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Hu Z, Zou Y, Ma Z, Liu W, Jin X, Yang J. Rapid screening and identification of targeted and non-targeted illegal added drugs in functional foods by MRSIT-HRMS based on NIST screening database. Food Chem 2024; 446:138913. [PMID: 38452505 DOI: 10.1016/j.foodchem.2024.138913] [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: 12/04/2023] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 03/09/2024]
Abstract
The last few decades have witnessed the increasing consumption of functional foods, leading to the expansion of the worldwide market. However, the illegal addition drugs in functional foods remains incessant despite repeated prohibition, making it a key focus of strict crackdowns by regulatory authorities. Effective analytical tools and procedures are desperately needed to rapidly screen and identify illegally added drugs in a large number of samples, given the growing amount and diversity of these substances in functional foods. The MRSIT-HRMS (Multiple Sample Rapid Introduction combined with High Resolution Mass Spectrometry) without chromatographic separation, after direct sampling, utilizes NIST software (National Institute of Standards and Technology) matching with a home-built library to target identification and non-targeted screen of illegal additives. When applied to 50 batches of suspicious samples, the targeted method detected illegal added drugs in 41 batches of samples, while the non-targeted method screened a new phosphodiesterase-5 (PDE-5) inhibitor type structural derivative. The positive results obtained by the targeted method were consistent with LC-MS/MS (QQQ). The novel MRSIT-HRMS with a limit of quantification (LOD) of 1 μg/mL achieved 100 % correct identification for all 50 batches of actual samples, demonstrating its potential as a highly promising and powerful tool for fast screening of illegally added drugs in functional food, especially when compared to traditional LC-MS/MS methods. This is essential for ensuring drug safety and public health.
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Affiliation(s)
- Ziyan Hu
- Nanjing Institute for Food and Drug Control, Nanjing 211198, China; Key Laboratory of Food Authenticity Identification Technology for Jiangsu Province Market Regulation, Nanjing 211198, China.
| | - Yixuan Zou
- National Institute of Metrology, Beijing 100029, China
| | - Zhi Ma
- Nanjing Institute for Food and Drug Control, Nanjing 211198, China; Key Laboratory of Food Authenticity Identification Technology for Jiangsu Province Market Regulation, Nanjing 211198, China
| | - Wenting Liu
- Nanjing Institute for Food and Drug Control, Nanjing 211198, China; Key Laboratory of Food Authenticity Identification Technology for Jiangsu Province Market Regulation, Nanjing 211198, China
| | - Xin Jin
- Nanjing Institute for Food and Drug Control, Nanjing 211198, China; Key Laboratory of Food Authenticity Identification Technology for Jiangsu Province Market Regulation, Nanjing 211198, China
| | - Jun Yang
- Nanjing Institute for Food and Drug Control, Nanjing 211198, China; Key Laboratory of Food Authenticity Identification Technology for Jiangsu Province Market Regulation, Nanjing 211198, China.
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2
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Kriikku P, Kankaanpää A, Gunnar T, Ojanperä I. Comparison of poisoning deaths with wastewater-based consumption estimates and assessment of fatal toxicity for amphetamine-type stimulant drugs. Drug Test Anal 2024; 16:641-649. [PMID: 37933709 DOI: 10.1002/dta.3599] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/08/2023]
Abstract
Among several established indicators that are used to monitor the illicit drug scene, drug-related deaths and wastewater-based epidemiology (WBE) stand out for population-level coverage. In this study, we aimed to compare temporal trends with respect to amphetamine, methamphetamine and methylenedioxymethamphetamine (MDMA) revealed by these indicators and explore the differences in fatal toxicity between the stimulants. All deaths in which poisoning caused by amphetamine, methamphetamine or MDMA was either the underlying or contributing cause of death in Finland in 2012, 2014, 2016, 2018 and 2020 were included in the study. Consumption of the studied drugs was measured by WBE in the same years. There was a significant correlation between poisoning and drug consumption for all three stimulants, and for amphetamine and MDMA, these figures increased over the study period. The highest fatal toxicity, as expressed by the number of deaths per million doses, was obtained for methamphetamine at an estimated dose of 50 mg, followed by MDMA (100 mg dose) and with amphetamine (50 mg dose). The fatal toxicity found here for the stimulants was close to that previously reported for many prescription opioids and tricyclic antidepressants. Our study is the first to quantitatively investigate the fatal toxicity of amphetamine-type stimulants by comparing deaths with consumption estimates derived from WBE. It shows that amphetamine, methamphetamine and MDMA possess a quite similar capacity to cause death. This new approach adds to the earlier methods of estimating drug-related harm.
