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Huang MC, Chiang LJ, Chien WH, Liu TH, Chen CH, Liu YL. Plasma leptin levels are lower in females, but not males, with ketamine use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024:1-11. [PMID: 39432890 DOI: 10.1080/00952990.2024.2394963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 08/18/2024] [Accepted: 08/18/2024] [Indexed: 10/23/2024]
Abstract
Background: Ketamine has emerged as a prominent substance of misuse. Leptin, an adipocyte-derived polypeptide hormone, has been implicated in the development of addiction. Sex-specific changes in leptin levels have been demonstrated following acute ketamine administration; the persistence of long-term ketamine use on leptin levels is uncertain.Objectives: To assess the sex-difference of leptin levels, and their persistence, in individuals with ketamine use disorder (KUD) compared to healthy controls.Methods: Plasma leptin levels were measured in 62 healthy controls (37 males, 25 females) and 68 participants with KUD (50 males, 18 females) on the first day (baseline) and after 1 and 2 weeks of abstinence. As leptin levels are affected by body mass index (BMI), BMI-adjusted leptin (leptin/BMI ratio) was also examined. Mixed model for repeated measures was used to examine changes after ketamine abstinence.Results: Compared to same-sex controls, female, but not male, participants with KUD demonstrated lower leptin levels and leptin/BMI ratio at baseline, week 1, and week 2 (leptin levels: p = .001, 0.006 and 0.032, respectively; leptin/BMI ratio: p = .004, 0.022, and 0.09, respectively). Repeated measures showed that leptin levels and the leptin/BMI ratio increased after 2 weeks of abstinence in male participants with KUD (p = .002 and 0.011, respectively), but females did not show such an increase (p > .05).Conclusions: Sex-specific differences were observed in leptin levels and the leptin/BMI ratio in individuals with KUD compared to controls. Lower leptin levels in females with KUD persisted after 2 weeks of abstinence.
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Affiliation(s)
- Ming-Chyi Huang
- Department of Addiction Sciences, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Li-Jung Chiang
- Department of Addiction Sciences, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Wan-Hsi Chien
- Department of Addiction Sciences, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Tung-Hsia Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
| | - Chun-Hsin Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yu-Li Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli County, Taiwan
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Hwang ZA, Li CW, Hsu AL, Wu CW, Chan WP, Huang MC. Assessment of resting cerebral perfusion between methamphetamine-associated psychosis and schizophrenia through arterial spin labeling MRI. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01857-1. [PMID: 38970667 DOI: 10.1007/s00406-024-01857-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/20/2024] [Indexed: 07/08/2024]
Abstract
OBJECTIVE The clinical manifestations of methamphetamine (METH)-associated psychosis (MAP) and acute paranoid schizophrenia (SCZ) are similar. This study aims to assess regional cerebral blood flow (rCBF) in individuals who use METH and in those with SCZ using the MRI arterial spin labeling (ASL) technique. METHODS We prospectively recruited 68 participants and divided them into four groups: MAP (N = 15), SCZ (N = 13), METH users with no psychosis (MNP; N = 22), and normal healthy controls (CRL; N = 18). We measured rCBF using an MRI three-dimensional pseudo-continuous ASL sequence. Clinical variables were assessed using the Positive and Negative Syndrome Scale (PANSS) and Brief Assessment of Cognition in Schizophrenia (BACS). Group-level rCBF differences were analyzed using a two-sample t-test. RESULTS Decreased rCBF was found in the precuneus, premotor cortex, caudate nucleus, dorsolateral prefrontal cortex, and thalamus in the MNP group compared with the CRL group. The MAP group had significantly decreased rCBF in the precuneus, hippocampus, anterior insula, inferior temporal gyrus, inferior orbitofrontal gyrus, and superior occipital gyrus compared with the MNP group. Increased rCBF in the precuneus and premotor cortex was seen in the MAP group compared with the SCZ group. rCBF in the precuneus and premotor cortex significantly correlated negatively with the PANSS but correlated positively with BACS scores in the MAP and SCZ groups. CONCLUSION METH exposure was associated with decreased rCBF in the precuneus and premotor cortex. Patients with MAP exhibited higher rCBF than those with SCZ, implying preserved insight and favorable outcomes. rCBF can therefore potentially serve as a diagnostic approach to differentiate patients with MAP from those with SCZ.
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Affiliation(s)
- Zhen-An Hwang
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Wei Li
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- GE Healthcare, Taipei, Taiwan
| | - Ai-Ling Hsu
- Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Changwei W Wu
- Graduate Institute of Mind, Brain and Consciousness (GIMBC), Taipei Medical University, Taipei, Taiwan
| | - Wing P Chan
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
| | - Ming-Chyi Huang
- Department of Addiction Sciences, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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Chen YC, Hsu JY, Chang CW, Chen PY, Lin YC, Hsu IL, Chu CJ, Lin YP, Liao PC. Investigation of New Psychoactive Substances (NPS), Other Illicit Drugs, and Drug-Related Compounds in a Taiwanese Wastewater Sample Using High-Resolution Mass-Spectrometry-Based Targeted and Suspect Screening. Molecules 2023; 28:5040. [PMID: 37446702 DOI: 10.3390/molecules28135040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/19/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
The proliferation of new psychoactive substances (NPSs) in recent years has posed a significant challenge to public health. Traditional monitoring methods have proven insufficient in tracking these constantly evolving substances, leading to the development of alternative approaches such as wastewater-based epidemiology (WBE). The present study aims to utilize high-resolution mass spectrometry (HRMS)-based targeted and suspect screening to profile NPS, other illicit drugs, and drug-related compounds in a Taiwanese wastewater sample. For the targeted analysis, 8 out 18 standards of illicit drugs have been identified. The suspect screening approach based on approximately 3600 substances in the SWGDRUG library can further identify 92 compounds, including opiate analgesics, synthetic cathinones, phenylalkylamines derivatives, phenethylamine derivatives, tryptamine derivatives, steroids, and ephedrine-related compounds. Additionally, the presence of 5-methoxy-2-aminoindane (MEAI) in the wastewater indicates that drug dealers have recently sold this potential NPS to evade drug regulations. This study firstly reports the HRMS-based comprehensive profile of NPS, other illicit drugs, and drug-related compounds in Taiwan, which could be applied as biomarkers for estimating the consumption of drugs.
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Affiliation(s)
- Yuan-Chih Chen
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Jen-Yi Hsu
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Chih-Wei Chang
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Pin-Yu Chen
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - Yung-Chieh Lin
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
| | - I-Lin Hsu
- Public Health Bureau, Tainan City Government, Tainan 704, Taiwan
| | - Chiau-Jun Chu
- Public Health Bureau, Tainan City Government, Tainan 704, Taiwan
| | - Yen-Ping Lin
- Public Health Bureau, Tainan City Government, Tainan 704, Taiwan
| | - Pao-Chi Liao
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
- Department of Food Safety/Hygiene and Risk Management, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan
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Ku YC, Chung HP, Hsu CY, Cheng YH, Hsu FIC, Tsai YC, Chao E, Lee TSH. Recidivism of Individuals Who Completed Schedule I Drugs Deferred Prosecution Treatment: A Population-Based Follow-Up Study from 2008 to 2020 in Taiwan. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-023-01034-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
AbstractDeferred Prosecution with Condition to Complete the Addiction Treatment (DPCCAT) is a judicial diversion program in Taiwan that shifts people who use drugs away from the label drug offender and toward the label patient. However, little is known about the effectiveness of completing a DPCCAT program on people who use drugs. Using a nationwide population-based retrospective panel data from 2008 to 2020, recidivism is defined as a person was caught urine positive and charged by a prosecutor after their completion of DPCCAT. After controlled gender, age, and region, comparisons of recidivism rates and time to relapse between Schedule I drug use only, Schedule I & II drug use, and heterogeneous group were examined. Of 24,248 participants with DPCCAT, 11,141 (46%) completed the one-year treatment program. Of completers, the five-year recidivism rates are significantly lower for the Schedule I drug use only (26%) than Schedule I & II drugs use (52%) and heterogeneous group (47%). Results from Cox regression indicated that the duration of recidivate to drug use is significantly longer for the Schedule I drug only than the other two groups after controlling for demographics. The main findings support that completion of a DPCCAT program only reduces the risk of recidivism for people who use Schedule I drug only and is less effective for polydrug users and heterogeneous group. We suggest that characteristics of people who use drugs and other criminal offenses should be taken into consideration for triage when DPCCAT is offered.
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Chang KC, Chen HP, Huang SW, Chen JS, Potenza MN, Pakpour AH, Lin CY. Comparisons of psychological distress and self-stigma among three types of substance use disorders receiving treatment-as-usual approaches: real-world data from a 9-month longitudinal study. Ther Adv Chronic Dis 2022; 13:20406223221140393. [PMID: 36483780 PMCID: PMC9723802 DOI: 10.1177/20406223221140393] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 11/03/2022] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND Substance use is an important issue worldwide and people with substance use disorders (SUDs) have been reported to have high levels of psychological distress and self-stigma. Therefore, psychological distress and self-stigma in people with SUDs are considerable. OBJECTIVE The present study used a longitudinal design to examine whether treatment-as-usual approaches in Taiwan improve psychological distress and self-stigma among people with three types of SUDs (heroin, amphetamine, and alcohol use disorders). DESIGN A 9-month longitudinal design involving four assessments spaced 3 months apart. METHODS Convenience sampling was used to recruit people with heroin (n = 112), amphetamine (n = 151), and alcohol (n = 56) use disorders from outpatient psychiatric center in Southern Taiwan. Psychological distress was assessed using the Depression, Anxiety, Stress Scale (DASS-21), and self-stigma was assessed using the Self-Stigma Scale-Short (SSS-S). Generalized estimating equation (GEE) models were constructed to understand between-group differences in psychological distress and self-stigma over time. RESULTS Patients with heroin and amphetamine use disorders had lower levels of psychological distress as compared with those with alcohol use disorder. Levels of psychological distress were lower at Time 2 to Time 4 as compared with Time 1. Patients with heroin and amphetamine use disorders had higher levels of self-stigma as compared with those with alcohol use disorder. Self-stigma levels remained stable over time. The dropout rate of receiving treatment-as-usual approach in the 9-month study was 60%. CONCLUSION Treatment as usual for SUDs among outpatients in Taiwan may decrease psychological distress but not self-stigma. However, such effects need to be further examined given the high drop-out rates and absence of a control condition. The findings suggest that self-stigma may warrant additional treatment for patients with SUDs.
