1
|
Cavalcante JA, Souza JC, Rohwedder JJR, Maldaner AO, Pasquini C, Hespanhol MC. A compact Fourier-transform near-infrared spectrophotometer and chemometrics for characterizing a comprehensive set of seized ecstasy samples. Spectrochim Acta A Mol Biomol Spectrosc 2024; 314:124163. [PMID: 38513320 DOI: 10.1016/j.saa.2024.124163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/06/2024] [Accepted: 03/14/2024] [Indexed: 03/23/2024]
Abstract
A comprehensive data set of ecstasy samples containing MDMA (N-methyl-3,4-methylenedioxyamphetamine) and MDA (3,4-methylenedioxyamphetamine) seized by the Brazilian Federal Police was characterized using spectral data obtained by a compact, low-cost, near-infrared Fourier-transform based spectrophotometer. Qualitative and quantitative characterization was accomplished using soft independent modeling of class analogy (SIMCA), linear discriminant analysis (LDA) classification, discriminating partial least square (PLS-DA), and regression models based on partial least square (PLS). By applying chemometric analysis, a protocol can be proposed for the in-field screening of seized ecstasy samples. The validation led to an efficiency superior to 96 % for ecstasy classification and estimating total actives, MDMA, and MDA content in the samples with a root mean square error of validation of 4.4, 4.2, and 2.7 % (m/m), respectively. The feasibility and drawbacks of the NIR technology applied to ecstasy characterization and the compromise between false positives and false negatives rate achieved by the classification models are discussed and a new approach to improve the classification robustness was proposed considering the forensic context.
Collapse
Affiliation(s)
- Jennifer A Cavalcante
- Chemistry Institute, State University of Campinas - UNICAMP, Rua Monteiro Lobato, 290, Campinas, SP, 13083-862, Brazil
| | - Jamille C Souza
- Group of Analysis and Education for Sustainability (GAES), Chemistry Department, Federal University of Viçosa (UFV), Viçosa, MG, 36570-900, Brazil
| | - Jarbas J R Rohwedder
- Chemistry Institute, State University of Campinas - UNICAMP, Rua Monteiro Lobato, 290, Campinas, SP, 13083-862, Brazil
| | - Adriano O Maldaner
- National Institute of Criminalistics, Federal Police, SAIS Quadra 07 Lote 23, 70610-200 Brasília, DF, Brazil
| | - Celio Pasquini
- Chemistry Institute, State University of Campinas - UNICAMP, Rua Monteiro Lobato, 290, Campinas, SP, 13083-862, Brazil
| | - Maria C Hespanhol
- Group of Analysis and Education for Sustainability (GAES), Chemistry Department, Federal University of Viçosa (UFV), Viçosa, MG, 36570-900, Brazil.
| |
Collapse
|
2
|
de Oliveira AL, Miranda RG, Dorta DJ. Recreational MDMA doses do not elicit hepatotoxicity in HepG2 spheroids under normo- and hyperthermia. Toxicology 2024; 503:153761. [PMID: 38401800 DOI: 10.1016/j.tox.2024.153761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 02/26/2024]
Abstract
MDMA (3,4-methylenedioxymethamphetamine), an entactogen with empathogenic and prosocial effects, is widely used in music festivals and other festive settings. High MDMA doses have been associated with drug-induced liver injury and cases of hyperthermia. Although the latter condition is thought to increase MDMA hepatotoxicity, this correlation remains poorly explored for recreational MDMA doses. On the other hand, the fact that MDMA acts to extinguish fear and to reconsolidate memory could be explored as an adjunct to psychotherapy during treatment of neuropsychiatric disorders such as post-traumatic stress disorder. In this context, assessing MDMA toxicity is relevant, and tridimensional cell culture has emerged as an alternative to animal models in toxicity assessment. Herein, we have used HepG2 spheroids to evaluate MDMA-induced hepatotoxicity at recreational doses, under normo- or hyperthermia. The MTT reduction assay did not evidence significantly reduced cell viability. Moreover, MDMA did not increase reactive oxygen species production, deplete the mitochondrial membrane potential, arrest the cell cycle, or induce apoptotic cell death. These findings support further pre-clinical investigation of MDMA safety from the perspective of both harm reduction and therapy given that non-abusive recreational and therapeutic doses overlap.
Collapse
Affiliation(s)
- Arthur L de Oliveira
- Department of Chemistry, Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP 14040-901, Brazil
| | - Raul G Miranda
- School of Pharmaceutical Sciences at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP 14040-901, Brazil
| | - Daniel J Dorta
- Department of Chemistry, Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP 14040-901, Brazil.
| |
Collapse
|
3
|
Nicolodi C, Slominski WH, Parabocz GC, Pericolo S, Da-Col JA, Martendal E. Headspace solid-phase microextraction - gas chromatography - mass spectrometry qualitative screening method for active compounds, adulterants and impurities in ecstasy tablets seized in Northern Santa Catarina State, Brazil. Forensic Sci Int 2024; 355:111932. [PMID: 38246066 DOI: 10.1016/j.forsciint.2024.111932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/09/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
The present work describes the development of a headspace solid-phase microextraction (HS-SPME) followed by gas chromatography - mass spectrometry (GC-MS) method for the qualitative analysis of compounds in seized ecstasy tablets that can be easily implemented in regular laboratories. HS-SPME with a DVB/CAR/PDMS 50/30 µm fiber was used to extract the ecstasy pills' components, including major and minor ones, in a single extraction/chromatographic run. For HS-SPME, the incubation time (0 min to 30 min), the extraction time (10 min to 40 min) and temperature (40 °C to 80 ºC), the buffer volume (3 mL to 8 mL), the buffer pH (6 to 9) and the NaCl concentration (0 mol/L to 6 mol/L) were evaluated using fractional factorial design. Different split ratios and detector voltages were also evaluated. The optimal compromise between sensitivity and peak resolution was found to be incubation and extraction at 65 ºC for 10 min and 25 min, respectively, 3 mL of pH 9 buffer containing 3 mol/L NaCl, using 40.0 mg of the powdered samples in a 15-mL amber glass vial, and an injection with a split ratio of 1:10 at 260 ºC for 10 min. Under optimal conditions, 44 samples from different seizures were analyzed. Seventy-five compounds were tentatively identified by the proposed method, including active substances, medicines, caffeine, safrole derivatives, synthesis intermediates and solvent residues. The number of tentatively identified compounds per sample varied from 8 to 24, with a mean of 15. Important findings in ecstasy samples, such as norcinamolaurin, α-methyl-1,3-benzodioxole-5-propanamide, α-methyl-3,4-methylenedioxyphenylpropionitrile, acetylsalicylic acid, piperonylonitrile, methyl isobutyl ketone, mesitylene, and 4-[3-(dimethylamino)propyl]- 2,6-dimethylphenol, identified with a frequency higher than 10%, are not found in the literature so far. The method precision, based on relative standard deviation of peak areas, ranged from 5% to 15%, depending on the compound. The method was shown to be simple, relatively fast, precise and a powerful tool for the identification of major and minor components in ecstasy tablets in a single analytical cycle, being useful for screening or quantitative purposes, if authentic standards are available.
Collapse
Affiliation(s)
- Caroline Nicolodi
- Laboratório de Pesquisa em Química Analítica e Nanomateriais Inorgânicos [Analytical Chemistry and Inorganic Nanomaterials Research Lab], Departamento de Química [Chemistry Department], Universidade do Estado de Santa Catarina [Santa Catarina State University], Joinville, SC, Brazil
| | - William Henrique Slominski
- Laboratório de Pesquisa em Química Analítica e Nanomateriais Inorgânicos [Analytical Chemistry and Inorganic Nanomaterials Research Lab], Departamento de Química [Chemistry Department], Universidade do Estado de Santa Catarina [Santa Catarina State University], Joinville, SC, Brazil
| | - Gisele Chibinski Parabocz
- Polícia Científica - Superintendência Regional de Joinville [Scientific Police - Joinville Regional Superintendency], Joinville, SC, Brazil
| | - Suellen Pericolo
- Polícia Científica - Superintendência Regional de Joinville [Scientific Police - Joinville Regional Superintendency], Joinville, SC, Brazil
| | - José Augusto Da-Col
- Laboratório de Pesquisa em Química Analítica e Nanomateriais Inorgânicos [Analytical Chemistry and Inorganic Nanomaterials Research Lab], Departamento de Química [Chemistry Department], Universidade do Estado de Santa Catarina [Santa Catarina State University], Joinville, SC, Brazil
| | - Edmar Martendal
- Laboratório de Pesquisa em Química Analítica e Nanomateriais Inorgânicos [Analytical Chemistry and Inorganic Nanomaterials Research Lab], Departamento de Química [Chemistry Department], Universidade do Estado de Santa Catarina [Santa Catarina State University], Joinville, SC, Brazil.
| |
Collapse
|
4
|
Santamarina R, Caldicott D, Fitzgerald J, Schumann JL. Drug-related deaths at Australian music festivals. Int J Drug Policy 2024; 123:104274. [PMID: 38065009 DOI: 10.1016/j.drugpo.2023.104274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Illicit drug use is overrepresented in music festival attendees compared with the general population. Drug use often involves a wide range of substances with the potential to cause drug toxicity. Law enforcement-centred strategies intended to deter drug use and supply at these mass gatherings have been implemented throughout Australia. However, many have been criticised for their lack of effectiveness, with evidence suggesting that they can inadvertently increase the risk of drug harm. Drug deaths are often multifactorial, providing added challenges in the development of prevention strategies. This study aimed to determine the frequency of deaths involving alcohol and other drugs at music festivals in Australia and to identify potential risk factors that may inform future harm reduction strategies. METHODS A descriptive case series study was conducted using the National Coronial Information System (NCIS) to investigate drug-related deaths at music festivals throughout Australia between 1 July 2000 (Queensland from 1 January 2001) and 31 December 2019, using a list of keywords comprising music festival names and terms. RESULTS There were 64 deaths, of which most involved males (73.4%) aged in their mid-20s (range 15-50 years). Drug toxicity was the most common primary cause of death (46.9%) followed by external injuries (37.5%). The drug most commonly detected or reported as being used was MDMA (65.6%), followed by alcohol (46.9%) and cannabis (17.2%), with most cases reporting the use of two or more drugs (including alcohol) and 36% reporting a history of drug misuse in the coroner's findings. Most deaths were unintentional, with less than a fifth of cases (17.2%) involving intentional self-harm. Clinical intervention was involved in 64.1% of cases and most festivals occurred in inner city locations (59.4%). CONCLUSIONS The findings suggest that drug-related deaths at music festivals in Australia typically involve young people using multiple illicit substances in combination with alcohol. Most are unintentional and could potentially be prevented through the implementation of a range of harm reduction strategies, including mobile medical care, drug checking services, and increased consumer education and awareness.
Collapse
Affiliation(s)
- R Santamarina
- Department of Forensic Medicine, Monash University, Victoria, Australia
| | - D Caldicott
- Emergency Department, Calvary Public Hospital Bruce, Canberra, Australian Capital Territory, Australia; ANU Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
| | - J Fitzgerald
- Department of Criminology, School of Social and Political Sciences, Faculty of Arts, The University of Melbourne, Melbourne, Victoria, Australia
| | - J L Schumann
- Department of Forensic Medicine, Monash University, Victoria, Australia; Victorian Institute of Forensic Medicine, Victoria, Australia; Monash Addiction Research Centre, Monash University, Victoria, Australia.
| |
Collapse
|
5
|
van Beek RJJ, Blankers M, Kleinjan M, Waldron J, Grabski M, Freeman T, Curran V, van der Pol P, van Laar M. Polydrug Use Typologies of Regular Ecstasy Users Visiting Electronic Dance Music Events: A Latent Class Analysis. Eur Addict Res 2023; 30:52-64. [PMID: 38154456 DOI: 10.1159/000534487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/22/2023] [Indexed: 12/30/2023]
Abstract
INTRODUCTION Polydrug use patterns among young adults using ecstasy vary, as well as their willingness to change them. Polydrug use patterns are likely associated with different adverse health outcomes. It is unknown whether polydrug use patterns of young adults who use ecstasy are similar in different countries. This study aims to identify and compare polydrug use patterns and willingness to change them of young adults that use ecstasy in the United Kingdom (UK) and the Netherlands (NL), two countries with a high prevalence of ecstasy use and a large electronic dance music (EDM) scene. METHODS The data from the online cross-sectional Electronic Music Scene Survey were used in a latent class analysis. The binary indicators used in the estimation were past-year substance use of 21 different substances. The sample consisted of young adult ecstasy users that regularly visit EDM events (age 18-34). RESULTS A total of 1,077 respondents from the UK (age M = 23.1) and 1,178 from the NL (age M = 23.7) that regularly visit EDM events were included in the analyses. In both countries, three polydrug use patterns of ecstasy users were identified based on Bayesian Information Criterion fit indices: a traditional polydrug use class (UK: 28%; NL: 40%), a stimulant and ketamine polydrug use class (UK: 48%; NL: 52%), and an extensive polydrug use class (UK: 24%; NL: 8%) characterized by substantial use of stimulants, depressant, and psychedelic substances. Overall, young adults that used ecstasy in the UK consumed 3,4-methylenedioxymeth-amphetamine (MDMA) more often as powder/crystalline and at higher dosages compared to young adults in the NL who preferred MDMA tablets. Regardless of polydrug class or country, most respondents indicated that they had the intention to reduce but not quit their use. CONCLUSION In both countries, structurally similar polydrug use patterns among young adults that use ecstasy were found, while the use frequencies of individual substances and preferred MDMA form varied between the countries.
