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Fitzgerald ND, Cottler LB, Palamar JJ. Public health surveillance of new psychoactive substances: recent developments. Curr Opin Psychiatry 2024; 37:270-276. [PMID: 38587019 PMCID: PMC11142873 DOI: 10.1097/yco.0000000000000938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
PURPOSE OF REVIEW New psychoactive substances (NPS) continue to emerge globally and present a threat to public health. This article summarizes the most recent literature on approaches for monitoring NPS use and adverse events related to use. RECENT FINDINGS A variety of approaches have recently been employed for surveillance of NPS use and associated harms, including the use of toxicology testing of patients in emergency departments, surveys of sentinel populations, drug checking and syringe services programs, wastewater-based epidemiology, and retrospective analyses of clinical samples and toxicology reports. These studies cover a range of time periods and NPS examined across numerous countries. SUMMARY Areas of particular interest for future research include the use of data from drug checking services to inform surveillance efforts of the illicit drug supply and the development of methods for wastewater-based monitoring of NPS. Studies that combine self-report data with toxicology testing in particular are important for capturing unintentional or unknown exposure to NPS including fentanyls and drugs like xylazine. Given the limitations associated with individual indicators of drug use and associated harms, the harmonization of multiple data sources can help present a more complete picture of both trends involving NPS to better inform public health responses.
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Affiliation(s)
- Nicole D. Fitzgerald
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Linda B. Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Joseph J. Palamar
- NYU Grossman School of Medicine, Department of Population Health, New York, New York, USA
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Palamar JJ, Fitzgerald ND, Carr TH, Rutherford C, Keyes KM, Cottler LB. National and regional trends in seizures of shrooms (psilocybin) in the United States, 2017-2022. Drug Alcohol Depend 2024; 258:111086. [PMID: 38326175 PMCID: PMC11088526 DOI: 10.1016/j.drugalcdep.2024.111086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/17/2023] [Accepted: 12/23/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Psilocybin, the principle psychoactive component in "shrooms", is regaining acceptance in therapeutic settings, leading to media coverage of medical benefits associated with use. Possession is also becoming increasingly decriminalized throughout the United States. There is a lack of data on prevalence of shroom use, but trends in law enforcement seizure data can provide one indicator of shroom availability in US communities. We determined whether seizures of shrooms have shifted between 2017 and 2022. METHODS This study examined national and regional trends in counts and total weight of shroom seizures reported to High Intensity Drug Trafficking Areas in the US between 2017 and 2022 (N=4526). RESULTS There were 402 seizures in 2017 compared to 1396 in 2022 with the plurality occurring in the Midwest (36.0%), followed by the West (33.5%). Between 2017 Quarter 1 (Q1) and 2022 Quarter 4 (Q4), the number of seizures increased by 368.9% (AQPC=7.0; 95 CI: 5.9-8.1) and there were significant increases in all four regions. In terms of weight, 226.0kg was seized in 2017 vs. 844.0kg in 2022, and the greatest total weight in seizures was in the West (1864.2kg, 42.6%), followed by the South (1831.9kg, 41.8%). Between 2017 Q1 and 2022 Q4, the total weight seized in the US increased by 2749.7% (AQPC=6.2, 95% CI: 0.3-12.4) and there were significant increases in all four regions. CONCLUSIONS Seizures of shrooms have increased, suggesting that availability may be escalating; thus, increases in prevention efforts and harm reduction education are warranted.
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Affiliation(s)
- Joseph J Palamar
- NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA.