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Affiliation(s)
| | | | - Shih-Wei Huang
- Institute of Environmental Toxin and Emerging
Contaminant, Cheng Shiu University, Kaohsiung, Taiwan
- Center for Environmental Toxin and
Emerging-contaminant Research, Cheng Shiu University, Kaohsiung,
Taiwan
| | - Jung-Sheng Chen
- Department of Medical Research, E-Da Hospital,
Kaohsiung, Taiwan
| | - Marc N. Potenza
- Department of Psychiatry, Yale School of
Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven,
CT, USA
- Connecticut Council on Problem Gambling,
Wethersfield, CT, USA
- Child Study Center, Yale School of Medicine,
New Haven, CT, USA
- Department of Neuroscience, Yale University,
New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven,
CT, USA
| | - Amir H. Pakpour
- Department of Nursing, School of Health and
Welfare, Jönköping University, Jönköping, Sweden
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Tang H, Tang W, An X, Lu Z, Jia Z. Tracking the Trend of Ketamine Use in China During 2010–2015: a Retrospective Observational Study. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00741-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Rhee J, Lee J, Kim J, Jang M, Shin I, Lee S. Determination of Ketamine and Norketamine in Hair and Evaluation of Polydrug Use in Ketamine Abusers Using Hair Analysis in Korea. J Anal Toxicol 2021; 45:993-1005. [PMID: 33196839 DOI: 10.1093/jat/bkaa166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/04/2020] [Accepted: 11/14/2020] [Indexed: 12/31/2022] Open
Abstract
This study evaluated hair samples from 28 subjects who tested positive for ketamine at Seoul Institute National Forensic Service in Korea between 2016 and 2017. Ketamine in the hair was extracted using a solution of 1% hydrochloric acid in methanol for 16 h. Extracts were analyzed using gas chromatography-mass spectrometry (GC-MS) or liquid chromatography-tandem mass spectrometry (LC-MS-MS). The LC-MS-MS method was validated by determining the limit of detection (LOD), limit of quantification (LOQ), linearity, intra- and inter-accuracy, precision and matrix effect. In 59 ketamine-positive hair or hair segments from 28 ketamine abusers, the ketamine concentration was found to be in the range of 0.011-335.8 ng/mg (mean, 13.6; median, 1.8), and the norketamine concentration was found to be in the range of 0.001-35.7 ng/mg (mean, 7.5; median, 0.44). The ratio of norketamine to ketamine concentrations in hair was in the range of 0.01-1.46 (mean, 0.34; median, 0.26). The distribution of ketamine concentration in hair samples was as follows: 0.01-0.1 ng/mg in 11 samples (18.6%), 0.1-5 ng/mg in 33 samples (55.9%), 5-10 ng/mg in 4 samples (6.8%), 10-15 ng/mg in 2 samples (3.4%), 15-20 ng/mg in 4 samples (6.8%), 40-45 ng/mg in 2 samples (3.4%), 45-50 ng/mg in 1 sample (1.7%) and >100 ng/mg in only 2 samples (3.4%). In the hair of ketamine abusers, 26 of 28 subjects were detected simultaneously ketamine with other drugs, including methylenedioxymethamphetamine (MDMA; n = 9), methamphetamine (MA; n = 3), MDMA/MA (n = 3), MDMA/para-methoxyamphetamine (PMA; n = 3), MDMA/PMA/MA (n = 2), cocaine (n = 1) and other drugs (n = 5, propofol, zolpidem or benzodiazepines). Along with ketamine, other controlled drugs were detected in most of the hair samples: MDMA (60.7%), MA (28.6%), PMA (17.9%), zolpidem (17.9%) and propofol (14.3%) in the frequency of abuse. In conclusion, most of the ketamine abusers (92.9%) were polydrug abusers, who were concomitantly abusing other controlled substances.
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Affiliation(s)
- Jongsook Rhee
- Forensic Toxicology Division, Busan institute National Forensic Service, 50 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do 50612, Republic of Korea
| | - Juseon Lee
- Forensic Toxicology Division, Busan institute National Forensic Service, 50 Geumo-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do 50612, Republic of Korea
| | - Jihyun Kim
- Forensic Toxicology Division, Seoul institute National Forensic Service, 139 Jiyang-ro, Yangcheon-gu, Seoul 08036, Republic of Korea
| | - Moonhee Jang
- Forensic Toxicology Division, Seoul institute National Forensic Service, 139 Jiyang-ro, Yangcheon-gu, Seoul 08036, Republic of Korea
| | - Ilchung Shin
- Forensic Toxicology Division, Seoul institute National Forensic Service, 139 Jiyang-ro, Yangcheon-gu, Seoul 08036, Republic of Korea
| | - Sangki Lee
- Forensic Toxicology Division, Seoul institute National Forensic Service, 139 Jiyang-ro, Yangcheon-gu, Seoul 08036, Republic of Korea
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Yoo S, Cho MH, Baek HS, Song JY, Lee HS, Yang EM, Yoo KH, Kim SJ, Shin JI, Lee KH, Ha TS, Jang KM, Lee JW, Kim KH, Cho H, Lee MJ, Suh JS, Han KH, Hyun HS, Ha IS, Cheong HI, Kang HG, Namgoong MK, Cho HK, Oh JH, Lee ST, Kim KS, Lee JH, Park YS, Kim SH. Characteristics of pediatric rhabdomyolysis and the associated risk factors for acute kidney injury: a retrospective multicenter study in Korea. Kidney Res Clin Pract 2021; 40:673-686. [PMID: 34510859 PMCID: PMC8685356 DOI: 10.23876/j.krcp.21.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/20/2021] [Indexed: 11/28/2022] Open
Abstract
Background The clinical features of pediatric rhabdomyolysis differ from those of the adults with rhabdomyolysis; however, multicenter studies are lacking. This study aimed to investigate the characteristics of pediatric rhabdomyolysis and reveal the risk factors for acute kidney injury (AKI) in such cases. Methods This retrospective study analyzed the medical records of children and adolescents diagnosed with rhabdomyolysis at 23 hospitals in South Korea between January 2007 and December 2016. Results Among 880 patients, those aged 3 to 5 years old composed the largest subgroup (19.4%), and all age subgroups were predominantly male. The incidence of AKI was 11.3%. Neurological disorders (53.6%) and infection (39.0%) were the most common underlying disorder and cause of rhabdomyolysis, respectively. The median age at diagnosis in the AKI subgroup was older than that in the non-AKI subgroup (12.2 years vs. 8.0 years). There were no significant differences in body mass index, myalgia, dark-colored urine, or the number of causal factors between the two AKI-status subgroups. The multivariate logistic regression model indicated that the following factors were independently associated with AKI: multiorgan failure, presence of an underlying disorder, strong positive urine occult blood, increased aspartate aminotransferase and uric acid levels, and reduced calcium levels. Conclusions Our study revealed characteristic clinical and laboratory features of rhabdomyolysis in a Korean pediatric population and highlighted the risk factors for AKI in these cases. Our findings will contribute to a greater understanding of pediatric rhabdomyolysis and may enable early intervention against rhabdomyolysis-induced AKI.
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Affiliation(s)
- Sukdong Yoo
- Department of Pediatrics, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Min Hyun Cho
- Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Hee Sun Baek
- Department of Pediatrics, Kyungpook National University, School of Medicine, Daegu, Republic of Korea
| | - Ji Yeon Song
- Department of Pediatrics, Pusan National University School of Medicine, Busan, Republic of Korea
| | - Hye Sun Lee
- Department of Pediatrics, National Police Hospital, Seoul, Republic of Korea
| | - Eun Mi Yang
- Department of Pediatrics, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Kee Hwan Yoo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Su Jin Kim
- Department of Pediatrics, Inha University School of Medicine, Incheon, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Keum Hwa Lee
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae-Sun Ha
- Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Kyung Mi Jang
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Republic of Korea
| | - Jung Won Lee
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Kee Hyuck Kim
- Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Republic of Korea
| | - Heeyeon Cho
- Department of Pediatrics, Samsung Medical Center, Seoul, Republic of Korea
| | - Mee Jeong Lee
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Jin-Soon Suh
- Department of Pediatrics, The Catholic University of Korea, Bucheon Saint Mary's Hospital, Bucheon, Republic of Korea
| | - Kyoung Hee Han
- Department of Pediatrics, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Hye Sun Hyun
- Department of Pediatrics, The Catholic University of Korea, Saint Vincent's Hospital, Suwon, Republic of Korea
| | - Il-Soo Ha
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hae Il Cheong
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Hee Gyung Kang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Mee Kyung Namgoong
- Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hye-Kyung Cho
- Department of Pediatrics, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Jae-Hyuk Oh
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sang Taek Lee
- Department of Pediatrics, Samsung Changwon Hospital, Changwon, Republic of Korea
| | - Kyo Sun Kim
- Department of Pediatrics, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Joo Hoon Lee
- Department of Pediatrics, Children's Hospital, Asan Medical Center, Seoul, Republic of Korea
| | - Young Seo Park
- Department of Pediatrics, Children's Hospital, Asan Medical Center, Seoul, Republic of Korea
| | - Seong Heon Kim
- Department of Pediatrics, Pusan National University School of Medicine, Busan, Republic of Korea
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9
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Arango E, Toriello A, Rosario Z, Cooper G. Increasing Prevalence of Ketamine in Drivers in New York City Including the Identification of 2-Fluoro-Deschloroketamine. J Anal Toxicol 2021; 45:799-806. [PMID: 34050644 DOI: 10.1093/jat/bkab057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/11/2021] [Accepted: 05/28/2021] [Indexed: 11/12/2022] Open
Abstract
Ketamine is a dissociative anesthetic used in veterinary and human medicine since the 1970s. Its clinical use has expanded to control of seizures, pre-hospital emergency medical services (EMS), and is finding new purpose as an analgesic alternative and antidepressant. Ketamine brings hope for effective management of chronic pain in the absence of opioids, and decreasing suicidal ideations, however, its persistence as a recreational drug for its hallucinogenic properties remains. In the wake of expanding medicinal purposes, the diversity of New York City's population was explored to better understand its misuse. This retrospective study looks at the prevalence of ketamine in driver fatalities over a period of 18 years (2003-2020) and cases involving suspected driving under the influence of drugs (DUID) over a period of 6 years (2015-2020). Ketamine was identified in 6 driver fatalities and in 47 DUID cases. None of the driver fatalities were suspected of ketamine misuse, due to administration either in hospital or EMS administration. In the DUID cases, an increasing trend was observed over the 6-year study period with 100% (N = 47) of the cases confirmed as non-hospital/non-EMS administered ketamine. Of the DUID cases, 94% were male, with the majority between the age of 21-39 years (85%) and were predominantly Hispanic (36%) and Asian (34%). Blood concentrations of ketamine ranged from 27 to > 2000 ng/mL with polydrug use prevalent. The most common drug classes detected in addition to ketamine were cannabinoids (38%), ethanol (32%), benzodiazepines (26%), cocaine (19%), and amphetamines/MDMA (15%). In 2019, 2-fluoro-deschloroketamine (2F-DCK) was identified in two cases for the first time. Despite its increased acceptance for mental health disorders, ketamine's persistence and misuse as a recreational drug remains and should continue to be monitored by relevant toxicological, clinical, and law enforcement communities along with emerging illicit ketamine analogs.