Collapse
Affiliation(s)
| | - Matthijs Blankers
- Trimbos Institute, Utrecht, The Netherlands
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marloes Kleinjan
- Trimbos Institute, Utrecht, The Netherlands
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands
| | - Jon Waldron
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Meryem Grabski
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Tom Freeman
- Clinical Psychopharmacology Unit, University College London, London, UK
- Department of Psychology, Addiction and Mental Health Group (AIM), University of Bath, Bath, UK
| | - Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | | | | |
Collapse
|
6
|
Palamar JJ, Salomone A, Massano M, Cleland CM. Trends in reported and biologically confirmed drug use among people who use ecstasy in the nightclub/festival-attending population, 2016-2022. Drug Alcohol Depend Rep 2023; 9:100198. [PMID: 38023341 PMCID: PMC10665664 DOI: 10.1016/j.dadr.2023.100198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023]
Abstract
Background Nightclub/festival attendees are a population with high rates of party drug use, but research is needed to determine whether there have been shifts in unintended drug exposure in this population (e.g., via adulterants) to inform prevention and harm reduction efforts. Methods Adults entering nightclubs and festivals in New York City were asked about past-year drug use in 2016 through 2022, with a subset providing a hair sample for testing. We focused on the 1943 who reported ecstasy use (of which 247 had a hair sample analyzed) and compared trends in self-reported drug use, drug positivity, and adjusted prevalence (adjusting for unreported use). Results MDMA positivity decreased from 74.4 % to 42.3 %, and decreases occurred regarding detection of synthetic cathinones ("bath salts"; a 100.0 % decrease), MDA (a 76.9 % decrease), amphetamine (an 81.3 % decrease), methamphetamine (a 64.2 % decrease), and ketamine (a 33.4 % decrease) (ps < .05). Although prevalence of MDA and synthetic cathinone use was comparable between self-report and adjusted report in 2022, gaps in prevalence were wider in 2016 (ps < .01). Adjusted prevalence of synthetic cathinone use decreased more across time than prevalence based on self-report (a 79.4 % vs. 69.1 % decrease) and adjusted report for MDA use decreased more than prevalence based on self-report (a 50.6 % vs. 38.9 % decrease). Conclusions Combining self-report and toxicology tests helped us determine that decreases in drug use/exposure were steeper regarding adjusted prevalence. Underreported drug exposure-possibly due to exposure to adulterants-appears to have had less of an effect on prevalence in 2022 than it did in 2016.
Collapse
Affiliation(s)
- Joseph J. Palamar
- NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA
| | - Alberto Salomone
- Department of Chemistry, University of Turin, Turin, Italy
- Centro Regionale Antidoping, Orbassano (TO), Italy
| | - Marta Massano
- Department of Chemistry, University of Turin, Turin, Italy
| | - Charles M. Cleland
- NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA
- Center for Drug Use and HIV/HCV Research, School of Global Public Health, New York University, New York, NY, USA
| |
Collapse
|
7
|
Nguyen VT, Harris AC, Eltit JM. Structural and functional perspectives on interactions between synthetic cathinones and monoamine transporters. Adv Pharmacol 2023; 99:83-124. [PMID: 38467490 DOI: 10.1016/bs.apha.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Synthetic cathinone derivatives comprise a family of psychoactive compounds structurally related to amphetamine. Over the last decade, clandestine chemists have synthesized a consistent stream of innovative cathinone derivatives to outpace governmental regulatory restrictions. Many of these unregulated substances are produced and distributed as designer drugs. Two of the principal chemical scaffolds exploited to expand the synthetic cathinone family are methcathinone and α-pyrrolidinopentiophenone (or α-pyrrolidinovalerophenone, α-PVP). These compounds' main physiological targets are monoamine transporters, where they promote addiction by potentiating dopaminergic neurotransmission. This chapter describes techniques used to study the pharmacodynamic properties of cathinones at monoamine transporters in vitro. Biochemical techniques described include uptake inhibition and release assays in rat brain synaptosomes and in mammalian expression systems. Electrophysiological techniques include current measurements using the voltage clamp technique. We describe a Ca2+ mobilization assay wherein voltage-gated Ca2+ channels function as reporters to study the action of synthetic cathinones at monoamine transporters. We discuss results from systematic structure-activity relationship studies on simple and complex cathinones at monoamine transporters with an emphasis on identifying structural moieties that modulate potency and selectivity at these transporters. Moreover, different profiles of selectivity at monoamine transporters directly predict compounds associated with behavioral and subjective effects within animals and humans. In conclusion, clarification of the structural aspects of compounds which modulate potency and selectivity at monoamine transporters is critical to identify and predict potential addictive drugs. This knowledge may allow prompt allocation of resources toward drugs that represent the greatest threats after drugs are identified by forensic laboratories.
Collapse
Affiliation(s)
- Vy T Nguyen
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Alan C Harris
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States
| | - Jose M Eltit
- Department of Physiology and Biophysics, School of Medicine, Virginia Commonwealth University, Richmond, VA, United States.
| |
Collapse
|
8
|
Jakob DA, Lewis M, Benjamin ER, Haltmeier T, Schnüriger B, Exadaktylos AK, Demetriades D. Pre-injury stimulant use in isolated severe traumatic brain injury: effect on outcomes. Eur J Trauma Emerg Surg 2023; 49:1683-1691. [PMID: 36066583 PMCID: PMC9446589 DOI: 10.1007/s00068-022-02095-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/19/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to assess the impact of pre-injury stimulant use (amphetamine, cocaine, methamphetamine and/or ecstasy) on outcomes after isolated severe traumatic brain injury (TBI). METHODS Retrospective 2017 TQIP study, including adult trauma patients (≥16 years old) who underwent drug and alcohol screening on admission and sustained an isolated severe TBI (head AIS ≥3). Patients with significant extracranial trauma (AIS ≥3) were excluded. Epidemiological and clinical characteristics, procedures and outcome variables were collected. Patients with isolated stimulant use were matched 1:1 for age, gender, mechanism of injury, head AIS and overall comorbidities, with patients with negative toxicology and alcohol screen. Outcomes in the two groups were compared with univariable and multivariable regression analysis. RESULTS 681 patients with isolated TBI and stimulant use were matched with 681 patients with negative toxicology and alcohol screen. The incidence of hypotension and CGS <9 was similar in the two groups. In multivariable regression analysis, stimulant use was not independently associated with mortality (OR 0.95, 95% CI 0.61-1.49). However, stimulant use was associated with longer hospital length of stay (HLOS) (RC 1.13, 95%CI 1.03-1.24). CONCLUSION Pre-injury stimulant use is common in patients admitted for severe TBI, but was not independently associated with mortality when compared to patients with negative toxicology. However, stimulant use was associated with a significant longer HLOS.
Collapse
Affiliation(s)
- Dominik Andreas Jakob
- Division of Trauma and Surgical Critical Care, Department of Surgery, Los Angeles County, University of Southern California Medical Center, University of Southern California, Los Angeles, CA 90033 USA
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Freiburgstrasse 16C, 3010 Bern, Switzerland
| | - Meghan Lewis
- Division of Trauma and Surgical Critical Care, Department of Surgery, Los Angeles County, University of Southern California Medical Center, University of Southern California, Los Angeles, CA 90033 USA
| | - Elizabeth Robinson Benjamin
- Division of Trauma and Acute Care Surgery, Department of Surgery, Grady Health System, Emory University, Atlanta, GA 30327 USA
| | - Tobias Haltmeier
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Beat Schnüriger
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Demetrios Demetriades
- Division of Trauma and Surgical Critical Care, Department of Surgery, Los Angeles County, University of Southern California Medical Center, University of Southern California, Los Angeles, CA 90033 USA
| |
Collapse
|
9
|
Jean FAM, Moulin F, Schwartz AN, Castel L, Montagni I, Macalli M, Notredame CE, Côté SM, Galéra C. Association between ADHD symptoms and illicit stimulants use following 1 year among French university students of the i-Share cohort. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02499-9. [PMID: 37268785 DOI: 10.1007/s00127-023-02499-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 05/24/2023] [Indexed: 06/04/2023]
Abstract
PURPOSE Although attention deficit hyperactivity disorder (ADHD) has been associated with illicit stimulants use, less is known about their prospective association in university students. We aimed to examine the association between ADHD symptoms at inclusion and illicit stimulants use following 1 year among university students. METHODS The i-Share cohort recruited French students from February 2013 to July 2020. The study included 4270 participants. The Adult ADHD Self-Report Scale (ASRS) was used to evaluate ADHD symptoms at inclusion. Illicit stimulants use was assessed at inclusion and 1 year after inclusion. Multivariable logistic regressions were conducted to assess the association between ADHD symptoms at inclusion and illicit stimulants use following 1 year. RESULTS High levels of ADHD symptoms at inclusion were associated with a greater probability of illicit stimulants use following 1 year (adjusted OR: 2.42 (1.51-3.8)). The adjusted odds ratio was 2.7 (1.08-7.84) among participants who had used illicit stimulant at least once (continuation) and 2.25 (1.04-4.37) among participants who had never used illicit stimulants at inclusion (initiation). CONCLUSION High levels of ADHD symptoms are a feature that may promote both initiation and continuation of illicit stimulants use among university students. Our findings suggest that university students with high levels of ADHD symptoms may benefit from screening to help identify those at risk of illicit stimulants use.
Collapse
Affiliation(s)
- François A M Jean
- Department of Psychiatry, Dr Jean Eric Techer Hospital, Calais, France
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
| | - Flore Moulin
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
| | - Ashlyn N Schwartz
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
- Department of Public Health, University of Tennessee, Knoxville, USA
| | - Laura Castel
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
| | - Ilaria Montagni
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
| | - Mélissa Macalli
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
| | - Charles-Edouard Notredame
- University of Lille, Lille, France
- PSY Lab, Lille Neuroscience & Cognition Centre, INSERM U1172, National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale-INSERM), Lille, France
- Teaching Hospital of Lille (Centre Hospitalier Universitaire de Lille-CHU de Lille), Lille, France
| | - Sylvana M Côté
- University of Bordeaux, Bordeaux, France
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France
- University of Montreal, Montreal, Canada
| | - Cédric Galéra
- University of Bordeaux, Bordeaux, France.
- Bordeaux Population Heltch Research Center, UMR1219, HEALTHY Team, National Institute of Health and Medical Research (Institut National de La Santé Et de La Recherche Médicale-INSERM), Bordeaux, France.
- Charles Perrens Hospital, Bordeaux, France.
- Pôle Universitaire de Psychiatrie de L'enfant et de L'adolescent, Centre Hospitalier Charles-Perrens, 146Bis, rue Léo-Saignat, 33076, Bordeaux, France.
| |
Collapse
|
10
|
de Jonge MC, Bukman AJ, Ter Bogt T, Onrust SA, Kleinjan M. What Do Young Adults Expect from the Recreational Use of Ecstasy (3,4-Methylenedioxymethamphetamine/Molly)? A Latent Class Analysis of a Convenience Sample of Dutch Young Adults. Eur Addict Res 2023:1-10. [PMID: 37271136 DOI: 10.1159/000530330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 03/16/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION This study offers insights into Dutch young people's expected social and personal consequences of ecstasy use. Substance use expectancies are assumed to be an essential component in explaining substance use behaviour and, therefore, the development of effective substance use prevention and treatment strategies. METHOD Dutch young adults with an online interest in drug-related social media posts were targeted with an online survey about their use of alcohol and drugs. This resulted in a convenience sample (N = 4182, 73.4% female, Mage = 21.11), of which 35.5% had used ecstasy at least once in their life and 29.3% had used ecstasy last year. Latent class analyses were used to identify subgroups based on both positive and negative expectancies of ecstasy use. Cross-class differences were examined using multinomial logistic regression. RESULTS This study yielded four distinct classes: only negative expectancies (13.6%), high positive and negative expectancies (23.5%), low to moderate positive and negative expectancies (20.6%), and mostly positive expectancies (22.4%). These classes differed significantly in lifetime experience with ecstasy use, intention to use ecstasy, perception of harmfulness and availability, and social norms regarding the use of ecstasy. CONCLUSION Findings show that ecstasy use expectancies can be used to create meaningful classes of users and non-users, and that these classes are different enough to warrant varied prevention approaches. Expectancies young people have regarding the use of ecstasy are associated with various ecstasy use-related variables and should be taken into consideration when developing and implementing preventive interventions.
Collapse
Affiliation(s)
| | | | - Tom Ter Bogt
- Utrecht University, Interdisciplinary Social Science, Utrecht, The Netherlands
| | | | - Marloes Kleinjan
- Trimbos Institute, Utrecht, The Netherlands
- Utrecht University, Interdisciplinary Social Science, Utrecht, The Netherlands
| |
Collapse
|
11
|
Fonseka LN, Woo BKP. Therapeutic role of psilocybin and 3,4-methylenedioxymethamphetamine in trauma: A literature review. World J Psychiatry 2023; 13:182-190. [PMID: 37303932 PMCID: PMC10251361 DOI: 10.5498/wjp.v13.i5.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/28/2023] [Accepted: 04/13/2023] [Indexed: 05/19/2023] Open
Abstract
With the Food and Drug Administration designation in 2017 of 3,4-methylenedioxymethamphetamine (MDMA) as a breakthrough therapy in post-traumatic stress disorder and psilocybin in treatment-resistant depression, psychedelic drugs have continued to garner the attention of researchers and clinicians for their promise of unmatched, rapid improvement in a multitude of psychiatric conditions. Classic psychedelic drugs including psilocybin, lysergic acid diethylamide, and ayahuasca, as well as non-classic drugs such as MDMA and ketamine, are currently being investigated for a potential therapeutic role in trauma, depressive disorders, and other psychopathologies. However, psilocybin and MDMA each have a functional profile well-suited for integration with psychotherapy. The present review focuses on psilocybin and MDMA in psychedelic-assisted therapy (PAT), as these studies compose most of the literature pool. In this review, we discuss the current and future uses of psychedelic drugs, with an emphasis on the role of MDMA and psilocybin in PAT in the setting of trauma and related comorbidities on the efficacy of psychedelic drugs across multiple psychiatric disorders. The article concludes with thoughts for future research, such as incorporating wearables and standardization of symptom scales, therapy styles, and assessment of adverse drug reactions.