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Affiliation(s)
- Pirkko Kriikku
- Forensic Chemistry Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Forensic Medicine, University of Helsinki, Helsinki, Finland
| | - Aino Kankaanpää
- Forensic Chemistry Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Teemu Gunnar
- Forensic Chemistry Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ilkka Ojanperä
- Forensic Chemistry Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Forensic Medicine, University of Helsinki, Helsinki, Finland
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3
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Bade R, van Herwerden D, Rousis N, Adhikari S, Allen D, Baduel C, Bijlsma L, Boogaerts T, Burgard D, Chappell A, Driver EM, Sodre FF, Fatta-Kassinos D, Gracia-Lor E, Gracia-Marín E, Halden RU, Heath E, Jaunay E, Krotulski A, Lai FY, Löve ASC, O'Brien JW, Oh JE, Pasin D, Castro MP, Psichoudaki M, Salgueiro-Gonzalez N, Gomes CS, Subedi B, Thomas KV, Thomaidis N, Wang D, Yargeau V, Samanipour S, Mueller J. Workflow to facilitate the detection of new psychoactive substances and drugs of abuse in influent urban wastewater. J Hazard Mater 2024; 469:133955. [PMID: 38457976 DOI: 10.1016/j.jhazmat.2024.133955] [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] [Received: 12/19/2023] [Revised: 02/22/2024] [Accepted: 03/03/2024] [Indexed: 03/10/2024]
Abstract
The complexity around the dynamic markets for new psychoactive substances (NPS) forces researchers to develop and apply innovative analytical strategies to detect and identify them in influent urban wastewater. In this work a comprehensive suspect screening workflow following liquid chromatography - high resolution mass spectrometry analysis was established utilising the open-source InSpectra data processing platform and the HighResNPS library. In total, 278 urban influent wastewater samples from 47 sites in 16 countries were collected to investigate the presence of NPS and other drugs of abuse. A total of 50 compounds were detected in samples from at least one site. Most compounds found were prescription drugs such as gabapentin (detection frequency 79%), codeine (40%) and pregabalin (15%). However, cocaine was the most found illicit drug (83%), in all countries where samples were collected apart from the Republic of Korea and China. Eight NPS were also identified with this protocol: 3-methylmethcathinone 11%), eutylone (6%), etizolam (2%), 3-chloromethcathinone (4%), mitragynine (6%), phenibut (2%), 25I-NBOH (2%) and trimethoxyamphetamine (2%). The latter three have not previously been reported in municipal wastewater samples. The workflow employed allowed the prioritisation of features to be further investigated, reducing processing time and gaining in confidence in their identification.
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Affiliation(s)
- Richard Bade
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia.
| | - Denice van Herwerden
- Van't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, the Netherlands
| | - Nikolaos Rousis
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Sangeet Adhikari
- School of Sustainable Engineering and Built Environment, Arizona State University, Tempe, AZ 85281, United States; Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, 1001 S. McAllister Ave., Tempe, AZ 85281, United States
| | - Darren Allen
- Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia
| | - Christine Baduel
- Université Grenoble Alpes, CNRS, IRD, Grenoble INP, Institute of Environmental Geosciences (IGE), Grenoble, France
| | - Lubertus Bijlsma
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda, Sos Baynat s/n, E-12071 Castellón, Spain
| | - Tim Boogaerts
- Toxicological Centre, Department of Pharmaceutical Sciences, University of Antwerp, 2610 Wilrijk, Belgium
| | - Dan Burgard
- Department of Chemistry and Biochemistry, University of Puget Sound, Tacoma, WA 98416, United States
| | - Andrew Chappell
- Institute of Environmental Science and Research Limited (ESR), Christchurch Science Centre, 27 Creyke Road, Ilam, Christchurch 8041, New Zealand
| | - Erin M Driver
- Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, 1001 S. McAllister Ave., Tempe, AZ 85281, United States
| | | | - Despo Fatta-Kassinos
- Nireas-International Water Research Centre and Department of Civil and Environmental Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - Emma Gracia-Lor
- Department of Analytical Chemistry, Faculty of Chemistry, Complutense University of Madrid, Avenida Complutense s/n, 28040 Madrid, Spain
| | - Elisa Gracia-Marín
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda, Sos Baynat s/n, E-12071 Castellón, Spain
| | - Rolf U Halden
