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Csaszar F, B Erdos M, Ellis R, Kelemen G, Javor R. Novel Psychoactive Substance Use and Psychological Trauma: A Multimethodological Analysis. Subst Use Misuse 2024:1-9. [PMID: 38907593 DOI: 10.1080/10826084.2024.2369181] [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: 06/24/2024]
Abstract
BACKGROUND Authors discuss the connections between novel psychoactive substance (NPS) use and psychological trauma. The transition from classical substances to NPS, a paradigm change, poses a challenge for the treatment systems. Objective: Research evidence suggests difficulties in emotion regulation and trauma-related NPS-use. Authors explore some demographic and psychopathological characteristics related to such findings and examine the connections between emotion regulation deficiency and the choice of substance. METHOD This study uses a methodological triangulation of a biologically identified sample to confirm NPS use, a survey method to describe users' socioeconomic characteristics, and Minnesota Multiphasic Personality Inventory (MMPI-2) subscales to study dysfunctions in emotion regulation. RESULTS Participants (77 patients) were mainly polydrug users. The transgenerational transfer of substance use was a salient feature, but material deprivation was not characteristic of the entire sample. NPS use was not connected to certain psychopathological characteristics the way classical substance use was. More than half of the respondents had elevated scores on MMPI-2 Demoralization (RCd) and Dysfunctional Negative Emotions (RC7) scales. Nearly half of them also scored high on Neuroticism/Negative Emotionality (NEGE). CONCLUSIONS Results suggest that NPS use in the context of polydrug use is connected to psychological trauma and emotion regulation deficiency, but the MMPI-2 scales to assess emotional dysfunctions are not connected to a particular type of NPS.
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Affiliation(s)
- Ferenc Csaszar
- Doctoral School of Clinical Neurosciences, Medical School, University of Pécs & Addiction Rehabilitation Department of Szigetvár Hospital, Szigetvár, Hungary
| | - Marta B Erdos
- Department of Community and Social Studies, Faculty of Humanities and Social Sciences, University of Pécs, Pécs, Hungary
- Social Innovation Evaluation Research Centre (SIERC), Faculty of Humanities and Social Sciences, University of Pécs, Pécs, Hungary
| | - Roger Ellis
- Social and Health Evaluation Unit - Identity Exploration Ltd., United Kingdom & University of Chester, Chester, UK
| | | | - Rebeka Javor
- Social Innovation Evaluation Research Centre (SIERC), Faculty of Humanities and Social Sciences, University of Pécs, Pécs, Hungary
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Thomas C, Dondaine T, Caron C, Bastien A, Chérot N, Deheul S, Gautier S, Cottencin O, Moreau-Crépeaux S, Bordet R, Carton L. Factors associated with the use of benzodiazepine and opioid prescription drug in the student population: a cross-sectional study. Sci Rep 2024; 14:13040. [PMID: 38844771 PMCID: PMC11156936 DOI: 10.1038/s41598-024-63037-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 05/23/2024] [Indexed: 06/09/2024] Open
Abstract
The misuse of benzodiazepines and opioid medications is frequent in students. To improve our understanding of this behavior, we aimed to identify factors associated with separate and concomitant use of these substances. Anonymous self-reported questionnaires were e-mailed to students enrolled at a French university between March and July 2021, covering: sociodemographic characteristics, academics, psychoactive substance use, ADHD symptomatology (adulthood and childhood), and psychiatric/psychological or addiction follow-up. Factors associated with the use of benzodiazepines and opioid medications included female sex (OR = 1.41 [1.08; 1.86]) and OR = 1.38 [1.06; 1.79], respectively), older age (OR = 1.65 [1.04; 2.6] and OR = 2.17 [1.4; 3.36], respectively), current psychiatric/psychological follow-up (OR = 6.53 [5.18; 8.24] and OR= 1.5 [1.12; 2.0], respectively), ADHD symptomatology (OR= 2.33 [1.71;3.16] and OR= 1.61 [1.15; 2.24], respectively), polyconsumption (tobacco use for benzodiazepine users, OR = 1.38 [1.04; 1.82]; alcohol use OR = 1.67 [1.17; 2.39] and tobacco use OR = 1.62 [1.23; 2.14] for opioid users). These factors were even more strongly associated with the concomitant use of benzodiazepines and opioid medications: older age (OR = 3.64 [2.22; 5.99]), female sex (OR = 1.54 [1.1; 2.14]), grade repetition (OR = 1.7 [1.14; 2.54]), psychiatric/psychological follow-up (OR = 4.51 [3.35;6.06]), ADHD symptomatology (OR = 5.3 [3.69; 7.63]), polyconsumption (tobacco use OR = 2.05 [1.39; 3] and cannabis use, OR = 2.07 [1.97; 4.16]. The factors associated with the use of benzodiazepines and prescription opioids identified in this study could lead to the development of targeted prevention methods.
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Affiliation(s)
- Charlotte Thomas
- Department of Psychiatry and Addiction Medicine, CHU Lille, Lille, France.
| | - Thibaut Dondaine
- University of Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
| | - Clément Caron
- Department of Psychiatry and Addiction Medicine, CHU Lille, Lille, France
| | - Axel Bastien
- Department of Psychiatry and Addiction Medicine, CHU Lille, Lille, France
| | - Nathalie Chérot
- IMPECS - IMPact de l'Environnement Chimique sur la Santé humaine, Department of Occupational Health, University of Lille, CHU Lille, Institut Pasteur de Lille, ULR 4483, 59000, Lille, France
| | - Sylvie Deheul
- CHU Lille, Pharmacology Department, Pharmacovigilance and Addictovigilance center, Lille, France
| | - Sophie Gautier
- University of Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
- CHU Lille, Pharmacology Department, Pharmacovigilance and Addictovigilance center, Lille, France
| | - Olivier Cottencin
- Lille Neuroscience & Cognition Centre (LiNC), Department of Psychiatry and Addiction Medicine, University of Lille, CHU Lille, INSERM U-1172, Plasticity & SubjectivitY (PSY) team, Lille, France
| | | | - Régis Bordet
- University of Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
- CHU Lille, Pharmacology Department, Pharmacovigilance and Addictovigilance center, Lille, France
| | - Louise Carton
- University of Lille, Inserm, CHU Lille, Lille Neuroscience and Cognition, Degenerative and Vascular Cognitive Disorders, UMR-S1172, Lille, France
- CHU Lille, Pharmacology Department, Pharmacovigilance and Addictovigilance center, Lille, France
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Ellilä V, Levola J, Denissoff A, Partanen M, Niemelä S. Psychotic-Like Experiences and Concurrent Substance Use Among People Who Use New Psychoactive Substances. Subst Use Misuse 2023; 58:1606-1614. [PMID: 37482647 DOI: 10.1080/10826084.2023.2236212] [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: 07/25/2023]
Abstract
New psychoactive substances (NPS) are a group of substances that mimic established drugs, e.g., cannabinoids, stimulants, and opioids. NPS use has been associated with psychotic-like experiences, but current research is limited. This study focused on NPS use and psychotic-like experiences in persons attending substance use services in South-West Finland. The primary aim was to evaluate if NPS use associates with psychotic-like experiences, and if the association is independent of comorbid psychotic illness. As a secondary aim, this study evaluated concurrent substance use among people who use NPS. The study was based on a voluntary and anonymous survey administered on-site for people attending substance use services. The survey was conducted in 17 substance use service centers in South-West Finland in 2019, totaling 219 respondents. Information on substance use, service use due to psychotic episodes, and comorbid psychotic illness was collected. A validated PROD questionnaire was used for information on psychotic-like experiences. In all, 17% of 219 participants (n = 38) reported NPS use. After adjustments with comorbid psychotic illness, age, and gender, NPS use associated with PROD-screen positivity, i.e., reporting at least three psychotic-like symptoms. NPS use also associated with service use due to substance-induced psychotic episodes, and extensive use of several substances. In this study, NPS use associated with psychotic-like experiences independently of comorbid psychotic illness. However, as NPS use is also associated with heavy use of several substances, this study implicates concurrent substance use as a confounding factor when studying NPS use, which should be considered in future research.
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Affiliation(s)
- Venla Ellilä
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland
| | - Jonna Levola
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
- HUS Brain Centre, Psychiatry, Hospital District of Helsinki and Uusimaa and Helsinki University Hospital, Helsinki, Finland
| | - Alexander Denissoff
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland
- Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
| | | | - Solja Niemelä
- Department of Psychiatry, Faculty of Medicine, University of Turku, Turku, Finland
- Addiction Psychiatry Unit, Department of Psychiatry, Turku University Hospital, Turku, Finland
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4
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Holborn T, Schifano F, Deluca P. No prescription? No problem: A qualitative study investigating self-medication with novel psychoactive substances (NPS). THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 118:104109. [PMID: 37422986 DOI: 10.1016/j.drugpo.2023.104109] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND The proliferation of Novel Psychoactive Substances (NPS) presents a challenge for global drug policy. The ease of online drug purchase and the emergence of the dark web have created new avenues for the growth of NPS. Despite the global nature of this issue, limited research has examined motivations of use. These include perceived safety or convenience, an interest in novel pharmacology and self-exploration. Recent evidence has suggested individuals may be self-medicating with NPS, however this phenomenon has yet to be thoroughly explored. This study aims to investigate the occurrence of NPS self-medication, identify the specific NPS involved, and understand the motivations behind their use. METHODS Discussions surrounding self-medication using NPS were collected between October 2022 and February 2023 via a content analysis of a Reddit community. Ninety-three threads, comprising 182,490 words and 5023 comments, were collected and cleaned. A frequency analysis was conducted to identify the NPS discussed, and data was analysed systematically through the process of iterative categorization (IC). RESULTS Our study revealed frequent discussions about the self-medication with several NPS, notably etizolam, clonazolam, diclazepam, flualprazolam, 2-FMA, 4F-MPH, 3-FPM and 3-MeO-PCP. Individuals were mainly self-treating ADHD, anxiety and depression. Motivations for choosing NPS included access, cost, legality and a dissatisfaction with conventional healthcare. Substances were often chosen based on a profile of "Functionality" and outcomes varied. The use of clonazolam was highlighted as particularly problematic. CONCLUSION The current study provides insight into the phenomenon of self-medication with NPS within an internet demographic, exploring the motivations behind why individuals choose NPS for a variety of disorders. The easy access to NPS and lack of scientific data pose a significant challenge for drug policy. Future policies should focus on improving healthcare providers knowledge of NPS use, removing barriers to adult ADHD diagnosis and rebuilding trust between individuals and addiction services.
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Affiliation(s)
- Tayler Holborn
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
| | - Paolo Deluca
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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Su YJ, Chen TH, Liao WH, Chang KS, Lai YC. Clinical characteristics in new psychoactive substance users: A single center study. Medicine (Baltimore) 2023; 102:e34084. [PMID: 37352073 PMCID: PMC10289540 DOI: 10.1097/md.0000000000034084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/25/2023] Open
Abstract
New psychoactive substances (NPS) are emerging illegal substances or synthetic drugs that pose public health threats worldwide. This study was aimed at reporting the clinical characteristics of NPS and classical illicit substances used by patients who presented to the emergency room. We conducted a retrospective cohort study on patients with suspected illicit substance use who visited the emergency department (ED) with the suspicion of illicit substance use. We divided the patients into 4 groups based on the NPS testing results: NPS positive, NPS negative, NPS combined with classical illicit drugs (INPS), and subjects with negative testing results. The majority of patients in all groups were male. The NPS users were significantly younger than those with negative results on toxic testing (26.4 vs 37.5, P = .005 < 0.05). The heart rate of NPS users was significantly faster than that of the group with negative results of toxic testing (111.1 vs 93.5 beats per minute, P = .046). The heartbeats of INPS group were also significantly faster than those with a negative result in toxicology screen (119.6 vs 93.5 beats per minute, P = .024). Those who used classical illicit drugs combined with NPS had significantly higher palpitation than those with negative results of toxic testing (27.3% vs 3.1%, P = .017). Patients who were highly suspicious of NPS use were younger, had tachycardia, felt palpitations, and had fair oxygen saturation compared to patients who were negative for urine toxicity screening.