Collapse
Affiliation(s)
- Lakshan N Fonseka
- Harvard South Shore-Psychiatry Residency Program, Veteran Affairs Boston Healthcare System, Brockton, MA 02301, United States
| | - Benjamin KP Woo
- Chinese American Health Promotion Laboratory, University of California, Los Angeles, Los Angeles, CA 90095, United States
- Department of Psychiatry and Biobehavioral Sciences, Olive View - University of California, Los Angeles Medical Center, Sylmar, CA 91342, United States
- Asian American Studies Center, University of California, Los Angeles, Los Angeles, CA 90095, United States
- Podiatric Medicine and Surgery, Western University of Health Sciences, Pomona, CA 91766, United States
| |
Collapse
|
12
|
Lemoine C, Bréhin C, Micheau P, Lavit M, Claudet I. An unusual route of non-intentional intoxication by ecstasy in a toddler. Arch Pediatr 2023; 30:254-256. [PMID: 37061359 DOI: 10.1016/j.arcped.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 11/03/2022] [Accepted: 03/04/2023] [Indexed: 04/17/2023]
Abstract
We report a pediatric case of ecstasy intoxication via an unusual route. A mother called the emergency services after her daughter had inserted an ecstasy pill into her nose. During transportation, the child developed hypertension, tachycardia, and tachypnea. She was admitted to the nearest regional hospital, where a physical examination revealed psychomotor agitation, mydriasis, hypertension, tachycardia, and no hyperthermia. Blood tests showed no abnormalities. She was subsequently transferred to a tertiary-level pediatric hospital. During transportation, she was described as being intensely agitated with persistent mydriasis, tachycardia, and high blood pressure. Urinary toxicological screening confirmed the presence of MDMA. She was discharged after 24 h.
Collapse
Affiliation(s)
- C Lemoine
- Pediatric emergency department, Children Hospital, CHU Toulouse, France
| | - C Bréhin
- Pediatric emergency department, Children Hospital, CHU Toulouse, France; UMR 1416, Inserm, IRSD, Toulouse, France
| | - P Micheau
- Pediatric emergency department, Children Hospital, CHU Toulouse, France
| | - M Lavit
- Laboratory of Toxicology, CHU Toulouse, France
| | - I Claudet
- Pediatric emergency department, Children Hospital, CHU Toulouse, France; UMR 1295, Inserm, CERPOP, Paul Sabatier University, UPS, Toulouse, France.
| |
Collapse
|
13
|
Cameron-Burr KT, Bola RA, Kiyatkin EA. Dantrolene sodium fails to reverse robust brain hyperthermia induced by MDMA and methamphetamine in rats. Psychopharmacology (Berl) 2023; 240:785-795. [PMID: 36700960 DOI: 10.1007/s00213-023-06321-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/19/2023] [Indexed: 01/27/2023]
Abstract
RATIONALE Hyperthermia induced by psychomotor stimulants may cause leakage of the blood-brain barrier, vasogenic edema, and lethality in extreme cases. Current treatments such as whole-body cooling are only symptomatic and a clear need to develop pharmacological interventions exists. Dantrolene sodium, a peripheral muscle relaxant used in the treatment of malignant hyperthermia, has been proposed as potentially effective to treat MDMA-hyperthermia in emergency rooms. However, debate around its efficacy for this indication persists. OBJECTIVES To investigate dantrolene as a treatment for illicit hyperthermia induced by psychomotor stimulant drugs, we examined how Ryanodex®, a concentrated formulation of dantrolene sodium produced by Eagle Pharmaceuticals, influences 3,4-methylenedioxymethamphetamine (MDMA)- and methamphetamine (METH)-induced hyperthermia in awake freely moving rats. We injected rats with moderate doses of MDMA (9 mg/kg) and METH (9 mg/kg) and administered Ryanodex® intravenously (6 mg/kg) after the development of robust hyperthermia (>2.5 °C) mimicking clinical acute intoxication. We conducted simultaneous temperature recordings in the brain, temporal muscle, and skin to determine the basic mechanisms underlying temperature responses. To assess the efficacy of dantrolene in attenuating severe hyperthermia, we administered MDMA to rats maintained in a warm ambient environment (29 °C), conditions which produce robust brain and body hyperthermia (>40 °C) and lethality. RESULTS Dantrolene failed to attenuate MDMA- and METH-induced hyperthermia, though locomotor activity was significantly reduced. All animals maintained at warm ambient temperatures that received dantrolene during severe drug-induced hyperthermia died within or soon after the recording session. CONCLUSIONS Our results suggest that dantrolene sodium formulations are not mechanistically suited to treat MDMA- and METH-induced hyperthermia.
Collapse
Affiliation(s)
- Keaton T Cameron-Burr
- Behavioral Neuroscience Branch, National Institute on Drug Abuse - Intramural Research Program, National Institutes of Health, DHHS, 251 Bayview Blvd, Baltimore, MD, 21224, USA
| | - R Aaron Bola
- Behavioral Neuroscience Branch, National Institute on Drug Abuse - Intramural Research Program, National Institutes of Health, DHHS, 251 Bayview Blvd, Baltimore, MD, 21224, USA
| | - Eugene A Kiyatkin
- Behavioral Neuroscience Branch, National Institute on Drug Abuse - Intramural Research Program, National Institutes of Health, DHHS, 251 Bayview Blvd, Baltimore, MD, 21224, USA.
| |
Collapse
|
14
|
Costa G, Serra M, Maccioni R, Casu MA, Kasture SB, Acquas E, Morelli M. Withania somnifera influences MDMA-induced hyperthermic, cognitive, neurotoxic and neuroinflammatory effects in mice. Biomed Pharmacother 2023; 161:114475. [PMID: 36905810 DOI: 10.1016/j.biopha.2023.114475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/11/2023] Open
Abstract
Withania somnifera (WS) is utilized in Ayurvedic medicine owing to its central and peripheral beneficial properties. Several studies have accrued indicating that the recreational amphetamine-related drug (+/-)- 3,4-methylenedioxymethamphetamine (MDMA; Ecstasy) targets the nigrostriatal dopaminergic system in mice, inducing neurodegeneration and gliosis, causing acute hyperthermia and cognitive impairment. This study aimed to investigate the effect of a standardized extract of W. somnifera (WSE) on MDMA-induced neurotoxicity, neuroinflammation, memory impairment and hyperthermia. Mice received a 3-day pretreatment with vehicle or WSE. Thereafter, vehicle- and WSE-pretreated mice were randomly divided into four groups: saline, WSE, MDMA alone, WSE plus MDMA. Body temperature was recorded throughout treatment, and memory performance was assessed by a novel object recognition (NOR) task at the end of treatment. Thereafter, immunohistochemistry was performed to evaluate in the substantia nigra pars compacta (SNc) and striatum the levels of tyrosine hydroxylase (TH), as marker of dopaminergic degeneration, and of glial fibrillary acidic protein (GFAP) and TMEM119, as markers of astrogliosis or microgliosis, respectively. MDMA-treated mice showed a decrease in TH-positive neurons and fibers in the SNc and striatum respectively, an increase in gliosis and body temperature, and a decrease in NOR performance, irrespective of vehicle or WSE pretreatment. Acute WSE plus MDMA counteracted the modifications in TH-positive cells in SNc, GFAP-positive cells in striatum, TMEM in both areas and NOR performance, as compared to MDMA alone, while no differences were observed as compared to saline. Results indicate that WSE acutely administered in combination with MDMA, but not as pretreatment, protects mice against the noxious central effects of MDMA.
Collapse
Affiliation(s)
- Giulia Costa
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy.
| | - Marcello Serra
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy
| | - Riccardo Maccioni
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy; Department of Immunology and Microbiology, Scripps Research, La Jolla, CA, USA
| | - Maria Antonietta Casu
- National Research Council of Italy, Institute of Translational Pharmacology, UOS of Cagliari, Scientific and Technological Park of Sardinia POLARIS, Pula, Italy
| | - Sanjay B Kasture
- Rajarshi Shahu College of Pharmacy, Buldhana, Maharashtra, India
| | - Elio Acquas
- Department of Life and Environmental Sciences, University of Cagliari, Cagliari, Italy
| | - Micaela Morelli
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy; National Research Council of Italy, Neuroscience Institute, Cagliari, Italy
| |
Collapse
|
15
|
Blanchot A, Antal MC, Ameline A, Gheddar L, Arbouche N, Raul JS, Kintz P. Pregnancy denial and unplanned home delivery: Considerations about fetal death causes and maternal drug use imputability. Forensic Sci Int 2023; 342:111538. [PMID: 36543017 DOI: 10.1016/j.forsciint.2022.111538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
Determining fetal death causes is a complex problem for the forensic pathologist. Beyond the medico-legal context, the expert must be able to evaluate the viability of the fetus at the time of death, to eliminate in-utero fetal death and to determine if the death is related to a fetal, a maternal, a placental cause, or simply related to obstetrical complications. The authors present the case of a 21-year-old woman who unexpectedly gave birth to a fetus during a party. As pregnancy was not acknowledged by the mother (regular menstrual cycles and use of hormonal contraception), no obstetrical check-up had been performed. She would have presented violent abdominal pain and expelled a mass in the toilet. The fetus body, enclosed in the amniotic pouch, and the placenta were found in the toilet. A forensic autopsy was performed jointly by a forensic pathologist and a specialist in fetal pathology. Histological, toxicological and genetic samples were collected. Body morphometry and bone maturation indicated a gestational age of 31-32 weeks of amenorrhea. A significant asphyxia syndrome and non-specific multi-visceral congestion were noted at autopsy. Histological analysis of the fetal tissues revealed a lung and skeletal muscle maturation in accordance with the estimated term. At the brain level, there were signs of anoxia and abnormal cortical development with periventricular nodular heterotopia areas. The placenta microscopic analysis revealed acute chorioamniotitis, the probable cause of the premature fetal expulsion. Toxicological analyses revealed the presence of ecstasy (48 ng/mL) and its metabolite MDA (2 ng/mL) in fetal blood. Although negative in blood, THC-COOH tested positive in urine (9 ng/mL). The fetus was repetitively exposed to cannabis, as Δ9-THC tested positive in hair (51 pg/mg). Maternal hair analysis on 4 × 3 cm evidenced a long-term use of cannabis, while results support single massive exposure to ecstasy. In this article, the authors try to explain the reflexive pathway carried out to establish death causes and the maternal toxic consumption imputability on the cerebral malformations and fetal death. This case illustrates both the interest of toxicological analyses in cases of fetal death and the importance of a collaborative work between forensic and fetal pathologists and toxicologists, which appeared critical to answer in the best conditions to the magistrates questions, as well as to the bereaved families.
Collapse
Affiliation(s)
- Adeline Blanchot
- Institut de médecine légale, 11 rue Humann, 67085 Strasbourg, France.
| | - Maria Cristina Antal
- UF6349 Fœtopathologie, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France
| | - Alice Ameline
- Institut de médecine légale, 11 rue Humann, 67085 Strasbourg, France
| | - Laurie Gheddar
- Institut de médecine légale, 11 rue Humann, 67085 Strasbourg, France
| | - Nadia Arbouche
- Institut de médecine légale, 11 rue Humann, 67085 Strasbourg, France
| | | | - Pascal Kintz
- Institut de médecine légale, 11 rue Humann, 67085 Strasbourg, France
| |
Collapse
|
16
|
Sottile JE, Macia KS, Wickham RE, Haug NA. Development and initial validation of an MDMA/ Ecstasy motives assessment. Addict Behav 2023; 136:107494. [PMID: 36162335 DOI: 10.1016/j.addbeh.2022.107494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/11/2022] [Accepted: 09/14/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE MDMA/Ecstasy motives differ from those of other substances such as alcohol, cannabis, and methamphetamine. Previous literature on alcohol and cannabis use identified social, expansion, enhancement, coping, and conformism as primary motives for use. MDMA/Ecstasy users also report using the drug for increases in self-awareness and energy. The development of an MDMA/Ecstasy use motives assessment has potential to inform treatment interventions and public policy on harm reduction. METHOD An MDMA/Ecstasy use motives assessment was developed from alcohol and cannabis motives measures and qualitative feedback from MDMA/Ecstasy users. Participants included an international sample of adults (N = 1754) who completed an online questionnaire regarding their motives for using recreational MDMA/Ecstasy. RESULTS Exploratory and confirmatory factor analysis supported a 4-factor MDMA/Ecstasy motives scale. The four motive scales showed good internal consistency reliabilitySocial (α = 0.88) Expansion (α = 0.81), Coping (α = 0.82), and Energy (α = 0.75). Conformity and Enhancement did not emerge as significant factors. Analyses demonstrated convergent and discriminant validity with relevant constructs including quantity/frequency of use, MDMA use disorder, sensation seeking personality, and positive and negative consequences of use. CONCLUSIONS MDMA/Ecstasy use motives differ from those of other substances due to the distinctly stimulating, emotional, and empathic effects sought by users. By identifying salient MDMA/Ecstasy motives, this study highlights the unique aspects of recreational MDMA/Ecstasy use. This research has utility for informing clinical practice and contributing to public health harm reduction efforts.
Collapse
Affiliation(s)
- James E Sottile
- Department of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304 USA
| | - Kathryn S Macia
- National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025 USA
| | - Robert E Wickham
- Department of Psychological Sciences, Northern Arizona University, S San Francisco Street, Flagstaff, AZ 86011 USA
| | - Nancy A Haug
- Department of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304 USA.
| |
Collapse
|
17
|
Ingebrigtsen E, Persett PS, Brekke M, Heyerdahl F, Hovda KE, Vallersnes OM. Poisoning with central stimulant drugs: an observational study from Oslo, Norway. Int J Emerg Med 2022; 15:54. [PMID: 36175843 PMCID: PMC9520889 DOI: 10.1186/s12245-022-00457-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Background The use of central stimulant drugs causes significant morbidity. We describe poisonings with central stimulant drugs and compare the different central stimulants concerning combinations with other drugs, treatment, and clinical course. Methods Patients presenting from 1 October 2013 to 31 March 2016 with poisoning related to the recreational use of central stimulant drugs were retrospectively included at a primary care emergency outpatient clinic and at a hospital emergency department in Oslo, Norway. Diagnosis of toxic agents was mainly based on the clinical assessment of the doctor treating the patient. Amphetamine and methamphetamine were co-categorized as amphetamine. Results Among the 1131 cases of acute poisoning with central stimulant drugs at the outpatient clinic, amphetamine was involved in 808 (71.4%), cocaine in 252 (22.3%) methylenedioxymethamphetamine (MDMA) in 104 (9.2%), and methylphenidate in 13 (1.1%). Among the 211 cases at the hospital, amphetamine was involved in 167 (79.1%), cocaine in 60 (28.4%), and MDMA in 38 (18.0%). Amphetamine was frequently combined with opioids (40.1% at the outpatient clinic and 41.9% at the hospital) and benzodiazepines (28.3% and 45.5%), while MDMA often was combined with ethanol (64.4% and 71.1%), as was cocaine (62.7% and 61.7%). Sedation was given in 5.2% and 38.4% of cases, naloxone in 9.4% and 37.0%, and flumazenil in 0.1% and 28.0%. In total, 16.5% of the cases at the outpatient clinic were transferred to a hospital for medical review and 8.5% to a psychiatric hospital. Among the hospital patients, 92.9% were admitted to intensive care. Conclusion Amphetamine was the most common central stimulant drug involved in acute poisoning in Oslo, often combined with opioids and benzodiazepines.