- School of Sustainable Engineering and Built Environment, Arizona State University, Tempe, AZ 85281, United States; Biodesign Center for Environmental Health Engineering, Biodesign Institute, Arizona State University, 1001 S. McAllister Ave., Tempe, AZ 85281, United States; OneWaterOneHealth, Arizona State University Foundation, 1001 S. McAllister Avenue, Tempe, AZ 85287-8101, United States
| | - Ester Heath
- Jožef Stefan Institute and International Postgraduate School Jožef Stefan, Jamova 39, 1000 Ljubljana, Slovenia
| | - Emma Jaunay
- Health and Biomedical Innovation, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide 5001, South Australia, Australia
| | - Alex Krotulski
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, Willow Grove, PA 19090, United States
| | - Foon Yin Lai
- Department of Aquatic Sciences and Assessment, Swedish University of Agricultural Sciences (SLU), SE-75007 Uppsala, Sweden
| | - Arndís Sue Ching Löve
- University of Iceland, Department of Pharmacology and Toxicology, Hofsvallagata 53, 107 Reykjavik, Iceland; University of Iceland, Faculty of Pharmaceutical Sciences, Hofsvallagata 53, 107 Reykjavik, Iceland
| | - Jake W O'Brien
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia; Van't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, the Netherlands
| | - Jeong-Eun Oh
- Department of Civil and Environmental Engineering, Pusan National University, Jangjeon-dong, Geumjeong-gu, Busan 46241, Republic of Korea
| | - Daniel Pasin
- Forensic Laboratory Division, San Francisco Office of the Chief Medical Examiner, 1 Newhall St, San Francisco, CA 94124, United States
| | | | - Magda Psichoudaki
- Nireas-International Water Research Centre and Department of Civil and Environmental Engineering, University of Cyprus, P.O. Box 20537, 1678 Nicosia, Cyprus
| | - Noelia Salgueiro-Gonzalez
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Department of Environmental Health Sciences, Via Mario Negri 2, 20156 Milan, Italy
| | | | - Bikram Subedi
- Department of Chemistry, Murray State University, Murray, KY 42071-3300, United States
| | - Kevin V Thomas
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
| | - Nikolaos Thomaidis
- Laboratory of Analytical Chemistry, Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis Zografou, 15771 Athens, Greece
| | - Degao Wang
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, PR China
| | - Viviane Yargeau
- Department of Chemical Engineering, McGill University, Montreal, QC, Canada
| | - Saer Samanipour
- Van't Hoff Institute for Molecular Sciences (HIMS), University of Amsterdam, the Netherlands; UvA Data Science Center, University of Amsterdam, the Netherlands
| | - Jochen Mueller
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba, Queensland 4102, Australia
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Ma J, Luu B, Ruderman SA, Whitney BM, Merrill JO, Mixson LS, Nance RM, Drumright LN, Hahn AW, Fredericksen RJ, Chander G, Lau B, McCaul ME, Safren S, O'Cleirigh C, Cropsey K, Mayer KH, Mathews WC, Moore RD, Napravnik S, Christopoulos K, Willig A, Jacobson JM, Webel A, Burkholder G, Mugavero MJ, Saag MS, Kitahata MM, Crane HM, Delaney JAC. Alcohol and drug use severity are independently associated with antiretroviral adherence in the current treatment era. AIDS Care 2024; 36:618-630. [PMID: 37419138 PMCID: PMC10771542 DOI: 10.1080/09540121.2023.2223899] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 06/05/2023] [Indexed: 07/09/2023]
Abstract
Substance use in people with HIV (PWH) negatively impacts antiretroviral therapy (ART) adherence. However, less is known about this in the current treatment era and the impact of specific substances or severity of substance use. We examined the associations of alcohol, marijuana, and illicit drug use (methamphetamine/crystal, cocaine/crack, illicit opioids/heroin) and their severity of use with adherence using multivariable linear regression in adult PWH in care between 2016 and 2020 at 8 sites across the US. PWH completed assessments of alcohol use severity (AUDIT-C), drug use severity (modified ASSIST), and ART adherence (visual analogue scale). Among 9400 PWH, 16% reported current hazardous alcohol use, 31% current marijuana use, and 15% current use of ≥1 illicit drugs. In multivariable analysis, current methamphetamine/crystal use, particularly common among men who had sex with men, was associated with 10.1% lower mean ART adherence (p < 0.001) and 2.6% lower adherence per 5-point higher severity of use (ASSIST score) (p < 0.001). Current and more severe use of alcohol, marijuana, and other illicit drugs were also associated with lower adherence in a dose-dependent manner. In the current HIV treatment era, individualized substance use treatment, especially for methamphetamine/crystal, and ART adherence should be prioritized.