| | - Nicole D Fitzgerald
- University of Florida, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, United States; NDEWS, University of Florida, USA
| | - Thomas H Carr
- Office of National Drug Control Policy, Washington-Baltimore High Intensity Drug Trafficking Areas Program; College of Public Affairs, Center for Drug Policy and Prevention, University of Baltimore, USA
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Linda B Cottler
- University of Florida, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, United States; NDEWS, University of Florida, USA
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Prevalence of drugs of abuse found in forensic testing of illicit drug seizures and urine samples from offenders/probationers in Hong Kong: A 3-year update. Forensic Sci Int 2020; 317:110535. [PMID: 33075647 DOI: 10.1016/j.forsciint.2020.110535] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/28/2020] [Accepted: 10/01/2020] [Indexed: 11/22/2022]
Abstract
The study investigates the prevalence of drugs of abuse detected from 2016 to 2018 through i) forensic drug testing of seizures from law enforcement agencies, and ii) common drugs of abuse for urinalysis of samples obtained from offenders/probationers under mandatory drug-use surveillance programmes. Under the selected drug testing groups, an average of 4677 cases/year (c.f. 5334 cases/year in 2011-2015) of illicit drug seizures and 19,501 samples/year (c.f. 28,438 samples/year in 2011-2015) for urinalysis, were examined from 2016 to 2018. The three most commonly encountered abused drugs in the period in both types of examinations were methamphetamine (MA), cocaine and heroin. The occurrence of ketamine, the most prevalent drug [1815 (34.0%) cases/year (for drug seizures), 2074 (7.3%) samples/year (for urinalysis)] in 2011-2015, had dropped significantly to 487 (10.4%) cases/year and 350 (1.8%) samples/year respectively. The drug positive rates for urinalysis in the selected population group (i.e., offenders/probationers requiring mandatory drug testing) increased steadily from 27.3% in 2016 to 30.8% in 2018 (an average of 29.0% vs. 22.1% in 2011-2015). The ratio of single drug use to more than one drug was about 4:1, showing predominant use of single drug. While MA was the most prevalent drug in the period, cases found with cocaine and cannabis increased steadily over the past 3 years. A rising trend was noted for cases identified with new psychoactive substances (NPS) in illicit drug seizures from an average of 87 cases/year in 2011-2015 to 211 cases/year in 2016-2018 although NPS cases still contributed to less than 5% of overall drug seizures. A total of 69 substances classified as NPS were encountered with 47 NPS newly encountered in 2016-2018 but 25 NPS found in 2011-2015 disappeared in this 3-year period. Cathinones, including both synthetic and plant-based, continued to be the major category of NPS cases (∼72%) in the region followed by synthetic cannabinoids, ketamine/PCP analogs and synthetic opioids.
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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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Drapalova E, Belackova V, Calado D, Van Dongen A, Paneva I, Pavarin R, Polidori E, Grund JP. Early Identification of Locally Emerging Trends in Psychoactive Substance Use - Experience and Best Practice in Four European Localities. Subst Use Misuse 2019; 54:1633-1645. [PMID: 30983453 DOI: 10.1080/10826084.2019.1600146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Timely information about trends in psychoactive substance use could yield tailored interventions and reduce potential harms. However, conventional epidemiological tools might have limited capacity to detect trends emerging on a local level. Objectives: The aim of this study was to explore best practice in the identification of new drug trends at the local level. Methods: A total of 33 key informants from seven European municipalities/regions were interviewed to describe trends in substance use in their locality and to provide expert insights on how these were identified. Semi-structured interviews were analyzed with open coding method. Results: Four case studies that described local trends and responses were compiled: onset of problematic GHB use in the Dutch municipality of Breda (1); emerging retail shops selling new psychoactive substances (NPS) across the regions of Czech Republic (2) and in the Portuguese Agueda and Coimbra (3); and use of drugs with unknown content in the Italian region of Emilia Romagna, and its city Bologna (4). "Early identifiers" in the four case studies were organizations that work directly with people who use drugs (PWUD), emergency departments, and local police. Efficient methods of horizontal and vertical information sharing, sometimes facilitated by communication platforms, were in place, such that included early warning systems on local, national, and supra-local level. Local-level identification systems appeared as best suited to provide locally relevant information. Conclusions: Best practice in identifying emerging trends should involve all relevant "early identifiers", should consist of supra-local exchange platforms, integrate the qualities of local-level identification, and be facilitated by local-level coordinators.