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Affiliation(s)
- Yu-Jang Su
- Toxicology Division, Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, HsinChu, Taiwan
| | - Tse-Hao Chen
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wei-Hsiang Liao
- Department of Emergency Medicine, TAMSUI BRANCH, Mackay Memorial Hospital, Taipei, Taiwan
| | - Kuo-Song Chang
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, Taipei City, Taiwan
- Department of Disaster Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Yen-Chun Lai
- Department of Anesthesiology. Taipei Medical University Hospital, Taipei, Taiwan
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6
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Kassew T, Tilahun SY, Alemayehu BF, Getnet B, Demilew D, Tarekegn GE, Alemu K, Yesuf YM, Oumer M, Mehari EA, Melkam M, Nenko G. Psychotic symptoms and its associated factors relating to psychoactive substance use among the youth population in Northwest Ethiopia. Front Psychiatry 2023; 14:1045111. [PMID: 37215660 PMCID: PMC10196362 DOI: 10.3389/fpsyt.2023.1045111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 04/11/2023] [Indexed: 05/24/2023] Open
Abstract
Background Substance use is associated with high rates of psychiatric symptoms including psychotic symptoms. Despite the severity of the problem, there are intervention gaps in Ethiopia. To combat this, relevant evidence is required to raise the awareness of service providers. This study aimed to assess the prevalence of psychotic symptoms and its associated factors among the youth population who uses psychoactive substances in the Central Gondar Zone, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted among the youth population in the Central Gondar zone, Northwest Ethiopia, from 01 January to 30 March 2021. A multistage sampling technique was used to recruit the study participants. All data were collected using questionnaires assessing socio-demographic; family-related variables; Depression, Anxiety, and Stress Scale; Multidimensional Scale Perceived Social Support (MSPSS), and Self-Reporting Questionnaire (SRQ-24). The data were analyzed using the STATA 14 statistical program. Results A total of 372 young people who used psychoactive substances (79.57%, 53.49%, 34.14%, and 16.13% were consuming alcohol, Khat, tobacco/cigarette products, and other substances such as shisha, inhalants, and drugs, respectively) were included in the study. The prevalence of psychotic symptoms was 24.2% with a 95% CI: 20.1, 28.8. Being married [AOR = 1.87 95% CI: 1.06, 3.48], recent loss of loved ones [AOR = 1.97 95% CI: 1.10, 3.18], low perceived social support [AOR = 1.61 95% CI: 1.11, 3.02], and severe psychological distress [AOR = 3.23 95% CI; 1.64, 6.54] were the factors associated with psychotic symptoms among young people with psychoactive substances use at a p-value of < 0.05. Conclusion Psychotic symptoms related to psychoactive substances among the youth population in Northwest Ethiopia were high. Thus, it is better to give a special attention to the youth population with low social support and existing psychological distress concurrent with psychoactive substance use.
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Affiliation(s)
- Tilahun Kassew
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sewbesew Yitayih Tilahun
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Biruk Fanta Alemayehu
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhanie Getnet
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Demeke Demilew
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gebrekidan Ewnetu Tarekegn
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yassin Mohammed Yesuf
- Department of Psychology, College of Social Science and Humanities, University of Gondar, Gondar, Ethiopia
| | - Mohammed Oumer
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eden Abetu Mehari
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health, Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Goshu Nenko
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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New Psychoactive Substances: Major Groups, Laboratory Testing Challenges, Public Health Concerns, and Community-Based Solutions. J CHEM-NY 2023. [DOI: 10.1155/2023/5852315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Across communities worldwide, various new psychoactive substances (NPSs) continue to emerge, which worsens the challenges to global mental health, drug rules, and public health risks, as well as combats their usage. Specifically, the vast number of NPSs that are currently available, coupled with the rate at which new ones emerge worldwide, increasingly challenges both forensic and clinical testing strategies. The well-established NPS detection techniques include immunoassays, colorimetric tests, mass spectrometric techniques, chromatographic techniques, and hyphenated types. Nonetheless, mitigating drug abuse and NPS usage is achievable through extensive community-based initiatives, with increased focus on harm reduction. Clinically validated and reliable testing of NPS from human samples, along with community-driven solution, such as harm reduction, will be of great importance, especially in combating their prevalence and the use of other illicit synthetic substances. There is a need for continued literature synthesis to reiterate the importance of NPS, given the continuous emergence of illicit substances in the recent years. All these are discussed in this overview, as we performed another look into NPS, from differentiating the major groups and identifying with laboratory testing challenges to community-based initiatives.
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Mirijello A, Sestito L, Antonelli M, Gasbarrini A, Addolorato G. Identification and management of acute alcohol intoxication. Eur J Intern Med 2023; 108:1-8. [PMID: 35985955 DOI: 10.1016/j.ejim.2022.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/03/2022] [Accepted: 08/11/2022] [Indexed: 02/07/2023]
Abstract
Acute alcohol intoxication (AAI) is a harmful clinical condition, potentially life-threatening, secondary to the intake of large amounts of alcohol. Clinical manifestations of AAI are characterized by behavioural and neurological symptoms, even if its effects involve several organs and apparatus. Moreover, severe alcohol intoxication can produce a global neurological impairment leading to autonomic dysfunction, respiratory depression, coma and cardiac arrest. The evaluation of blood alcohol concentrations (BAC) is useful to confirm the suspicion of intoxication, both for clinical and legal reasons. Most of patients with AAI are referred to Emergency Departments due to behavioural, social, traumatic or clinical complications. Patient's stabilization is the first step in the management of AAI, in order to support vital functions and to prevent complications. Metadoxine represents a useful drug to increase ethanol metabolism and elimination. Given that AAI could represent a sentinel event of chronic alcohol abuse, patients presenting with acute intoxication should be screened for the presence of an underlying alcohol use disorder and referred to and an alcohol addiction unit to start a multidisciplinary treatment to achieve long term alcohol abstinence. The present review will focus on clinical features, diagnostic criteria and treatment strategies of AAI.
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Affiliation(s)
- Antonio Mirijello
- Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Luisa Sestito
- Department of Medical Sciences, Hepatology and Gastroenterology Unit, Catholic University of Rome, Italy
| | - Mariangela Antonelli
- Department of Medical Sciences, Hepatology and Gastroenterology Unit, Catholic University of Rome, Italy
| | - Antonio Gasbarrini
- Department of Medical Sciences, Hepatology and Gastroenterology Unit, Catholic University of Rome, Italy
| | - Giovanni Addolorato
- Department of Medical Sciences, Hepatology and Gastroenterology Unit, Catholic University of Rome, Italy.
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Kim M, Kim H, Han K, Yoo J, Yang K, Jeon HJ. Changes in alcohol consumption and the risk of cardiovascular diseases in patients with depression who had not consumed alcohol: A nationwide cohort study. J Psychiatr Res 2022; 155:458-464. [PMID: 36183599 DOI: 10.1016/j.jpsychires.2022.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/01/2022] [Accepted: 09/16/2022] [Indexed: 11/30/2022]
Abstract
Although numerous studies have examined the association between alcohol consumption and cardiovascular diseases (CVDs) in the general population, such association in patients with depression has not been reported yet. Thus, the objective of this study was to examine the association between changes in alcohol consumption and CVDs in patients with depression who had not consumed alcohol. A national database of medical records in South Korea was used and 375,710 subjects newly diagnosed with depression who had not consumed alcohol within two years after the diagnosis of depression (1st point) were identified. Subjects were categorized into three groups (non-drinkers, mild-to-moderate drinkers, and heavy drinkers) based on the status of alcohol intake within two years after the 1st point (2nd point). Subjects were followed up for the occurrence of CVDs including myocardial infarction (MI), ischemic stroke, and all-cause mortality. Among eligible subjects, 329,802 non-drinkers, 43,659 mild-to-moderate drinkers, and 2,249 heavy drinkers were identified. Compared to non-drinkers, heavy drinkers showed increased risks for MI (aHR, 1.41; 95% CI, 1.08-1.83), ischemic stroke (aHR, 1.49; 95% CI, 1.12-1.99), composite CVDs (aHR, 1.48; 95% CI, 1.21-1.80), and all-cause mortality (aHR, 1.38; 95% CI, 1.13-1.68). Compared to those who maintained abstinence from alcohol, those who started heavy drinking after the diagnosis of depression had increased risks of CVDs and all-cause mortality. These data highlight the need for alcohol consumption limitations for people who are diagnosed with depression in clinical settings.
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Affiliation(s)
- Minsoo Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyewon Kim
- Department of Psychiatry, Hanyang University Hospital, Seoul, South Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea
| | - Juhwan Yoo
- Department of Biomedicine & Health Science, The Catholic University of Korea, Seoul, South Korea
| | - Kyojin Yang
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea; Department of Health Sciences & Technology, Department of Medical Device Management & Research, Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
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10
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Engelgardt P, Krzyżanowski M, Piotrowski P, Borkowska-Sztachańska M, Wasilewska A. Analytically confirmed presence of psychoactive substances, especially new psychoactive substances in a group of patients hospitalized with mental and behavioural disorders due to the use of psychoactive substances diagnosis. Int J Occup Med Environ Health 2022; 35:485-495. [PMID: 35543545 PMCID: PMC10464757 DOI: 10.13075/ijomeh.1896.01863] [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: 04/28/2021] [Accepted: 02/02/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES The study assessed the presence of new psychoactive substances (NPS) in comparison to "classic" drugs in the group of newly admitted patients with mental and behavioral disorders due to the use of psychoactive substances diagnosis (section F11-19 according to ICD-10). MATERIAL AND METHODS Data from anamnesis and the blood and urine samples were collected from 116 patients diagnosed with mental and behavioral disorders due to psychoactive substance use. All of them expressed written informed consent. Analytical confirmation was obtained by highperformance liquid chromatography coupled to tandem mass spectrometry (LC/MS/MS). Liquid-liquid extraction was used for sample preparation. RESULTS In the sample, 108 (93%) of 116 were positive for psychoactive substances (including 96 cases where >1 substance was found), 69% of individuals were tested positive for opioids and 67% for benzodiazepines. Eleven (9%) of 116 patient samples were positive for NPS. We detected 7 different substances. Six of them were synthetic cannabinoids: PB-22, MDMB-CHMICA, MMB-CHMICA, AB-CHMINACA, MMB-FUBINACA, THJ-2201 and one synthetic cathinone 3-CMC. CONCLUSIONS The prevalence and NPS profile (the predominance of synthetic cannabinoids) are similar in the group of people with addiction to psychoactive substances as in populations of people taking recreational drugs and the overdose patients admitted to the hospital. Int J Occup Med Environ Health. 2022;35(4):485-95.
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Affiliation(s)
- Piotr Engelgardt
- University of Warmia and Mazury, Faculty of Medicine, Department of Pathomorphology and Forensic Medicine, Olsztyn, Poland
| | - Maciej Krzyżanowski
- University of Warmia and Mazury, Faculty of Medicine, Department of Pathomorphology and Forensic Medicine, Olsztyn, Poland
| | - Przemysław Piotrowski
- University of Warmia and Mazury, Faculty of Medicine, Department of Pathomorphology and Forensic Medicine, Olsztyn, Poland
| | | | - Agnieszka Wasilewska
- University of Warmia and Mazury, Faculty of Medicine, Department of Psychiatry, Olsztyn, Poland
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Dal Farra D, Valdesalici A, Zecchinato G, De Sandre A, Saccon D, Simonato P, Corazza O, Martinotti G, Smith AL, Solmi M. Knowledge and Use of Novel Psychoactive Substances in an Italian Sample with Substance Use Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:915. [PMID: 35055743 PMCID: PMC8776073 DOI: 10.3390/ijerph19020915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/30/2021] [Accepted: 01/10/2022] [Indexed: 01/27/2023]
Abstract
This study aims to determine prevalence and frequency of use of novel psychoactive substances (NPS) and to identify the factors associated with NPS use in an Italian sample of patients diagnosed with substance use disorder (SUD). Prevalence and correlates of NPS knowledge and use were assessed in 185 patients with SUD in three addiction services (Padova, Belluno, Feltre) in the Veneto region with an ad-hoc designed survey. Two thirds of the samples reported knowing NPS and one third reported using them. NPS were considered by them less dangerous than "regular" substances of abuse (t = 6.06 mean 0.78, p < 0.001). Factors associated with NPS use were youth (OR = 4.81; p < 0.001), studentship (OR = 4.99; p = 0.004), subsequent mental disorders diagnosis (OR = 2.49; p = 0.027), suicide attempt history (OR = 11.67; p < 0.001), home detention (OR = 2.30; p = 0.040), residential care (OR = 5.66; p = 0.002), and polysubstance abuse (t = 8.99 mean 2.65 p < 0.001). NPS use in patients with SUD is highly prevalent, particularly in the youngest age group, and associated with psychiatric comorbidity and worse prognosis. It is crucial to systematically assess NPS use and inform addiction service users with SUD of the toxic and potentially lethal side effects. Mental healthcare professionals working in addiction services should receive education and training. Cohort and longitudinal studies are needed.