Collapse
Affiliation(s)
- Erlend Ingebrigtsen
- Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Surgery, Orkdal Hospital, St Olav's Hospital, Orkdal, Norway
| | | | - Mette Brekke
- General Practice Research Unit, University of Oslo, Oslo, Norway
| | - Fridtjof Heyerdahl
- Air Ambulance Department, Oslo University Hospital, Oslo, Norway.,The Norwegian Air Ambulance Foundation, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Knut Erik Hovda
- Department of Acute Medicine, The Norwegian CBRNe Centre of Medicine, Oslo University Hospital, Oslo, Norway
| | - Odd Martin Vallersnes
- Department of General Practice, University of Oslo, Oslo, Norway. .,Department of Emergency General Practice, Oslo Accident and Emergency Outpatient Clinic, City of Oslo Health Agency, Oslo, Norway.
| |
Collapse
|
18
|
Griffin A, Kirkbride KP, Henry J, Painter B, Linacre A. Recovery of integrated and surface trace DNA from illicit drug tablets. Forensic Sci Int Genet 2022; 61:102772. [PMID: 36099863 DOI: 10.1016/j.fsigen.2022.102772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/11/2022] [Accepted: 09/06/2022] [Indexed: 11/04/2022]
Abstract
In many parts of the world, tablets are a commonly encountered form of illicit drug preparation. Whilst previous research has investigated the feasibility of detecting trace DNA on illicit drug capsules, this has not been performed for tablets. Tablets have a unique substrate surface and therefore the amount of DNA transferring to them and persisting on them may be different to capsules; there may also be differences in the collection efficiency and the outcome of downstream DNA processing and analysis steps. The ability to profile the DNA from individuals who handled tablets during their preparation and distribution would add another level of discrimination between various drug seizures or corroborate chemical profiling outcomes which may link various seizures to a common origin. DNA from two different individuals (male and female) was added to the tablets in two stages. Firstly, tablet powder was spiked with DNA from one individual to mimic the situation where DNA traces are incorporated during the drug synthesis or final drying stages. The powder was then pressed into tablets in a clean environment without intentional addition of DNA. Subsequently, a second individual counted out the tablets into bags of ten to mimic the preparation for distribution at a user level. The exterior of the tablet was swabbed and then the entire tablet and the swab were put through separate DNA extractions, yielding two DNA extracts for each tablet. Swabs of the exterior tablet surface yielded single source DNA profiles that identified the tablet handler in 100 % of samples. The tablet extract yielded the donor of the DNA intentionally added within the drug powder in 80% of samples with varying levels of support, however contributions of the exterior handler were detected in 60 % of samples. The identification of individuals potentially involved in the synthesis of the drugs compared to the distribution of the tablets will provide invaluable strategic intelligence related to illicit drug investigations and to law enforcement agencies.
Collapse
Affiliation(s)
- Amy Griffin
- College of Science & Engineering, Flinders University, Adelaide 5042, Australia.
| | - K Paul Kirkbride
- College of Science & Engineering, Flinders University, Adelaide 5042, Australia
| | - Julianne Henry
- College of Science & Engineering, Flinders University, Adelaide 5042, Australia; Forensic Science SA, GPO Box 2790, Adelaide 5000, Australia
| | - Ben Painter
- College of Science & Engineering, Flinders University, Adelaide 5042, Australia; Forensic Science SA, GPO Box 2790, Adelaide 5000, Australia
| | - Adrian Linacre
- College of Science & Engineering, Flinders University, Adelaide 5042, Australia
| |
Collapse
|
19
|
Basedow LA, Wiedmann MF, Roessner V, Golub Y, Kuitunen-Paul S. Coping motives mediate the relationship between PTSD and MDMA use in adolescents with substance use disorders. Addict Sci Clin Pract 2022; 17:46. [PMID: 36057623 PMCID: PMC9441101 DOI: 10.1186/s13722-022-00329-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 08/17/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) and substance use disorders (SUDs) often co-occur in adolescent patients. Previous research has shown that these patients differ from SUD patients without PTSD in terms of their substance use patterns. In this study, we aimed to test whether substance use in this population is related to an attempt to self-medicate PTSD-related symptoms. METHODS German adolescent patients (aged 13-18 years) at an outpatient clinic for SUD treatment, n = 111 (43% female), completed a self-designed questionnaire on use motives, a measure of PTSD-related experiences, and underwent a standardized psychiatric interview including structured substance use questions. Participants were subsequently classified as 'no traumatic experiences ('noTEs' but SUD), 'traumatic experiences but no current PTSD diagnosis' ('TEs' with SUD), and 'PTSD' with SUD. After establishing a self-designed motive measurement through exploratory and confirmatory factor analyses, we calculated non-parametric group differences and a mediation analysis in a linear regression framework. RESULTS The past-year frequency of MDMA use was highest in the PTSD group and lowest in the noTE group (H (2) = 7.2, p = .027, η2 = .058), but no differences were found for frequencies of tobacco, alcohol, cannabis, or stimulant use (all H ≤ 4.9, p ≥ .085, η2 ≤ .033). While controlling for sex, the three groups showed a similar pattern (highest in the PTSD group and lowest in the noTE group) for coping scores (F (103) = 5.77, p = .004, η2 = .101). Finally, mediation analyses revealed an indirect effect of coping score (b = 0.61, 95% CI [0.29, 1.58], p = .145) on the association between group membership and MDMA use frequency. CONCLUSIONS In adolescent SUD patients, we found an association of current PTSD and lifetime traumatic experiences with higher MDMA use that could be partially explained by substance use being motivated by an attempt to cope with mental health symptoms. This indicates a coping process involved specifically in MDMA use compared to the use of other psychoactive substances, possibly due to unique psychoactive effects of MDMA.
Collapse
Affiliation(s)
- Lukas Andreas Basedow
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
- Division of Clinical Psychology and Psychotherapy, Dept. of Psychology, Philipps-University of Marburg, Marburg, Germany.
| | - Melina Felicitas Wiedmann
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Yulia Golub
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Chair for Clinical Psychology and Psychotherapy, Technische Universität Chemnitz, Chemnitz, Germany
| |
Collapse
|
20
|
Griffin A, Kirkbride KP, Henry J, Ben Painter, Linacre A. DNA on drugs (part 2): An extended study into the transfer and persistence of DNA onto illicit drug capsules using realistic scenarios. Forensic Sci Int Genet 2022; 60:102740. [PMID: 35716495 DOI: 10.1016/j.fsigen.2022.102740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 11/15/2022]
Abstract
Capsules are now the main form of ecstasy rather than tablets in Australia and therefore their examination is of interest to forensic drug chemists in Australia and possibly elsewhere. Recently, we used controlled experimental conditions to show that capsules may be a source of DNA that can be used to identify those involved in production and distribution of illicit drugs. The question remains: in realistic scenarios where there are more unknowns, can we still detect DNA, and determine whose it is, on the exterior of capsules? The concept of comprehensive forensic intelligence and investigations - utilizing both biological and chemical signatures - relating to illicit drug preparations (i.e., the capsules and their contents) may be of great use to law enforcement. Experiments were conducted with both semi-realistic and realistic scenarios where two volunteers were asked to firstly use an encapsulator and mimic the loading of capsules, then Volunteer 1 would count out the capsules that Volunteer 2 prepared, and vice versa. This was to simulate the scenario where one person was involved in the assembly of the capsules which were then separated into smaller bags of 10 capsules by a second person for distribution. Gelatine and vegetable capsules were tested, with 10 replicates used per capsule type, scenario, and volunteer (total n = 80 capsules). Volunteer 2 was included as a contributor to the DNA profiles generated from 100% of samples handled by them within the semi-realistic scenario, whereas the other volunteer could be included as a contributor in 65% of samples. For the realistic scenario, profiles could be generated with the inclusion of both volunteers as profile contributors in 15% of samples and from just one of the volunteers in a further 50% of samples (therefore in total, either both or one of the volunteers were detected in 65% of realistic samples). Surprisingly, it was not necessarily the case that the last person to handle the capsule was the major or only contributor. The potential variability in the DNA quantities that could be deposited onto the capsules of genuine illicit drugs is high and would vary on a case-by-case basis. Nevertheless, this study has indicated that in realistic scenarios where two people are involved in the later stages of illicit drug capsule preparation, that either one or both individuals may be identified, potentially opening new investigative leads for law enforcement agencies as well as offering new information for intelligence-led policing.
Collapse
Affiliation(s)
- Amy Griffin
- College of Science & Engineering, Flinders University, Adelaide 5042, Australia.
| | - K Paul Kirkbride
- College of Science & Engineering, Flinders University, Adelaide 5042, Australia
| | - Julianne Henry
- College of Science & Engineering, Flinders University, Adelaide 5042, Australia; Forensic Science SA, GPO Box 2790, Adelaide 5000, Australia
| | - Ben Painter
- College of Science & Engineering, Flinders University, Adelaide 5042, Australia; Forensic Science SA, GPO Box 2790, Adelaide 5000, Australia
| | - Adrian Linacre
- College of Science & Engineering, Flinders University, Adelaide 5042, Australia
| |
Collapse
|
21
|
Bavato F, Stamatakos S, Ohki CMY, Seifritz E, Romualdi P, Grünblatt E, Quednow BB. Brain-derived neurotrophic factor protects serotonergic neurons against 3,4-methylenedioxymethamphetamine (" Ecstasy") induced cytoskeletal damage. J Neural Transm (Vienna) 2022. [PMID: 35420371 DOI: 10.1007/s00702-022-02502-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/06/2022] [Indexed: 10/24/2022]
Abstract
3,4-Methylenedioxymethamphetamine (MDMA, "Ecstasy") use has been linked to persistent alterations of the brain serotonergic (5-HT) system in animal and human studies, but the molecular underpinnings are still unclear. Cytoskeletal structures such as neurofilament light chain (NfL) are promising markers of drug-induced brain toxicity and may be involved in MDMA neurotoxicity. The brain-derived neurotrophic factor (BDNF) promotes the growth and sprouting of 5-HT neurons and its differential response to MDMA administration was suggested to mediate dose- and region-dependent 5-HT damage by MDMA. However, the role of BDNF pre-treatment in preventing MDMA neurotoxicity and the potential effects of MDMA on NfL are still elusive. Therefore, a differentiated 5-HT neuronal cell line obtained from rat raphe nucleus (RN46A) was treated in vitro with either MDMA, BDNF, MDMA + BDNF, or vehicle. Cell viability (measured by MTT) and intracellular NfL levels (immunocytochemistry assay) were reduced by MDMA, but partially rescued by BDNF co-treatment. Our findings confirmed that BDNF levels can influence MDMA-induced 5-HT damage, and support BDNF to be a crucial target for neuroprotective interventions of the 5-HT system. We also provide evidence on the sensitivity of NfL to MDMA neurotoxicity, with potential implications for in-vivo monitoring of drug-induced neurotoxicity.
Collapse
|
22
|
Chan G, Sun T, Lim C, Yuen WS, Stjepanović D, Rutherford B, Hall W, Johnson B, Leung J. An age-period-cohort analysis of trends in psychedelic and ecstasy use in the Australian population. Addict Behav 2022; 127:107216. [PMID: 34979428 DOI: 10.1016/j.addbeh.2021.107216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/31/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022]
Abstract
AIM To test the age, cohort, and period effect on past-year use trends in psychedelic drugs and ecstasy. METHOD Data were from a repeated cross-sectional nationally representative household survey in Australia conducted every three years between 2001 and 2019. An age-period-cohort model was used to test the effect of age, birth cohort, and period on past year psychedelic and ecstasy use. Participants were between 18 and 80 years old at the time of the survey. The total sample size was 149,296 (Mean age = 45.8; 56% female). Past-year use of psychedelics and ecstasy were the key outcome variables. There were six birth cohorts that were derived in each survey: 1936-50, 1951-60, 1961-70, 1971-80, 1981-90, and 1991-2001. There were seven periods that coincided with survey years: 2001, 2004, 2007, 2010, 2013, 2016 and 2019. Age was treated as continuous. RESULTS Past-year use of both psychedelics and ecstasy decreased with age, b = -0.87, 95% CI [-1.14, -0.61] and b = -0.84, 95% CI [-1.08, -0.60]. For ecstasy, while there was significant variation across periods (p < .001), there was no obvious trend. There was a significant birth cohort effect (p < .001), with prevalence increasing from the 1936-50 cohort, peaking in the 1971-80 cohort and then decreasing in the 1991-2001 cohort. For psychedelics, there was significant variation across periods (p < .001) with an upward trend. There was a significant birth cohort effect (p < .001), with prevalence increasing from the 1936-50 cohort to similarly high prevalence for the three most recent cohorts (1971-80, 1981-90, 1991-2001). CONCLUSION There were strong cohort and period effects in trends in the use of psychedelic and ecstasy.