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Affiliation(s)
- Eva Drapalova
- a Department of Addictology, 1st Faculty of Medicine , Charles University in Prague and General University Hospital in Prague , Czech Republic
| | - Vendula Belackova
- a Department of Addictology, 1st Faculty of Medicine , Charles University in Prague and General University Hospital in Prague , Czech Republic
| | | | | | | | - Raimondo Pavarin
- e Epidemiological Monitoring Center on Addiction, Mental Health DSM-DP , Azienda USL di Bologna , Italy
| | | | - Jean-Paul Grund
- a Department of Addictology, 1st Faculty of Medicine , Charles University in Prague and General University Hospital in Prague , Czech Republic
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Lamy FR, Daniulaityte R, Zathred M, Nahhas RW, Sheth A, Martins SS, Boyer EW, Carlson RG. "You got to love rosin: Solventless dabs, pure, clean, natural medicine." Exploring Twitter data on emerging trends in Rosin Tech marijuana concentrates. Drug Alcohol Depend 2018; 183:248-252. [PMID: 29306816 PMCID: PMC5803369 DOI: 10.1016/j.drugalcdep.2017.10.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 10/22/2017] [Accepted: 10/24/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND "Rosin tech" is an emerging solventless method consisting in applying moderate heat and constant pressure on marijuana flowers to prepare marijuana concentrates referred to as "rosin." This paper explores rosin concentrate-related Twitter data to describe tweet content and analyze differences in rosin-related tweeting across states with varying cannabis legal statuses. METHOD English language tweets were collected between March 15, 2015 and April 17, 2017, using Twitter API. U.S. geolocated unique (no retweets) tweets were manually coded to evaluate the content of rosin-related tweets. Adjusted proportions of Twitter users and personal communication tweets per state related to rosin concentrates were calculated. A permutation test was used to analyze differences in normalized proportions between U.S. states with different cannabis legal statuses. RESULTS eDrugTrends collected 8389 tweets mentioning rosin concentrates/technique. 4164 tweets (49.6% of total sample) posted by 1264 unique users had identifiable state-level geolocation. Content analysis of 2010 non-retweeted tweets revealed a high proportion of media-related tweets (44.2%) promoting rosin as a safer and solventless production method. Tweet-volume-adjusted percentages of geolocated Twitter users and personal communication tweets about rosin were respectively up to seven and sixteen times higher between states allowing recreational use of cannabis and states where cannabis is illegal. CONCLUSION Our results indicate that there are higher proportions of personal communication tweets and Twitter users tweeting about rosin in U.S. states where cannabis is legalized. Rosin concentrates are advertised as a safer, more natural form of concentrates, but more research on this emerging form of marijuana concentrate is needed.
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Affiliation(s)
- Francois R. Lamy
- Department of Health Social Sciences, Mahidol University, Salaya, Thailand
| | - Raminta Daniulaityte
- Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Wright State University, Dayton, OH, United States,Ohio Center of Excellence in Knowledge-enabled Computing, Department of Computer Science and Engineering, Wright State University, Dayton, OH, United States
| | - Mussah Zathred
- Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Wright State University, Dayton, OH, United States
| | - Ramzi W. Nahhas
- Department of Population and Public Health Sciences, Wright State University, Dayton, OH, United States,Department of Psychiatry, Wright State University, Dayton, OH, United States
| | - Amit Sheth
- Ohio Center of Excellence in Knowledge-enabled Computing, Department of Computer Science and Engineering, Wright State University, Dayton, OH, United States
| | - Silvia S. Martins
- Department of Epidemiology, Columbia University, New York, NY, United States
| | - Edward W. Boyer
- Brigham and Women's Hospital, Harvard Medical School, MA, United States
| | - Robert G. Carlson
- Center for Interventions, Treatment, and Addictions Research, Department of Population and Public Health Sciences, Wright State University, Dayton, OH, United States,Ohio Center of Excellence in Knowledge-enabled Computing, Department of Computer Science and Engineering, Wright State University, Dayton, OH, United States
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Kim SJ, Marsch LA, Hancock JT, Das AK. Scaling Up Research on Drug Abuse and Addiction Through Social Media Big Data. J Med Internet Res 2017; 19:e353. [PMID: 29089287 PMCID: PMC5686417 DOI: 10.2196/jmir.6426] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 09/01/2017] [Accepted: 09/20/2017] [Indexed: 01/24/2023] Open
Abstract
Background Substance use–related communication for drug use promotion and its prevention is widely prevalent on social media. Social media big data involve naturally occurring communication phenomena that are observable through social media platforms, which can be used in computational or scalable solutions to generate data-driven inferences. Despite the promising potential to utilize social media big data to monitor and treat substance use problems, the characteristics, mechanisms, and outcomes of substance use–related communications on social media are largely unknown. Understanding these aspects can help researchers effectively leverage social media big data and platforms for observation and health communication outreach for people with substance use problems. Objective The objective of this critical review was to determine how social media big data can be used to understand communication and behavioral patterns of problematic use of prescription drugs. We elaborate on theoretical applications, ethical challenges and methodological considerations when using social media big data for research on drug abuse and addiction. Based