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Affiliation(s)
- Elba Arango
- Department of Forensic Toxicology, NYC Office of Chief Medical Examiner, 520 First Avenue, New York, NY 10016
| | - Allison Toriello
- Department of Forensic Toxicology, NYC Office of Chief Medical Examiner, 520 First Avenue, New York, NY 10016
| | - Zoila Rosario
- Department of Forensic Toxicology, NYC Office of Chief Medical Examiner, 520 First Avenue, New York, NY 10016
| | - Gail Cooper
- Department of Forensic Toxicology, NYC Office of Chief Medical Examiner, 520 First Avenue, New York, NY 10016
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Lee CY, Wu PH, Chen TC, Lu PL. Changing Pattern of Chemsex Drug Use Among Newly Diagnosed HIV-Positive Taiwanese from 2015 to 2020 in the Era of Treat-All Policy. AIDS Patient Care STDS 2021; 35:134-143. [PMID: 33835851 DOI: 10.1089/apc.2020.0246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Chemsex drug use (CDU) is a frequent, yet neglected issue in the era of treat-all policy. We evaluated the temporal pattern of CDU, factors associated with CDU, and drug-drug interactions (DDIs) between chemsex drugs and initial antiretroviral therapy (ART) by surveying 621 Taiwanese individuals (mean age: 29.7 years; 99.2% men; 92.9% men who have sex with men) diagnosed with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) from 2015 to 2020 [2015 to 2016 (period 1), 2017 to 2018 (period 2), and 2019 to 2020 (period 3)]. CDU was defined as chemsex in the past 1 year before HIV diagnosis. CDU remained prevalent across three periods (34.3-30.5%). Among CDU, methamphetamine (43.4%) was most frequently used, followed by amphetamine (40.0%) and poppers (various alkyl nitrites) (39.5%). We identified significantly increasing amphetamine use (37.0-61.5%) and decreasing ecstasy (methylenedioxy-methamphetamine) use (32.1-17.9%) in CDU across three periods. Besides, polydrug chemsex also significantly increased in CDU across three periods (23.5-43.6%), with amphetamine plus gamma-hydroxybutyrate being the most commonly used combination. CDU was associated with multiple sexual partners and a history of sexually transmitted diseases (STDs). DDIs between chemsex drugs and initial ART remained stable across three periods (10.6-7.8%), with cobicistat/elvitegravir and methamphetamine most common combination. In summary, the magnitude of CDU remained high across 2015-2020 in Taiwan, causing DDIs with initial ART agents. Strategies to reduce the frequency of high-risk sexual practices, STD transmission, and DDIs for newly diagnosed HIV-positive patients engaging in chemsex should be implemented.
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Affiliation(s)
- Chun-Yuan Lee
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Hua Wu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tun-Chieh Chen
- Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Infection Control Office, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Po-Liang Lu
- Department of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Taiwan
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11
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Chen PH, Tsai SY, Pan CH, Chang HM, Chen YL, Su SS, Chen CC, Kuo CJ. Age Effect on Incidence, Physical, and Psychiatric Comorbidity for Sudden Cardiac Death in Schizophrenia: Effet de l'âge sur l'incidence, la comorbidité physique et psychiatrique de la mort cardiaque subite dans la schizophrénie. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:367-375. [PMID: 32799653 PMCID: PMC8172351 DOI: 10.1177/0706743720948429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The pathogenesis of sudden cardiac death may differ between younger and older adults in schizophrenia, but evidence remains scant. This study investigated the age effect on the incidence and risk of the physical and psychiatric comorbidity for sudden cardiac death. METHODS Using 2000 to 2016 data from the Taiwan National Health Insurance Research Database and Department of Health Death Certification System, we identified a national cohort of 170,322 patients with schizophrenia, 1,836 of whom had a sudden cardiac death. Standardized mortality ratios (SMRs) were estimated. Hazard ratios and population attributable fractions of distinctive comorbidities for sudden cardiac death were assessed. RESULTS The SMRs of sudden cardiac death were all >1.00 across each age group for both sexes, with the highest SMR in male patients aged <35 years (30.88, 95% CI: 26.18-36.18). The fractions of sudden cardiac death attributable to hypertension and congestive heart failure noticeably increased with age. By contrast, the fraction attributable to drug-induced mental disorder decreased with age. Additionally, chronic hepatic disease and sleep disorder increased the risk of sudden cardiac death in patients aged <35 years. Dementia and organic mental disorder elevated the risk in patients aged between 35-54 years. Ischemic heart disease raised the risk in patients aged ≥55 years. CONCLUSIONS The risk is increased across the lifespan in schizophrenia, particularly for younger male patients. Furthermore, physical and psychiatric comorbidities have age-dependent risks. The findings suggest that prevention strategies targeted toward sudden cardiac death in patients with schizophrenia must consider the age effect.
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Affiliation(s)
- Pao-Huan Chen
- Department of Psychiatry, 63474Taipei Medical University Hospital, Taipei.,Psychiatric Research Center, 63474Taipei Medical University Hospital, Taipei.,Department of Psychiatry, School of Medicine, College of Medicine, 63474Taipei Medical University, Taipei
| | - Shang-Ying Tsai
- Department of Psychiatry, 63474Taipei Medical University Hospital, Taipei.,Psychiatric Research Center, 63474Taipei Medical University Hospital, Taipei.,Department of Psychiatry, School of Medicine, College of Medicine, 63474Taipei Medical University, Taipei
| | - Chun-Hung Pan
- Taipei City Psychiatric Center, 433112Taipei City Hospital, Taipei.,Department of Psychology, National Chengchi University, Taipei
| | - Hu-Ming Chang
- Taipei City Psychiatric Center, 433112Taipei City Hospital, Taipei
| | - Yi-Lung Chen
- Taipei City Psychiatric Center, 433112Taipei City Hospital, Taipei
| | - Sheng-Siang Su
- Taipei City Psychiatric Center, 433112Taipei City Hospital, Taipei
| | - Chiao-Chicy Chen
- Department of Psychiatry, School of Medicine, College of Medicine, 63474Taipei Medical University, Taipei.,Department of Psychiatry, 36897Mackay Memorial Hospital, Taipei.,Department of Psychiatry, Mackay Medical College, Taipei
| | - Chian-Jue Kuo
- Psychiatric Research Center, 63474Taipei Medical University Hospital, Taipei.,Department of Psychiatry, School of Medicine, College of Medicine, 63474Taipei Medical University, Taipei.,Taipei City Psychiatric Center, 433112Taipei City Hospital, Taipei
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12
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Lee SO, Lee JE, Lee S, Lee SH, Kang JS. Prevalence and patterns of illicit drug use in people with human immunodeficiency virus infection in Korea. PLoS One 2021; 16:e0249361. [PMID: 33793637 PMCID: PMC8016334 DOI: 10.1371/journal.pone.0249361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 03/16/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Data on illicit drug use by Korean people infected with HIV are lacking. Here, we examined the prevalence and patterns of illicit drug use among people infected with HIV in Korea. MATERIAL AND METHODS In this cross-sectional study, we included all patients infected with HIV who visited a tertiary care hospital in Korea from January 1990 to May 2020. Sociodemographic data of patients, including drug use, were collected at the first visit and during follow-up. RESULTS Among 1,267 patients, 5.13% reported the use of an illicit drug in their lifetime, and 2.61% were users of injection drugs. The most commonly used drugs were cannabis/marijuana and methamphetamine, followed by nitrite inhalants, cocaine, dextromethorphan, carisoprodol, and 3,4-methylenedioxymethamphetamine. The illicit drug users tended to be younger than non-users, homosexuals/bisexuals, and infected with hepatitis C virus (HCV); they had a higher CD4+ cell count than non-users. Among 65 users of illicit drugs, only 24.6% revealed their drug use at the first visit interview, and 24.6% reported using two or more drugs in their lifetime. Individuals who used injection drugs were more likely to be arrested for drug-related charges than the users of non-injection drugs. Moreover, they tended to be heavy users of illicit drugs, to report using two or more drugs in their lifetime, and to be HCV seropositive. In contrast, the users of non-injection drugs were more likely to be experimental users and to start using drugs overseas for the first time, but less likely to report their drug use at the first interview. CONCLUSIONS The prevalence of illicit drug use in people with HIV infection in Korea may have been underestimated. Further research based on more accurate measurements are warranted.