Collapse
Affiliation(s)
- Gary Chan
- National Centre for Youth Substance Use Research, Brisbane, Australia.
| | - Tianze Sun
- National Centre for Youth Substance Use Research, Brisbane, Australia
| | - Carmen Lim
- National Centre for Youth Substance Use Research, Brisbane, Australia
| | - Wing See Yuen
- National Drug and Alcohol Research Centre, Sydney, Australia
| | | | | | - Wayne Hall
- National Centre for Youth Substance Use Research, Brisbane, Australia
| | - Ben Johnson
- National Centre for Youth Substance Use Research, Brisbane, Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research, Brisbane, Australia
| |
Collapse
|
23
|
Levent A, Davelaar EJ. Recreational drug use and prospective memory. Psychopharmacology (Berl) 2022; 239:909-922. [PMID: 35129670 DOI: 10.1007/s00213-022-06081-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 02/01/2022] [Indexed: 11/28/2022]
Abstract
Prospective memory (PM) impairment in recreational drug users has been documented in recent years. However, most studies on the effects of drugs on PM contain several methodological challenges, such as small sample size (< 100 participants), unrepresentative sample type (e.g., student or patient), short abstinence period (< 7 days), and lack of control of potential confounds (e.g., sleep and IQ). The present study investigated the possible consequences of recreational drug use on prospective memory, using self-report and lab-based prospective memory measures while overcoming the methodological challenges. The sample was composed of 47 non-users (27 females, age range from 18 to 50 +) and 53 drug users (21 females, age range from 18 to 50 +). Recreational drug users reported significantly more deficits in the long-term episodic, short-term habitual, and internally cued PM failures subscales of the Prospective Memory Questionnaire. However, these deficits were eliminated after controlling for covariates (e.g., age, sleep quality, general health, alcohol usage). Recreational drug users also performed worse than non-users in the short-term, long-term, event-based, and time-based PM subscales of the Royal Prince Alfred Prospective Memory Test. These results remained significant after controlling for the covariates. Drug users demonstrated greater impairments on time-based and long-term PM tasks thought to be linked with executive functioning. Taken together, the present study provides further support for recreational drug-related deficits in PM and highlights a dissociation between self-report and lab-based PM measures.
Collapse
Affiliation(s)
- Adnan Levent
- Department of Psychological Sciences, Birkbeck, University of London, Male Street, London, WC1E 7HX, UK.
| | - Eddy J Davelaar
- Department of Psychological Sciences, Birkbeck, University of London, Male Street, London, WC1E 7HX, UK
| |
Collapse
|
24
|
Palamar JJ, Sönmez İ. A qualitative investigation exploring why dance festivals are risky environments for drug use and potential adverse outcomes. Harm Reduct J 2022; 19:12. [PMID: 35120530 PMCID: PMC8817488 DOI: 10.1186/s12954-022-00598-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/28/2022] [Indexed: 02/03/2023] Open
Abstract
Background Dance festivals have been shown to be high-risk events for use of drugs such as ecstasy/MDMA and possible adverse effects associated with use. However, few studies have examined what makes festivals such risky environments. We aimed to determine festival-specific risk factors for adverse outcomes related to drug use. Methods In-depth interviews were conducted with 35 key informants in North America who deemed themselves experts in new psychoactive substances, and identified as drug checkers, sellers, or experienced users. Interviews were coded in an inductive manner, and we conducted thematic analysis to identify relevant themes. Results We identified four main themes focusing on festival attendance as a risk factor for risky drug use and related outcomes: attendees inexperienced with electronic dance music parties and party drugs, risky drug purchasing, risky drug use practices, and festival-specific environmental risk factors. Festivals attract a wide array of people not experienced with party drugs, yet drugs like ecstasy are commonly sought by such individuals inside festivals. Relying on strangers inside to purchase drugs is a risk factor for purchasing adulterated product. Fear of security/police at festivals leads to risky drug-taking such as ingesting one’s full batch of drugs at the entrance. These risks are compounded by environmental factors including crowding, hot temperature, and lack of water (which lead to dehydration), long/consecutive event days (which can lead to exhaustion), and inadequate medical emergency response. Conclusions We determined modifiable risk factors which can both inform future research and future prevention and harm reduction efforts in this scene.
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, Room 1752, New York, NY, 10016, USA.
| | - İbrahim Sönmez
- Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| |
Collapse
|
25
|
Kermanian F, Seghatoleslam M, Mahakizadeh S. MDMA related neuro-inflammation and adenosine receptors. Neurochem Int 2022; 153:105275. [PMID: 34990730 DOI: 10.1016/j.neuint.2021.105275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/25/2021] [Accepted: 12/30/2021] [Indexed: 12/20/2022]
Abstract
3,4-methylenedioxymethamphetamine (MDMA) is a world-wide abused psychostimulant, which has the neurotoxic effects on dopaminergic and serotonergic neurons in both rodents and non-human primates. Adenosine acts as a neurotransmitter in the brain through the activation of four specific G-protein-coupled receptors and it acts as a neuromodulator of dopamine neurotransmission. Recent studies suggest that stimulation of adenosine receptors oppose many behavioral effects of methamphetamines. This review summarizes the specific cellular mechanisms involved in MDMA neuroinflammatory effects, along with the protective effects of adenosine receptors.
Collapse
Affiliation(s)
- Fatemeh Kermanian
- Department of Anatomy, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Masoumeh Seghatoleslam
- Evaluative Clinical Sciences, Sunnybrook Research Institute, University of Toronto, ON, Canada
| | - Simin Mahakizadeh
- Department of Anatomy, Faculty of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| |
Collapse
|
26
|
Lo Monte F, Englebert J. Borderline Personality Disorder, Lived Space, and the Stimmung. Psychopathology 2022; 55:179-189. [PMID: 35114681 DOI: 10.1159/000521182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022]
Abstract
Most articles and theories about borderline personality disorder (BPD), either in the psychoanalytical field or the cognitivist one, explicitly or implicitly inscribe themselves in a topographical framework that either carry a fundamental representational a priori or give prominence to causal explanations. Less is written about the phenomenological everyday life-world of borderline people. This article aims to contribute to the description of such a world. Drawing upon clinical sequences that give prominence to the first-person perspective, we will analyse the experience of some typical "symptoms" of BPD in a phenomenological and topological way. We will be led to conclude that the borderline stimmung seems to display the following characteristics: a pervading immediacy of lived experience, a territorialization that tends towards ubiquity, a certain difficulty to deal with the unity and difference poles, a quite horizontal concern with ecstasy and elation, and a waning of reflexivity in the lived space.
Collapse
Affiliation(s)
- Fabian Lo Monte
- Department of Psychology, University of Liège, Liège, Belgium.,Clinique Notre-Dame des Anges, Liège, Belgium
| | - Jérôme Englebert
- Centre de Recherches: Pénalité, Sécurité & Déviances, University of Brussels, Brussels, Belgium.,Centre de Recherche Interdisciplinaire sur la Déviance et la Pénalité (CRID&P), University of Louvain, Ottignies-Louvain-la-Neuve, Belgium.,Centre de Recherches Phénoménologiques, University of Liège, Liège, Belgium
| |
Collapse
|
27
|
Jones GM, Nock MK. MDMA/ ecstasy use and psilocybin use are associated with lowered odds of psychological distress and suicidal thoughts in a sample of US adults. J Psychopharmacol 2022; 36:46-56. [PMID: 34983249 DOI: 10.1177/02698811211058923] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Suicide is one of the leading causes of death worldwide and rates within the United States have risen over the past two decades. Hence, there is a critical need for novel tools to treat suicidal ideation and related mental health conditions. 3,4-Methylenedioxymethamphetamine (MDMA)/ecstasy and classic psychedelics may be two such tools. AIMS The aim of this study was to assess non-causal associations between MDMA/ecstasy and classic psychedelic use and psychological distress and suicide risk. METHODS In this study, we examined the aforementioned associations among 484,732 adult participants in the National Survey on Drug Use and Health (2008-2019). RESULTS Lifetime MDMA/ecstasy use was associated with reduced odds of past year suicidal thinking (10% reduced odds; odds ratio (OR) = 0.90; 95% confidence interval, CI = (0.84-0.97); p < 0.01) and past year suicidal planning (OR = 0.88; 95% CI = (0.78-0.99); p < 0.05). Furthermore, lifetime psilocybin use was associated with reduced odds of past month psychological distress (OR = 0.78; 95% CI = (0.73-0.84); p < 0.001) and past year suicidal thinking (OR = 0.90; 95% CI = (0.83-0.96); p < 0.01). Finally, lysergic acid diethylamide (LSD) was associated with increased odds of past year suicidal thinking (OR = 1.07; 95% CI = (1.00-1.15); p < 0.05). CONCLUSION MDMA/ecstasy and psilocybin use are associated with reduced odds of suicidal thinking and related outcomes-though experimental studies are needed to determine whether these associations are causal. These findings call for more research into the efficacy of MDMA/ecstasy and classic psychedelics for treating psychological distress and suicidal thoughts and behaviors, and for updated drug legislation that allows for further investigation into these substances.
Collapse
Affiliation(s)
- Grant M Jones
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| |
Collapse
|
28
|
Smith MA, Schmidt KT, Sharp JL, Pearson T, Davis AL, Gibson AN, Potter KM. Lack of evidence for positive reinforcing and prosocial effects of MDMA in pair-housed male and female rats. Eur J Pharmacol 2021; 913:174646. [PMID: 34800468 DOI: 10.1016/j.ejphar.2021.174646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
3,4-Methylenedioxymethamphetamine (MDMA) is classified as an entactogen, producing feelings of emotional openness and relatedness. One unique feature of MDMA is that people tend to selectively take this drug in social and/or intimate situations. Although MDMA is recognized as having abuse liability, preclinical studies report that it has weak reinforcing effects in animals. The objective of this study was to characterize the positive reinforcing and prosocial effects of MDMA in a translational model of the social environment in which two rats have simultaneous and contingent access to MDMA in close physical proximity. To this end, MDMA self-administration was examined on both fixed and progressive ratio schedules of reinforcement in six groups of rats: (1) isolated males, (2) isolated females, (3) male-male dyads, (4) female-female dyads, (5) male-female dyads, and (6) female-male dyads. For pair-housed rats, data from both rats were analyzed. Next, social preferences were examined in a partner preference test. MDMA failed to produce positive reinforcing effects under all conditions examined. Across a 30-fold dose range (0.01-1.0 mg/kg/infusion), MDMA did not maintain higher responding than saline on both schedules of reinforcement and in all groups tested. In partner preference tests, a history of shared exposure to MDMA did not establish a social preference, and acute administration of MDMA failed to establish a preference for another MDMA-treated rat. These data suggest that social contact does not increase the positive reinforcing effects of MDMA in rats, and that neither contingent nor noncontingent MDMA administration establishes a social preference in rats.
Collapse
Affiliation(s)
- Mark A Smith
- Department of Psychology and Program in Neuroscience, Davidson College, Davidson, NC, USA.
| | - Karl T Schmidt
- Department of Psychology and Program in Neuroscience, Davidson College, Davidson, NC, USA
| | - Jessica L Sharp
- Department of Psychology and Program in Neuroscience, Davidson College, Davidson, NC, USA
| | - Tallia Pearson
- Department of Psychology and Program in Neuroscience, Davidson College, Davidson, NC, USA
| | - Anna L Davis
- Department of Psychology and Program in Neuroscience, Davidson College, Davidson, NC, USA
| | - Abigail N Gibson
- Department of Psychology and Program in Neuroscience, Davidson College, Davidson, NC, USA
| | - Kenzie M Potter
- Department of Psychology and Program in Neuroscience, Davidson College, Davidson, NC, USA
| |
Collapse
|
29
|
van Amsterdam J, Brunt TM, Pierce M, van den Brink W. Hard Boiled: Alcohol Use as a Risk Factor for MDMA-Induced Hyperthermia: a Systematic Review. Neurotox Res 2021; 39:2120-2133. [PMID: 34554408 PMCID: PMC8639540 DOI: 10.1007/s12640-021-00416-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 09/07/2021] [Accepted: 09/11/2021] [Indexed: 11/10/2022]
Abstract
Although MDMA (ecstasy) is a relatively safe recreational drug and is currently considered for therapeutic use for the treatment of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), recreational MDMA use occasionally elicits hyperthermia and hyponatremia, sometimes with a fatal outcome. Specific risk factors for both adverse effects are profuse sweating while vigorously dancing under unfavorable conditions such as high ambient temperatures and insufficient fluid suppletion which result in dehydration. Concomitant use of MDMA and alcohol is highly prevalent, but adds to the existing risk, because alcohol facilitates the emergence of MDMA-induced adverse events, like hyperthermia, dehydration, and hyponatremia. Because of potential health-related consequences of concomitant use of MDMA and alcohol, it is important to identify the mechanisms of the interactions between alcohol and MDMA. This review summarizes the main drivers of MDMA-induced hyperthermia, dehydration, and hyponatremia and the role of concomitant alcohol use. It is shown that alcohol use has a profound negative impact by its interaction with most of these drivers, including poikilothermia, exposure to high ambient temperatures, heavy exercise (vigorous dancing), vasoconstriction, dehydration, and delayed initiation of sweating and diuresis. It is concluded that recreational and clinical MDMA-users should refrain from concomitant drinking of alcoholic beverages to reduce the risk for adverse health incidents when using MDMA.