on a critical review process, we propose a typology with key initiatives to address the knowledge gap in the use of social media for research on prescription drug abuse and addiction. Methods First, we provided a narrative summary of the literature on drug use–related communication on social media. We also examined ethical considerations in the research processes of (1) social media big data mining, (2) subgroup or follow-up investigation, and (3) dissemination of social media data-driven findings. To develop a critical review-based typology, we searched the PubMed database and the entire e-collection theme of “infodemiology and infoveillance” in the Journal of Medical Internet Research / JMIR Publications. Studies that met our inclusion criteria (eg, use of social media data concerning non-medical use of prescription drugs, data informatics-driven findings) were reviewed for knowledge synthesis. User characteristics, communication characteristics, mechanisms and predictors of such communications, and the psychological and behavioral outcomes of social media use for problematic drug use–related communications are the dimensions of our typology. In addition to ethical practices and considerations, we also reviewed the methodological and computational approaches used in each study to develop our typology. Results We developed a typology to better understand non-medical, problematic use of prescription drugs through the lens of social media big data. Highly relevant studies that met our inclusion criteria were reviewed for knowledge synthesis. The characteristics of users who shared problematic substance use–related communications on social media were reported by general group terms, such as adolescents, Twitter users, and Instagram users. All reviewed studies examined the communication characteristics, such as linguistic properties, and social networks of problematic drug use–related communications on social media. The mechanisms and predictors of such social media communications were not directly examined or empirically identified in the reviewed studies. The psychological or behavioral consequence (eg, increased behavioral intention for mimicking risky health behaviors) of engaging with and being exposed to social media communications regarding problematic drug use was another area of research that has been understudied. Conclusions We offer theoretical applications, ethical considerations, and empirical evidence within the scope of social media communication and prescription drug abuse and addiction. Our critical review suggests that social media big data can be a tremendous resource to understand, monitor and intervene on drug abuse and addiction problems.
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Affiliation(s)
- Sunny Jung Kim
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, NH, United States.,Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Lisa A Marsch
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Dartmouth College, Lebanon, NH, United States.,Department of Psychiatry, Dartmouth-Hitchcock Medical Center, Lebanon, NH, United States
| | - Jeffrey T Hancock
- Department of Communication, Stanford University, Stanford, CA, United States
| | - Amarendra K Das
- Healthcare Effectiveness Research, IBM, Cambridge, MA, United States
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New psychoactive substances: Current health-related practices and challenges in responding to use and harms in Europe. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 40:84-92. [DOI: 10.1016/j.drugpo.2016.10.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 09/01/2016] [Accepted: 10/18/2016] [Indexed: 01/12/2023]
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Mitchell JT, Sweitzer MM, Tunno AM, Kollins SH, McClernon FJ. "I Use Weed for My ADHD": A Qualitative Analysis of Online Forum Discussions on Cannabis Use and ADHD. PLoS One 2016; 11:e0156614. [PMID: 27227537 PMCID: PMC4882033 DOI: 10.1371/journal.pone.0156614] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Accepted: 05/17/2016] [Indexed: 01/27/2023] Open
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) is a risk factor for problematic cannabis use. However, clinical and anecdotal evidence suggest an increasingly popular perception that cannabis is therapeutic for ADHD, including via online resources. Given that the Internet is increasingly utilized as a source of healthcare information and may influence perceptions, we conducted a qualitative analysis of online forum discussions, also referred to as threads, on the effects of cannabis on ADHD to systematically characterize the content patients and caregivers may encounter about ADHD and cannabis. Methods A total of 268 separate forum threads were identified. Twenty percent (20%) were randomly selected, which yielded 55 separate forum threads (mean number of individual posts per forum thread = 17.53) scored by three raters (Cohen’s kappa = 0.74). A final sample of 401 posts in these forum threads received at least one endorsement on predetermined topics following qualitative coding procedures. Results Twenty-five (25%) percent of individual posts indicated that cannabis is therapeutic for ADHD, as opposed to 8% that it is harmful, 5% that it is both therapeutic and harmful, and 2% that it has no effect on ADHD. This pattern was generally consistent when the year of each post was considered. The greater endorsement of therapeutic versus harmful effects of cannabis did not generalize to mood, other (non-ADHD) psychiatric conditions, or overall domains of daily life. Additional themes emerged (e.g., cannabis being considered sanctioned by healthcare providers). Conclusions Despite that there are no clinical recommendations or systematic research supporting the beneficial effects of cannabis use for ADHD, online discussions indicate that cannabis is considered therapeutic for ADHD—this is the first study to identify such a trend. This type of online information could shape ADHD patient and caregiver perceptions, and influence cannabis use and clinical care.