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Affiliation(s)
- Soon Ok Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jeong Eun Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Shinwon Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sun Hee Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Medical Research Institute, Pusan National University Hospital, Busan, Korea
- * E-mail:
| | - Jin Suk Kang
- Division of Infectious Disease, Department of Internal Medicine, Inje University College of Medicine, Inje University Busan Paik Hospital, Busan, Korea
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13
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Chou HH, Hsieh CH, Chaou CH, Chen CK, Yen TH, Liao SC, Seak CJ, Chen HY. Synthetic cathinone poisoning from ingestion of drug-laced "instant coffee packets" in Taiwan. Hum Exp Toxicol 2021; 40:1403-1412. [PMID: 33715482 DOI: 10.1177/0960327121996043] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Synthetic cathinone abuse is a global health issue. Synthetic cathinones emerged in Taiwan in 2009, and their prevalence rapidly rose. They are usually made into "instant coffee packets," and these so-called "toxic coffee packets" may also contain psychoactive drugs other than synthetic cathinones. Due to the diversity of the ingredients, clinical presentations can be complex. METHODS Retrospective analysis of emergency department (ED) patients who reported ingesting toxic coffee packets at three Chang-Gung Memorial Hospitals located in northern Taiwan between January, 2015 and December, 2019. RESULTS Sixty patients were included. Their mean age was 28.85 ± 9.24 years and 47(78.33%) were male. The most common presentations were palpitation, agitation, hallucination, and altered consciousness. Tachycardia and hypertension were common, while hyperthermia was observed in only three patients. Three patients (5%) developed rhabdomyolysis, and one underwent transient hemodialysis. Most patients were discharged from the ED, but 15(25%) were admitted, of whom nine (15%) were admitted to the intensive care unit (ICU), and one eventually died. Confirmation tests (mass-spectrometry-based analysis) were available in 10 patients; all reported positive for at least one type of synthetic cathinone. Polysubstance exposure was common. In multivariate logistic regression analyses, Glasgow coma scale ≤13 and the presence of seizure were associated with ICU admission. CONCLUSION Patients who report ingesting toxic coffee packets are very likely to have been exposed to synthetic cathinones. Polysubstance exposure is common following ingestion. Cardiovascular and neurological symptoms are the main presentations, and severe complications such as rhabdomyolysis and life-threatening dysrhythmia can occur.
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Affiliation(s)
- H-H Chou
- Department of Emergency Medicine, 38014Chang Gung Memorial Hospital, Keelung
| | - C-H Hsieh
- Department of Emergency Medicine, 38014Chang Gung Memorial Hospital, Linkou
| | - C-H Chaou
- Department of Emergency Medicine, 38014Chang Gung Memorial Hospital, Linkou.,College of Medicine, 38014Chang Gung University, Taoyuan
| | - C-K Chen
- Department of Emergency Medicine, 38014Chang Gung Memorial Hospital, Linkou
| | - T-H Yen
- College of Medicine, 38014Chang Gung University, Taoyuan.,Department of Nephrology and Clinical Poison Center, 38014Chang Gung Memorial Hospital, Taoyuan
| | - S-C Liao
- Department of Emergency Medicine, 38014Chang Gung Memorial Hospital, Keelung
| | - C-J Seak
- Department of Emergency Medicine, 38014Chang Gung Memorial Hospital, Linkou.,College of Medicine, 38014Chang Gung University, Taoyuan.,Department of Emergency Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City
| | - H-Y Chen
- Department of Emergency Medicine, 38014Chang Gung Memorial Hospital, Linkou.,College of Medicine, 38014Chang Gung University, Taoyuan
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14
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Anderson SAR, Catallozzi M. Autism Spectrum Disorder and the Risk of Substance Use Disorder: A Call for Targeted Screening and Prevention in Adolescents. JAMA Pediatr 2021; 175:e205376. [PMID: 33393966 DOI: 10.1001/jamapediatrics.2020.5376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Sarah Ann R Anderson
- Department of Pediatrics, New York-Presbyterian Morgan Stanley Children's Hospital, Columbia University Irving Medical Center, New York
| | - Marina Catallozzi
- Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.,Vagelos College of Physicians & Surgeons, Columbia University, New York, New York.,Mailman School of Public Health, New York, New York
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15
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Li CW, Ku SWW, Huang P, Chen LY, Wei HT, Strong C, Bourne A. Factors associated with methamphetamine dependency among men who have sex with men engaging in chemsex: Findings from the COMeT study in Taiwan. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 93:103119. [PMID: 33468444 DOI: 10.1016/j.drugpo.2021.103119] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/16/2020] [Accepted: 12/31/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Sexualized drug use or "chemsex" in Taiwan commonly incorporates the use of methamphetamine. Our study aimed to assess the extent of severity of dependence of methamphetamine among MSM in Taiwan as well as motivations for engagement in chemsex. METHODS Direct messages were sent to users of a large MSM social networking application in Taiwan between November 2018 and January 2019. MSM who had at least one experience of using drugs during sex in the preceding 12 months were invited to complete an online survey that assessed their sexual behavior, substance use and motivations for engaging in chemsex. The Severity of Dependence Scale was used to assess methamphetamine dependency. Multivariable logistic regression was used to determine the factors associated with methamphetamine dependency. RESULTS From a total of 1906 responses, 517 had used methamphetamine in their lifetime and were included in the analysis. The majority (87.2%) used more than one substance when engaging in chemsex in the past six months, while a quarter reported injection of methamphetamine within the last six months. The most commonly reported motivations for participants to engage in chemsex were to have fun, for relaxation, and to increase the intensity of the sexual experience. Nearly half (46.0%) exhibited signs of methamphetamine dependency. Lower monthly income, injection of methamphetamine, ever feeling lonely in the past 3 months and concerns about their substance use expressed by others were significantly associated with methamphetamine dependency. CONCLUSION A high proportion of MSM population who engaged in chemsex were at risk of developing methamphetamine dependency. While motivations for engaging in chemsex were diverse and suggest potential for enhanced sexual experience for some, community health organization for gay men's health and healthcare providers should be vigilant at identifying the risk of methamphetamine dependency and provide in-time, brief intervention or referrals when needed.
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Affiliation(s)
- Chia-Wen Li
- Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Stephane Wen-Wei Ku
- Division of Infectious Diseases, Department of Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan
| | - Poyao Huang
- Fairbank Center for Chinese Studies, Harvard University, Cambridge, MA, United States
| | - Lian-Yu Chen
- Kumming Prevention and Control Center, Taipei City Hospital, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Han-Ting Wei
- Kumming Prevention and Control Center, Taipei City Hospital, Taipei, Taiwan; Department of Psychiatry, Branch of Linsen, Chiniese Medicine, and Kumming, Taipei City Hospital, Taipei, Taiwan
| | - Carol Strong
- Department of Public Health, College of Medicine, National Cheng Kung University, 8F-8068, No. 138, ShengLi Rd., North Dist, Tainan 704, Taiwan.
| | - Adam Bourne
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia; Kirby Institute, UNSW Sydney, Australia
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16
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Weng TI, Chen LY, Chen JY, Chen PS, Hwa HL, Fang CC. Characteristics of analytically confirmed illicit substance-using patients in the Emergency Department. J Formos Med Assoc 2020; 119:1827-1834. [DOI: 10.1016/j.jfma.2020.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/07/2019] [Accepted: 01/02/2020] [Indexed: 12/29/2022] Open
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17
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Yen CF, Lin HC, Ko CH, Wu HC, Hsu CY, Wang PW. Sleep quality among individuals with ketamine use and the mediating role of craving. Sci Rep 2020; 10:20535. [PMID: 33239629 PMCID: PMC7689503 DOI: 10.1038/s41598-020-77631-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/13/2020] [Indexed: 12/13/2022] Open
Abstract
Sleep problems are common in Taiwan. Poor sleep may be associated with many illnesses, including substance use disorders. Ketamine use disorder has significantly increased in Taiwan in recent years and may lead to physical and cognitive problems. Craving for ketamine is a risk factor for ketamine use and relapse, and poor sleep quality may increase craving. This study aimed to explore the mediating effects of craving on the relationship between poor sleep quality and ketamine use. Demographic data, sleep quality, severity of dependence and craving were recorded for current ketamine users and abstinent ketamine users. Mediation analysis was used to examine the mediating effect of craving on the relationship between poor sleep and ketamine use. This study enrolled 414 current ketamine users with ketamine use disorder, 238 current ketamine users without ketamine use disorder, and 102 abstinent ketamine users with ketamine use disorder. Compared with healthy controls, all ketamine users had poor sleep quality. Poor sleep quality was associated with the initiation of and dependence on ketamine use. Craving can mediate the relationship between poor sleep quality and ketamine use. Poor sleep quality remains a problem for those abstaining from ketamine use. Poor sleep quality in ketamine users is an important issue because it is directly and indirectly through craving associated with ketamine use.
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Affiliation(s)
- Cheng-Fang Yen
- Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Psychiatry, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan
| | - Huang-Chi Lin
- Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Psychiatry, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan
| | - Chih-Hung Ko
- Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Psychiatry, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.,Department of Psychiatry, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-Chi Wu
- Department of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Chih-Yao Hsu
- Department of Addiction Science, Kai-Suan Psychiatric Hospital, Kaohsiung, Taiwan
| | - Peng-Wei Wang
- Department of Psychiatry, Faculty of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. .,Department of Psychiatry, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung, 807, Taiwan.
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Abstract
PURPOSE OF REVIEW Abuse of new psychoactive substances (NPS) has been a new global concern. So far, there has been no international consensus on legislative control of NPS. Scrutiny of Taiwan's illegal drug use history reveals that legislation and policy play an important role in tackling the drug issues. RECENT FINDINGS Since the early 2000s, use of club drugs (mostly NPS) has become popular in local rave parties and dance clubs in Taiwan. Some NPS, such as ketamine, synthetic cathinones, and para-methoxymethamphetamine, have posed a risk to public health and a challenge to drug policy. SUMMARY The illegal drug use history in Taiwan was firstly briefly reviewed, and the recent NPS use situation was depicted. Heroin and methamphetamine have been the most predominant drugs, but NPS such as ketamine and synthetic cathinones have become a new issue. The toxicological profiles of commonly abused NPS in Taiwan, although limited, were discussed. By comparison of the legislative mechanism for NPS control between Taiwan, South Korea, and Japan, it was found that timely and flexible legislative mechanism(s) is essential for early identification, surveillance, and comprehensive evaluation. In addition, researches on NPS epidemiology and toxicology are needed to firm up evidence-based strategies for effective prevention, treatment, and harm reduction measures.