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Affiliation(s)
- Deborah Dal Farra
- Department of General Psychology, University of Padua, 35122 Padova, Italy; (D.D.F.); (A.V.)
| | - Alice Valdesalici
- Department of General Psychology, University of Padua, 35122 Padova, Italy; (D.D.F.); (A.V.)
| | | | - Alfio De Sandre
- Addiction Department, AULSS 1 Dolomiti, 32021 Agordo, Italy;
| | - Diego Saccon
- Addiction Department, AULSS 4 Veneto Orientale, 30027 San Donà di Piave, Italy;
| | | | - Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK; (O.C.); (G.M.)
| | - Giovanni Martinotti
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK; (O.C.); (G.M.)
- Department of Neuroscience, Imaging, Clinical Sciences, University “G.d’Annunzio”, 66100 Chieti-Pescara, Italy
| | - Andrew L. Smith
- Department of Psychiatry, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, ON K1N 6N5, Canada
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12
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Haslacher D, Novkovic N, Buthut M, Heinz A, Soekadar SR. Pathological Delta Oscillations in Hallucinogen Persisting Perception Disorder: A Case Report. Front Psychiatry 2022; 13:867314. [PMID: 35401281 PMCID: PMC8987195 DOI: 10.3389/fpsyt.2022.867314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hallucinogen persisting perception disorder (HPPD) is characterized by spontaneous recurrence of visual hallucinations or disturbances after previous consumption of hallucinogens, such as lysergic acid diethylamide (LSD). The underlying physiological mechanisms are unknown and there is no standardized treatment strategy available. CASE PRESENTATION A 33-year-old male patient presented with persistent visual distortions (halos around objects, intensified colors, positive after images, and trails following moving objects) that developed after repeated use of hallucinogenic drugs at the age of 18. Symptoms developed gradually and worsened several months later, resulting in various pharmacological and psychosocial treatment attempts that remained unsuccessful, however. At presentation, 32-channel electroencephalography (EEG) showed increased delta activity over the occipital brain regions, reminiscent of occipital intermittent rhythmic delta activity (OIRDA) usually seen in children. Two sessions of cathodal (inhibitory) transcranial direct current stimulation (tDCS) over 30 min attenuated visual hallucinations and occipital delta activity by approximately 60%. The response persisted for over four weeks. CONCLUSION Pathological delta activity over occipital brain regions may play an important role in the development and perpetuation of HPPD and can be attenuated by non-invasive brain stimulation.
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Affiliation(s)
- David Haslacher
- Department of Psychiatry and Neurosciences, Clinical Neurotechnology Lab, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nikolina Novkovic
- Department of Psychiatry and Neurosciences, Clinical Neurotechnology Lab, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Maria Buthut
- Department of Psychiatry and Neurosciences, Clinical Neurotechnology Lab, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Andreas Heinz
- Department of Psychiatry and Neurosciences, Clinical Neurotechnology Lab, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Surjo R Soekadar
- Department of Psychiatry and Neurosciences, Clinical Neurotechnology Lab, Neuroscience Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
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13
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Albert N, Catthoor K, Morrens M. Akathisia after chronic usage of synthetic cathinones: A case study. Front Psychiatry 2022; 13:1046486. [PMID: 36620653 PMCID: PMC9816890 DOI: 10.3389/fpsyt.2022.1046486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/07/2022] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Synthetic cathinones are a heterogenous group of new psychoactive substances (NPS) with a surging prevalence of use. They are sold under the name of "Bath Salts," "Legal Highs" or "Research Chemical." It is a heterogeneous group of substances that have a varying binding selectivity and affinity. Due to limited availability of NPS screening tests, inadequate legislation, the exponential increases in availability of new NPS and the comorbid use of other illicit substances, scientific research remains scarce. As a result, insight in their mental and psychomotor effects is limited. CASE DESCRIPTION We present a case of a 21-year-old woman with daily usage of synthetic cathinones, more specifically α-Pyrrolidinopentiophenone (α-PVP-better known as "Flakka"), α-Pyrrolidinohexiophenone (α-PHP) and alpha-Pyrrolidinoisohexaphenone (α-PHiP). Besides a severe paranoid psychotic state of mind, characterized by persecutory and somatic delusions, there was also a very pronounced psychomotor restlessness during the whole period of hospitalization which was diagnosed as akathisia. She reported that she was unable to sit during meals, had difficulty standing still and felt a constant urge to pay attention to the restlessness. The patient did not take any antipsychotic medication at admission. RESULTS The patient was treated in accordance with the current guidelines concerning akathisia with a combination of Quetiapine 200 mg, Propranolol 80 mg, Diazepam 10 mg, Biperiden 4 mg, and Mirtazapine 15 mg without any sufficient alleviation of complaints. Before the start of the treatment, Barnes Akathisia Rating Scale (BARS) score was 11 out of 14 which evolved toward a score of 7 over the course of the 40 day hospitalization, implying persisting severe akathisia which only improved modestly. CONCLUSION The current case suggests that besides cocaine, amphetamines and methamphetamines, synthetic cathinones can also increase the risk for development of extrapyramidal symptoms such as akathisia. Especially a-PVP-analogs as used by the current patient and Pyrovalerone-analogs such as Methylenedioxypyrovalerone (MDPV) are very powerful dopamine reuptake-inhibitors which might lead to strong locomotor activation. Up to this day it remains very difficult to establish a guideline concerning the treatment of intoxication with synthetic cathinones or dependence thereof.
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Affiliation(s)
- Niels Albert
- Hospital Network Antwerp (ZNA), Antwerp, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Kirsten Catthoor
- Hospital Network Antwerp (ZNA), Antwerp, Belgium.,Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Manuel Morrens
- Faculty of Medicine and Health Sciences, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium.,Scientific Initiative Neuropsychiatric and Psychopharmacological Studies (SINAPS), University Psychiatric Centre (UPC) Duffel, Duffel, Belgium
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14
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Corbo M, Martinotti G, Aguglia A, Salvi V, Amerio A, Calò S, Fusar-Poli L, Serafini G, Signorelli M, Amore M, Mencacci C, Di Sciascio G, Biggio G, Aguglia E, Di Giannantonio M. Long-acting second-generation and oral antipsychotics for substance use disorders and psychotic symptoms: Prescribing attitudes among Italian psychiatrists. Perspect Psychiatr Care 2021; 57:1700-1706. [PMID: 33616260 DOI: 10.1111/ppc.12738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To explore Italian psychiatrists' attitudes toward the off-label use of second generation antipsychotics (SGAs) in patients with substance use disorder and psychotic symptoms. DESIGN AND METHODS A sample of 300 Italian psychiatrists associated with the Italian Society of Neuropsychopharmacology was randomly selected to complete a survey about the off-label prescription of SGAs. FINDINGS Oral aripiprazole (32.7%), olanzapine (30.2%), and quetiapine (25.2%) were considered "appropriate." Long-acting antipsychoticss were generally considered "inappropriate." PRACTICE IMPLICATIONS Our findings reflect a substantial level of uncertainty and a lack of coherent clinical guidance within the realm of dual diagnosis treatment. Therefore, they emphasize the need to develop specific guidelines to improve the management of pharmacotherapy among this population.
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Affiliation(s)
- Mariangela Corbo
- Department of Neuroscience Imaging and Clinical Science, "G. d'Annunzio" University of Chieti, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience Imaging and Clinical Science, "G. d'Annunzio" University of Chieti, Chieti, Italy.,Department of Pharmacy, Pharmacology and Clinical Science, University of Hertfordshire, Herts, UK
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Virginio Salvi
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,Mood Disorders Program, Tufts Medical Center, Boston, Massachusetts, USA
| | - Salvatore Calò
- Department of Mental Health, Local Health Agency, Lecce, Italy
| | - Laura Fusar-Poli
- Department of Clinical and Experimental Medicine, Psychiatric Clinic University Hospital "Gaspare Rodolico", University of Catania, Catania, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maria Signorelli
- Department of Clinical and Experimental Medicine, Psychiatric Clinic University Hospital "Gaspare Rodolico", University of Catania, Catania, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli Sacco, Milan, Italy
| | | | - Giovanni Biggio
- Department of Life and Environmental Sciences, Institute of Neuroscience, CNR, University of Cagliari, Cagliari, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, Psychiatric Clinic University Hospital "Gaspare Rodolico", University of Catania, Catania, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience Imaging and Clinical Science, "G. d'Annunzio" University of Chieti, Chieti, Italy
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15
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Miuli A, Stigliano G, Lalli A, Coladonato M, D’Angelo L, Esposito F, Cappello C, Pettorruso M, Martinotti G, Schifano F, Di Giannantonio M. “Purple Drank” (Codeine and Promethazine Cough Syrup): A Systematic Review of a Social Phenomenon with Medical Implications. J Psychoactive Drugs 2020; 52:453-462. [DOI: 10.1080/02791072.2020.1797250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- A. Miuli
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - G. Stigliano
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - A. Lalli
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - M. Coladonato
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - L. D’Angelo
- Department of Business Administration, “G. d’Annunzio” University, Chieti, Italy
| | - F. Esposito
- Department of Legal and Social Science, “G. d’Annunzio” University, Chieti, Italy
| | - C. Cappello
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - M. Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - G. Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
- Department of Pharmacy, Pharmacology, Clinical Science, University of Hertfordshire, Herts, UK
| | - F Schifano
- Department of Pharmacy, Pharmacology, Clinical Science, University of Hertfordshire, Herts, UK
| | - M. Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, Chieti, Italy
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16
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Exploring the Baseline Knowledge and Experience of Healthcare Professionals in the United Kingdom on Novel Psychoactive Substances. Brain Sci 2020; 10:brainsci10030142. [PMID: 32131479 PMCID: PMC7139605 DOI: 10.3390/brainsci10030142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/16/2020] [Accepted: 02/26/2020] [Indexed: 12/30/2022] Open
Abstract
Objective: This survey aimed to explore knowledge and experience on novel psychoactive substances (NPS) of healthcare professionals (HCPs). The study also aimed to assess how HCPs would like to improve their knowledge of NPS. Methods: Seventy paper questionnaires were disseminated in 2017 within continuing education events to pharmacists, nurses and general practitioners (GPs). Additionally, 127 online surveys were completed using the Qualtrics platform by other HCPs and mental health nurses in six United Kingdom (UK) independent mental health hospitals long-stay in-patient rehabilitation services. Two educational sessions involving pharmacists and GPs were also held in late 2017 and mid-2018. Knowledge of NPS by HCPs was evaluated prior to the start of the educational events. Evaluation forms were handed out post-sessions to garner feedback, especially on areas for improvement for future sessions. Statistical analysis of data was undertaken using SPSS (V.25). Results: Most HCPs reported only ‘basic’ to ‘intermediate’ NPS knowledge. Substance misuse service staff felt more informed, were more often consulted and had greater confidence regarding NPS compared to hospital and primary care professionals. A negative association was found between the age of the HCP and knowledge of NPS. Most participants expressed a need for regular training and updates as insufficient NPS-related information is currently received. Conclusions: An improvement within the self-reported knowledge of HCPs on NPS is evident in comparison to previous studies. Continued education of HCPs on NPS is fundamental for the provision of improved harm reduction services, which can enhance overall care for NPS service users.