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Affiliation(s)
- John T. Mitchell
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Center for Addiction Science and Technology, Durham, North Carolina, United States of America
- * E-mail:
| | - Maggie M. Sweitzer
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Center for Addiction Science and Technology, Durham, North Carolina, United States of America
| | - Angela M. Tunno
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Scott H. Kollins
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Center for Addiction Science and Technology, Durham, North Carolina, United States of America
| | - F. Joseph McClernon
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, United States of America
- Duke Center for Addiction Science and Technology, Durham, North Carolina, United States of America
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Daniulaityte R, Carlson R, Brigham G, Cameron D, Sheth A. "Sub is a weird drug:" A web-based study of lay attitudes about use of buprenorphine to self-treat opioid withdrawal symptoms. Am J Addict 2015; 24:403-9. [PMID: 26009867 DOI: 10.1111/ajad.12213] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Revised: 02/06/2015] [Accepted: 03/12/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Illicit use of buprenorphine has increased in the U.S., but our understanding of its use remains limited. This study aims to explore Web-forum discussions about the use of buprenorphine to self-treat opioid withdrawal symptoms. METHODS PREDOSE, a novel Semantic Web platform, was used to extract relevant posts from a Web-forum that allows free discussions on illicit drugs. First, we extract information about the total number of buprenorphine-related posts per year between 2005 and 2013. Second, PREDOSE was used to identify all posts that potentially contained discussions about buprenorphine and opioid withdrawal. A total number of 1,217 posts that contained these terms were extracted and entered into NVivo data base. A random sample of 404 (33%) posts was selected and content analyzed. RESULTS Buprenorphine-related posts increased over time, peaking in 2011. The posts were about equally divided between those that expressed positive and negative views about the effectiveness of buprenorphine in relieving withdrawal symptoms. Web-forum participants emphasized that buprenorphine's effectiveness may become compromised because of the "size of a person habit," and/or when users repeatedly switch back and forth between buprenorphine and other illicit opioids. Most posts reported use of significantly lower amounts of buprenorphine (≤2 mg) than doses used in standard treatment. Concomitant use of other psychoactive substances was also commonly reported, which may present significant health risks. CONCLUSIONS Our findings highlight the usefulness of Web-based data in drug abuse research and add new information about lay beliefs about buprenorphine that may help inform prevention and policy measures.
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Affiliation(s)
- Raminta Daniulaityte
- Department of Community Health, Center for Interventions, Treatment, and Addictions Research (CITAR), Boonshoft School of Medicine, Wright State University, Dayton, Ohio
| | - Robert Carlson
- Department of Community Health, Center for Interventions, Treatment, and Addictions Research (CITAR), Boonshoft School of Medicine, Wright State University, Dayton, Ohio
| | - Gregory Brigham
- Department of Psychiatry, University of Cincinnati, ADAPT, Roseburg, Oregon
| | - Delroy Cameron
- Ohio Center of Excellence in Knowledge-enabled Computing (Kno.e.sis), Wright State University, Dayton, Ohio
| | - Amit Sheth
- Ohio Center of Excellence in Knowledge-enabled Computing (Kno.e.sis), Wright State University, Dayton, Ohio
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Fentanyls: Are we missing the signs? Highly potent and on the rise in Europe. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:626-31. [PMID: 25976511 DOI: 10.1016/j.drugpo.2015.04.003] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 03/25/2015] [Accepted: 04/07/2015] [Indexed: 11/21/2022]
Abstract
Fentanyl is a synthetic opioid analgesic historically used as a pain reliever and an anaesthetic. Recent concerns have arisen around the illicit use of fentanyl and its analogues in a number of European countries, linked to their high potency and associated risk of fatal overdose. Evidence has been emerging from Estonia for over a decade of entrenched patterns of fentanyl use, including injection of the drug and hundreds of overdose deaths. More recently, reports indicate that both fentanyl and 3-methylfentanyl (TMF) have been marketed as a replacement for heroin in European countries (e.g. Bulgaria, Slovakia) affected by heroin shortages. In addition, Germany, Finland and the United Kingdom, reported new outbreaks of fentanyl-related deaths. This combination of increasing mortality data alongside law enforcement intelligence suggesting both diversion and illicit production of fentanyls, prompted wider investigation using a targeted multi-source data collection exercise and analysis. This identified that in the European context, fentanyls are 'low use but high risk/harm' substances. Evidence shows that Estonia stands out as having an endemic problem, while the use of fentanyls in other European countries appears to be geographically localised. Developments in illicit supply of fentanyls reflect the complexity of Europe's contemporary drug market: manifesting illicit production and use, the diversion and misuse of medicines, and the online sale of non-controlled new psychoactive substances. Likewise effective and integrated responses will need to address fentanyl production, diversion as well as ensuring the availability of harm reduction measures to users.