Collapse
Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
| | - Tibor M Brunt
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Mimi Pierce
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands
| |
Collapse
|
30
|
Eslami SM, Khorshidi L, Ghasemi M, Rashidian A, Mirghazanfari M, Nezhadi A, Chamanara M, Mirjani R. Protective effects of atorvastatin and rosuvastatin on 3,4-methylenedioxymethamphetamine (MDMA)-induced spatial learning and memory impairment. Inflammopharmacology 2021; 29:1807-18. [PMID: 34780009 DOI: 10.1007/s10787-021-00891-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 11/01/2021] [Indexed: 12/16/2022]
Abstract
3,4-Methylenedioxymethamphetamine (MDMA) or "Ecstasy", which has been used for recreational purposes, is shown to impair memory and brain functions. Statins, beyond their efficient cholesterol-lowering impact through inhibition of HMG-COA reductase enzyme, possess multiple actions referred to as pleiotropic effects. In this regard, we aimed to investigate the neuroprotective effects of atorvastatin and rosuvastatin on MDMA-induced neurotoxicity. Adult male Wistar rats received atorvastatin (5, 10, and 20 mg/kg; orally) and rosuvastatin (5, 10, 20 mg/kg; orally) for 21 consecutive days. Then, spatial memory and learning were evaluated by Morris water maze (MWM) test. Rats were intraperitoneally injected with MDMA (2.5, 5, and 10 mg/kg) 30 min before the first training session in 4 training days of MWM task. Afterward, rats were euthanized and their hippocampuses were dissected to evaluate reactive oxygen species (ROS) production, lipid peroxidation (LPO), and caspase-3 and -9 activities. Our findings showed that MDMA (5 and 10 mg/kg) significantly impaired spatial memory functions and dramatically increased ROS production, LPO, and caspase-3 and -9 activities compared to control. Also, atorvastatin (5, 10, and 20 mg/kg) and rosuvastatin (20 mg/kg) significantly improved memory performances and inhibited the elevation of ROS, LPO, and caspase-3 and -9 activities induced by MDMA. In conclusion, the results indicated that MDMA-induced cognitive impairment is followed by oxidative stress and activation of apoptotic pathways in the hippocampus. However, atorvastatin and rosuvastatin suppressed these deleterious consequences of MDMA and revealed protective effects against activation of pathways leading to cell damage.
Collapse
|
31
|
Nikolić S, Cvetković D, Ječmenica D, Živković V. Atypical longitudinal self-inflicted incised wounds as a cause of death in an ecstasy user. Forensic Sci Med Pathol 2021. [PMID: 34724160 DOI: 10.1007/s12024-021-00436-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 10/20/2022]
Abstract
A 32-year-old chronic drug abuser was found dead at the entrance to his home, covered in blood. Pools of blood, bloody footprints and bloodstains were found across the apartment. A double-edged razor was recovered from the scene. Autopsy revealed multiple incised wounds: two on the palmar aspect of both forearms (37 cm and 33 cm long, oriented longitudinally). The cuts extended into the subcutaneous adipose tissue, muscles and blood vessels. There was an additional 30 cm cut extending across the middle of the torso anteriorly and two more cuts on the anteromedial aspect of the lower legs, set symmetrically (about 23 and 25 cm long). These three cuts were more shallow than the upper extremity wounds. No hesitation wounds were identified. Toxicological analysis identified MDMA (ecstasy). The cause of death was exsanguination. The deceased has been using ecstasy for the previous five years and had a history of inpatient psychiatric treatment due to psychosis with delusions and hallucinations. These self-inflicted incised wounds had many atypical features: location (torso, legs and arms), longitudinal orientation and symmetrical distribution, absence of hesitation injuries, use of both dominant and non-dominant hand. The absence of previous suicide attempts and suicide note suggest that these self-inflicted injuries were not planned beforehand, but were abrupt. We hypothesize that this injury pattern is associated with both acute and chronic effects of MDMA.
Collapse
|
32
|
Abstract
Preclinical and clinical studies indicate that 3,4-methylenedioxymethamphetamine (MDMA; 'ecstasy'), in addition to having abuse potential, may elicit acute and persistent abnormalities of varying severity at the central level. Importantly, neurotoxic effects of MDMA have been demonstrated in experimental animals. Accordingly, central toxicity induced by MDMA may pose a serious harm for health, since MDMA is among the substances that are used for recreational purposes by young and adult people. This review provides a concise overview of recent findings from preclinical and clinical studies that evaluated the central effects of MDMA, and the mechanisms involved in the neurotoxicity induced by this amphetamine-related drug.
Collapse
Affiliation(s)
- Giulia Costa
- Department of Biomedical Sciences, Section of Neuroscience, University of Cagliari, Cagliari, Italy.
| | - Krystyna Gołembiowska
- Maj Institute of Pharmacology, Polish Academy of Sciences, Department of Pharmacology, 12 Smętna, 31-343 Kraków, Poland
| |
Collapse
|
33
|
Montgomery C, Roberts CA. Neurological and cognitive alterations induced by MDMA in humans. Exp Neurol 2021; 347:113888. [PMID: 34624331 DOI: 10.1016/j.expneurol.2021.113888] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/27/2021] [Accepted: 10/02/2021] [Indexed: 11/24/2022]
Abstract
3,4 Methylenedioxymethamphetamine generally referred to as MDMA or 'ecstasy' is a ring-substituted phenethylamine stimulant which produces powerful empathogenic effects. Use of MDMA remains popular despite prohibition, and potential long-term negative consequences of repeated use. MDMA produces its acute subjective effects primarily by stimulating the release of serotonin via action at the serotonin transporter (SERT). There is evidence that MDMA administration may lead to long lasting neurotoxic effects on serotonin neurons in primates, and reductions in markers of central serotonin axons, and axon terminals in animals. In humans, demonstration of serotonergic neurotoxicity is much more difficult to identify, and much of the research is complicated by confounding issues of polysubstance use, genetic and environmental factors and reliance on self-reports of previous drug use. We do not review the mechanisms for neurotoxicity in detail as they are covered elsewhere in this special issue. There is a large body of literature, however, which has investigated potential cognitive and neurocognitive consequences of repeated MDMA use. Here we review the literature on cognition, and neuroimaging studies that have investigated structural and functional brain changes associated with ecstasy use.
Collapse
|
34
|
Sheikholeslami B, Tootoonchi Z, Lavasani H, Hosseinzadeh Ardakani Y, Rouini M. Investigation of MDMA Inhibitory Effect on CytochromeP450 3A4 in Isolated Perfused Rat Liver Model Using Tramadol. Adv Pharm Bull 2021; 11:530-536. [PMID: 34513628 PMCID: PMC8421619 DOI: 10.34172/apb.2021.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/13/2020] [Accepted: 08/05/2020] [Indexed: 11/14/2022] Open
Abstract
Purpose: MDMA (methylenedioxymethamphetamine) is a synthetic compound, which is a structurally derivative of amphetamine. Also, it acts like an amphetamine, structurally, and functionally. MDMA uses mechanism-based inhibition, to inhibit isoenzyme CYP2D6. It can also inhibit other isoenzymes contributing to its metabolism, including CYP3A4 which is the most important member of the cytochrome P450 superfamily. Since more than 50% of drugs are metabolized by CYP3A4, its inhibition may cause harmful and even lethal drug interactions. Tramadol, as an opioid-like analgesic, is mainly metabolized into O-desmethyl tramadol (M1), by CYP2D6 and undergoes N-demethylation to M2, by CYP2B6 and CYP3A4. Due to the significant potential of abusing tramadol, either alone or in combination with MDMA, the rate of its toxicity and side effects may increase following possible MDMA relevant enzyme inhibition. Methods: Different doses of MDMA (1-10 mg/kg) were intraperitoneally administered to Wistar male rats of both control and treatment groups. Then, after one hour, their isolated livers were perfused by perfusion buffer containing tramadol (1 µg/mL). Afterward, perfusate samples were collected. They were analyzed by HPLC to determine the concentrations of tramadol and its metabolites. Results: MDMA administration in treatment groups reduced M1 production. On the other hand, by following the treatment with different MDMA doses, the M2 metabolic ratio increased by 46 to 101%. Conclusion: it seems that the regular doses of MDMA cannot inhibit the CYP3A4 activity.
Collapse
Affiliation(s)
- Behjat Sheikholeslami
- Biopharmaceutics and Pharmacokinetics Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Tootoonchi
- Biopharmaceutics and Pharmacokinetics Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Hoda Lavasani
- Biopharmaceutics and Pharmacokinetics Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Yalda Hosseinzadeh Ardakani
- Biopharmaceutics and Pharmacokinetics Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Rouini
- Biopharmaceutics and Pharmacokinetics Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
35
|
Peacock A, Gibbs D, Price O, Barratt MJ, Ezard N, Sutherland R, Hill PL, Grigg J, Lenton S, Page R, Salom C, Hughes C, Bruno R. Profile and correlates of colorimetric reagent kit use among people who use ecstasy/MDMA and other illegal stimulants in Australia. Int J Drug Policy 2021; 97:103334. [PMID: 34246017 DOI: 10.1016/j.drugpo.2021.103334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/20/2021] [Accepted: 05/31/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Colorimetric reagent kits can provide information about the compounds present in drug samples. This study aimed to identify patterns and correlates of colorimetric reagent kit use, as well as behavioural outcomes of testing, amongst people who use illegal stimulants in a context that lacks permanent government-sanctioned drug checking services. METHODS Australians residing in capital cities who reported regularly using ecstasy/MDMA and/or other illegal stimulants ≥monthly in the past six months were recruited via social media and word-of-mouth from April-July 2019 (N = 792). Participants were asked about testing the contents and/or purity of illegal drugs, and features of last colorimetric reagent kit use. Logistic regression identified correlates of last using a kit (referent: no use of drug checking technology to test drug contents/purity in the past year). RESULTS Over one-third (36%) reported testing drug contents and/or purity; of this group, 86% had last used a colorimetric reagent kit. On the last occasion, 52% reported someone else had conducted testing; 58% said testing occurred <24 h before planned drug use; and 24% reported testing for quantity of a substance. Correlates of drug checking comprised: being younger, male, past six-month use of new psychoactive substances, accessing community-based health services for alcohol or other drug reasons, selling drugs for cash profit, obtaining information from peers who had tried the drug, and searching online for reports of the drug by stamp/appearance. The majority (84%) tested a substance they had been sold and/or given as MDMA; of these, 87% detected MDMA. Of those who expected and detected MDMA, 29% and 11% reported results to their peers and dealer, respectively. CONCLUSION People who use ecstasy/MDMA and/or other illegal stimulants seek out objective information about substance contents. In countries that lack permanent government-sanctioned drug checking services, it is important to acknowledge that people already engage in drug checking but with suboptimal technologies and without tailored specialist advice and education.
Collapse
Affiliation(s)
- Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; School of Psychological Sciences, University of Tasmania, Hobart, Australia.
| | - Daisy Gibbs
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Olivia Price
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Monica J Barratt
- Social and Global Studies Centre and Digital Ethnography Research Centre, RMIT University, Melbourne, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Nadine Ezard
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; National Centre for Clinical Research on Emerging Drugs, Sydney, Australia; St Vincent's Hospital, Sydney, Australia
| | - Rachel Sutherland
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Penelope L Hill
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; National Centre for Clinical Research on Emerging Drugs, Sydney, Australia; Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia; School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia
| | - Jodie Grigg
- National Drug Research Institute, Curtin University, Perth, Australia
| | - Simon Lenton
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; National Drug Research Institute, Curtin University, Perth, Australia
| | - Robert Page
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; St Vincent's Hospital, Sydney, Australia
| | - Caroline Salom
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; Institute for Social Science Research, The University of Queensland, Brisbane, Australia
| | - Caitlin Hughes
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; Centre for Crime Policy and Research, Flinders University, Adelaide, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia; School of Psychological Sciences, University of Tasmania, Hobart, Australia
| |
Collapse
|
36
|
Palamar JJ, Fitzgerald ND, Cottler LB. Shifting awareness among electronic dance music party attendees that drugs may contain fentanyl or other adulterants. Int J Drug Policy 2021; 97:103353. [PMID: 34242960 DOI: 10.1016/j.drugpo.2021.103353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 06/08/2021] [Accepted: 06/13/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Drugs like ecstasy, cocaine, and counterfeit prescription pills can contain fentanyl. We examined knowledge about potential adulteration/contamination of such drugs among people attending electronic dance music (EDM) parties. METHODS Adults in New York City were surveyed entering randomly selected EDM parties during the summers of 2018 (n=1,029) and 2019 (n=559). Surveys assessed perceptions that: 1) ecstasy/Molly can contain adulterants more dangerous than MDMA, 2) cocaine can contain fentanyl, and 3) prescription pills from non-pharmacy sources can contain fentanyl. We compared prevalence of perceptions between 2018 and 2019. RESULTS Prevalence of agreeing that cocaine can contain fentanyl increased from 42.1% to 58.6%, a 39.2% increase (p=.003). Increases in agreement were not significant regarding ecstasy potentially containing adulterants (55.0% vs. 59.0%) and non-pharmacy prescription drugs potentially containing fentanyl (46.8% vs. 52.9%). Those reporting past-year ecstasy use in particular reported increased agreement that ecstasy can be adulterated (from 52.9% to 80.0%, a 51.2% increase; p<.001) and those reporting past-year cocaine use reported increased agreement that cocaine can be adulterated (from 48.2% to 70.7%, a 46.7% increase; p=.016). CONCLUSIONS Knowledge of potential adulteration or contamination of commonly used drugs in this high-risk scene is increasing. Continued education about possible drug contents is needed.
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, Room 1752, New York, NY 10016, United States.
| | - Nicole D Fitzgerald
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Linda B Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, United States
| |
Collapse
|
37
|
Koning RPJ, Benschop A, Wijffels C, Noijen J. Visitors of the Dutch drug checking services: Profile and drug use experience. Int J Drug Policy 2021; 95:103293. [PMID: 34052555 DOI: 10.1016/j.drugpo.2021.103293] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Drug checking services (DCS) provide information about drug content and purity, alongside personalized feedback, to people who use drugs; however, the demographic and drug use characteristics of DCS clients are rarely reported. This paper describes these characteristics for clients of the Dutch DCS, the Drug Information and Monitoring System (DIMS). METHODS 1,530 participants completed a pen-and-paper questionnaire at one of eight participating DCS in the Netherlands in 2018. RESULTS The participants were mostly highly educated males in their twenties with no migration background. Experience with drugs prior to coming to the DCS was common. Only 0.7% indicated they had never used any of the twenty drugs studied. 93% of participants reported use of ecstasy or MDMA with an average of 6.3 years since first use. CONCLUSIONS These results indicate that drug checking can be a valuable tool for public health services as it facilitates access to more difficult-to-reach communities who use drugs. It is unlikely that DCS encourage drug initiation, since almost all people who visit the Dutch DCS already report experience with drugs. However, DCS should be aware that their services might not be easily accessible or attractive to all demographic groups.
