111/dar.13404] [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: 04/28/2021] [Revised: 08/05/2021] [Accepted: 10/08/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION There are few contemporary data on illicit drug use at music festivals. We describe drug use patterns and prevalence of specific higher-risk drug-related behaviours, and their associations with festivalgoer characteristics. METHODS We approached attendees at six major music festivals in New South Wales, Australia, from November 2019 to March 2020. Participants self-completed an anonymous survey on prior and intended drug use and associated higher-risk behaviours; double dropping; higher-volume ethanol alongside drug use; higher quantity 3,4-methylenedioxymethamphetamine (MDMA); mixing stimulants; and preloading. Logistic regression and UpSet analyses were performed to identify festivalgoer characteristics and the intersection of high-risk behaviours, respectively. RESULTS Of 1229 participants, 372 (30.3%) used or planned to use drugs at the festival. In multivariable analyses, men and those purchasing drugs both inside and outside the venue had greater odds of engaging in higher-risk behaviours. Of those using MDMA, 47.9% reported double dropping. People using drugs for the first time had 3.3 (95% confidence interval 1.2-8.7) greater odds of higher-volume ethanol alongside drug use. People reporting that police/police dog presence influenced their decision to take drugs had 2.2 (95% confidence interval 1.4-3.6) greater odds of preloading. In UpSet analysis, preloading was the most common intersection (17% of those using drugs). DISCUSSIONS AND CONCLUSIONS Engagement in the five higher-risk drug behaviours was common, particularly amongst males and those using drugs for the first time, while police/police dog presence appeared to influence higher-risk behaviours amongst festival attendees. This information can be used to inform harm reduction advice, public health and law enforcement strategies.
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Affiliation(s)
- Amy Healey
- St Vincent's Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Krista J Siefried
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, Australia.,National Centre for Clinical Research on Emerging Drugs, UNSW Sydney, Sydney, Australia.,National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | | | - Erica Franklin
- DanceWize NSW, New South Wales Users Association, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychology, University of Tasmania, Hobart, Australia
| | - Monica J Barratt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,Social and Global Studies Centre and Digital Ethnography Research Centre, RMIT University, Melbourne, Australia
| | - Jonathan Brett
- St Vincent's Clinical School, Faculty of Medicine, UNSW Sydney, Sydney, Australia.,Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, Australia.,Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, Australia
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Pavarin RM, Bettelli S, Nostrani E, Mazzotta C, Salsano V, Ulgheri AL, Lentidoro A, Pezzi A, Bregli C. Substance consumption styles during the COVID-19 lockdown for socially integrated people who use drugs. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1923842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Raimondo Maria Pavarin
- Epidemiological Monitoring Center on Addiction, Azienda USL Bologna, Mental Health DSM-DP, Ausl Bologna, Italy
- University of Bologna, Bologna, Italy
| | - Sara Bettelli
- Epidemiological Monitoring Center on Addiction, Azienda USL Bologna, Mental Health DSM-DP, Ausl Bologna, Italy
| | - Elia Nostrani
- Epidemiological Monitoring Center on Addiction, Azienda USL Bologna, Mental Health DSM-DP, Ausl Bologna, Italy
| | | | | | - Anna Laura Ulgheri
- Epidemiological Monitoring Center on Addiction, Azienda USL Bologna, Mental Health DSM-DP, Ausl Bologna, Italy
| | | | - Annalisa Pezzi
- Azienda USL Bologna, Administrative Department, Bologna, Italy
| | - Claudia Bregli
- U.O.C. Dipendenze Patologiche AUSL Romagna, Forlì, Italy
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10
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Feltmann K, Elgán TH, Strandberg AK, Kvillemo P, Jayaram-Lindström N, Grabski M, Waldron J, Freeman T, Curran HV, Gripenberg J. Illicit Drug Use and Associated Problems in the Nightlife Scene: A Potential Setting for Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4789. [PMID: 33946164 PMCID: PMC8125188 DOI: 10.3390/ijerph18094789] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022]
Abstract
Illicit drug use is prevalent in the nightlife scene, especially at electronic dance music (EDM) events. The aim of the present study was to investigate illicit drug use patterns and consequences of drug use among frequent visitors of EDM events. Young adults (18-34 years old) who had visited at least six EDM events in Sweden during the past year participated in a web-based survey on drug use patterns and its consequences. Fifty-nine percent of participants had used illicit drugs during the past year, most often cannabis followed by ecstasy, cocaine, and amphetamine. Nightlife venues were identified as the main setting for the use of central stimulants, while cannabis was mostly used at home. Frequent alcohol and tobacco use was associated with illicit drug use. The most prevalent negative consequences of drug use were related to mental health, such as impairments in mood, sleep, and memory problems, but physical manifestations were also reported, such as palpitations and collapsing. These findings confirm that drug use is prevalent and associated with negative health effects among EDM nightlife attendees. The nightlife scene is a setting with promising potential to reach a high-risk target group with illicit drug use prevention interventions.