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17
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Hussien R, Ahmed S, Awad H, El-Setouhy M, El-Shinawi M, Hirshon JM. Identification of 'Voodoo': an emerging substance of abuse in Egypt. INTERNATIONAL JOURNAL OF ENVIRONMENTAL ANALYTICAL CHEMISTRY 2020; 102:104-116. [PMID: 35002018 PMCID: PMC8734563 DOI: 10.1080/03067319.2020.1715384] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/27/2019] [Indexed: 06/14/2023]
Abstract
BACKGROUND 'Voodoo' is a new substance of abuse that recently spread among youth in Egypt. It has numerous potentially dangerous effects on humans. However, to date the composition of the main constituents of this compound is unknown. PURPOSE We sought to identify the active components of this unknown substance"voodoo". METHODS Three samples were collected and analysed by high-performance liquid chromatography with photodiode array detector (HPLC-PAD), gas chromatography/mass spectrometry (GC/MS), and ultra-performance liquid chromatography/mass spectrometry (UPLC-MS/MS) using targeted multiple reaction monitoring (MRM). RESULTS HPLC-PAD analysis showed that samples 1 and 2 had some common major peaks, the same retention time, and similar spectra, whereas sample 3 showed different peaks. GC/MS analysis revealed the presence of various putatively identified bioactive compounds, including quinazolines, morphinan alkaloid, cannabinoids, penitrem A, and the well-known synthetic cannabinoid FUB-AMB (methyl(2S)-2-{[1-[(4-fluorophenyl)methyl]indazole-3-carbonyl]amino}-3 methylbutanoate). UPLC-MS/MS analysis revealed the presence of common compounds such as tetrahydrocannabinol (THC), amphetamine, 3,4-methylenedioxyamphetamine, tramadol, and oxazepam. CONCLUSION We concluded that Voodoo is a mixture of substances of abuse at varying concentrations.
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Affiliation(s)
- Rania Hussien
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Sarah Ahmed
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hanem Awad
- Regulatory Toxicology Lab, Centre of Excellence, National Research Centre, Cairo, Egypt
| | - Maged El-Setouhy
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed El-Shinawi
- Department of Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Jon Mark Hirshon
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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18
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Corazza O, Coloccini S, Marrinan S, Vigar M, Watkins C, Zene C, Negri A, Aresti A, Darke S, Rinaldi R, Metastasio A, Bersani G. Novel Psychoactive Substances in Custodial Settings: A Mixed Method Investigation on the Experiences of People in Prison and Professionals Working With Them. Front Psychiatry 2020; 11:460. [PMID: 32528329 PMCID: PMC7264108 DOI: 10.3389/fpsyt.2020.00460] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/06/2020] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Novel Psychoactive Substances (NPS), especially Synthetic Cannabinoid Receptor Agonists (SCRAs), pose a substantial challenge to health and the security of the prison environment. This study analyses the phenomenon from the perspective of people in prison and that of professionals working with them. METHODS A phenomenological qualitative approach was used to analyze self-reported experiences with 'Spice' (NPS) among users in prison. A semi-structured questionnaire was also disseminated among professionals working in these settings to better understand (a) the impact of NPS on their work; (b) perceived issues on safety in their working environment; (c) approaches used to tackle the phenomenon and best practices. RESULTS Psychotic events resulting from the collected Spice accounts (5) were marked by hallucinations, depression, self-harm, and suicidal ideations. Other emerging elements included fear, paranoia, inability to be with others, mistrust, breakdown and other risky behaviors. Overall, 186 responses from prison staff were collected across the country. 67% claimed NPS to have had a deep impact on their work as they commonly witnessed espisodes involving outbursts of anger, slurred speech, hallucinations, psychosis, and significant mental deterioration among those in prison. Some 91% have witnessed aggression at least once, with 53% experiencing direct harm. Suggested interventions included enhanced training and education (84%), improved detection (92%) and treatment and support services (93%). CONCLUSIONS Findings highlight the urgent need for joint multi-disciplinary efforts to tackle the exponential escalation of NPS in prisons as well as to facilitate the recovery and societal reintegration of those affected. Phenomenology can be recommended as a valuable methods to study drug induced experiences.
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Affiliation(s)
- Ornella Corazza
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Sara Coloccini
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Shanna Marrinan
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Mike Vigar
- G4S Care and Justice Services, Swansea, United Kingdom
| | - Caryl Watkins
- G4S Care and Justice Services, Swansea, United Kingdom
| | - Cosimo Zene
- School of History, Religions and Philosophies, University of London (SOAS), London, United Kingdom
| | - Attilio Negri
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,School of Pharmacology and Clinical Toxicology, University of Milan, Milan, Italy
| | - Andreas Aresti
- History, Sociology and Criminology, University of Westminster, London, United Kingdom
| | - Sacha Darke
- History, Sociology and Criminology, University of Westminster, London, United Kingdom
| | - Raffaella Rinaldi
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences Departmental Section of Legal Medicine, Sapienza University of Rome, Rome, Italy
| | - Antonio Metastasio
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Camden and Islington NHS Trust, London, United Kingdom
| | - Giuseppe Bersani
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
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19
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Frequency and Predictors of Alcohol-Related Outcomes Following Alcohol Residential Rehabilitation Programs: A 12-Month Follow-Up Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050722. [PMID: 30823386 PMCID: PMC6427603 DOI: 10.3390/ijerph16050722] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/21/2019] [Accepted: 02/23/2019] [Indexed: 01/12/2023]
Abstract
Excessive use of alcohol has been identified as a major risk factor for diseases, injury conditions and increased mortality. The aims of this study were to estimate the frequency of success (abstinence and no alcohol related hospitalization) at 6- and 12-month follow-up after hospital discharge, and to identify the predictors of success. In 2009, a total of 1040 patients at their first admission in one of the 12 Residential Alcohol Abuse Rehabilitation Units (RAARUs) participating in the CORRAL (COordinamento of Residenzialità Riabilitative ALcologiche) project were included in the study. Several socio-demographic and clinical variables, and the number of treatments' strategies during the rehabilitation were collected. Information on alcohol abstinence and no alcohol related hospitalization was assessed through a phone interview using a health worker-administered structured questionnaire at six and 12 months after discharge. An inverse probability weighted, repeated measures Poisson regression model with robust variance was applied to estimate the association between patients' characteristics and the study's outcomes, accounting for non-responders status. The frequencies of abstinence and non-alcohol related hospitalization were 68.38% and 90.73% at six months, respectively, and 68.65% and 87.6% at 12 months, respectively. Patients that were already abstainers in the month before RAARUs' admission have an increased probability of being abstainers after discharge (relative risk: RR 1.20, 95% confidence interval: 95%CI 1.08⁻1.33) and of having an alcohol related hospitalization at 12 months. Subjects undergoing more than four treatment strategies (RR 1.19; 95% CI 1.01⁻1.40) had a higher abstinence probability and lower probability of no alcohol related hospitalizations after 12 months. Finally, patients with dual diagnosis (co-occurrence of alcohol abuse/dependence and psychiatric disorders) have a decreased probability of not being hospitalized for alcohol-related problems (RR 0.95; 95% CI 0.91⁻0.99). The results of this study suggest that specific attention should be paid to the intensity of treatment, with particular regard to a multidisciplinary rehabilitation in order to respond to the complexity of alcohol dependent patients.
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20
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Smith KE, Staton M. Synthetic cannabinoid use among a sample of individuals enrolled in community-based recovery programs: Are synthetic cannabinoids actually preferred to other drugs? Subst Abus 2018; 40:160-169. [PMID: 30457960 DOI: 10.1080/08897077.2018.1528495] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Over the past decade, availability and use of novel psychoactive substances such as synthetic cannabinoid receptor agonists (SCRA) have proliferated globally. However, the prevalence of SCRAs use remains uncertain, as does the degree to which individuals reporting SCRA use prefer SCRA to other drugs. Methods: In April 2017, a total of 500 anonymous surveys were completed by clients enrolled in a residential drug recovery program. Chi-square and t tests were used to examine significant differences between those who had ever used SCRA and those who had not. Logistic regression analysis was conducted in order to determine which other substances used within the past 12 months were significantly associated with past-12-month SCRA use. Results: About 69% (68.4%) of clients reported lifetime SCRA use. Those reporting SCRA use were predominantly younger ( x¯ = 32.5 vs. 40.7, P < .001), single (60.3% vs. 48.1%, P = .011), and white (87.1% vs. 77.7%, P = .008) and were more likely to have experienced past-12-month homelessness (6.5% vs. 3.2%, P = .004). This group had higher rates of probation/parole involvement (79.2% vs. 61.8%, P < .001) and incarceration (91.8% vs. 79.6%, P < .001). Individuals reporting SCRA use also showed extensive substance use histories and favored heroin, opioids, and amphetamines compared with SCRA. Only 5.2% of the SCRA-using group stated that SCRA was a preferred substance, and only 11.8% reported that they would try SCRA again. E-cigarettes (adjusted odds ratio [AOR] = 1.88), traditional cannabis (AOR = 3.87), amphetamines (AOR = 2.20), and synthetic cathinones (AOR = 3.51) were significantly associated with past-12-month SCRA use. Motivations for use included circumnavigating drug screens and peer influence. Approximately half of those who tried SCRA reported adverse effects associated with use. Conclusions: Prevalence of SCRA use among individuals with a history of substance misuse and criminal justice system involvement is high; however, SCRA are not indicated as a preferred drug.
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Affiliation(s)
- Kirsten Elin Smith
- Kent School of Social Work, University of Louisville , Louisville , Kentucky , USA.,Center on Drug and Alcohol and Research, University of Kentucky , Lexington , Kentucky , USA
| | - Michele Staton
- Department of Behavioral Science, University of Kentucky , Lexington , Kentucky , USA.,Center on Drug and Alcohol and Research, University of Kentucky , Lexington , Kentucky , USA
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Wilson L, Szigeti A, Kearney A, Clarke M. Clinical characteristics of primary psychotic disorders with concurrent substance abuse and substance-induced psychotic disorders: A systematic review. Schizophr Res 2018; 197:78-86. [PMID: 29117908 DOI: 10.1016/j.schres.2017.11.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 11/01/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Distinguishing between a primary psychotic disorder with concurrent substance abuse (PPD+SA) and a substance-induced psychotic disorder (SIPD) can be diagnostically challenging. We aimed to determine if these two diagnoses are clinically distinct, particularly in relation to psychopathology. In addition, we aimed to examine the specific clinical features of cannabis-induced psychotic disorder (CIPD) as compared to primary psychotic disorder with concurrent cannabis abuse (PPD+CA) and also to SIPD associated with any substance. METHODS A systematic review of SIPD literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Using strict inclusion criteria, a total of six studies examining SIPD were included in the review (two of which only considered psychosis induced by cannabis alone). The findings did not reveal many consistent differences in psychopathology. However, we did find that that compared to PPD+SA, individuals with SIPD have a weaker family history of psychotic disorder; a greater degree of insight; fewer positive symptoms and fewer negative symptoms; more depression (only in CIPD) and more anxiety. CONCLUSION There remains a striking paucity of information on the psychopathology, clinical characteristics and outcome of SIPD. Our review highlights the need for further research in this area.
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Affiliation(s)
- Lorna Wilson
- Cluain Mhuire Community Mental Health Service, Newtownpark Avenue, Blackrock, Dublin, Ireland.
| | - Attila Szigeti
- DETECT Early Intervention in Psychosis Service, Avila House, Carysfort Avenue, Blackrock Business Park, Dublin, Ireland
| | | | - Mary Clarke
- DETECT Early Intervention in Psychosis Service, Avila House, Carysfort Avenue, Blackrock Business Park, Dublin, Ireland
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22
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Pierluigi S, Laura B, Attilio N, Gurjeet K B, Gloria P, Davide M, Borgherini G, Giovanni M, Fabrizio S, Perini G, Ornella C. "Marvin, the Paranoid Android": The Case of an Alpha-PVP User in the Expanding Galaxy of NPS. J Psychoactive Drugs 2018; 50:306-313. [PMID: 29768112 DOI: 10.1080/02791072.2018.1447172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Alpha-PVP can be defined as a novel psychoactive substance (NPS)-more specifically, a novel synthetic cathinone with unpredictable stimulant effects in humans. "Marvin" arrived at a Dual Diagnosis Unit at Parco dei Tigli, Italy. He underwent a 30-day rehabilitation program to overcome his problematic Alpha-PVP use as a psychonaut. We conducted an online search to understand the properties of Alpha-PVP and its presence in scientific literature, reviewing official reports and the online drug market (e.g., fora, webpages). In the Dual Diagnosis Unit, Marvin completed the 30-day rehabilitation program that included assessments and group and individual cognitive behavioral therapy. Alpha-PVP is a synthetic cathinone with stimulant properties, available in the online market but with unpredictable effects in humans. The present case reports an important risk of psychosis in a psychonaut patient who arrived and declared its intense use before admission to our Unit. This article describes the psychopathological effects of the novel compound Alpha-PVP in a psychonaut patient. Patients attending clinics that have used Alpha-PVP pose a new challenge for traditional services of mental health and addiction.