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Huang MC, Chen CH, Chen LY, Chang HM, Chen CK, Lin SK, Xu K. Chronic ketamine abuse is associated with orexin-A reduction and ACTH elevation. Psychopharmacology (Berl) 2020; 237:45-53. [PMID: 31377886 DOI: 10.1007/s00213-019-05342-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 07/25/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Ketamine has emerged as a major substance of abuse worldwide. Evidence suggests a role of orexin system in reward processing, withdrawal, and stress response. It also interacts with the stress mechanisms of hypothalamic-pituitary-adrenal (HPA) axis to regulate drug-taking behavior. The study aimed to explore the relevance of orexin and stress hormones to chronic ketamine abuse. METHODS We enrolled 67 ketamine-dependent (KD) patients and 64 controls. The levels of orexin-A, adrenocorticotropic hormone (ACTH), and cortisol were measured at baseline, 1 week, and 2 weeks after ketamine discontinuation. KD patients were assessed by Beck Depression Inventory, Beck Anxiety Inventory, and Visual Analogue Scale for ketamine craving at baseline. RESULTS Compared with the controls, KD patients had significantly lower orexin-A (0.65 ± 0.12 vs. 0.74 ± 0.10 ng/mL, p < 0.001) and increased ACTH (32.3 ± 16.3 vs. 22.3 ± 11.0 pg/mL, p = 0.008) levels at baseline, whereas cortisol levels were similar between two groups. Levels of the three markers did not correlate with ketamine use variables, craving, depression, or anxiety symptoms. The levels did not alter after 1 or 2 weeks of ketamine discontinuation. Notably, those with higher anxiety had lower orexin-A but increased cortisol levels than did those with lower anxiety. CONCLUSIONS This study showed that KD patients had persistent orexin-A reduction and stress hormone dysregulation in early abstinence. The anxious phenotype of KD might be associated with a lower orexin-A expression. These results point to a promising pathway to investigate the neurochemical mechanisms of ketamine addiction.
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Affiliation(s)
- Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, 309, Song-De Road, Xinyi District, Taipei City, 110, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Xing St., Taipei, 110, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chun-Hsin Chen
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, 111, Sec. 3, Hsing-Long Rd, Taipei, 116, Taiwan
| | - Lian-Yu Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, 309, Song-De Road, Xinyi District, Taipei City, 110, Taiwan.,Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Hu-Ming Chang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, 309, Song-De Road, Xinyi District, Taipei City, 110, Taiwan
| | - Chih-Ken Chen
- Department of Psychiatry & Community Medicine Research Center, Chang Gung Memorial Hospital, 200, Ln 208, Ji-Jing 1st Rd, Keelung, Taiwan. .,Chang Gung University School of Medicine, 5, Fu-Hsing Rd, Gue-Shan District Taoyuan City, 333, Taiwan.
| | - Shih-Ku Lin
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, 309, Song-De Road, Xinyi District, Taipei City, 110, Taiwan. .,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Xing St., Taipei, 110, Taiwan.
| | - Ke Xu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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20
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Lin C, Wong BY, Lo MT, Chiu YC, Lin YH. Development of an addiction index and delineation 15-year trends of illicit drugs from the Taiwan national drug enhancement database. J Psychiatr Res 2020; 120:131-136. [PMID: 31670261 DOI: 10.1016/j.jpsychires.2019.10.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 10/25/2022]
Abstract
Illicit drug use contributes to substantial morbidity and mortality. Drug scheduling, a legal measure in drug enforcement, is often structured as a hierarchy based on addiction tendency, abuse trends, and harm, but may lack data-driven evidence when classifying substances. Our study aims to measure addiction tendency and use trends based on real-world data. We used the open access database of National Police Agency, Ministry of the Interior in Taiwan and analyzed all daily criminal cases of illicit drugs from 2013 to 2017 and monthly illicit drug enforcement data from the same database from 2002 to 2017. We hypothesized that repeat and frequent use despite legal consequence may be a reflection of addictive behavior, and empirical mode decomposition was applied in analysis to calculate addiction tendency indices and intrinsic 15-year use trends. Our analysis showed heroin has the highest addiction index, followed by methamphetamine. 3,4-Methyl enedioxy methamphetamine, marijuana, and ketamine had lower addictive propensities. This result is consistent with most drug scheduling hierarchies. 15-year use trends of substances were consistent with previous epidemiological studies.
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Affiliation(s)
- Chen Lin
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan City, Taiwan.
| | - Bo-Yu Wong
- Institute of Population Health Sciences, National Health Research Institute, Miaoli, Taiwan.
| | - Men-Tzung Lo
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan City, Taiwan.
| | - Yu-Chuan Chiu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan.
| | - Yu-Hsuan Lin
- Institute of Population Health Sciences, National Health Research Institute, Miaoli, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan.
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21
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Chen L, Chen C, Chen C, Chang H, Huang M, Xu K. Association of Craving and Depressive Symptoms in Ketamine‐Dependent Patients Undergoing Withdrawal Treatment. Am J Addict 2019; 29:43-50. [DOI: 10.1111/ajad.12978] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 09/18/2019] [Accepted: 10/20/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- Lian‐Yu Chen
- Department of Psychiatry, Taipei City Psychiatric CenterTaipei City Hospital Taipei Taiwan
- Institute of Epidemiology and Preventive MedicineNational Taiwan University Taipei Taiwan
- Kunming Prevention and Control CenterTaipei City Hospital Taipei Taiwan
| | - Chih‐Ken Chen
- Department of Psychiatry & Community Medicine Research CenterChang Gung Memorial Hospital Keelung Taiwan
- Chang Gung University School of Medicine Taoyuan Taiwan
| | - Chun‐Hsin Chen
- Department of Psychiatry, Wan‐Fang HospitalTaipei Medical University Taipei Taiwan
- Department of Psychiatry, School of Medicine, College of MedicineTaipei Medical University Taipei Taiwan
- Psychiatric Research Center, Wang‐Fang HospitalTaipei Medical University Taipei Taiwan
| | - Hu‐Ming Chang
- Department of Psychiatry, Taipei City Psychiatric CenterTaipei City Hospital Taipei Taiwan
| | - Ming‐Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric CenterTaipei City Hospital Taipei Taiwan
- Department of Psychiatry, School of Medicine, College of MedicineTaipei Medical University Taipei Taiwan
- Psychiatric Research Center, Wang‐Fang HospitalTaipei Medical University Taipei Taiwan
- Psychiatric Research CenterTaipei Medical University Hospital Taipei Taiwan
| | - Ke Xu
- Department of PsychiatryYale University School of Medicine New Heaven Connecticut
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22
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Baek JH, Ha K, Kim Y, Cho YA, Yang SY, Choi Y, Jang SL, Park T, Ha TH, Hong KS. Psychopathologic structure of bipolar disorders: exploring dimensional phenotypes, their relationships, and their associations with bipolar I and II disorders. Psychol Med 2019; 49:2177-2185. [PMID: 30326977 DOI: 10.1017/s003329171800301x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Given its diverse disease courses and symptom presentations, multiple phenotype dimensions with different biological underpinnings are expected with bipolar disorders (BPs). In this study, we aimed to identify lifetime BP psychopathology dimensions. We also explored the differing associations with bipolar I (BP-I) and bipolar II (BP-II) disorders. METHODS We included a total of 307 subjects with BPs in the analysis. For the factor analysis, we chose six variables related to clinical courses, 29 indicators covering lifetime symptoms of mood episodes, and 6 specific comorbid conditions. To determine the relationships among the identified phenotypic dimensions and their effects on differentiating BP subtypes, we applied structural equation modeling. RESULTS We selected a six-factor solution through scree plot, Velicer's minimum average partial test, and face validity evaluations; the six factors were cyclicity, depression, atypical vegetative symptoms, elation, psychotic/irritable mania, and comorbidity. In the path analysis, five factors excluding atypical vegetative symptoms were associated with one another. Cyclicity, depression, and comorbidity had positive associations, and they correlated negatively with psychotic/irritable mania; elation showed positive correlations with cyclicity and psychotic/irritable mania. Depression, cyclicity, and comorbidity were stronger in BP-II than in BP-I, and they contributed significantly to the distinction between the two disorders. CONCLUSIONS We identified six phenotype dimensions; in addition to symptom features of manic and depressive episodes, various comorbidities and high cyclicity constructed separate dimensions. Except for atypical vegetative symptoms, all factors showed a complex interdependency and played roles in discriminating BP-II from BP-I.
