Teenage toxins: recreational poisoning in the adolescent

Once was not enough: A case report of the concomitant intoxication of amlodipine (calcium channel blocker) and clonazepam (benzodiazepine)

We report a case of concurrent ingestion of Clonazepam and Amlodipine in a 25‐year‐old man, in a second attempt to take his life, which resulted in unconsciousness, hypotension, and hypokalemia. The clinical and/or biochemical presentation varied from the individual pattern when ingested. In the scarcity of consensus recommendations, supportive treatment helped.

Supportive treatment is the rule of management of concomitant ingestion of Amlodipine and Clonazepam. The clinical and/or biochemical presentation of benzodiazepine and calcium channel blocker may vary from the individual pattern.

Clonazepam: Indications, Side Effects, and Potential for Nonmedical Use

After participating in this activity, learners should be better able to:• Assess the misuse potential of clonazepam• Characterize the nonmedical use of clonazepam• Identify the health problems associated with long-term use of clonazepam ABSTRACT: Clonazepam, a benzodiazepine, is commonly used in treating various conditions, including anxiety disorders and epileptic seizures. Due to its low price and easy availability, however, it has become a commonly misused medication, both in medical and recreational contexts. In this review, we aim to highlight the behavioral and pharmacological aspects of clonazepam and its history following its approval for human use. We examine the circumstances commonly associated with the nonmedical use of clonazepam and raise points of particular concern. Clonazepam, alone or in combination with other psychoactive substances, can lead to unwanted effects on health, such as motor and cognitive impairment, sleep disorders, and aggravation of mood and anxiety disorders. Prolonged use of clonazepam may lead to physical dependence and tolerance. There is therefore a need to find safer therapeutic alternatives for treating seizures and anxiety disorders. Greater awareness of its frequent nonmedical use is also needed to achieve safer overall use of this medication.

Use of synthetic stimulants and hallucinogens in a cohort of electronic dance music festival attendees

Novel psychoactive substances (NPS), often characterized as unregulated psychoactive compounds designed to circumvent existing legislation, have become mainstream on the illicit drug market. Because of their physical and mind-altering properties, NPS may be deliberately or inadvertently ingested at electronic dance music (EDM) festivals to enhance the attendees' appreciation of the music and overall experience. Their widespread use at EDM festivals have been well documented and several adverse events and fatalities associated with NPS ingestion have been reported in the United States. The diversity and rapid turnover in the prevalence of any particular NPS at any given point of time has created several challenges for public health officials, law enforcement, and forensic science communities. Epidemiological studies are often published long after drugs have cycled through the peak of their popularity with users and the scope of testing frequently failing to detect, identify or report the most recently available drugs. The aims of the study included discovering emerging NPS, ascertaining their overall prevalence and determining patterns of use and trends within this targeted population. Over the course of two years, biological samples were collected from 396 (126 blood samples; 227 urine samples; and 384 oral fluid samples) EDM festival attendees. Additionally, survey data regarding prescription and recreational drug use within the last week were collected with follow-up questions related to what substance(s) the person had ingested, amount taken, when the substance was last taken and perceived effects. All biological samples were screened and subsequently confirmed and/or quantified, when appropriate. In response to survey questions, 72% of the participants reported using a recreational drug or medicinal substance within the last week. Users most commonly reported using marijuana and alcohol, followed by "Molly" and cocaine. Of the 396 individuals tested, approximately 75% of the population was positive in at least one biological specimen for drugs and/or alcohol. Of those positive samples, 36% were confirmed to contain one or more NPS and/or 3,4-methylenedioxy-methamphetamine (MDMA). High rates of turnover and spikes in popularity related to NPS are supported by samples confirming positive for alpha-PVP in 2014, however, one year later not a single case was positive for alpha-PVP, and instead increasing numbers of subjects were positive for ethylone.

Binge drinking among Brazilian students: a gradient of association with socioeconomic status in five geo-economic regions

BACKGROUND

Socioeconomic status (SES) may be directly associated with binge drinking (BD) and country inequality. The aims of this study were to describe the characteristics of BD among high school students in Brazil and the association of BD with students' socioeconomic status in the five different Brazilian macro-regions.

METHODS

A national cross sectional survey was carried out using a multistage probabilistic sample of 17,297 high school students aged 14-18 years drawn from 789 public and private schools in each of the 27 Brazilian state capitals. Self-report data about BD behaviors and SES were analyzed via weighted logistic regressions and a funnel plot.

RESULTS

Almost 32% of the students engaged in BD in the past-year. Being in the highest SES stratum doubled the risk of BD among students in all five Brazilian macro-regions. There was a gradient in the association between past-year BD and socioeconomic status: as SES increased; the chance of having recently engaged in BD also increased. In Brazilian capitals as a whole, being a boy versus being a girl (adjusted odds ratio - aOR=1.40 [95%CI 1.26; 1.58]), being older (aOR=1.47 [95%CI 1.40; 1.55]) and attending private versus public schools (aOR=1.39 [95%CI 1.18; 1.62]) were associated with greater risk for BD.

CONCLUSIONS

Contrary to what is observed in developed countries, students living in Brazilian capitals may be at an increased risk of BD when they belong to the highest socioeconomic status. There might be similar associations between high SES and BD among adolescents growing up in other emerging economies.