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Affiliation(s)
- Simonato Pierluigi
- a School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK.,b Dual Diagnosis Unit , Casa di Cura Parco dei Tigli , Padova , Italy
| | - Bulsis Laura
- b Dual Diagnosis Unit , Casa di Cura Parco dei Tigli , Padova , Italy
| | - Negri Attilio
- c Postgraduate School of Clinical Pharmacology and Toxicology , University of Milan , Milan , Italy
| | - Bansal Gurjeet K
- a School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK
| | - Pessa Gloria
- b Dual Diagnosis Unit , Casa di Cura Parco dei Tigli , Padova , Italy
| | - Mioni Davide
- b Dual Diagnosis Unit , Casa di Cura Parco dei Tigli , Padova , Italy
| | | | - Martinotti Giovanni
- d Department of Neuroscience and Imaging , University "G. D'Annunzio , Chieti-Pescara , Italy
| | - Schifano Fabrizio
- a School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK
| | - Giulia Perini
- b Dual Diagnosis Unit , Casa di Cura Parco dei Tigli , Padova , Italy
| | - Corazza Ornella
- a School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK
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Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives. Brain Sci 2018; 8:brainsci8030047. [PMID: 29547576 PMCID: PMC5870365 DOI: 10.3390/brainsci8030047] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 12/23/2022] Open
Abstract
Hallucinogen Persisting Perception Disorder (HPPD) is a rare, and therefore, poorly understood condition linked to hallucinogenic drugs consumption. The prevalence of this disorder is low; the condition is more often diagnosed in individuals with a history of previous psychological issues or substance misuse, but it can arise in anyone, even after a single exposure to triggering drugs. The aims of the present study are to review all the original studies about HPPD in order to evaluate the following: (1) the possible suggested etiologies; (2) the possible hallucinogens involved in HPPD induction; (3) the clinical features of both HPPD I and II; (4) the possible psychiatric comorbidities; and (5) the available and potential therapeutic strategies. We searched PubMed to identify original studies about psychedelics and Hallucinogen Persisting Perception Disorder (HPPD). Our research yielded a total of 45 papers, which have been analyzed and tabled to provide readers with the most updated and comprehensive literature review about the clinical features and treatment options for HPPD.
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Deng H, Mohite S, Suchting R, Nielsen DA, Okusaga OO. Impact of synthetic cannabinoid use on hospital stay in patients with bipolar disorder versus schizophrenia, or other psychotic disorders. Psychiatry Res 2018; 261:248-252. [PMID: 29329043 DOI: 10.1016/j.psychres.2017.12.089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 11/14/2017] [Accepted: 12/31/2017] [Indexed: 11/15/2022]
Abstract
Synthetic cannabinoid products have become popular and have led to an increased number of patients presenting to emergency departments and psychiatric hospitals. The purpose of this study was to evaluate the impact of synthetic cannabinoid use at admission on length of stay and doses of antipsychotics at discharge in individuals with bipolar disorder, schizophrenia and other psychotic disorders. We retrospectively examined medical records of 324 inpatients admitted from January 2014 to July 2015. We found that synthetic cannabinoid use predicted length of stay and antipsychotic dose using structural equation modeling. Further, the association of synthetic cannabinoid use with length of stay was partly mediated by antipsychotic dose. These associations were independent of specific diagnosis. In conclusion, patients with bipolar disorder, schizophrenia, or other psychotic disorders who reported synthetic cannabinoid use at admission had shorter length of stay and received lower doses of antipsychotics, irrespective of clinical diagnoses.
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Affiliation(s)
- Huiqiong Deng
- Harris County Psychiatric Center, University of Texas Health Science Center at Houston, Houston, TX, United States; Department of Psychiatry and Behavioral Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United States.
| | - Satyajit Mohite
- Harris County Psychiatric Center, University of Texas Health Science Center at Houston, Houston, TX, United States; Department of Psychiatry and Behavioral Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United States
| | - David A Nielsen
- The Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Olaoluwa O Okusaga
- Harris County Psychiatric Center, University of Texas Health Science Center at Houston, Houston, TX, United States; Department of Psychiatry and Behavioral Sciences, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, United States
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25
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Octodrine: New Questions and Challenges in Sport Supplements. Brain Sci 2018; 8:brainsci8020034. [PMID: 29461475 PMCID: PMC5836053 DOI: 10.3390/brainsci8020034] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 02/16/2018] [Accepted: 02/17/2018] [Indexed: 11/23/2022] Open
Abstract
Background: Octodrine is the trade name for Dimethylhexylamine (DMHA), a central nervous stimulant that increases the uptake of dopamine and noradrenaline. Originally developed as a nasal decongestant in the 1950’s, it has recently been re-introduced on the market as a pre-workout and ‘fat-burner’ product but its use remains unregulated. Our work provides the first observational cross-sectional analytic study on Octodrine as a new drug trend and its associated harms after a gap spanning seven decades. Methods: A comprehensive multilingual assessment of literature, websites, drug fora and other online resources was carried out with no time restriction in English, German, Russian and Arabic. Keywords included Octodrine’s synonyms and chemical isomers. Results: Only five relevant publications emerged from the literature search, with most of the available data on body building websites and fora. Since 2015, Octodrine has been advertised online as “the next big thing” and “the god of stimulants,” with captivating marketing strategies directed at athletes and a wider cohort of users. Reported side-effects include hypertension, dyspnoea and hyperthermia. Conclusions: The uncontrolled use of Octodrine, its physiological and psychoactive effects raise serious health implications with possible impact on athletes and doping practices. This new phenomenon needs to be thoroughly studied and monitored.
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Abstract
OBJECTIVE Several studies demonstrated an association between alcohol consumption and unhealthy food habits. Particularly, in young adults it has been observed the tendency to use extreme forms of weight control as a way to compensate planned binge drinking. METHOD A questionnaire was administered to a sample of 4275 healthy subjects (43.9% males; 56.1% females), aged between 18 and 26 (mean age 22.04). The survey investigated socio-economic characteristics, drinking habits with a specific focus on binge consumption, abnormal eating behaviours and psychoactive substance use. RESULTS 34.1% of the overall sample reported to limit their calorie intake before drinking, with no significant gender difference. A significant correlation was found between drunkorexic attitudes and, respectively, binge drinking behaviours (p < .01), use of cocaine (p < .01), and use of Novel Psychoactive Substances (p < .01). DISCUSSION Our data identified drunkorexia as a common behaviour among Italian young adults. Raising awareness on drunkorexia may help health care providers to timely address and approach its possible short- and long-term consequences. LEVEL OF EVIDENCE Level V (descriptive study).
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27
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Mdege ND, Meader N, Lloyd C, Parrott S, McCambridge J. The Novel Psychoactive Substances in the UK Project: empirical and conceptual review work to produce research recommendations. PUBLIC HEALTH RESEARCH 2017. [DOI: 10.3310/phr05040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BackgroundAlthough illegal drug use has largely been declining in the UK over the past decade, this period has witnessed the emergence of a range of novel psychoactive substances (NPS) (‘legal highs’). These are new, mostly synthetic, substances that mimic the effects of existing drugs). Despite there being many causes for concern in relation to NPS, there has been little prior study of the burden associated with their use in public health terms. Clarity is lacking on research priorities in this rapidly developing literature.ObjectivesTo inform the development of public health intervention research on NPS by reviewing existing data on their use, associated problems and potential responses to such problems.DesignA scoping review and narrative synthesis of selected bodies of evidence was undertaken to summarise and evaluate what is known about NPS use and the related harms of, and responses to, such use. Relevant literature was identified from electronic databases (covering January 2006 to June 2016 inclusive), Google (Google Inc., Mountain View, CA, USA), relevant websites and online drug forums and by contacting experts. Articles were included if they were primary studies, secondary studies involving the analysis and interpretation of primary research or discussion papers. A conceptual framework postulating an evidence-informed public health approach to NPS use in the UK was developed through a pragmatic literature review, the iterative development of concepts and finalisation in light of the results from the empirical review work. The process also involved feedback from various stakeholders. Research recommendations were developed from both strands of work.ResultsA total of 995 articles were included in the scoping review, the majority of which related to individual-level health-related adverse effects attributable to NPS use. The prevalence of lifetime NPS use varied widely between (e.g. with higher prevalence in young males) and within population subgroups. The most commonly reported adverse effects were psychiatric/other neurological, cardiovascular, renal and gastrointestinal manifestations, and there is limited evidence available on responses. In these and other respects, available evidence is at an early stage of development. Initial evidence challenges the view that NPS should be treated differently from other illicit drugs. The conceptual framework indicated that much of the evidence that would be useful to inform public health responses does not yet exist. We propose a systems-based prevention approach that develops existing responses, is multilevel and life course informed in character, and emphasises commonalities between NPS and other legal and illegal drug use. We make 20 recommendations for research, including nine key recommendations.LimitationsScoping reviews do not interrogate evidence in depth, and the disjunction between the scoping review and the conceptual framework findings is worthy of careful attention.ConclusionsKey research recommendations build on those that have previously been made and offer more evidence-based justification and detail, as previous recommendations have not yet been acted on. The case for decision-making on commissioning new research based on these recommendations is both strong and urgent.Future workThe validity of recommendations generated through this project could be enhanced via further work with research commissioners, policy-makers, researchers and the public.Study registrationThe systematic review element of this study is registered as PROSPERO CRD42016026415.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Noreen D Mdege
- Department of Health Sciences, University of York, York, UK
| | - Nick Meader
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Charlie Lloyd
- Department of Health Sciences, University of York, York, UK
| | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
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28
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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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Canazza I, Ossato A, Vincenzi F, Gregori A, Di Rosa F, Nigro F, Rimessi A, Pinton P, Varani K, Borea PA, Marti M. Pharmaco-toxicological effects of the novel third-generation fluorinate synthetic cannabinoids, 5F-ADBINACA, AB-FUBINACA, and STS-135 in mice. In vitro and in vivo studies. Hum Psychopharmacol 2017; 32. [PMID: 28597570 DOI: 10.1002/hup.2601] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 04/10/2017] [Accepted: 04/11/2017] [Indexed: 01/08/2023]
Abstract
INTRODUCTION 5F-ADBINACA, AB-FUBINACA, and STS-135 are 3 novel third-generation fluorinate synthetic cannabinoids that are illegally marketed as incense, herbal preparations, or research chemicals for their psychoactive cannabis-like effects. METHODS The present study aims at investigating the in vitro and in vivo pharmacological activity of 5F-ADBINACA, AB-FUBINACA, and STS-135 in male CD-1 mice, comparing their in vivo effects with those caused by the administration of Δ9 -THC and JWH-018. In vitro competition binding experiments revealed a nanomolar affinity and potency of the 5F-ADBINACA, AB-FUBINACA, and STS-135 on mouse and human CB1 and CB2 receptors. Moreover, these synthetic cannabinoids induced neurotoxicity in murine neuro-2a cells. RESULTS In vivo studies showed that 5F-ADBINACA, AB-FUBINACA, and STS-135 induced hypothermia; increased pain threshold to both noxious mechanical and thermal stimuli; caused catalepsy; reduced motor activity; impaired sensorimotor responses (visual, acoustic, and tactile); caused seizures, myoclonia, and hyperreflexia; and promoted aggressiveness in mice. Behavioral and neurological effects were fully prevented by the selective CB1 receptor antagonist/inverse agonist AM 251. Differently, the visual sensory response induced by STS-135 was only partly prevented by the AM 251, suggesting a CB1 -independent mechanism. CONCLUSIONS For the first time, the present study demonstrates the pharmaco-toxicological effects induced by the administration of 5F-ADBINACA, AB-FUBINACA, and STS-135 in mice and suggests their possible detrimental effects on human health.