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Affiliation(s)
- Kristin Feltmann
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Tobias H. Elgán
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Anna K. Strandberg
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Pia Kvillemo
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Nitya Jayaram-Lindström
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
| | - Meryem Grabski
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
| | - Jon Waldron
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
| | - Tom Freeman
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath BA2 7AY, UK
| | - Helen Valerie Curran
- Clinical Psychopharmacology Unit, University College London, 1-19 Torrington Place, London WC1E 7HB, UK; (M.G.); (J.W.); (T.F.); (H.V.C.)
| | - Johanna Gripenberg
- STAD, Stockholm Prevents Alcohol and Drug Problems, SE-113 64 Stockholm, Sweden; (T.H.E.); (A.K.S.); (P.K.); (J.G.)
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Norra Stationsgatan 69, SE-113 64 Stockholm, Sweden;
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Vera BDV, Carmona-Marquez J, Vidal-Giné C, Fernández-Calderón F. Harm Reduction Strategies and Drug-Related Negative Consequences in the Dance Music Scene: The Moderating Role of Polysubstance Use. Subst Use Misuse 2021; 56:777-781. [PMID: 33663340 DOI: 10.1080/10826084.2021.1892144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although simultaneous polysubstance use (SPU) is associated with greater harms than concurrent polysubstance use (CPU), no previous research has examined the effectiveness of harm reduction strategies in reducing drug-related harms in people who use drugs simultaneously and whether these strategies have a differential impact on drug-related negative consequences according to SPU patterns. Objectives: to examine the relationship between SPU patterns, harm reduction strategies and drug-related consequences experienced among people who attend dance music settings, and to examine the moderating role of SPU patterns in the relationship between harm reduction strategies and drug-related negative consequences Methods: a web-based survey was used to gather data from 649 substance-using attendees at dance music settings (mean age = 26.2, 68% male). The survey collected data on: settings of last party attended, drug use, harm reduction strategies used and drug-related negative consequences experienced during last party attended. Results: Latent class analysis identified two SPU profiles: Moderate SPU and Severe SPU. Participants in the severe SPU class experienced more drug-related negative consequences at their last party in comparison with those in the moderate SPU class. Regardless of SPU pattern, avoiding binge drinking was related to fewer drug-related negative consequences, whilst avoiding mixing stimulants was related to fewer drug-related negative consequences only among those participants in the severe simultaneous polysubstance use class. Conclusions: These findings could help to inform the design of messages and tailored interventions aimed at minimizing drug-related negative consequences among people who use multiple substances in the dance music scene.