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Smirnov A, Hayatbakhsh R, Alati R, Legosz M, Burns L, Kemp R, Wells H, Najman JM. Psychological Distress and Drug Use Patterns of Young Adult Ecstasy Users: A Complementary Analysis of Australian Datasets. Subst Use Misuse 2014; 49:77-86. [PMID: 23905585 DOI: 10.3109/10826084.2013.819366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We examine psychological distress (PD) in young adult Ecstasy users in relation to age of initiation and frequency of use of Ecstasy, cannabis, alcohol, and tobacco. Using two Australian community samples, we assess whether different sampling methods produce comparable estimates of these associations. The Natural History Study of Drug Use (NHSDU; N = 339) in 2009 used population sampling and the 2009 Ecstasy and Related Drug Reporting System (EDRS; N = 359) used purposive sampling. Participants, aged 19-23 years, were recurrent Ecstasy users. PD was assessed using Kessler 10 in the EDRS and Hospital Anxiety Depression Scale in the NHSDU. In both samples, PD was associated with daily tobacco use and early drug initiation, but not frequent Ecstasy use. One-third smoke tobacco daily. Study limitations and implications are noted.
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Affiliation(s)
- Andrew Smirnov
- a 1Queensland Alcohol and Drug Research and Education Centre, School of Population Health, The University of Queensland , Herston, Queensland, Australia.,b 2Drug Harm Reduction Branch, Health Protection Directorate, Queensland Health, Division of the Chief Health Officer , Herston, Queensland, Australia
| | - Reza Hayatbakhsh
- a 1Queensland Alcohol and Drug Research and Education Centre, School of Population Health, The University of Queensland , Herston, Queensland, Australia
| | - Rosa Alati
- c 3School of Population Health, The University of Queensland , Herston, Queensland, Australia.,d 4Centre for Youth Substance Abuse Research, The University of Queensland , Herston, Queensland, Australia
| | - Margot Legosz
- e 5Crime and Misconduct Commission, North Tower Green Square, Fortitude Valley , Queensland, Australia
| | - Lucy Burns
- f 6National Drug and Alcohol Research Centre, University of New South Wales , Randwick, New South Wales, Australia
| | - Robert Kemp
- b 2Drug Harm Reduction Branch, Health Protection Directorate, Queensland Health, Division of the Chief Health Officer , Herston, Queensland, Australia
| | - Helene Wells
- e 5Crime and Misconduct Commission, North Tower Green Square, Fortitude Valley , Queensland, Australia
| | - Jake M Najman
- a 1Queensland Alcohol and Drug Research and Education Centre, School of Population Health, The University of Queensland , Herston, Queensland, Australia.,g 7School of Social Science, The University of Queensland, St Lucia , Queensland, Australia
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Daniulaityte R, Carlson R, Falck R, Cameron D, Perera S, Chen L, Sheth A. "I just wanted to tell you that loperamide WILL WORK": a web-based study of extra-medical use of loperamide. Drug Alcohol Depend 2013. [PMID: 23201175 PMCID: PMC3633632 DOI: 10.1016/j.drugalcdep.2012.11.003] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIMS Many websites provide a means for individuals to share their experiences and knowledge about different drugs. Such User-Generated Content (UGC) can be a rich data source to study emerging drug use practices and trends. This study examined UGC on extra-medical use of loperamide among illicit opioid users. METHODS A website that allows for the free discussion of illicit drugs and is accessible for public viewing was selected for analysis. Web-forum posts were retrieved using web crawlers and retained in a local text database. The database was queried to extract posts with a mention of loperamide and relevant brand/slang terms. Over 1290 posts were identified. A random sample of 258 posts was coded using NVivo to identify intent, dosage, and side-effects of loperamide use. RESULTS There has been an increase in discussions related to loperamide's use by non-medical opioid users, especially in 2010-2011 Loperamide was primarily discussed as a remedy to alleviate a broad range of opioid withdrawal symptoms, and was sometimes referred to as "poor man's" methadone. Typical doses ranged 70-100mg per day, much higher than an indicated daily dose of 16mg. CONCLUSIONS This study suggests that loperamide is being used extra-medically to self-treat opioid withdrawal symptoms. There is a growing demand among people who are opioid dependent for drugs to control withdrawal symptoms, and loperamide appears to fit that role. The study also highlights the potential of the Web as a "leading edge" data source in identifying emerging drug use practices.