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Affiliation(s)
- Isabella Canazza
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Andrea Ossato
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Fabrizio Vincenzi
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Adolfo Gregori
- Carabinieri, Department of Scientific Investigation (RIS), Rome, Italy
| | - Fabiana Di Rosa
- Carabinieri, Department of Scientific Investigation (RIS), Rome, Italy
| | - Federica Nigro
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Alessandro Rimessi
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Paolo Pinton
- Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Katia Varani
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Pier Andrea Borea
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Matteo Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Center for Neuroscience and Istituto Nazionale di Neuroscienze, University of Ferrara, Ferrara, Italy
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Acciavatti T, Lupi M, Santacroce R, Aguglia A, Attademo L, Bandini L, Ciambrone P, Lisi G, Migliarese G, Pinna F, Quattrone D, Ribolsi M, Signorelli MS, Calò S, Schifano F, di Giannantonio M, Martinotti G. Novel psychoactive substance consumption is more represented in bipolar disorder than in psychotic disorders: A multicenter-observational study. Hum Psychopharmacol 2017; 32. [PMID: 28517032 DOI: 10.1002/hup.2578] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 02/02/2017] [Accepted: 02/16/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Comorbidities between psychiatric diseases and use of traditional substances of abuse are common. Nevertheless, there are few data regarding the use of novel psychoactive substances (NPS) among psychiatric patients. Aim of this multicentre survey is to investigate the consumption of a number of psychoactive substances in a young psychiatric sample. METHODS Between December 2013 and September 2015, a questionnaire was administered in 10 Italian psychiatric care facilities to a sample of 671 patients, aged 18-26 (mean age 22.24; SD 2.87). RESULTS About 8.2% of the sample declared to have used NPS at least once, and 2.2% had consumed NPS in the previous 3 months. The three psychiatric diagnoses most frequently associated with NPS use were bipolar disorder (23.1%), personality disorders (11.8%), and schizophrenia and related disorders (11.6%). In univariate regression analysis, bipolar disorder was positively associated with NPS consumption, an association that did not reach statistical significance in the multivariate analysis. CONCLUSIONS The use of NPS in a young psychiatric population appears to be frequent, and probably still underestimated. Bipolar disorder shows an association with NPS use. Careful and constant monitoring and an accurate evaluation of possible clinical effects related to NPS use are necessary.
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Affiliation(s)
- Tiziano Acciavatti
- Department of Neuroscience and Imaging, "G. d'Annunzio" University, Chieti, Italy
| | - Matteo Lupi
- Department of Neuroscience and Imaging, "G. d'Annunzio" University, Chieti, Italy
| | - Rita Santacroce
- Department of Neuroscience and Imaging, "G. d'Annunzio" University, Chieti, Italy
| | | | | | - Laura Bandini
- Department of Biomedical and Neuromotor Sciences DIBINEM, Bologna University, Bologna, Italy
| | | | | | - Giovanni Migliarese
- Department of Neuroscience, Azienda Ospedaliera FateBeneFratelli, Milan, Italy
| | - Federica Pinna
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Diego Quattrone
- Section of Psychiatry, Department of Neuroscience, Messina University, Messina, Italy
| | | | | | | | - Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - Giovanni Martinotti
- Department of Neuroscience and Imaging, "G. d'Annunzio" University, Chieti, Italy
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31
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Loi B, Zloh M, De Luca MA, Pintori N, Corkery J, Schifano F. 4,4'-Dimethylaminorex ("4,4'-DMAR"; "Serotoni") misuse: A Web-based study. Hum Psychopharmacol 2017; 32. [PMID: 28657180 DOI: 10.1002/hup.2575] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/21/2017] [Accepted: 01/27/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND 4,4'-DMAR (4,4'-dimethylaminorex; "Serotoni") is a potent stimulant drug that has recently been associated with a number of fatalities in Europe. Over the last few years, online communities have emerged as important resources for disseminating levels of technical knowledge on novel psychoactive substances. OBJECTIVE Analysing the information provided by the fora communities on 4,4'-DMAR use, additionally critical reviewing the available evidence-based literature on this topic. METHODS Different website drug fora were identified. A critical review of the existing evidence-based literature was undertaken. Individuation and analysis of qualitative data from the identified website fora were performed. RESULTS The combined search results identified six website fora from which a range of qualitative data on recurring themes was collected. These themes included routes of administration and doses; desired effects; adverse effects; comparison with other drugs; association with other drugs; medications self-administered to reverse 4,4'-DMAR action; overall impression; and provision of harm-reduction advice. CONCLUSIONS Although being characterized by a number of methodological limitations, the social networks' Web monitoring approach (netnography) may be helpful to better understand some of the clinical and psychopharmacological issues pertaining to a range of novel psychoactive substances, including 4,4'-DMAR, for which only extremely little, if any, scientific knowledge is available.
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Affiliation(s)
- Barbara Loi
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Pharmacology & Post-graduate Medicine, University of Hertfordshire, Hatfield, UK
| | - Mire Zloh
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Pharmacology & Post-graduate Medicine, University of Hertfordshire, Hatfield, UK
| | - Maria Antonietta De Luca
- Department of Biomedical Sciences, Division of Neuropsychopharmacology, University of Cagliari, Cagliari, Italy
| | - Nicholas Pintori
- Department of Biomedical Sciences, Division of Neuropsychopharmacology, University of Cagliari, Cagliari, Italy
| | - John Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Pharmacology & Post-graduate Medicine, University of Hertfordshire, Hatfield, UK
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, Department of Pharmacy, Pharmacology & Post-graduate Medicine, University of Hertfordshire, Hatfield, UK
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32
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Bersani G, Prevete E. Novel psychoactive substances (NPS) use in severe mental illness (SMI) patients: Potential changes in the phenomenology of psychiatric diseases. Hum Psychopharmacol 2017; 32. [PMID: 28657186 DOI: 10.1002/hup.2591] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/07/2017] [Accepted: 03/13/2017] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Literature is quite poor about the clinical effects of novel psychoactive substances (NPS) and the long-term consequences of NPS use in psychiatric patients. Consequently, it is of the greatest interest to examine which effects NPS can exert in patients with previous severe mental illness (SMI), such as psychotic patients. The aim of this work was a comprehensive review about NPS use in patients with SMI. METHODS We searched Medline or PubMed for relevant English-language citations and reviews describing relationships between NPS use and mental disorders, as well as for the main groups of substances and associated psychiatric manifestations. All studies reporting single case or case series of patients were selected. RESULTS The NPS use in patients with SMI is probably underestimated. The one existing systematic review considers only 14 studies, 12 of which are case reports. Most clinical results report acute symptom exacerbation of preexisting psychosis. Paranoid, mood, and aggression symptoms occur more frequently. CONCLUSIONS NPS use could modify clinical features of SMI, but these conclusions cannot be generalizable. More evidence is needed to establish the causal and effective connection between NPS use and course of illness, type of psychiatric symptoms, and outcome of treatment in terms of adherence or response.
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Affiliation(s)
- Giuseppe Bersani
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Elisabeth Prevete
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
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Martinotti G, Cinosi E, Santacroce R, Papanti D, Pasquini A, Mancini V, Corbo M, Fiori F, Sarchione F, Marchetti D, Verrocchio MC, Di Giannantonio M, Torrens M, Schifano F, Morlan Coarasa MJ, Merino Del Villar C. Substance-related psychopathology and aggressiveness in a nightlife holiday resort: Results from a pilot study in a psychiatric inpatient unit in Ibiza. Hum Psychopharmacol 2017; 32. [PMID: 28557062 DOI: 10.1002/hup.2586] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/03/2017] [Accepted: 03/06/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVES We aimed to describe a sample of subjects admitted to a psychiatric unit after the intake of psychoactive substances for recreational purposes. METHODS Between June and September 2015, 49 subjects were included. Sociodemographic characteristics and psychopathological aspects were investigated, and urine samples for further analysis were collected. Three subgroups (cannabinoids, stimulants, and depressors users) were identified, according to the structured interview regarding substance use and urinalysis. RESULTS Level of aggressiveness was found to be significantly higher (p < .05) in the cannabinoids subgroup. Self-reported symptom severity was comparable among groups, but trends could be identified: SCL-90 results showed a prevalence of anxiety symptoms among depressors users, hostility or aggression in the tetrahydrocannabinol subgroup, and psychoticism in the stimulants subgroup. CONCLUSIONS The use of psychoactive substances was be characterised by poly-use of both traditional and novel substances. The presence of aggressiveness emerged as a main feature associated with the use of cannabis and other cannabinoids. Binge drinking and sleep deprivation also represented a relevant component in almost all the evaluated subjects.
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Affiliation(s)
- Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy.,Department of Pharmacy, Pharmacology, Postgraduate Medicine, University of Hertfordshire, Hatfield, Herts, UK
| | - Eduardo Cinosi
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Rita Santacroce
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy.,Department of Pharmacy, Pharmacology, Postgraduate Medicine, University of Hertfordshire, Hatfield, Herts, UK
| | - Duccio Papanti
- Department of Medical, Surgical, and Health Sciences, University of Trieste, Italy
| | - Anna Pasquini
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Valerio Mancini
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Mariangela Corbo
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Federica Fiori
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Fabiola Sarchione
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Daniela Marchetti
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Maria Cristina Verrocchio
- Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Marta Torrens
- Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Fabrizio Schifano
- Department of Pharmacy, Pharmacology, Postgraduate Medicine, University of Hertfordshire, Hatfield, Herts, UK
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Fantinati A, Ossato A, Bianco S, Canazza I, De Giorgio F, Trapella C, Marti M. 1-cyclohexyl-x-methoxybenzene derivatives, novel psychoactive substances seized on the internet market. Synthesis and in vivo pharmacological studies in mice. Hum Psychopharmacol 2017; 32. [PMID: 28657178 DOI: 10.1002/hup.2560] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Among novel psychoactive substances notified to EMCDDA and Europol were 1-cyclohexyl-x-methoxybenzene stereoisomers (ortho, meta, and para). These substances share some structural characteristics with phencyclidine and tramadol. Nowadays, no information on the pharmacological and toxicological effects evoked by 1-cyclohexyl-x-methoxybenzene are reported. The aim of this study was to investigate the effect evoked by each one stereoisomer on visual stimulation, body temperature, acute thermal pain, and motor activity in mice. METHODS Mice were evaluated in behavioral tests carried out in a consecutive manner according to the following time scheme: observation of visual placing response, measures of core body temperature, determination of acute thermal pain, and stimulated motor activity. RESULTS All three stereoisomers dose-dependent inhibit visual placing response (rank order: meta > ortho > para), induce hyperthermia at lower and hypothermia at higher doses (meta > ortho > para) and cause analgesia to thermal stimuli (para > meta = ortho), while they do not alter motor activity. CONCLUSIONS For the first time, this study demonstrates that systemic administration of 1-cyclohexyl-x-methoxybenzene compounds markedly inhibit visual response, promote analgesia, and induce core temperature alterations in mice. This data, although obtained in animal model, suggest their possible hazard for human health (i.e., hyperthermia and sensorimotor alterations). In particular, these novel psychoactive substances may have a negative impact in many daily activities, greatly increasing the risk factors for workplace accidents and traffic injuries.
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Affiliation(s)
- Anna Fantinati
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Andrea Ossato
- Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Sara Bianco
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Isabella Canazza
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Fabio De Giorgio
- Institute of Public Health, Section of Legal Medicine, Catholic University of Rome, Rome, Italy
| | - Claudio Trapella
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Matteo Marti
- Department of Life Sciences and Biotechnology (SVeB), University of Ferrara, Ferrara, Italy.,Center for Neuroscience and Istituto Nazionale di Neuroscienze, Ferrara, Italy
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Mekonen T, Fekadu W, Chane T, Bitew S. Problematic Alcohol Use among University Students. Front Psychiatry 2017; 8:86. [PMID: 28579966 PMCID: PMC5437113 DOI: 10.3389/fpsyt.2017.00086] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/01/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Alcohol is attributable to many diseases and injury-related health conditions, and it is the fifth leading risk factor of premature death globally. Hence, the objective of this study was to assess the proportion and associated factors of problematic alcohol use among University students. MATERIAL AND METHODS Cross-sectional study was conducted among 725 randomly selected University students from November to December 2015. Data were collected by self-administered questionnaire, and problematic alcohol use was assessed by Alcohol Use Disorder Identification Test. Chi-square test was used to show association of problematic use and each variable and major predicators was identified using logistic regression with 95% confidence interval (CI); and variables with p-value less than 0.05 were considered statistically significant. RESULTS About 83 (11.4%) of the samples were problematic alcohol users of which 6.8% had medium level problems and 4.6% had high level problems. Significantly associated variables with problematic alcohol use among students were presence of social phobia (AOR = 1.7, 95% CI: 1.0, 2.8), lifetime use of any substance (AOR = 6.9, 95% CI: 3.8, 12.7), higher score in students cumulative grade point average (AOR = 0.6, 95% CI: 0.4, 0.9), and having intimate friend who use alcohol (AOR = 2.2, 95% CI: 1.3, 3.8). CONCLUSION Problematic alcohol use among university students was common and associated with social phobia, poor academic achievement, lifetime use of any substance, and peer pressure. Strong legislative control of alcohol in universities is important to reduce the burden of alcohol.