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Affiliation(s)
- J Ma
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - B Luu
- Department of Medicine, University of Toronto, Toronto, Canada
| | - S A Ruderman
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - B M Whitney
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - J O Merrill
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - L S Mixson
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - R M Nance
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - L N Drumright
- Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
| | - A W Hahn
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - R J Fredericksen
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - G Chander
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - B Lau
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - M E McCaul
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - S Safren
- Department of Psychology, University of Miami, Miami, FL, USA
| | - C O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychology, Harvard Medical School, Boston, MA, USA
| | - K Cropsey
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - K H Mayer
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- The Fenway Institute, Boston, MA, USA
| | - W C Mathews
- Department of Medicine, University of California, San Diego, CA, USA
| | - R D Moore
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - S Napravnik
- Department of Medicine, University of North Carolina, Chapel Hill, NC, USA
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - K Christopoulos
- Department of Medicine, University of California, San Francisco, CA, USA
| | - A Willig
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - J M Jacobson
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - A Webel
- Department of Child, Family, and Population Health Nursing, Unviersity of Washington, Seattle, WA, USA
| | - G Burkholder
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - M J Mugavero
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - M S Saag
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - M M Kitahata
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - H M Crane
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - J A C Delaney
- Department of Medicine, University of Washington, Seattle, WA, USA
- College of Pharmacy, University of Manitoba, Winnipeg, Canada
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Oliveira Gracini CLD, Nascimento GG, Vidigal MTC, Oliveira MND, Herval ÁM, Blumenberg C, Vieira WA, Lima RR, Paranhos LR. Suicide ideation and psychotropic recreational drug use by adolescents: a systematic review and meta-analysis. SAO PAULO MED J 2024; 142:e2022641. [PMID: 38655989 DOI: 10.1590/1516-3180.2022.0641.r2.23012024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/23/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Adolescence is characterized by complex and dynamic changes, often involving experimentation, including the use of psychotropic substances. Although it is well-established that recreational psychotropic drugs are associated with suicide ideation in adults, evidence of this association in adolescents remains limited. OBJECTIVE To investigate the relationship between suicide ideation and psychotropic recreational drug use among adolescents. DESIGN AND SETTING Systematic review with meta-analysis developed at Universidade Federal de Uberlândia (UFU) and Universidade Estadual de Campinas (UNICAMP), Brazil. METHODS A search across eight electronic databases for observational studies, without language or publication year restrictions, was conducted. The Joanna Briggs Institute tool was used to assess the risk of bias. Random-effects meta-analyses and odds ratios were used to measure the effects. RESULTS The search yielded 19,732 studies, of which 78 were included in the qualitative synthesis and 32 in the meta-analysis. The findings indicated that suicidal ideation was 1.96 times more likely (95% confidence interval, CI = 1.47; 2.61) for adolescents who used some drug recurrently and 3.32 times more likely (95%CI = 1.86; 5.93) among those who abused drugs. Additionally, adolescents who used cannabis were 1.57 times more likely (95%CI = 1.34; 1.84) to experience suicide ideation compared with non-users, while cocaine users had 2.57 times higher odds (95%CI = 1.47; 4.50). CONCLUSIONS Psychotropic recreational drug use is associated with suicidal ideation among adolescents regardless of current or previous use, abuse, or type of substance used. SYSTEMATIC REVIEW REGISTRATION Registered in the PROSPERO database under the identification number CRD42021232360. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021232360.