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Affiliation(s)
- Raminta Daniulaityte
- Center for Interventions, Treatment, and Addictions Research, Department of Community Health, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, United States.
| | - Robert Carlson
- Center for Interventions, Treatment, and Addictions Research (CITAR) Department of Community Health, Boonshoft School of Medicine, Wright State University
| | - Russel Falck
- Center for Interventions, Treatment, and Addictions Research (CITAR) Department of Community Health, Boonshoft School of Medicine, Wright State University
| | - Delroy Cameron
- Ohio Center of Excellence in Knowledge-Enabled Computing (Kno.e.sis), Wright State University: http://knoesis.org
| | - Sujan Perera
- Ohio Center of Excellence in Knowledge-Enabled Computing (Kno.e.sis), Wright State University: http://knoesis.org
| | - Lu Chen
- Ohio Center of Excellence in Knowledge-Enabled Computing (Kno.e.sis), Wright State University: http://knoesis.org
| | - Amit Sheth
- Ohio Center of Excellence in Knowledge-Enabled Computing (Kno.e.sis), Wright State University: http://knoesis.org
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Deluca P, Davey Z, Corazza O, Di Furia L, Farre M, Flesland LH, Mannonen M, Majava A, Peltoniemi T, Pasinetti M, Pezzolesi C, Scherbaum N, Siemann H, Skutle A, Torrens M, van der Kreeft P, Iversen E, Schifano F. Identifying emerging trends in recreational drug use; outcomes from the Psychonaut Web Mapping Project. Prog Neuropsychopharmacol Biol Psychiatry 2012; 39:221-6. [PMID: 22841965 DOI: 10.1016/j.pnpbp.2012.07.011] [Citation(s) in RCA: 183] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 07/10/2012] [Accepted: 07/10/2012] [Indexed: 01/12/2023]
Abstract
BACKGROUND This paper presents the outcomes of the 2-year European Union funded Psychonaut Web Mapping Project which aimed at developing and implementing an integrated web mapping system to promptly identify and learn about novel psychoactive substances (NPS; "legal highs") through the regular monitoring of the Internet. METHODS More than 200 discussion forums, social media, online shops, websites and other Internet resources (e.g. YouTube, eBay, Google, Google Insight) have been extensively and regularly monitored in 7 European countries (UK, Finland, Norway, Belgium, Germany, Italy and Spain) for emerging trends of NPS throughout the period of the study. RESULTS Key online resources have been identified as "leading edge" which have provided accurate and timely information on novel emerging compounds. In total more than 400 substances/products have been recorded. NPS have been noted online before reaching wider audiences. DISCUSSION Although a high number of novel psychoactive substances have been identified in the 2-year duration of the project, not all have become trends that needed public health response. Conversely, new recreational drug phenomena such as "spice drugs," mephedrone and naphyrone were all identified as emerging trends in forums and websites. In addition, it has been possible for the first time to collate detailed information on these and several more compounds even though no or limited scientific publications were available. It is therefore recommended that these monitoring activities are to be continued, that more countries, researchers and health professionals are involved, and that the findings are widely shared with all the relevant agencies, health professionals and future research projects. Implications, advantages and limitations of using the Internet as primary source for identifying emerging trends are also discussed.