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Affiliation(s)
- Tesfa Mekonen
- Psychiatry Department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Wubalem Fekadu
- Psychiatry Department, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tefera Chane
- College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Shimelash Bitew
- School of Public Health, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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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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Khaled SM, Hughes E, Bressington D, Zolezzi M, Radwan A, Badnapurkar A, Gray R. The prevalence of novel psychoactive substances (NPS) use in non-clinical populations: a systematic review protocol. Syst Rev 2016; 5:195. [PMID: 27871332 PMCID: PMC5117541 DOI: 10.1186/s13643-016-0375-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 11/08/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Novel psychoactive substances (NPS) are new narcotic or psychotropic drugs that are not controlled by the United Nations drug convention that may pose a serious public health threat due to their wide availability for purchase on the internet and in so called "head shops." Yet, the extent of their global use remains largely unknown. The aim of this study is to conduct a systematic review of the prevalence of NPS use in non-clinical populations. METHODS This is a systematic review of observational studies. Embase, MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane Library, Lilacs, Scopus, Global Health, PsychINFO, Web of Science, and the World Health Organization (WHO) regional databases will be searched for eligible prevalence studies published between 2010 and 2016. Data from cross-sectional studies that report the prevalence of NPS use (one or more types) in participants (of any age) from censuses or probabilistic or convenience samples will be included. Data will be extracted from eligible publications, using a data extraction tool developed for this study. Visual and statistical approaches will be adopted instead of traditional meta-analytic approaches. DISCUSSION This review will describe the distributions of various types of prevalence estimates of NPS use and explore the impact of different population groups and study-related and tempo-geographical variables on characteristics of these distributions over the period of 2010 to 2016. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42016037020.
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Affiliation(s)
- Salma M Khaled
- Social and Economic Survey Research Institute, Qatar University, Doha, Qatar.
| | - Elizabeth Hughes
- Applied Mental Health Research, The University of Huddersfield, Huddersfield, UK
| | | | - Monica Zolezzi
- Clinical Pharmacy and Practice, College of Pharmacy, Qatar University, Doha, Qatar
| | - Ahmed Radwan
- Psychiatry Residency Program, Hamad Medical Corporation, Doha, Qatar
| | - Ashish Badnapurkar
- Health Services and Population Research Centre, Hamad Medical Corporation, Doha, Qatar
| | - Richard Gray
- Health Services and Population Research Centre, Hamad Medical Corporation, Doha, Qatar
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Gray R, Bressington D, Hughes E, Ivanecka A. A systematic review of the effects of novel psychoactive substances 'legal highs' on people with severe mental illness. J Psychiatr Ment Health Nurs 2016; 23:267-81. [PMID: 27037639 DOI: 10.1111/jpm.12297] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 11/27/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Novel psychoactive substances (NPS) include synthetic drugs mimicking the effects of illicit drugs, e.g. synthetic cannabinoids, and herbs such as Salvia divinorum. NPS are substances that can trigger hallucinations and other effects altering the mind, and are currently uncontrolled by the United Nations' 1961 Narcotic Drugs/1971 Psychotropic Substances Conventions. NPS affect brain chemistry that induces the psychoactive effects, such as hallucinations and feeling 'high'. It is unknown what effects such drugs have on people with severe mental illness (i.e. psychotic illnesses). WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Our review demonstrates that little is known about the effects of various NPS on people with severe mental illness. Almost nothing is known about the long-term consequences of NPS use on the mental and physical health of SMI patients. Patients may lack understanding that NPS are psychoactive drugs that can impact on their mental and physical wellbeing. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Some patients might be reluctant or do not think it is relevant to disclose NPS use. Commonly used illicit drug screening is unlikely to detect the presence of NPS, therefore health and mental health professionals should directly enquire about NPS and actively encourage patients with severe mental illness to disclose any substance use. PATIENT AND PUBLIC INVOLVEMENT IN THE RESEARCH There was no significant patient and public involvement in the development and conduct of this study . ABSTRACT Introduction Novel psychoactive substances (NPS) are synthetic substances that have been developed to produce altered states of consciousness and perceptions. People with severe mental illness (SMI) are more likely to use NPS than people without mental illness, but the short- and long-term effects of NPS are largely unknown. Method We systematically reviewed the literature about the effects of NPS on people with SMI. Results We included 12 case reports, 1 cross-sectional survey and 1 qualitative study. Participants included mostly males aged between 20 and 35 years. A variety of NPS were used, including synthetic cathinones and herbs such as Salvia. The most commonly reported effects of NPS were psychotic symptoms (in some cases novel in form and content to the patients' usual symptoms) and significant changes in behaviour, including agitation, aggression and violence. Patients' vital signs, such as blood pressure, pulse rate and temperature, were also commonly affected. Conclusion NPS potentially have serious effects on people with SMI, but our findings have limited generalizability due to a reliance on case studies. There is a paucity of evidence about the long-term effects of these substances. Further research is required to provide a better understanding about how different NPS affect patients' mental and physical health.
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Affiliation(s)
- R Gray
- Health Services and Population Research Centre, Hamad Medical Corporation, Doha, Qatar
| | - D Bressington
- School of Nursing, Hong Kong Polytechnic, Hong Kong, Hong Kong
| | - E Hughes
- School of Health and Human Sciences, University of Huddersfield, Huddersfield, UK
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Stanley JL, Mogford DV, Lawrence RJ, Lawrie SM. Use of novel psychoactive substances by inpatients on general adult psychiatric wards. BMJ Open 2016; 6:e009430. [PMID: 27165643 PMCID: PMC4874170 DOI: 10.1136/bmjopen-2015-009430] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 11/05/2015] [Accepted: 11/27/2015] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Non-illicit alternatives to controlled drugs, known as novel psychoactive substances (NPS), have recently risen to prominence. They are readily available, with uncertain pharmacology and no widely available assay. Given that psychiatric patients are at risk of comorbid substance abuse, we hypothesised that NPS use would be present in the psychiatric population, and sought to determine its prevalence and investigate the characteristics of those who use these drugs with a retrospective review of discharge letters. SETTING General adult inpatient wards of a psychiatric hospital in a Scottish city. PARTICIPANTS All adult inpatients (18-65) discharged from general psychiatric wards between 1 July 2014 and 31 December 2014. Of the 483 admissions identified, 46 were admissions for maintenance electroconvulsive therapy (ECT) and were excluded. Of the remaining 437 admissions, 49 discharge letters were unobtainable, leaving 388 admissions to analyse. PRIMARY OUTCOME MEASURE The mention, or lack thereof, of NPS use in discharge letters was our planned primary outcome measure and was also the primary outcome measure we used in our analysis. RESULTS NPS use was identified in 22.2% of admissions, contributing to psychiatric symptoms in 59.3%. In comparison to non-users, NPS users were younger (p<0.01), male and more likely to have a forensic history ((p<0.001) for both). The diagnosis of drug-induced psychosis was significantly more likely in NPS users (p<0.001, OR 18.7, 95% CI 8.1 to 43.0) and the diagnosis of depression was significantly less likely (p<0.005, OR 0.133, CI 0.031 to 0.558). Use of cannabis was significantly more likely in NPS users (p<0.001, OR 4.2, CI 2.5 to 7.1), as was substitute opiate prescribing (p<0.001, OR 3.7, CI 1.8 to 7.4). CONCLUSIONS NPS use was prevalent among young, male psychiatric inpatients, in particular those with drug-induced psychosis and often occurred alongside illicit drug use.
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Affiliation(s)
- Jack L Stanley
- Undergraduate—5th year, University of Edinburgh, Edinburgh, UK
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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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Jankowski W, Hoffmann M. Can Google Searches Predict the Popularity and Harm of Psychoactive Agents? J Med Internet Res 2016; 18:e38. [PMID: 26916984 PMCID: PMC4786686 DOI: 10.2196/jmir.4033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 04/09/2015] [Accepted: 01/19/2016] [Indexed: 02/03/2023] Open
Abstract
Background Predicting the popularity of and harm caused by psychoactive agents is a serious problem that would be difficult to do by a single simple method. However, because of the growing number of drugs it is very important to provide a simple and fast tool for predicting some characteristics of these substances. We were inspired by the Google Flu Trends study on the activity of the influenza virus, which showed that influenza virus activity worldwide can be monitored based on queries entered into the Google search engine. Objective Our aim was to propose a fast method for ranking the most popular and most harmful drugs based on easily available data gathered from the Internet. Methods We used the Google search engine to acquire data for the ranking lists. Subsequently, using the resulting list and the frequency of hits for the respective psychoactive drugs combined with the word “harm” or “harmful”, we estimated quickly how much harm is associated with each drug. Results We ranked the most popular and harmful psychoactive drugs. As we conducted the research over a period of several months, we noted that the relative popularity indexes tended to change depending on when we obtained them. This suggests that the data may be useful in monitoring changes over time in the use of each of these psychoactive agents. Conclusions Our data correlate well with the results from a multicriteria decision analysis of drug harms in the United Kingdom. We showed that Google search data can be a valuable source of information to assess the popularity of and harm caused by psychoactive agents and may help in monitoring drug use trends.
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Affiliation(s)
- Wojciech Jankowski
- Faculty of Chemistry, Adam Mickiewicz University in Poznan, Poznan, Poland.
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Marshall AM, Heffernan T, Hamilton C. The Synergistic Impact of Excessive Alcohol Drinking and Cigarette Smoking upon Prospective Memory. Front Psychiatry 2016; 7:75. [PMID: 27199782 PMCID: PMC4846809 DOI: 10.3389/fpsyt.2016.00075] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/14/2016] [Indexed: 11/13/2022] Open
Abstract
The independent use of excessive amounts of alcohol or persistent cigarette smoking have been found to have a deleterious impact upon Prospective Memory (PM: remembering future intentions and activities), although to date, the effect of their concurrent use upon PM is yet to be explored. The present study investigated the impact of the concurrent use of drinking excessive amounts of alcohol and smoking cigarettes (a "Polydrug" group) in comparison to the combined effect of the single use of these substances upon PM. The study adopted a single factorial independent groups design. The Cambridge Prospective Memory Test (CAMPROMPT) is a test of both time-based and event-based PM and was used here to measure PM. The CAMPROMPT was administered to 125 adults; an excessive alcohol user group (n = 40), a group of smokers who drink very little alcohol (n = 20), a combined user group (the "Polydrug" group) who drink excessively and smoke cigarettes (n = 40) and a non-drinker/low alcohol consumption control group (n = 25). The main findings revealed that the Polydrug users recalled significantly fewer time-based PM tasks than both excessive alcohol users p < 0.001 and smokers p = 0.013. Polydrug users (mean = 11.47) also remembered significantly fewer event-based PM tasks than excessive alcohol users p < 0.001 and smokers p = 0.013. With regards to the main aim of the study, the polydrug users exhibited significantly greater impaired time-based PM than the combined effect of single excessive alcohol users and cigarette smokers p = 0.033. However, no difference was observed between polydrug users and the combined effect of single excessive alcohol users and cigarette smokers in event-based PM p = 0.757. These results provide evidence that concurrent (polydrug) use of these two substances has a synergistic effect in terms of deficits upon time-based PM. The observation that combined excessive drinking and cigarette smoking leads to a greater impairment in time-based PM may be of paramount importance, given the key role PM plays in everyday independent living.
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Affiliation(s)
| | - Thomas Heffernan
- Department of Psychology, Northumbria University , Newcastle upon Tyne , UK
| | - Colin Hamilton
- Department of Psychology, Northumbria University , Newcastle upon Tyne , UK
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Following "the Roots" of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries. BIOMED RESEARCH INTERNATIONAL 2015; 2015:968786. [PMID: 26640804 PMCID: PMC4657101 DOI: 10.1155/2015/968786] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/13/2015] [Accepted: 10/15/2015] [Indexed: 12/17/2022]
Abstract
The use of substances to enhance human abilities is a constant and cross-cultural feature in the evolution of humanity. Although much has changed over time, the availability on the Internet, often supported by misleading marketing strategies, has made their use even more likely and risky. This paper will explore the case of Mitragyna speciosa Korth. (kratom), a tropical tree used traditionally to combat fatigue and improve work productivity among farm populations in Southeast Asia, which has recently become popular as novel psychoactive substance in Western countries. Specifically, it (i) reviews the state of the art on kratom pharmacology and identification; (ii) provides a comprehensive overview of kratom use cross-culturally; (iii) explores the subjective experiences of users; (iv) identifies potential risks and side-effects related to its consumption. Finally, it concludes that the use of kratom is not negligible, especially for self-medication, and more clinical, pharmacological, and socioanthropological studies as well as a better international collaboration are needed to tackle this marginally explored phenomenon.