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Affiliation(s)
- Belén Del Valle Vera
- Faculty of Psychology, National University of Córdoba, Córdoba, Argentina.,Institute of Psychological Research, IIPSI, UNC-CONICET, Córdoba, Argentina
| | - José Carmona-Marquez
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain.,Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Claudio Vidal-Giné
- Non-Governmental Organization Welfare and Development, Energy Control, Antequera, Spain
| | - Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain.,Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
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van Amsterdam J, Pennings E, van den Brink W. Fatal and non-fatal health incidents related to recreational ecstasy use. J Psychopharmacol 2020; 34:591-599. [PMID: 31909673 PMCID: PMC7249611 DOI: 10.1177/0269881119897559] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The recreational drug ecstasy (3,4-methylenedioxymethamphetamine) is currently used world-wide. Severe (including fatal) health incidents related to ecstasy have been reported but a risk assessment of acute non-fatal and fatal ecstasy-related health incidents has never been performed. METHODS In the current risk assessment review, national data of non-fatal health incidents collected in the Netherlands were combined with the nationwide exposure to ecstasy, that is, last-year prevalence of ecstasy use. In addition, the annual number of ecstasy-related deaths in Great Britain (Scotland, Wales and England) was used to assess the risk of fatal ecstasy-related cases. RESULTS In the Netherlands, the estimated risk of a moderate to severe acute health incident following the use of ecstasy is one in 900 pills (0.11%), whereas for cocaine it is one in 1600 doses (0.06%) and for gamma-hydroxybutyrate one in 95 doses (1.05%). With respect to ecstasy-related deaths in Great Britain, the estimated risk of ecstasy alone per user is 0.01-0.06%, which is close to the range of the fatality risk in chronic alcohol users (0.01-0.02%), amphetamine users (0.005%) and cocaine users (0.05%), but much lower than that of opiate use (heroin and morphine: 0.35%). CONCLUSION The current review shows that almost no data are available on the health risks of ecstasy use. The few data that are available show that ecstasy is not a safe substance. However, compared to opiates (heroin, morphine), the risk of acute ecstasy-related adverse health incidents per ecstasy user and per ecstasy use session is relatively low.
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Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Amsterdam
University Medical Center, Amsterdam, the Netherlands,Jan van Amsterdam, Department of Psychiatry,
Academic Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, 1070AW, the
Netherlands. Emails: ;
| | - Ed Pennings
- The Maastricht Forensic Institute,
Maastricht, the Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam
University Medical Center, Amsterdam, the Netherlands
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13
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Black E, Govindasamy L, Auld R, McArdle K, Sharpe C, Dawson A, Vazquez S, Brett J, Friend C, Shaw V, Tyner S, McDonald C, Koop D, Tall G, Welsby D, Habig K, Madeddu D, Cretikos M. Toxicological analysis of serious drug-related harm among electronic dance music festival attendees in New South Wales, Australia: A consecutive case series. Drug Alcohol Depend 2020; 213:108070. [PMID: 32554172 DOI: 10.1016/j.drugalcdep.2020.108070] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 04/13/2020] [Accepted: 04/27/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND A substantial increase in drug-related harm was observed during the 2018-2019 music festival season in New South Wales, Australia, including the deaths of five young people. As part of a rapid public health response, the New South Wales Ministry of Health referred samples from patients with suspected severe drug-related illness for forensic toxicological testing to identify the type and concentration of substances associated with the presentations. METHODS Cases were identified through a variety of active and passive surveillance systems, and selected consecutively based on indicators of clinical severity. Comprehensive toxicology testing of blood and urine samples was expedited for all cases. Demographic and clinical characteristics were collated, together with quantitative toxicology results. Results were analysed using descriptive statistics. RESULTS Forty cases from eleven different music festivals were included. The majority of cases (80.0%) were aged 25 years and under. There were five fatalities, and 62.5% of cases were admitted to intensive care units. MDMA was the most frequent substance, detected in 87.5% of cases. In 82.9% of cases with MDMA, blood concentrations were above thresholds that have been associated with toxicity. Multiple substances were detected in 60.0% of cases. Novel psychoactive substances were not detected. CONCLUSIONS Our findings strongly suggest that MDMA-related toxicity was a major factor in the severity of the clinical presentations among these cases. Other substances may have enhanced MDMA toxicity but appear unlikely to have caused severe toxicity in isolation. These findings have important implications for harm reduction strategies targeted to music festival settings.