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Affiliation(s)
- Cássia Lima de Oliveira Gracini
- MSc. Nurse, Master's student, Postgraduate Program in Management and Public Health, Universidade Estadual de Campinas (UNICAMP), Piracicaba (SP), Brazil
| | - Gustavo Giacomelli Nascimento
- PhD. Dentist, Principal Investigator, National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore; Professor, Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Maria Tereza Campos Vidigal
- MSc. Dentist, Master's student, Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Murilo Navarro de Oliveira
- MSc. Dentist, Doctoral student, Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Álex Moreira Herval
- PhD. Dentist, Professor, Division of Preventive and Community Dentistry, School of Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia (MG), Brazil
| | - Cauane Blumenberg
- PhD. Computer Scientist, Collaborative Researcher, Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Walbert A Vieira
- MSc. Dentist, Doctoral student, Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba (SP), Brazil
| | - Rafael Rodrigues Lima
- PhD. Dentist, Professor, Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém (PA), Brazil
| | - Luiz Renato Paranhos
- PhD. Dentist, Professor, Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
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6
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Byrne CJ, Sani F, Thain D, Fletcher EH, Malaguti A. Psychosocial factors associated with overdose subsequent to Illicit Drug use: a systematic review and narrative synthesis. Harm Reduct J 2024; 21:81. [PMID: 38622647 PMCID: PMC11017611 DOI: 10.1186/s12954-024-00999-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND AND AIMS Psychological and social status, and environmental context, may mediate the likelihood of experiencing overdose subsequent to illicit drug use. The aim of this systematic review was to identify and synthesise psychosocial factors associated with overdose among people who use drugs. METHODS This review was registered on Prospero (CRD42021242495). Systematic record searches were undertaken in databases of peer-reviewed literature (Medline, Embase, PsycINFO, and Cinahl) and grey literature sources (Google Scholar) for work published up to and including 14 February 2023. Reference lists of selected full-text papers were searched for additional records. Studies were eligible if they included people who use drugs with a focus on relationships between psychosocial factors and overdose subsequent to illicit drug use. Results were tabulated and narratively synthesised. RESULTS Twenty-six studies were included in the review, with 150,625 participants: of those 3,383-4072 (3%) experienced overdose. Twenty-one (81%) studies were conducted in North America and 23 (89%) reported polydrug use. Psychosocial factors associated with risk of overdose (n = 103) were identified and thematically organised into ten groups. These were: income; housing instability; incarceration; traumatic experiences; overdose risk perception and past experience; healthcare experiences; perception of own drug use and injecting skills; injecting setting; conditions with physical environment; and social network traits. CONCLUSIONS Global rates of overdose continue to increase, and many guidelines recommend psychosocial interventions for dependent drug use. The factors identified here provide useful targets for practitioners to focus on at the individual level, but many identified will require wider policy changes to affect positive change. Future research should seek to develop and trial interventions targeting factors identified, whilst advocacy for key policy reforms to reduce harm must continue.
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Affiliation(s)
- Christopher J Byrne
- Division of Molecular and Clinical Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK.
- Directorate of Public Health, NHS Tayside, Kings Cross Hospital, Dundee, UK.
| | - Fabio Sani
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Scrymgeour Building, Dundee, UK
| | - Donna Thain
- Directorate of Public Health, NHS Tayside, Kings Cross Hospital, Dundee, UK
| | - Emma H Fletcher
- Directorate of Public Health, NHS Tayside, Kings Cross Hospital, Dundee, UK
| | - Amy Malaguti
- Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Scrymgeour Building, Dundee, UK
- Tayside Drug and Alcohol Recovery Psychology Service, NHS Tayside, Dundee, UK
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7
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Xu Y, Li X, Xu P, Yan F, Wang D. Comparative pharmacokinetic and intracerebral distribution of MDMB-4F-BICA in mice following inhalation ('vapor') and subcutaneous injection. J Pharm Biomed Anal 2024; 241:115988. [PMID: 38301574 DOI: 10.1016/j.jpba.2024.115988] [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: 10/25/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 02/03/2024]
Abstract
MDMB-4F-BICA, also known as 4F-MDMB-BICA, is a new psychoactive substance that emerged in 2020. It is often illegally added to electronic cigarette oil for inhalation abuse, leading to serious adverse symptoms and even death. There are significant differences in pharmacokinetics between inhalation administration and conventional drug delivery methods. Inhalation administration can pass through the blood-brain barrier to enter the brain directly. However, the specific distribution of the drug in the brain following inhalation has not been well investigated. In order to scientifically compare the absorption and distribution of MDMB-4F-BICA after two administration methods (inhalation and subcutaneous injection), this study analyzed the drug concentration in mice blood and brain by LC-MS/MS after systemic exposure inhalation in the form of electronic cigarettes. The aim was to conduct the pharmacokinetics study of MDMB-4F-BICA after inhalation('vapor') administration. Pharmacokinetics and distribution of the compound revealed that the maximum concentrations in blood of this compound were reached at 0.5 min and 15 min, respectively, and the concentration in the brain reached the maximum at the same time after two modes of administration. The drug concentration in the brain was higher than that of subcutaneous injection, and the drug remained at a low concentration in the brain for a long period (20 ng/g brain tissue) with a significant distribution in several olfactory primary cortex brain regions. Taken together, the pharmacokinetics of the synthetic cannabinoid MDMB-4F-BICA after single systemic exposure inhalation were investigated for the first time in this study. A basis for subsequent evaluation research of inhalation-related harmfulness is provided by comparing the distribution of drugs in the brain after the two administration modes.