Collapse
|
38
|
Demirtaş AA, Öncül H. Solar retinopathy from sun gazing under the influence of ecstasy: A longitudinal analysis of OCT and OCTA findings. Photodiagnosis Photodyn Ther 2021; 35:102359. [PMID: 34048970 DOI: 10.1016/j.pdpdt.2021.102359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/15/2021] [Accepted: 05/21/2021] [Indexed: 11/20/2022]
Abstract
This report presents the clinical and optical coherence tomography (OCT) and OCT angiography (OCTA) findings from a case of acute and chronic solar retinopathy (SR) caused by sun gazing while under the influence of the hallucinogenic drug methylenedioxymethamphetamine, which is commonly known as ecstasy. This retrospective and observational case report involves a 16-year-old male patient who developed disruption of all foveolar layers two days after using ecstasy and subsequently gazing at the sun. The patient underwent visual acuity testing, dilated fundus examination, visual field analysis, OCT, and OCTA imaging. He exhibited visual recovery with the permanent disruption of the photoreceptor outer layers, and demonstrated enlargement in the deep foveal avascular zone areas during later follow-up periods, from one month to two years. This report aims to draw attention to SR that may occur after sun gazing while using hallucinogenic drugs and the importance of OCT and OCTA imaging in follow-up exams in such cases.
Collapse
Affiliation(s)
- Atılım Armağan Demirtaş
- Department of Ophthalmology, Health Sciences University, Tepecik Training and Research Hospital, Izmir, Turkey.
| | - Hasan Öncül
- Department of Ophthalmology, Health Sciences University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Turkey
| |
Collapse
|
39
|
van Amsterdam J, Peters GJY, Pennings E, Blickman T, Hollemans K, Breeksema JJJ, Ramaekers JG, Maris C, van Bakkum F, Nabben T, Scholten W, Reitsma T, Noijen J, Koning R, van den Brink W. Developing a new national MDMA policy: Results of a multi-decision multi-criterion decision analysis. J Psychopharmacol 2021; 35:537-546. [PMID: 33530825 PMCID: PMC8155737 DOI: 10.1177/0269881120981380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ecstasy (3,4-methylenedioxymethamphetamine (MDMA)) has a relatively low harm and low dependence liability but is scheduled on List I of the Dutch Opium Act ('hard drugs'). Concerns surrounding increasing MDMA-related criminality coupled with the possibly inappropriate scheduling of MDMA initiated a debate to revise the current Dutch ecstasy policy. METHODS An interdisciplinary group of 18 experts on health, social harms and drug criminality and law enforcement reformulated the science-based Dutch MDMA policy using multi-decision multi-criterion decision analysis (MD-MCDA). The experts collectively formulated policy instruments and rated their effects on 25 outcome criteria, including health, criminality, law enforcement and financial issues, thematically grouped in six clusters. RESULTS The experts scored the effect of 22 policy instruments, each with between two and seven different mutually exclusive options, on 25 outcome criteria. The optimal policy model was defined by the set of 22 policy instrument options which gave the highest overall score on the 25 outcome criteria. Implementation of the optimal policy model, including regulated MDMA sales, decreases health harms, MDMA-related organised crime and environmental damage, as well as increases state revenues and quality of MDMA products and user information. This model was slightly modified to increase its political feasibility. Sensitivity analyses showed that the outcomes of the current MD-MCDA are robust and independent of variability in weight values. CONCLUSION The present results provide a feasible and realistic set of policy instrument options to revise the legislation towards a rational MDMA policy that is likely to reduce both adverse (public) health risks and MDMA-related criminal burden.
Collapse
Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Amsterdam
University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Ed Pennings
- The Maastricht Forensic Institute,
Maastricht, The Netherlands
| | | | | | - Joost J Jacobus Breeksema
- Department of Psychiatry, Leiden
University Medical Center, Leiden, The Netherlands; University Centre of Psychiatry,
University Medical Centre Groningen, Groningen, The Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology and
Psychopharmacology, Faculty of Neuroscience and Psychology, Maastricht University,
Maastricht, The Netherlands
| | - Cees Maris
- Faculty of Law, University of Amsterdam,
Amsterdam, The Netherlands
| | | | - Ton Nabben
- Department of Urban Management,
Faculty Society and Law, Amsterdam University of Applied Sciences, Amsterdam, The
Netherlands
| | | | | | | | | | - Wim van den Brink
- Department of Psychiatry, Amsterdam
University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
40
|
Javanmard MZ, Meghrazi K, Ghafori SS, Karimipour M. The ameliorating effects of Vitamin E on hepatotoxicity of ecstasy. J Res Med Sci 2020; 25:91. [PMID: 33273936 PMCID: PMC7698444 DOI: 10.4103/jrms.jrms_496_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/19/2020] [Accepted: 05/29/2020] [Indexed: 11/05/2022]
Abstract
Background: The production of stress oxidative condition in body which is caused by consumption of ecstasy (3,4-methylenedioxymethamphetamine [MDMA]) leads to a liver damage. As an antioxidant, Vitamin E can protect cells and tissues against the deleterious effects of free radicals. This study evaluates the protective effects of Vitamin E on MDMA induced liver toxicity. Materials and Methods: Twenty-eight male albino mice were randomly assigned to four equal groups. Group 1 received saline (control), Group 2 received MDMA and saline, Group 3 received MDMA, and Vitamin E and Group 4 received Vitamin E. MDMA was injected with single daily dose, three sequential days/week for 5 weeks. At the end of the period, blood samples were collected for a biochemical analysis and then the mice were sacrificed by cervical dislocation for histopathological and biochemical examinations of liver. Results: The administration of Vitamin E attenuated the increased levels of alanine transaminase, aspartate transaminase, and alkaline phosphatase enzymes in serum. Vitamin E treatments significantly restored endogenous antioxidant enzymes (reduced glutathione and superoxide dismutase enzyme) activities as compared with MDMA-treated animals. Histological examination of liver revealed significant morphological tissue injuries in hepatocytes after MDMA being used, but in coadministration of vitamin E and MDMA, these morphological alterations reduced. Conclusion: The study showed that MDMA administration has adverse effects on the liver. Vitamin E lessened the deleterious impact considerably.
Collapse
Affiliation(s)
| | - Khadije Meghrazi
- Department of Biochemistry, Urmia University of Medical Sciences, Urmia, IR Iran
| | - Sayed Soran Ghafori
- Student Research Committee, Urmia University of Medical Sciences, Urmia, IR Iran
| | - Mojtaba Karimipour
- Department of Anatomy, Urmia University of Medical Sciences, Urmia, IR Iran
| |
Collapse
|
41
|
Bade R, White JM, Nguyen L, Pandopulos AJ, Gerber C. What is the drug of choice of young festivalgoers? Drug Alcohol Depend 2020; 216:108315. [PMID: 33045619 DOI: 10.1016/j.drugalcdep.2020.108315] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/19/2020] [Accepted: 09/17/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Drug and alcohol consumption are commonplace at festivals including those aimed at younger attendees. However, there is little quantitative information about the extent of this consumption. This work investigates drug use at a school-leaver festival and how it compares to non-festival weeks. METHODS Influent wastewater was collected over three consecutive weeks from a location where a school-leaver festival occurs. Multiple liquid chromatography-mass spectrometry methods were used to analyse the use of illicit drugs, pharmaceuticals with abuse potential, new psychoactive substances (NPS), alcohol and cannabis. A method for human neurotransmitter metabolites was also utilised to show the population change and allow the drugs found to be normalised to a population. RESULTS A total of 12 compounds were quantifiable: methamphetamine, 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxymethamphetamine (MDMA), alcohol, cannabis, cocaine, morphine, codeine, fentanyl, buprenorphine, oxycodone and nicotine. The NPS methylone was found solely over the festival weekend but at levels below the limit of quantification of the analytical method. The catecholamine metabolites vanillylmandelic acid (VMA) and homovanillic acid (HVA) were found over the entire three weeks, with identical trends - an increase over the festival weekend - indicating a population increase. HVA was used to normalise the drug mass loads to derive a population normalised mass load. Statistical differences using Hedges' g showed large changes in the use of MDMA and MDA over the festival week. Smaller increases were also seen for alcohol and cocaine. CONCLUSIONS The drugs of choice for the attendees of this school-leaver festival were MDMA and MDA.
Collapse
Affiliation(s)
- Richard Bade
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide, SA 5000, Australia
| | - Jason M White
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide, SA 5000, Australia
| | - Lynn Nguyen
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide, SA 5000, Australia
| | - Aaron J Pandopulos
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide, SA 5000, Australia
| | - Cobus Gerber
- University of South Australia, UniSA: Clinical and Health Sciences, Health and Biomedical Innovation, Adelaide, SA 5000, Australia.
| |
Collapse
|
42
|
Abstract
Background Ecstasy (3,4-methylenedioxymethamphetamine [MDMA]), commonly referred to as Molly in the US, is commonly adulterated with drugs potentially more dangerous than MDMA. Synthetic cathinones ("bath salts") are common adulterants, and use of these compounds tends to be stigmatized. We investigated whether presenting information on the extent of ecstasy being adulterated with "bath salts" affects intentions to use. Methods A total of 1,025 adults entering electronic dance music parties were surveyed in 2018. Using an experimental posttest-only design with random assignment, half were randomly assigned to view a published Vice headline about ecstasy/Molly commonly being adulterated with "bath salts." Results Overall, 30.5% of the sample reported past-year ecstasy use, and before viewing the headline, 16.4% agreed that ecstasy/Molly commonly contains "bath salts." While controlling for pre-test knowledge of "bath salt" adulteration, viewing the headline reduced the odds of intention to use ecstasy/Molly only among non-past-year ecstasy users (Odd ratio [OR] = 0.54; p = .048). Viewing the headline increased the odds (OR = 1.81, p = .030) of past-year ecstasy users' intention to test their ecstasy for adulterants. Conclusions Knowledge that ecstasy is commonly adulterated may help reduce the risk for future use among non-recent users and increase the willingness of users to test their ecstasy. This information can be used to target those at risk for ecstasy/Molly use.
Collapse
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University School of Medicine, New York, NY, USA.,Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing, New York, NY, USA
| | - Patricia Acosta
- Department of Population Health, New York University School of Medicine, New York, NY, USA
| | - Charles M Cleland
- Center for Drug Use and HIV/HCV Research, New York University Rory Meyers College of Nursing, New York, NY, USA
| |
Collapse
|
43
|
Meikle S, Carter O, Bedi G. Individual differences in distress, impulsivity, and coping motives for use as predictors of problematic ecstasy use. Addict Behav 2020; 108:106397. [PMID: 32353691 DOI: 10.1016/j.addbeh.2020.106397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 02/16/2020] [Accepted: 03/14/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Ecstasy users who report problematic use of ecstasy experience adverse social, psychological, and health-related consequences not reported by non-problem users. Relatively little is known about the risk factors for the development of problematic ecstasy use. Such information would be valuable for targeted intervention, prevention, and education AIMS: The current study aimed to fill this gap by investigating several hypothesised risk factors for problematic use and the relationships between them. METHODS Self-reported impulsivity, psychological distress, sex, and coping motives for ecstasy use were investigated as predictors of problematic ecstasy use in a cross-sectional online survey. RESULTS The sample consisted of 483 individuals (60.5% male, 38.3% female, 1.2% other) aged 18-62 years, reporting ecstasy use on an average of 59.7 occasions (SD = 167.8). Both higher self-reported impulsivity and psychological distress predicted problem ecstasy use, and both these relationships were partially mediated by coping motives. When these variables were examined in a combined mediation model accounting for their covariance, psychological distress still predicted problematic use partially via an effect on coping motives, while impulsivity showed only a direct effect on problem use. No sex differences in problem ecstasy use were observed. CONCLUSIONS Increased trait impulsivity and psychological distress appear to confer greater risk of problematic ecstasy use. Targeting these factors, as well as coping motives for ecstasy use, may be useful in efforts to prevent and reduce problematic ecstasy use among those who use the drug.
Collapse
|
44
|
Sgambato V. Breathing new life into neurotoxic-based monkey models of Parkinson's disease to study the complex biological interplay between serotonin and dopamine. Prog Brain Res 2020; 261:265-285. [PMID: 33785131 DOI: 10.1016/bs.pbr.2020.07.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Numerous clinical studies have shown that the serotonergic system also degenerates in patients with Parkinson's disease. The causal role of this impairment in Parkinson's symptomatology and the response to treatment remains to be refined, in particular thanks to approaches allowing the two components DA and 5-HT to be isolated if possible. We have developed a macaque monkey model of Parkinson's disease exhibiting a double lesion (dopaminergic and serotonergic) thanks to the sequential use of MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) and MDMA (3,4-methylenedioxy-N-methamphetamine) (or MDMA prior MPTP). We characterized this monkey model by multimodal imaging (PET, positron emission tomography with several radiotracers; DTI, diffusion tensor imaging), behavioral assessments (parkinsonism, dyskinesia, neuropsychiatric-like behavior) and post-mortem analysis (with DA and 5-HT markers). When administrated after MPTP, MDMA damaged the 5-HT presynaptic system without affecting the remaining DA neurons. The lesion of 5-HT fibers induced by MDMA altered rigidity and prevented dyskinesia and neuropsychiatric-like symptoms induced by levodopa therapy in MPTP-treated animals. Interestingly also, prior MDMA administration aggravates the parkinsonian deficits and associated DA injury. Dystonic postures, action tremor and global spontaneous activities were significantly affected. All together, these data clearly indicate that late or early lesions of the 5-HT system have a differential impact on parkinsonian symptoms in the macaque model of Parkinson's disease. Whether MDMA has an impact on neuropsychiatric-like symptoms such as apathy, anxiety, depression remains to be addressed. Despite its limitations, this toxin-based double-lesioned monkey model takes on its full meaning and provides material for the experimental study of the heterogeneity of patients.