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Affiliation(s)
- Ji Hyun Baek
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyooseob Ha
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yongkang Kim
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Young-Ah Cho
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Yung Yang
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yujin Choi
- Samsung Biomedical Research Institute, Seoul, Korea
| | | | - Taesung Park
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Tae Hyon Ha
- Department of Psychiatry, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - Kyung Sue Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Samsung Biomedical Research Institute, Seoul, Korea
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23
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Identification of synthetic cannabinoids that were seized, consumed, or associated with deaths in Kuwait in 2018 using GC-MS and LC-MS-MS analysis. Forensic Sci Int 2019; 303:109960. [PMID: 31550599 DOI: 10.1016/j.forsciint.2019.109960] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/31/2019] [Accepted: 09/08/2019] [Indexed: 01/18/2023]
Abstract
Synthetic cannabinoids are gaining much popularity worldwide. Although the death rate associated with their use is rising, these drugs are the largest and fastest growing class of novel psychoactive substances. Despite increased concerns regarding adverse effects stemming from the use of synthetic cannabinoids, there is no published data on the subject for the Gulf region or Kuwait, specifically. The current study investigates the diversity of synthetic cannabinoids in Kuwait in 2018. In total, 434 cases from the Narcotics and Psychotropic Laboratory, 70 cases from the Toxicology Laboratory, and six cases from the Forensic Medicine Department were reviewed and analyzed. Numerous synthetic cannabinoid types were identified using GC-MS and LC-MS-MS. The majority of synthetic cannabinoids were members of the indazole-3-carboxamide or indole-3-carboxamide families. Members from the indazole-3-carboxamide family identified in Kuwait were 5F-ADB, FUB-AMB, ADB-FUBINACA, AB-FUBINACA, 5F-ADB-PINACA, 5F-AKB-48, 5Cl-AKB-48, MDMB-FUBINACA, 5F-AB-PINACA, APINACA, and AB-PINACA whereas MDMB-CHMICA, 5F-MDMB-PICA, ADB-BICA, and MMB-CHMICA belonged to the indole-3-carboxamide family. In addition, members of other families were identified, including CBL2201 and UR-144, which belonged to indole-3-carboxylate and cyclopropylindole families, respectively. The most common synthetic cannabinoids were 5F-ADB, FUB-AMB, and 5Cl-AKB-48. Various mixes of two, three, or four types of synthetic cannabinoids were identified, and mixtures of synthetic cannabinoids with other illicit drugs were also present. Our findings show that in Kuwait, the most common mix of synthetic cannabinoids is FUB-AMB with 5F-ADB. These two types were mixed, either together or individually, with methamphetamine, tramadol, heroin, Δ9THC, and ketamine. Most importantly, our results reveal the synthetic cannabinoid types that were associated with six reported deaths.
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Jhang J, Wang H, Hsu Y, Birder LA, Kuo H. Upregulation of neurotrophins and transforming growth factor‐β expression in the bladder may lead to nerve hyperplasia and fibrosis in patients with severe ketamine‐associated cystitis. Neurourol Urodyn 2019; 38:2303-2310. [DOI: 10.1002/nau.24139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/20/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Jia‐Fong Jhang
- Department of Urology, Hualien Tzu Chi General HospitalBuddhist Tzu Chi Medical Foundation, and Tzu Chi University Hualien Taiwan
| | - Hsiu‐Jen Wang
- Department of Urology, Hualien Tzu Chi General HospitalBuddhist Tzu Chi Medical Foundation, and Tzu Chi University Hualien Taiwan
| | - Yung‐Hsiang Hsu
- Department of PathologyBuddhist Tzu Chi General Hospital and Tzu Chi University Hualien Taiwan
| | - Lori A. Birder
- Departments of Medicine, Pharmacology, and Chemical BiologyUniversity of Pittsburgh Pittsburgh Pennsylvania
| | - Hann‐Chorng Kuo
- Department of Urology, Hualien Tzu Chi General HospitalBuddhist Tzu Chi Medical Foundation, and Tzu Chi University Hualien Taiwan
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25
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Feng LY, Lan YC, Huang JJ, Li JH. HIV risk and the association with accessibility coverage to medical facilities and socioeconomic status among heroin users in Kaohsiung, Taiwan (2011-2015): A GIS approach. Kaohsiung J Med Sci 2019; 35:56-62. [PMID: 30844142 DOI: 10.1002/kjm2.12009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 11/22/2018] [Indexed: 11/08/2022] Open
Abstract
Illegal drug use has caused considerable health and social costs. Access to medical treatment has been one of the most cost-effective interventions to reduce problematic drug use. Accessibility to treatment, which can be analyzed by the spatial approach such as geographic information system (GIS), has thus been utilized as a measure of the proportion of population that reaches appropriate health services. In this study, the association of accessibility coverage to medical facilities and socioeconomic status with human immunodeficiency virus (HIV) risk for heroin users was evaluated by GIS analysis in Kaohsiung, Taiwan. Data of 7890 heroin users were collected from 2011 to 2015 and categorized into five risk groups according to their income and distance to treatment settings. The results of this GIS-based analysis show that the areas with over 50% accessibility coverage rate had less amounts of HIV cases with statistical significance. Inconvenient access to medical facilities could result in poor treatment outcomes such as higher HIV incidences. Therefore, in order to effectively reduce HIV incidences among the heroin users, the accessibility coverage and locations of medical treatment facilities should meet the needs of drug users. It is also advised that the formulation of policies associated with illegal drug use problems should be evidence-based and geographical indicators could serve for this purpose from either prevention or intervention perspective.
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Affiliation(s)
- Ling-Yi Feng
- Program in Toxicology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Ching Lan
- Department of Health Risk Management, College of Management, China Medical University, Taichung, Taiwan.,Big Data and Cyber Security Division, Walsin Lihwa Corporation, Taipei, Taiwan
| | - Joh-Jong Huang
- Department of Health, Kaohsiung City Government, Kaohsiung, Taiwan
| | - Jih-Heng Li
- Program in Toxicology, Kaohsiung Medical University, Kaohsiung, Taiwan.,School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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26
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Oberenko AV, Kachin SV, Sagalakov SА. Types of synthetic cannabinoids seized from illicit trafficking in the territory of the Siberian Federal District (Russia) between 2009-2018. Forensic Sci Int 2019; 302:109902. [PMID: 31382224 DOI: 10.1016/j.forsciint.2019.109902] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 07/02/2019] [Accepted: 07/04/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND In the last decade, new psychoactive substances including synthetic cannabinoids (SC) have appeared and are rapidly spreading in the Siberian Federal District of Russia. The determination of the individual composition of the synthetic cannabinoids is very important, first of all, for assessing the risk of harming the health of potential consumers as well as for determining sources of their appearance. OBJECTIVE To describe the types of synthetic cannabinoids, the dynamics of their occurrence and distribution in the illegal market of drugs in the territory of the Siberian Federal District (Russia) for the period from January 2009 till December 2018. Compare the results obtained with the SC distribution trends in other countries. METHOD A retrospective analysis of databases (narcotic reports, chromatograms, mass-spectrums) obtained from GC-MS studies of 2142 samples taken from illicit trafficking in the territory of the Siberian Federal District (Russia) from January 2009 to December 2018 was conducted. RESULTS AND CONCLUSION During the analyzed period, 61 individual SCs of various types were identified in the studied samples. Of these, the AB-PINACA-CHM, MDMB(N)-2201, CBL-2201, TMCP-2201 were found most frequently (10-24% cases). In single cases JWH-018-Br, JWH-018-CI, JWH-019, MBA-2201 and QCBL(N)-2201 were identified. The share of the other identified individual SC did not exceed 10%. The results obtained are compared with the SC distribution trends in some countries of the Asia-Pacific region, the European Union and Turkey. Creating an objective global picture of the prevalence of SC requires a unified approach to the provision of relevant representative data.
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Affiliation(s)
- Andrey V Oberenko
- Criminal Expertise Centre of the Transport Administration of the Ministry of Internal Affairs of Russia in the Siberian Federal District, 50 Lomonosova St., Krasnoyarsk, 660058, Russian Federation; Siberian Federal University, 79 Svobodnyi Pr., Krasnoyarsk, 660041, Russian Federation.
| | - Sergei V Kachin
- Siberian Federal University, 79 Svobodnyi Pr., Krasnoyarsk, 660041, Russian Federation
| | - Sergei А Sagalakov
- Siberian Federal University, 79 Svobodnyi Pr., Krasnoyarsk, 660041, Russian Federation
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27
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Zhang X, Huang R, Li P, Ren Y, Gao J, Mueller JF, Thai PK. Temporal profile of illicit drug consumption in Guangzhou, China monitored by wastewater-based epidemiology. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:23593-23602. [PMID: 31203544 DOI: 10.1007/s11356-019-05575-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 05/24/2019] [Indexed: 06/09/2023]
Abstract
Wastewater-based epidemiology (WBE) has been widely used as a complementary method for estimating consumption of illicit drugs in the population. Temporal drug consumption estimates derived from WBE can provide important information for law enforcement and public health authorities in understanding changes in supply and demand of illicit drugs, but currently lacking in China. In this study, influent wastewater samples from a municipal sewage treatment plant in Guangzhou, China were collected for 8 weeks to investigate the temporal change in consumption of six illicit drugs in the catchment. The results indicated that methamphetamine and ketamine were the dominant illicit drugs in Guangzhou with the per capita use of 14.7-470.7 mg/day/1000 people and 64.9-673.7 mg/day/1000 people, respectively. No distinct weekly patterns were observed for illicit drug consumption in Guangzhou, indicating that drug users are likely to be regular ones. Further assessment about the impact of public holidays on the consumption behavior of drugs showed little impact for ketamine (p = 0.689), but higher consumptions of methamphetamine (p = 0.003) and cocaine (p = 0.027) were observed during public holidays than the control period. The considerable decrease in drug consumption observed in October 2017 compared with January and May 2017 was possibly the consequence of law enforcement action.
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Affiliation(s)
- Xiaohan Zhang
- School of Environment and Energy, South China University of Technology, Higher Education Mega Center, Panyu District, Guangzhou, 510006, People's Republic of China
| | - Riheng Huang
- Guangzhou Sewage Purification Co., Ltd, Guangzhou, People's Republic of China
| | - Ping Li
- School of Environment and Energy, South China University of Technology, Higher Education Mega Center, Panyu District, Guangzhou, 510006, People's Republic of China
| | - Yuan Ren
- School of Environment and Energy, South China University of Technology, Higher Education Mega Center, Panyu District, Guangzhou, 510006, People's Republic of China.
- The Key Laboratory of Pollution Control and Ecosystem Restoration in Industry Clusters, Ministry of Education, Guangzhou, 510006, People's Republic of China.