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Affiliation(s)
- Eleanor Black
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia.
| | - Laksmi Govindasamy
- New South Wales Public Health Officer Training Program, Centre for Epidemiology and Evidence, NSW Ministry of Health, St Leonards 2065, NSW, Australia
| | - Robin Auld
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Kylie McArdle
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, 2145, NSW, Australia
| | - Caroline Sharpe
- Office of the Chief Health Officer, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Andrew Dawson
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, 2145, NSW, Australia
| | - Santiago Vazquez
- Forensic and Analytical Science Service, New South Wales Health Pathology, Lidcombe 2141, NSW, Australia
| | - Jonathan Brett
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, 2145, NSW, Australia
| | - Caren Friend
- Western Sydney Local Health District, New South Wales Health, Sydney NSW, Australia
| | - Vanessa Shaw
- Forensic and Analytical Science Service, New South Wales Health Pathology, Lidcombe 2141, NSW, Australia
| | - Sophie Tyner
- Office of the Chief Health Officer, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Catherine McDonald
- Forensic and Analytical Science Service, New South Wales Health Pathology, Lidcombe 2141, NSW, Australia
| | - David Koop
- New South Wales Health Emergency Management Unit, NSW Ambulance, Rozelle 2039, NSW, Australia
| | - Gary Tall
- Aeromedical and Medical Retrieval Services, NSW Ambulance, 2039, Rozelle NSW, Australia
| | - Deb Welsby
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Karel Habig
- Aeromedical and Medical Retrieval Services, NSW Ambulance, 2039, Rozelle NSW, Australia
| | - Daniel Madeddu
- Alcohol and Other Drugs, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Michelle Cretikos
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
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14
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Arunogiri S, Moayeri F, Crossin R, Killian JJ, Smith K, Scott D, Lubman DI. Trends in gamma-hydroxybutyrate-related harms based on ambulance attendances from 2012 to 2018 in Victoria, Australia. Addiction 2020; 115:473-479. [PMID: 31618793 DOI: 10.1111/add.14848] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/30/2019] [Accepted: 09/29/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Although the prevalence of gamma-hydroxybutyrate (GHB) use is relatively low globally, harms related to the drug appear to be increasing. Few existing studies present reliable, representative, population-level data on GHB-related harms. The aim of this study was to investigate trends in acute GHB-related harms within an ambulance database in Australia. DESIGN, SETTING AND PARTICIPANTS Cross-sectional, retrospective analysis of data on all GHB-related ambulance attendances in the state of Victoria, Australia during a 7-year period (January 2012-December 2018) MEASUREMENTS: Presentations were characterized based on patient demographics, transport to hospital, co-occurring substance use (i.e. GHB only, alcohol, methamphetamine, heroin, benzodiazepine and cannabis) and clinical presentation (e.g. symptoms of anxiety, psychosis, depression). FINDINGS There were 5866 GHB-related ambulance attendances between 2012 and 2018, with the prevalence rate increasing from 8.8 per 100 000 population in 2012 to a maximum of 21.7 per 100 000 population in 2017. Methamphetamine [odds ratio (OR) = 6.23, P < 0.001] and benzodiazepine-related (OR = 1.43, P < 0.001) co-occurrences; ages between 18-29 (OR = 6.58, P < 0.001) and 30-39 years (OR = 2.02, P < 0.001); and male gender (OR = 1.23, P < 0.001) were significant predictors of GHB-related attendances. CONCLUSIONS There has been a 147% increase in the prevalence of GHB-related ambulance attendances in Victoria, Australia between 2012 and 2019, largely attributable to a growth in the proportions of people using gamma-hydroxybutyrate alone or concurrently with methamphetamine.
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Affiliation(s)
- Shalini Arunogiri
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.,Turning Point, Eastern Health, Richmond, VIC, Australia
| | | | - Rose Crossin
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.,Turning Point, Eastern Health, Richmond, VIC, Australia
| | - Jessica J Killian
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.,Turning Point, Eastern Health, Richmond, VIC, Australia
| | - Karen Smith
- Ambulance Victoria, Doncaster, VIC, Australia.,Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, VIC, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Richmond, VIC, Australia
| | - Debbie Scott
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.,Turning Point, Eastern Health, Richmond, VIC, Australia
| | - Dan I Lubman
- Monash Addiction Research Centre and Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.,Turning Point, Eastern Health, Richmond, VIC, Australia
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15
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González Ponce BM, Díaz-Batanero C, Vera BDV, Dacosta-Sánchez D, Fernández-Calderón F. Personality traits and their association with drug use and harm reduction strategies among polysubstance users who attend music festivals. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1672818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Carmen Díaz-Batanero
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | | | | | - Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
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