Collapse
Affiliation(s)
- Véronique Sgambato
- Université de Lyon, CNRS UMR 5229, Institut des Sciences Cognitives Marc Jeannerod, Bron, France.
| |
Collapse
|
45
|
Southey M, Kathirgamalingam A, Crawford B, Kaul R, McNamara J, John-Leader F, Heslop J, Pit SW. Patterns of ecstasy use amongst live music event attendees and their opinions on pill testing: a cross sectional study. Subst Abuse Treat Prev Policy 2020; 15:55. [PMID: 32758263 PMCID: PMC7405356 DOI: 10.1186/s13011-020-00295-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 07/21/2020] [Indexed: 12/20/2022]
Abstract
Background Pill testing services could potentially be used to reduce drug-related harm. This study aims to identify patterns of ecstasy use among live music event attendees; explore the opinions and potential usage of illicit pill testing programs and examine factors associated with the likelihood of still taking a pill containing a potential harmful substance. Methods A cross-sectional survey was completed by 760 people attending a major Australian live music event in 2017. Results The most commonly used drug in the last 12 months was ecstasy (73.9%). About 5% of people who use drugs had sought medical attention due to consumption of ecstasy. People who use drugs agreed “a lot” that pill testing should be provided for free at live music events (82.2%) and that it should be combined with harm reduction advice (62.9%). Additionally, 32% of all participants agreed ‘a lot’ that they would be more likely to take illicit drugs at a music festival if pill-testing services were present. However, if people perceived that a harmful substance was detected in their drugs after using a pill testing service, 52.3% of people who have used illicit drugs reported that they would ‘not at all’ be likely to still consume the drug. They also reported that they would still take a pill if testing demonstrated the presence of unintended MDMA-type substances (70.3%), amphetamines (31.2%) or ketamine (27.8%). Multivariate analyses demonstrated that only increased frequency of ecstasy use was significantly associated with taking a pill despite pill testing services detecting a harmful substance. Gender, age, alcohol and previously seeking ecstasy-related medical attention were not associated in the multivariate analyses. Conclusions A high proportion of live music attendees consume alcohol and ecstasy. Both people who have and who have not used illicit drugs support the implementation of pill testing services. People reported they would change their consumption patterns according to the results given by pill testing services. The findings may be used to stimulate public debate, and assist drug and alcohol policy makers in the implementation of harm minimisation strategies such as combining pill testing services with harm reduction advice.
Collapse
Affiliation(s)
- Madeleine Southey
- University Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, PO Box 3074, Lismore, NSW, 2480, Australia
| | - Ashwini Kathirgamalingam
- University Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, PO Box 3074, Lismore, NSW, 2480, Australia
| | - Benjamin Crawford
- University Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, PO Box 3074, Lismore, NSW, 2480, Australia
| | - Rohan Kaul
- University Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, PO Box 3074, Lismore, NSW, 2480, Australia
| | - Jack McNamara
- University Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, PO Box 3074, Lismore, NSW, 2480, Australia
| | - Franklin John-Leader
- Harm Reduction and Health Promotion Programs, HIV and Related Programs (HARP), North Coast Public Health, Mid-North Coast Local Health District, Lismore, Australia
| | - Jenny Heslop
- Harm Reduction and Health Promotion Programs, HIV and Related Programs (HARP), North Coast Public Health, Mid-North Coast Local Health District, Lismore, Australia
| | - Sabrina Winona Pit
- University Centre for Rural Health, School of Medicine, Western Sydney University, 62 Uralba Street, PO Box 3074, Lismore, NSW, 2480, Australia. .,Faculty of Medicine and Health, University Centre for Rural Health, Lismore, Australia.
| |
Collapse
|
46
|
Taylor S, Ayres T, Jones E. Enlightened hedonism? Independent drug checking amongst a group of ecstasy users. Int J Drug Policy 2020; 83:102869. [PMID: 32702610 DOI: 10.1016/j.drugpo.2020.102869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 06/24/2020] [Accepted: 07/08/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Research indicates that a body of ecstasy users across the globe employ 'home' drug testing technologies to learn more about the content of their drugs - a process referred to throughout this article as independent drug checking (IDC). Whilst a small number of studies offer accounts of this process, they do so through a narrow lens of harm reduction, potentially overlooking wider socio-cultural factors which may affect this. In response, this article draws on Slavoj Žižek's political theory of the cultural injunction to enjoy, situating IDC in the wider political economy of neoliberal consumer capitalism to contextualise and interpret its use as integral to pleasure and leisure. METHODS This empirical study documents the thoughts and experiences of a group of UK ecstasy users who independently use a privately owned drug-testing kit. Drawing on qualitative data generated through 20 semi-structured interviews, the article considers two research questions; what role did drug checking play in the group's drug journeys and leisure activities?; and is drug checking thought to be purposeful? FINDINGS For this group of ecstasy users, issues of safety and self-responsibility interweaved with the pursuit of pleasure as they sought to enjoy their drug consumption, but in a way that navigated potential harms. IDC therefore served to maximise pleasure via its 'guarantee' of a prolonged, enjoyable, authentic consumer experience whilst simultaneously safeguarding wellbeing via its premise of more responsible and controlled consumption practices. CONCLUSION IDC allowed this group of drug consumers to partake in 'enlightened hedonism' - demonstrating their conformity to the imperatives of capitalism and its social norms. Despite recognising the limitations of IDC and disclosing potentially harmful outcomes, the group's engagement with capitalist markets provided a belief that investment in your consumer experience can both improve it and make it safer - premises that belie the empirical reality.
Collapse
Affiliation(s)
- Stuart Taylor
- School of Justice Studies, Liverpool John Moores University, Redmonds Building, Brownlow Hill, Liverpool, L3 5UG, UK.
| | | | | |
Collapse
|
47
|
Black E, Govindasamy L, Auld R, McArdle K, Sharpe C, Dawson A, Vazquez S, Brett J, Friend C, Shaw V, Tyner S, McDonald C, Koop D, Tall G, Welsby D, Habig K, Madeddu D, Cretikos M. Toxicological analysis of serious drug-related harm among electronic dance music festival attendees in New South Wales, Australia: A consecutive case series. Drug Alcohol Depend 2020; 213:108070. [PMID: 32554172 DOI: 10.1016/j.drugalcdep.2020.108070] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 04/13/2020] [Accepted: 04/27/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND A substantial increase in drug-related harm was observed during the 2018-2019 music festival season in New South Wales, Australia, including the deaths of five young people. As part of a rapid public health response, the New South Wales Ministry of Health referred samples from patients with suspected severe drug-related illness for forensic toxicological testing to identify the type and concentration of substances associated with the presentations. METHODS Cases were identified through a variety of active and passive surveillance systems, and selected consecutively based on indicators of clinical severity. Comprehensive toxicology testing of blood and urine samples was expedited for all cases. Demographic and clinical characteristics were collated, together with quantitative toxicology results. Results were analysed using descriptive statistics. RESULTS Forty cases from eleven different music festivals were included. The majority of cases (80.0%) were aged 25 years and under. There were five fatalities, and 62.5% of cases were admitted to intensive care units. MDMA was the most frequent substance, detected in 87.5% of cases. In 82.9% of cases with MDMA, blood concentrations were above thresholds that have been associated with toxicity. Multiple substances were detected in 60.0% of cases. Novel psychoactive substances were not detected. CONCLUSIONS Our findings strongly suggest that MDMA-related toxicity was a major factor in the severity of the clinical presentations among these cases. Other substances may have enhanced MDMA toxicity but appear unlikely to have caused severe toxicity in isolation. These findings have important implications for harm reduction strategies targeted to music festival settings.
Collapse
Affiliation(s)
- Eleanor Black
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia.
| | - Laksmi Govindasamy
- New South Wales Public Health Officer Training Program, Centre for Epidemiology and Evidence, NSW Ministry of Health, St Leonards 2065, NSW, Australia
| | - Robin Auld
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Kylie McArdle
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, 2145, NSW, Australia
| | - Caroline Sharpe
- Office of the Chief Health Officer, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Andrew Dawson
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, 2145, NSW, Australia
| | - Santiago Vazquez
- Forensic and Analytical Science Service, New South Wales Health Pathology, Lidcombe 2141, NSW, Australia
| | - Jonathan Brett
- New South Wales Poisons Information Centre, The Children's Hospital at Westmead, 2145, NSW, Australia
| | - Caren Friend
- Western Sydney Local Health District, New South Wales Health, Sydney NSW, Australia
| | - Vanessa Shaw
- Forensic and Analytical Science Service, New South Wales Health Pathology, Lidcombe 2141, NSW, Australia
| | - Sophie Tyner
- Office of the Chief Health Officer, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Catherine McDonald
- Forensic and Analytical Science Service, New South Wales Health Pathology, Lidcombe 2141, NSW, Australia
| | - David Koop
- New South Wales Health Emergency Management Unit, NSW Ambulance, Rozelle 2039, NSW, Australia
| | - Gary Tall
- Aeromedical and Medical Retrieval Services, NSW Ambulance, 2039, Rozelle NSW, Australia
| | - Deb Welsby
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Karel Habig
- Aeromedical and Medical Retrieval Services, NSW Ambulance, 2039, Rozelle NSW, Australia
| | - Daniel Madeddu
- Alcohol and Other Drugs, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| | - Michelle Cretikos
- Clinical Quality and Safety, Centre for Population Health, New South Wales Ministry of Health, St Leonards 2065, NSW, Australia
| |
Collapse
|
48
|
Palamar JJ, Keyes KM. Trends in drug use among electronic dance music party attendees in New York City, 2016-2019. Drug Alcohol Depend 2020; 209:107889. [PMID: 32050110 PMCID: PMC7127946 DOI: 10.1016/j.drugalcdep.2020.107889] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/24/2020] [Accepted: 01/28/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Electronic dance music (EDM) party attendees are a high-risk population for drug use and associated adverse effects. We examined trends in past-year drug use within this population to better inform prevention and harm reduction efforts. METHODS Each summer from 2016 through 2019, we used time-space sampling to survey a cross-section of adults entering EDM parties at randomly selected nightclubs and at dance festivals in New York City. Ns ranged from 504 (2019) to 1,087 (2016). We estimated log-linear trends in past-year use of 16 different synthetic drugs or drug classes. RESULTS Between 2016 and 2019, estimated past-year prevalence of use of ketamine increased from 5.9% to 15.3% (a 157.6% relative increase; P = .007), LSD use increased from 9.9% to 16.6% (a 67.7% relative increase, P < .001), powder cocaine use increased from 17.3% to 35.2% (a 103.5% relative increase, P < .001), and GHB use increased from 1.0% to 4.2% (a 311.8% relative increase; P = .002). Past-year use of >3 drugs increased from 12.7% to 20.5% (a 61.4% relative increase; P = .013); however, estimated past-year use of unknown powders decreased from 2.0% to 1.1% (a relative 44.7% decrease; P = .038) and ecstasy/MDMA/Molly use was stable across years (at 25.0 to 28.5 %; P = .687). CONCLUSIONS Reports of powder cocaine, LSD, ketamine, and GHB are becoming more prevalent among EDM party attendees. Prevention and harm reduction efforts are needed to address increasing use. Research is also needed to examine whether increasing media coverage of medical use of ketamine and other psychedelics affects prevalence of recreational use.
Collapse
Affiliation(s)
- Joseph J. Palamar
- New York University School of Medicine, Department of Population Health, New York, NY
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| |
Collapse
|
49
|
Dolan SB, Johnson MW. The drug purity discounting task: Ecstasy use likelihood is reduced by probabilistic impurity according to harmfulness of adulterants. Drug Alcohol Depend 2020; 208:107772. [PMID: 31974022 DOI: 10.1016/j.drugalcdep.2019.107772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/28/2019] [Accepted: 11/21/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Ecstasy typically contains adulterants in addition to, or in lieu of, MDMA which may pose a greater risk to users than MDMA itself. The current study aimed to evaluate the effectiveness of adulterant-related informational prompts in reducing Ecstasy use using a novel probability discounting task. METHODS An online sample of past-month Ecstasy users (N = 278) were randomized to one of four different framing prompt conditions: no prompt; a prompt describing MDMA's effects; a prompt describing adulterants as inert "filler"; or a prompt describing adulterants as pharmacologically-active, potentially-harmful compounds. Each prompt contained general, potential public-health information that was not specifically related to subsequent behavioral tasks. All participants then completed an identical Drug Purity Discounting Task, in which they indicated the likelihood of using a sample of Ecstasy across different probabilities of the sample being impure, and then completed a hypothetical Ecstasy purchasing task. RESULTS Likelihood of Ecstasy use decreased as impurity probability increased across conditions. Ecstasy use likelihood was highest in the "inert" prompt condition, whereas pharmacologically-active adulterant or adulterant-nonspecific prompts resulted in comparably low likelihood of use. Ecstasy-use likelihood did not differ among conditions when the likelihood of sample impurity was 0. Ecstasy purchasing did not differ among groups. Inelastic purchasing was associated with greater likelihood of using potentially-impure Ecstasy. CONCLUSIONS Altogether, these data highlight the necessity of education regarding pharmacologically-active, rather than inert, adulterants in Ecstasy, and suggest that increased access to drug checking kits and services may mitigate some of the harms associated with Ecstasy use.
Collapse
|
50
|
Abstract
Mephedrone and MDMA are both constituents of party drugs, with mephedrone being relatively new compared to MDMA. This review compares current knowledge regarding the patterns of usage and neuropsychobiological effects of both mephedrone and MDMA. Both drugs share common psychoactive effects, the duration of which is significantly shorter with mephedrone use, attributing towards a pattern of binge use among users. Both drugs have also been associated with adverse health, psychiatric, and neurocognitive problems. Whilst there is extensive research into the psychobiological problems induced by MDMA, the evidence for mephedrone is comparatively limited. The adverse effect profile of mephedrone appears to be less severe than that of MDMA. Users often believe it to be safer, although both drugs have been associated with overdoses. The neurotoxic potential of mephedrone appears to be low, whereas MDMA can cause long-term damage to the serotonergic system, although this needs further investigation. The abuse liability of mephedrone is significantly greater than that of MDMA, raising concerns regarding the impact of lifetime usage on users. Given that mephedrone is relatively new, the effects of long-term exposure are yet to be documented. Future research focused on lifetime users may highlight more severe neuropsychobiological effects from the drug.
Collapse
Affiliation(s)
- Jessica Mead
- Department of Psychology, School of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom.
| | - Andrew Parrott
- Department of Psychology, School of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom
| |
Collapse
|