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Martinotti G, Sepede G, Brunetti M, Ricci V, Gambi F, Chillemi E, Vellante F, Signorelli M, Pettorruso M, De Risio L, Aguglia E, Angelucci F, Caltagirone C, Di Giannantonio M. BDNF concentration and impulsiveness level in post-traumatic stress disorder. Psychiatry Res 2015; 229:814-8. [PMID: 26277035 DOI: 10.1016/j.psychres.2015.07.085] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 07/27/2015] [Accepted: 07/30/2015] [Indexed: 12/13/2022]
Abstract
Among the symptoms of post-traumatic stress disorder (PTSD), impulsiveness has been observed in patients with high levels of hyperarousal. Recent literature reveals the importance of investigating the role of neurotrophins, such as brain-derived neurotrophic factor (BDNF), in several psychiatric disorders. Specifically, contrasting findings have been reported on the levels of serum BDNF in subjects with PTSD. The aim of the present study was to investigate the correlation between BDNF serum levels and impulsiveness in PTSD. To this end, we measured BDNF serum levels in 23 PTSD patients and a control group of 19 trauma-exposed non-PTSD subjects. Results indicate a positive correlation in the PTSD group; that is, the higher the BDNF levels the higher the impulsiveness score, as measured by the Barratt Impulsiveness Scale (BIS-11), suggesting that impulsiveness could be associated with greater BDNF production. Alternatively, it is also possible that high impulsiveness acts as a psychological mechanism that counteracts the negative effects exerted by the traumatic experience and the associated obsessive thoughts. The present paper discusses both hypotheses.
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Affiliation(s)
- Giovanni Martinotti
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Gianna Sepede
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy; Department of Basic Medical Sciences, Neurosciences and Sense Organs, University "A. Moro", Bari, Italy.
| | - Marcella Brunetti
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Valerio Ricci
- IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, 00179 Rome, Italy
| | - Francesco Gambi
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Eleonora Chillemi
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | - Federica Vellante
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
| | | | | | - Luisa De Risio
- Department of Neuroscience, Catholic University of Rome, Italy
| | | | - Francesco Angelucci
- IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, 00179 Rome, Italy
| | - Carlo Caltagirone
- IRCCS Santa Lucia Foundation, Department of Clinical and Behavioural Neurology, 00179 Rome, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging, and Clinical Sciences, University "G.d'Annunzio", Chieti, Italy
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46
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Cho SB, Llaneza DC, Adkins AE, Cooke M, Kendler KS, Clark SL, Dick DM. Patterns of Substance Use Across the First Year of College and Associated Risk Factors. Front Psychiatry 2015; 6:152. [PMID: 26578984 PMCID: PMC4621385 DOI: 10.3389/fpsyt.2015.00152] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/09/2015] [Indexed: 11/24/2022] Open
Abstract
Starting college is a major life transition. This study aims to characterize patterns of substance use across a variety of substances across the first year of college and identify associated factors. We used data from the first cohort (N = 2056, 1240 females) of the "Spit for Science" sample, a study of incoming freshmen at a large urban university. Latent transition analysis was applied to alcohol, tobacco, cannabis, and other illicit drug uses measured at the beginning of the fall semester and midway through the spring semester. Covariates across multiple domains - including personality, drinking motivations and expectancy, high school delinquency, peer deviance, stressful events, and symptoms of depression and anxiety - were included to predict the patterns of substance use and transitions between patterns across the first year. At both the fall and spring semesters, we identified three subgroups of participants with patterns of substance use characterized as: (1) use of all four substances; (2) alcohol, tobacco, and cannabis use; and (3) overall low substance use. Patterns of substance use were highly stable across the first year of college: most students maintained their class membership from fall to spring, with just 7% of participants in the initial low substance users transitioning to spring alcohol, tobacco, and cannabis users. Most of the included covariates were predictive of the initial pattern of use, but covariates related to experiences across the first year of college were more predictive of the transition from the low to alcohol, tobacco, and cannabis user groups. Our results suggest that while there is an overall increase in alcohol use across all students, college students largely maintain their patterns of substance use across the first year. Risk factors experienced during the first year may be effective targets for preventing increases in substance use.
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Affiliation(s)
- Seung Bin Cho
- Department of African American Studies, Virginia Commonwealth University, Richmond, VA, USA
| | - Danielle C. Llaneza
- Department of African American Studies, Virginia Commonwealth University, Richmond, VA, USA
| | - Amy E. Adkins
- Department of African American Studies, Virginia Commonwealth University, Richmond, VA, USA
| | - Megan Cooke
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Kenneth S. Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Shaunna L. Clark
- Department of Pharmacotherapy and Outcome Science, Virginia Commonwealth University, Richmond, VA, USA
| | - Danielle M. Dick
- Department of African American Studies, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
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47
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Acute Effects of the Novel Psychoactive Drug 2C-B on Emotions. BIOMED RESEARCH INTERNATIONAL 2015; 2015:643878. [PMID: 26543863 PMCID: PMC4620274 DOI: 10.1155/2015/643878] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 09/27/2015] [Indexed: 12/22/2022]
Abstract
Background. 2C-B (Nexus) is one of the most widespread novel psychoactive substances. There is limited information about its pharmacological properties, and few studies in humans concern its acute and chronic effects. 2C-B has been classified as a stimulant, hallucinogen, entactogen, and/or empathogen. Objectives. To evaluate the emotional, subjective, and cardiovascular effects of 2C-B. Methods. Twenty healthy recreational 2C-B users (12 women) self-administered a 20 mg dose of 2C-B. Evaluations included emotional (IAPS, FERT, and speech), subjective (visual analog scales, ARCI, VESSPA, HRS, and POMS questionnaires), and cardiovascular effects (blood pressure and heart rate). Results. Positive subjective effects predominated with a reduction of anger under the influence of 2C-B. It did, however, increase reactivity to negative emotional stimuli and decrease the ability to recognize expressions of happiness. Augmented emotionality in speech could be appreciated by others. 2C-B induced euphoria and well-being, changes in perceptions, and slight hallucinogenic states. Mild sympathetic actions were observed. Conclusions. The specific profile that 2C-B exerts on emotions suggests its classification as an entactogen with psychedelic properties.
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48
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Santacroce R, Corazza O, Martinotti G, Bersani FS, Valeriani G, Di Giannantonio M. Psyclones: a roller coaster of life? Hidden synthetic cannabinoids and stimulants in apparently harmless products. Hum Psychopharmacol 2015. [PMID: 26216561 DOI: 10.1002/hup.2410] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The urge to gain information on a new drug marketed online as 'Psyclone' has emerged after the death of a 38-year-old man in Bolton (UK). The fatality appeared to be a consequence of smoking this psychoactive product. METHODS From October to December 2013, qualitative searches of the Web have been carried out in English and Italian, using the keywords 'Psyclone', 'Psyclone legal high', 'Psyclone incense' and 'Psyclone research chemical' on the Google search engine and on the database provided by the Global Public Health Intelligence Network. RESULTS Our research highlighted the existence of two psychoactive products labelled as Psyclone but with different contents and packaging: a herbal blend containing two synthetic cannabinoids (AKB-48 and 5f-PB-22) and a research chemical containing 50% ethylphenidate, 30% caffeine and 20% lidocaine. Desired and side effects of both compounds are explored in the paper. CONCLUSIONS Being sold as a legal product, Psyclone may appeal to recreational users, who remain unaware of its real content. This is a serious public health threat, which may lead to acute intoxications and fatalities. Further studies in the field, including Internet monitoring, are therefore required.
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Affiliation(s)
- Rita Santacroce
- Department of Neuroscience and Imaging, University 'G. d'Annunzio', Chieti, Italy.,School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Giovanni Martinotti
- Department of Neuroscience and Imaging, University 'G. d'Annunzio', Chieti, Italy
| | - Francesco Saverio Bersani
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Valeriani
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
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49
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Kapitány-Fövény M, Mervó B, Kertész M, Corazza O, Farkas J, Kökönyei G, Urbán R, Demetrovics Z. Is there any difference in patterns of use and psychiatric symptom status between injectors and non-injectors of mephedrone? Hum Psychopharmacol 2015. [PMID: 26216556 DOI: 10.1002/hup.2490] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE In recent years, increasing intravenous mephedrone use was reported in several countries. The aim of this study was to describe the characteristics of such a form of mephedrone use, while identifying the differences between injectors and non-injectors in patterns of mephedrone use and psychiatric symptom status. METHODS One hundred and forty-five mephedrone users were surveyed on patterns of mephedrone use using a structured questionnaire as well as the Brief Symptom Inventory. RESULTS Majority of users received mephedrone from acquaintances and used it in discos/parties settings regarding both first and current mephedrone use. Intranasal use was the most typical route of administration (84.4%). Injectors (11%) used the drug more frequently and in higher dosages. This group included a greater proportion of opiate users (37.5%) and showed more diffuse psychiatric symptoms. Regarding the predictors of being an injector, heroin use showed the highest odds ratio. CONCLUSIONS Intravenous mephedrone use is associated with a higher risk of harmful drug use, elevated psychiatric symptom profile and increased possibility of mephedrone being considered as an addictive substance. These findings might be important in efficient treatment planning.
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Affiliation(s)
- Máté Kapitány-Fövény
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary.,Nyírő Gyula Hospital Drug Outpatient and Prevention Center, Budapest, Hungary.,Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Barbara Mervó
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Máté Kertész
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Judit Farkas
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary.,Nyírő Gyula Hospital Drug Outpatient and Prevention Center, Budapest, Hungary
| | - Gyöngyi Kökönyei
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Róbert Urbán
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
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50
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Martinotti G, Lupi M, Carlucci L, Cinosi E, Santacroce R, Acciavatti T, Chillemi E, Bonifaci L, Janiri L, Di Giannantonio M. Novel psychoactive substances: use and knowledge among adolescents and young adults in urban and rural areas. Hum Psychopharmacol 2015. [PMID: 26216566 DOI: 10.1002/hup.2486] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Novel psychoactive substances (NPS) are new psychotropic drugs, not scheduled under the International Conventions on Psychotropic Substances, but which may pose a relevant public health threat. In this study, we investigated knowledge and use of NPS in a sample of Italian youth in urban and rural areas. METHODS Between December 2012 and October 2013, we administered a questionnaire to a sample of 3011 healthy subjects (44.7% men; 55.3% women), aged between 16 and 24 years and recruited in urban, intermediate and rural areas of Italy. RESULTS Of the global sample, 53.3% declared to have some knowledge on NPS, with a higher knowledge in urban areas. Mephedrone (26%), desomorphine (22.6%) and methamphetamine (21.7%) were the most commonly known drugs. NPS use was reported by 4.7% of the sample, without significant differences between urban and rural areas; mephedrone (3.3%), synthetic cannabinoids (1.2%) and Salvia divinorum (0.3%) consumption has been identified. NPS use was also predictive of binge-drinking behaviours (χ(2) (4) = 929.58, p < .001). DISCUSSION Urban areas may represent a focal point for preventive strategies, given the presence of higher levels of NPS knowledge. Moreover, the association between binge-drinking habits and NPS use was really strong. This issue should not be underestimated because of its medical, psychopathological and social consequences.
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Affiliation(s)
- Giovanni Martinotti
- Department of Neuroscience and Imaging, " G. d'Annunzio" University, Chieti, Italy
| | - Matteo Lupi
- Department of Neuroscience and Imaging, " G. d'Annunzio" University, Chieti, Italy
| | - Leonardo Carlucci
- Department of Psychological Sciences, Humanities and Territory, " G. d'Annunzio" University, Chieti, Italy
| | - Eduardo Cinosi
- Department of Neuroscience and Imaging, " G. d'Annunzio" University, Chieti, Italy
| | - Rita Santacroce
- Department of Neuroscience and Imaging, " G. d'Annunzio" University, Chieti, Italy
| | - Tiziano Acciavatti
- Department of Neuroscience and Imaging, " G. d'Annunzio" University, Chieti, Italy
| | | | | | - Luigi Janiri
- Institute of Psychiatry and Psychology, Catholic University Medical School, Rome, Italy
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