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Affiliation(s)
- Paolo Deluca
- National Addiction Centre, Institute of Psychiatry, King's College London, London, UK.
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15
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Abstract
AIMS Decisions on whether and how to 'schedule' drugs (i.e. to determine their legal status and penalties to be applied for sale or possession) are often heavily criticized. We sought to assess more comprehensively the results of such decisions for newly emerging drugs. METHODS Through analysis of legislation and secondary sources, we identified 63 substances that have emerged since 1971, including all that have been added to the most restrictive schedule by the United Nations, United States, United Kingdom, Canada, Australia and/or New Zealand. MEASUREMENTS For each jurisdiction we recorded whether, when, and how the substance was scheduled and note what decisions engendered substantial criticism or controversy within the international treaties' framework of balancing medical benefits with risk of abuse. FINDINGS (i) The rate of emergence of new drugs has been fairly steady. (ii) There is broad cross-national agreement on what should be scheduled. (iii) The United States often acts first. (iv) Temporary bans that delay final decisions by 12-18 months can sometimes allow final decisions to be grounded on a substantially expanded research base. (v) It appears that no more than seven of the decisions reached by the United States with respect to the 63 substances are candidates for being considered errors, and arguably the United States has committed at most one serious Type I and one serious Type II error. Results for other countries are broadly similar. CONCLUSIONS The process for determining the legal status of new psychoactive substances appears to function reasonably well, within the framework of international treaty obligations. Most criticisms relate to one or a few substances (e.g. 3,4-methylenedioxymethamphetamine) and/or complaints that the decisions discount benefits that are not recognized by the treaties (e.g. recreational or religious use).
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Affiliation(s)
- Carolyn Coulson
- Carnegie Mellon University Heinz College, Pittsburgh, PA 15213, USA.
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16
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Fischer JA, Clavarino AM, Najman JM. Drug, sex and age differentials in the use of Australian publicly funded treatment services. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2012; 6:13-21. [PMID: 22879751 PMCID: PMC3411539 DOI: 10.4137/sart.s8561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Context: Little is known about the proportion of the Australian population using alcohol or other drugs who may seek treatment. There is a need to have some additional estimates of population morbidity which reflect harms associated with use. Objective: To determine Australian population rates of publicly funded community based specialised alcohol and other drug treatment and in-patient hospital care by those ‘at risk’, by drug type, sex and age. Design and setting: The design is secondary data analysis of publicly available datasets. We use the latest available complete data on Australian general population incidence of alcohol, cannabis amphetamines and ecstasy use (2007 National Drug Strategy Household Survey) and nationally collected administrative data on publicly funded specialised alcohol and other drug treatment services (2006–2007 Alcohol and Other Drug Treatment Services National Minimum Dataset) and public hospitals (2006–2007 National Hospital Morbidity Minimum Dataset) to calculate rates of drug treatment and in-patient hospital care per 1000 Australians. ‘At risk’ for alcohol is defined as being at risk of short term harm, as defined by the National Health and Medical Research Council (2001). ‘At risk’ for illicit drugs is defined as those exposed to potential harm through at least weekly use of cannabis, amphetamines and ecstasy use. Results: Risky alcohol consumption followed by recent cannabis use appears to lead to most harm. Greater harm seems to be experienced by males rather than females. Younger adults (15–19 years) and older adults (40+ years) seem also to experience the highest rates of harm. Conclusions: It is possible to derive population estimates of harms associated with licit and illicit drugs use. Treatment rates vary across drug type, gender and age. Alcohol and cannabis are the substances whose use leads to the greatest demand for services. Ecstasy appears to generate few presentations for treatment. Publicly available data can be used to estimate harms associated with the use of particular substances. Such estimates are best interpreted in the light of other ways of estimating harms.
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Affiliation(s)
- Jane Anne Fischer
- School of Pharmacy, Pharmacy Australia Centre for Excellence, The University of Queensland, Woolloongabba, Queensland, 4102, Australia
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HUGHES CAITLINE, CHALMERS JENNY, BRIGHT DAVIDA, MATTHEW-SIMMONS FRANCIS, SINDICICH NATASHA. Examining supply changes in Australia's cocaine market. Drug Alcohol Rev 2011; 31:263-72. [DOI: 10.1111/j.1465-3362.2011.00350.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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