- The Key Laboratory of Environmental Protection and Eco-Remediation of Guangdong Regular Higher Education Institutions, Guangzhou, People's Republic of China.
| | - Jianfa Gao
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD, 4102, Australia.
| | - Jochen F Mueller
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD, 4102, Australia
| | - Phong K Thai
- Queensland Alliance for Environmental Health Science (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, QLD, 4102, Australia
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28
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Shin Y, Kong TY, Cheong JC, Kim JY, Lee JI, Lee HS. Simultaneous determination of 75 abuse drugs including amphetamines, benzodiazepines, cocaine, opioids, piperazines, zolpidem and metabolites in human hair samples using liquid chromatography-tandem mass spectrometry. Biomed Chromatogr 2019; 33:e4600. [PMID: 31116452 DOI: 10.1002/bmc.4600] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/16/2019] [Indexed: 11/07/2022]
Abstract
A liquid chromatography-tandem mass spectrometric method for the simultaneous determination of 75 abuse drugs and metabolites, including 19 benzodiazepines, 19 amphetamines, two opiates, eight opioids, cocaine, lysergic acid diethylamide, zolpidem, three piperazines and 21 metabolites in human hair samples, was developed and validated. Ten-milligram hair samples were decontaminated, pulverized using a ball mill, extracted with 1 mL of methanol spiked with 28 deuterated internal standards in an ultrasonic bath for 60 min at 50°C, and purified with Q-sep dispersive solid-phase extraction tubes. The purified extracts were evaporated to dryness and the residue was dissolved in 0.1 mL of 10% methanol. The 75 analytes were analyzed on an Acquity HSS T3 column using gradient elution of methanol and 0.1% formic acid and quantified in multiple reaction monitoring mode with positive electrospray ionization. Calibration curves were linear (r ≥ 0.9951) from the lower limit of quantitation (2-200 pg/mg depending on the drug) to 2000 pg/mg. The coefficients of variation and accuracy for intra- and inter-assay analysis at three QC levels were 4.3-12.9% and 89.2-109.1%, respectively. The overall mean recovery ranged from 87.1 to 105.3%. This method was successfully applied to the analysis of 11 forensic hair samples obtained from drug abusers.
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Affiliation(s)
- Yongho Shin
- BK21 PLUS Team for Creative Leader Program for Pharmacomics-based Future Pharmacy and Drug Metabolism and Bioanalysis Laboratory, College of Pharmacy, The Catholic University of Korea, Bucheon, Republic of Korea
| | - Tae Yeon Kong
- BK21 PLUS Team for Creative Leader Program for Pharmacomics-based Future Pharmacy and Drug Metabolism and Bioanalysis Laboratory, College of Pharmacy, The Catholic University of Korea, Bucheon, Republic of Korea
| | - Jae Cheol Cheong
- Forensic Genetics and Chemistry Division, Supreme Prosecutor's Office, Seoul, Republic of Korea
| | - Jin Young Kim
- Forensic Genetics and Chemistry Division, Supreme Prosecutor's Office, Seoul, Republic of Korea
| | - Jae Il Lee
- Forensic Genetics and Chemistry Division, Supreme Prosecutor's Office, Seoul, Republic of Korea
| | - Hye Suk Lee
- BK21 PLUS Team for Creative Leader Program for Pharmacomics-based Future Pharmacy and Drug Metabolism and Bioanalysis Laboratory, College of Pharmacy, The Catholic University of Korea, Bucheon, Republic of Korea
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29
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Cheng WC, Dao KL. Prevalence of drugs of abuse found in testing of illicit drug seizures and urinalysis of selected population in Hong Kong. Forensic Sci Int 2019; 299:6-16. [DOI: 10.1016/j.forsciint.2019.03.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/07/2019] [Accepted: 03/12/2019] [Indexed: 10/27/2022]
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30
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Göl E, Çok I. New psychoactive substances in Turkey: Narcotics cases assessed by the Council of Forensic Medicine between 2016 and 2017 in Ankara, Turkey. Forensic Sci Int 2019; 294:113-123. [DOI: 10.1016/j.forsciint.2018.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/02/2018] [Accepted: 11/04/2018] [Indexed: 11/30/2022]
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31
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Wang LJ, Chen MY, Lin CY, Chong MY, Chou WJ, You YH, Tsai CP, Chen YS, Lu SF. Difference in long-term relapse rates between youths with ketamine use and those with stimulants use. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2018; 13:50. [PMID: 30577882 PMCID: PMC6303878 DOI: 10.1186/s13011-018-0188-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 12/11/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Understanding the relapse risk among different illicit drugs is vital for developing an adequate relapse prevention policy. Therefore, the current study aims to explore the potential difference in long-term relapse rates between youths who use ketamine and those who use stimulants (3,4-Methylenedioxymethamphetamine [MDMA] or methamphetamine). METHODS The study's participants included 92 youths with ketamine use (ketamine group, mean age: 16.0 years) and 43 youths with MDMA/methamphetamine use (stimulants group, mean age: 16.1 years) that had undergone a family-oriented treatment program in a medical center in Taiwan. All participants were followed up for a maximum of 7 years in order to observe their long-term outcomes with regard to substance use relapse. RESULTS During the follow-up period, compared to the 34.8% relapse rate in ketamine users, their counterparts who used MDMA or methamphetamine had a significantly higher relapse rate (60.5%, Adjusted HR = 1.86, 95%CI: 1.06-3.28, p = 0.032). Of the youths in the ketamine group that relapsed, 65.6% continued to use ketamine in their relapse event, while 34.4% switched to MDMA or methamphetamine. Among the relapsing youths in the stimulants group, 84.6% continued to use MDMA or methamphetamine in their relapse event, while 15.4% switched to ketamine (p = 0.042). CONCLUSIONS Compared to adolescents who use ketamine, those using MDMA or methamphetamine had higher relapse rates and were more likely to use the same type of drug upon relapsing. These results can serve as a crucial reference for developing relapse prevention policies of illicit drugs for the youth population.
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Affiliation(s)
- Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Mei-Yen Chen
- Taiwan Kaohsiung Juvenile and Family Court, Kaohsiung, Taiwan
| | - Chin-Yin Lin
- Taiwan Kaohsiung Juvenile and Family Court, Kaohsiung, Taiwan
| | - Mian-Yoon Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Jiun Chou
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Han You
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Pu Tsai
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yi-Syuan Chen
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shing-Fang Lu
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan. .,Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital, 123, Ta-Pei Road, Niao-Sung District, Kaohsiung City, 83301, Taiwan.
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Castañeda AM, Lee CS, Kim YC, Lee D, Moon JY. Addressing Opioid-Related Chemical Coping in Long-Term Opioid Therapy for Chronic Noncancer Pain: A Multicenter, Observational, Cross-Sectional Study. J Clin Med 2018; 7:E354. [PMID: 30322212 PMCID: PMC6210168 DOI: 10.3390/jcm7100354] [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: 09/01/2018] [Revised: 10/10/2018] [Accepted: 10/13/2018] [Indexed: 11/30/2022] Open
Abstract
Opioid consumption has increased worldwide, which carries the risk of opioid use disorder (OUD). However, the literature on OUD and opioid-related chemical coping (OrCC) in chronic noncancer pain (CNCP) is heterogeneous, with most studies conducted in the United States. We performed a multicenter, observational, cross-sectional study to address OrCC in long-term opioid therapy (LtOT) for CNCP in South Korea. The objectives were to determine the frequency and predictors of OrCC. We included 258 patients. Among them, fifty-five (21%) patients showed OrCC. The sample had high pain catastrophizing (≥30 points; 66%), moderate-severe insomnia (≥15 points; 63%), low resilience (68 points), and high suicidal ideation (67%). OrCC patients had greater pain interference (85.18% vs. 58.28%, p = 0.017) and lower satisfaction with the LtOT (56.4% vs. 78.3%, p = 0.002). In multivariable analysis, alcohol abuse (OR = 6.84, p = 0.001), prescription drugs abuse (OR = 19.32, p = 0.016), functional pain (OR = 12.96, p < 0.001), head and neck pain (OR = 2.48, p = 0.039), MEDD (morphine equivalent daily dose) ≥ 200 mg/day (OR = 3.48, p = 0.006), and ongoing litigation (OR = 2.33, p = 0.047) were significant predictors of OrCC. In conclusion, the break-out of OrCC in CNCP in South Korea was comparable to those in countries with high opioid consumption, such as the United States, regardless of the country's opioid consumption rate.
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Affiliation(s)
- Anyela Marcela Castañeda
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital College of Medicine, 101Daehak-ro, Jongno-gu, Seoul 03080, Korea.
| | - Chang-Soon Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital College of Medicine, 101Daehak-ro, Jongno-gu, Seoul 03080, Korea.
| | - Yong-Chul Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital College of Medicine, 101Daehak-ro, Jongno-gu, Seoul 03080, Korea.
| | - Dasom Lee
- Department of Psychiatry, Seoul National University Hospital College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea.
| | - Jee Youn Moon
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital College of Medicine, 101Daehak-ro, Jongno-gu, Seoul 03080, Korea.
- Department of Integrated Cancer Care Center, Seoul National University Cancer Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea.
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Wang LJ, Chen CK, Lin SK, Chen YC, Xu K, Huang MC. Cognitive profile of ketamine-dependent patients compared with methamphetamine-dependent patients and healthy controls. Psychopharmacology (Berl) 2018; 235:2113-2121. [PMID: 29713787 DOI: 10.1007/s00213-018-4910-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 04/17/2018] [Indexed: 01/22/2023]
Abstract
BACKGROUND Ketamine has emerged as a major substance of abuse worldwide and has been listed with methamphetamine (METH) as two of the most widely available illicit substances in Taiwan. Only a few studies have examined the long-term consequences of chronic and heavy ketamine abuse. We compared the cognitive function of ketamine-dependent patients with that of METH-dependent patients and healthy controls. METHODS We recruited 165 participants (58 ketamine-dependent and 49 METH-dependent patients who sought treatment and 58 healthy controls) and evaluated them by using a cognitive test battery, the Brief Assessment of Cognition in Schizophrenia, with scores being estimated in reference to normative data in general population. RESULTS The ketamine-dependent patients had significantly poorer performance than did the controls in many cognitive tests, including verbal memory, motor speed, verbal fluency, and attention and processing speed, and the battery as a whole. METH-dependent patients exhibited poorer function in motor speed, verbal fluency, and attention and processing speed. The ketamine group performed poorer than did METH group in the domains of verbal memory, working memory, and attention and processing speed and the composite battery scores. A previous experience of ketamine-induced psychotomimetic symptoms, using higher doses of ketamine, and longer abstinence appeared to be associated with performance in some tests; however, the significance disappeared after multiple comparison correction. CONCLUSIONS The ketamine-dependent patients had impaired cognitive function, and METH-dependent patients exhibited intermediate performance between ketamine-dependent patients and healthy controls. Given the growing population of ketamine abusers, public education on the cognitive consequences should be provided.
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Affiliation(s)
- Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chih-Ken Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan.,Chang Gung University School of Medicine, Taoyuan, Taiwan
| | - Shih-Ku Lin
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, 309, Song-De Road, Taipei, Taiwan
| | - Yi-Chih Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan.,Chang Gung University School of Medicine, Taoyuan, Taiwan
| | - Ke Xu
- Department of Psychiatry, Yale School of Medicine, New Heaven, CT, USA
| | - Ming-Chyi Huang
- Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan. .,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, 309, Song-De Road, Taipei, Taiwan.
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Kwon NJ, Han E. A commentary on the effects of methamphetamine and the status of methamphetamine abuse among youths in South Korea, Japan, and China. Forensic Sci Int 2018; 286:81-85. [DOI: 10.1016/j.forsciint.2018.02.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/31/2017] [Accepted: 02/18/2018] [Indexed: 12/11/2022]
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Rapid and accurate quantification of amphetamine and methamphetamine in human urine by antibody decorated magnetite nanoparticles coupled with matrix-assisted laser desorption ionization time-of-flight mass spectrometer analysis. Anal Chim Acta 2018; 1025:134-140. [PMID: 29801602 DOI: 10.1016/j.aca.2018.03.057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/12/2018] [Accepted: 03/30/2018] [Indexed: 01/28/2023]
Abstract
In this study, a novel method for the simultaneous determination and accurate quantification of abused drugs in human urine was developed. Antibody conjugated boronic acid modified magnetite nanoparticles (Fe3O4, MNPs) were prepared for the selectively purification of illicit drugs in combination with high resolution matrix-assisted laser desorption ionization time-of-flight mass spectrometer (MALDI-TOF MS) analysis. Illicit drugs, amphetamine (AM) and methamphetamine (MA), were used as model analytes to demonstrate the feasibility of our strategy. Boronic acid functionalized MNPs were first prepared via one-pot synthesis to simplify and improve the efficiency of a chemical reaction. Anti-amphetamine antibody (anti-AM antibody) and anti-methamphetamine antibody (anti-MA antibody) was conjugated onto boronic acid modified MNPs, respectively, through the formation of boronate ester bond that could maintain the correct orientation to maximally capture their antigens. The capacity of antibody conjugation to boronic acid modified MNPs was at least 24 μg antibody/mg MNPs. Antibody-conjugated MNPs were designed to specifically capture AM and MA in human urine samples, both of which can be directly eluted to MALDI target plate by adding MALDI CHCA matrix solution for the following MALDI-MS analysis. The linear range of detection of the proposed method were 25-400 ng/mL and 25-1000 ng/mL with coefficients of determination between 0.9923 and 0.9997 for AM and MA, respectively. The lowest detectable concentrations of AM and MA were 1.87 and 3.75 ng/mL, respectively. More importantly, the proposed method allows rapid and accurate quantification of AM and MA from three suspects' urine samples. The obtained results are consistent with traditional GC/MS analysis. Antibody-conjugated MNPs could thus prove to be powerful tools for important applications such as forensic science, food safety and clinical diagnosis of disease.
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Piper BJ, Suarez MJ, Piserchio JP, Shah DT, Simoyan OM, McCall KL, Desrosiers CE, Nichols SD. Illicit and prescription drug misuse as reported to the Maine Diversion Alert Program. Forensic Sci Int 2018; 285:65-71. [PMID: 29453006 DOI: 10.1016/j.forsciint.2018.01.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 12/12/2017] [Accepted: 01/29/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The opioid epidemic is rapidly evolving and new tools are needed to combat drug abuse. The Maine Diversion Alert Program (DAP) is an informational resource that facilitates communication about drug arrests between the criminal justice and healthcare fields. The objectives of this report were to: (1) describe the illegal and prescription pharmaceuticals reported to the DAP; (2) determine if the drugs implicated in arrests changed from the first to latter half of 2016; (3) identify the demographic and other characteristics of arrestees; and (4) outline the strengths and limitations of the DAP for other areas considering implementing similar programs. METHODS The arrests (N=2,368, 31.4% female, mean age=33.7, SD=9.9, Min=18, Max=71.5) reported to the DAP were examined. Drugs were classified by Drug Enforcement Administration Schedule (I-V, non-controlled prescription) and into families (opioids, stimulants, sedatives, hallucinogens, and other). A comparison between the first and second half of 2016 and arrest by county was completed. RESULTS Arrests involved 2,957 substances (drugs and paraphernalia). Most arrests (80.6%) involved a single drug. One-third (33.2%) of arrests involved illicit drugs (i.e. Schedule I) and three-fifths (59.8%) were for controlled prescription medical drugs (i.e. Schedule II-V), and a minority (6.8%) involved non-controlled prescription drugs (e.g. gabapentin, bupropion). Opioids (e.g. heroin, buprenorphine, and oxycodone) accounted for over-half (51.3%) of arrests followed by stimulants (29.0%, e.g. cocaine), and sedatives (7.6%). Arrests for oxycodone significantly decreased (51.9%) and alprazolam increased (89.3%) during 2016. Arrestees for non-controlled prescription drugs were older than arrestees for illegal drugs. Arrests, correcting for population, were most common in more urban (e.g. Androscoggin and Cumberland) counties. CONCLUSIONS Opioids (illicit and prescription) account for over half of all arrests. However, arrests for oxycodone decreased while arrests for benzodiazepines, and especially alprazolam, increased in 2016. The DAP is a novel source of information for healthcare decisions and can empirically inform law enforcement about drug misuse and addiction.
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Affiliation(s)
- Brian J Piper
- Geisinger Commonwealth School of Medicine, Scranton, PA 18509, USA.
| | - Michael J Suarez
- Geisinger Commonwealth School of Medicine, Scranton, PA 18509, USA
| | - John P Piserchio
- Geisinger Commonwealth School of Medicine, Scranton, PA 18509, USA
| | - Dipam T Shah
- Geisinger Commonwealth School of Medicine, Scranton, PA 18509, USA
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Huang MC, Chen LY, Chang HM, Liang XY, Chen CK, Cheng WJ, Xu K. Decreased Blood Levels of Oxytocin in Ketamine-Dependent Patients During Early Abstinence. Front Psychiatry 2018; 9:633. [PMID: 30534093 PMCID: PMC6275217 DOI: 10.3389/fpsyt.2018.00633] [Citation(s) in RCA: 11] [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: 10/10/2018] [Accepted: 11/07/2018] [Indexed: 01/03/2023] Open
Abstract
Background: Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, is a common drug of abuse worldwide. Existing evidence suggest a disruption of oxytocin system involves in the development of addiction. In this study, we aimed to investigate the role of oxytocin in ketamine addiction by measuring the blood oxytocin levels in ketamine-dependent (KD) patients. Methods: Sixty-five KD patients and 65 controls were enrolled. Fasting plasma levels of oxytocin were determined at baseline and 1 and 2 weeks after ketamine withdrawal. Ketamine use variables, Beck Depression Inventory, Beck Anxiety Inventory (BAI), Visual Analog Scale for craving, and Childhood Trauma Questionnaire-short form were assessed in KD patients. Results: KD patients had significantly lower levels of oxytocin at baseline compared to controls (5.89 ± 2.13 vs. 9.53 ± 4.17 ng/mL, P < 0.001). Oxytocin levels increased after one (6.74 ± 2.63, P < 0.002) and 2 weeks (6.89 ± 2.69, P = 0.01) of withdrawal in KD patient despite the levels were still lower than controls (P = 0.001 and 0.002, respectively). The clinical variables did not correlate with baseline oxytocin levels except BAI scores, which showed a negative correlation with the levels (r = -0.263; P = 0.039). Conclusion: We found a distinctively reduced oxytocin level in KD patients and the level did not normalize after early abstinence. Lower oxytocin might be associated with anxious phenotype of ketamine dependence. These results suggest that oxytocin system dysregulated following chronic ketamine abuse and might provide insight in evaluating the potential therapeutic use of oxytocin for treating ketamine dependence.
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Affiliation(s)
- Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Lian-Yu Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan.,Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Hu-Ming Chang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Xiao-Yu Liang
- Department of Psychiatry, Yale University School of Medicine, New Heaven, CT, United States
| | - Chih-Ken Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan.,Chang Gung University School of Medicine, Taoyuan, Taiwan
| | - Wan-Ju Cheng
- Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan.,Department of Public Health, China Medical University, Taichung, Taiwan
| | - Ke Xu
- Department of Psychiatry, Yale University School of Medicine, New Heaven, CT, United States
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Highly Sensitive FPW-Based Microsystem for Rapid Detection of Tetrahydrocannabinol in Human Urine. SENSORS 2017; 17:s17122760. [PMID: 29186023 PMCID: PMC5750750 DOI: 10.3390/s17122760] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 11/21/2017] [Accepted: 11/23/2017] [Indexed: 11/20/2022]
Abstract
This paper presents a highly sensitive flexural plate-wave (FPW)-based microsystem for rapid detection of tetrahydrocannabinol (THC) in human urine. First, a circular-type interdigital transducer (IDT) was integrated with a circular-type silicon-grooved reflective grating structure (RGS) to reduce insertion loss. Then, with lower insertion loss (−38.758 dB), the FPW device was used to develop a novel THC biosensor, and the results reveal that this FPW-THC biosensor has low detection limit (1.5625 ng/mL) and high mass-sensitivity (126.67 cm2/g). Finally, this biosensor was integrated with field-programmable gate array (FPGA) board and discrete components for prototyping a FPW readout system, whose maximum error was 12.378 kHz to ensure that the linearity of detection up to R-square is equal to 0.9992.
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Assessment of types of synthetic cannabinoids in narcotic cases assessed by the Council of Forensic Medicine between 2011–2015, Ankara, Turkey. Forensic Sci Int 2017; 280:124-129. [DOI: 10.1016/j.forsciint.2017.09.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/14/2017] [Accepted: 09/24/2017] [Indexed: 11/17/2022]
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