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Affiliation(s)
- Yawen Xu
- School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China; Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Beijing 100193, China
| | - Xiangyu Li
- Key Laboratory of Drug Monitoring and Control, Drug Intelligence and Forensic Center, Ministry of Public Security, Beijing 100193, China; Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Beijing 100193, China
| | - Peng Xu
- School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China; Key Laboratory of Drug Monitoring and Control, Drug Intelligence and Forensic Center, Ministry of Public Security, Beijing 100193, China; Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Beijing 100193, China
| | - Fang Yan
- School of Pharmacy, China Pharmaceutical University, Nanjing 210009, China; Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Beijing 100193, China.
| | - Dan Wang
- Key Laboratory of Drug Monitoring and Control, Drug Intelligence and Forensic Center, Ministry of Public Security, Beijing 100193, China; Office of China National Narcotics Control Commission, China Pharmaceutical University Joint Laboratory on Key Technologies of Narcotics Control, Beijing 100193, China.
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Yan X, Ni Y, Lu Y, Wang Q, Tang W, Tan RKJ, Tucker JD, Hall BJ, Baral S, Song H, Zhou Y, Wu D. Homoprejudiced Violence Experiences and High-Risk Sexual Behaviors among Chinese Men Who Have Sex with Men: Depression Severity and Recreational Drug Usage as Potential Mediators. Arch Sex Behav 2024; 53:1265-1276. [PMID: 38172350 DOI: 10.1007/s10508-023-02775-4] [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] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 11/29/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024]
Abstract
Homoprejudiced violence is a type of aggression against an individual or a community based on their actual or perceived sexual orientation. It may be linked to risks of acquiring HIV/STI via psychosocial variables. This study explored the association between homoprejudiced violence experiences and high-risk sexual behaviors, and potential psychosocial mediators. Using cross-sectional survey data collected in China through Blued among men who have sex with men (MSM) in January 2021, this study conducted multiple mediation analyses. Standard instruments were used to collect data on depressive symptoms in the last two weeks (PHQ-9), recreational drug usage in the last three months, and ever experiencing homoprejudiced violence (12-item survey instrument). Dependent variables were having condomless anal sex and having three or more sexual partners in the last three months. Among 1828 MSM, nearly half (847, 46%) had experienced homoprejudiced violence. Twenty-three percent (427) reached a score that suggested moderate or severe depression and 35% (644) had used recreational drugs. In the last three months, 40% (731) had condomless anal sex and 34% (626) had three or more sexual partners. The indirect mediational coefficients through depression on condomless anal sex and multiple sexual partners were 0.04 (95% CI: [0.02, 0.07]) and 0.02 (95% CI: [0.001, 0.05]), respectively. The indirect mediational coefficient of homoprejudiced violence experience on multiple sexual partners through recreational drug use was 0.05 (95% CI: [0.03, 0.08]). These findings suggest that more comprehensive interventions are needed to address the syndemic of homoprejudiced violence, mental health issues, and HIV/STI-related risks.
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Affiliation(s)
- Xumeng Yan
- Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, No. 101 Longmian Avenue Nanjing, Nanjing, 211166, Jiangsu, China
- University of North Carolina Project-China, Guangzhou, China
- Department of Community Health Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Yuxin Ni
- University of North Carolina Project-China, Guangzhou, China
- Department of Health Law Policy and Management, Boston University, Boston, MA, USA
| | - Ying Lu
- University of North Carolina Project-China, Guangzhou, China
| | - Qianyun Wang
- University of North Carolina Project-China, Guangzhou, China
- Department of Social Welfare, University of California Los Angeles, Los Angeles, CA, USA
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rayner Kay Jin Tan
- University of North Carolina Project-China, Guangzhou, China
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- International Diagnostics Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Brian J Hall
- Center for Global Health Equity, New York University Shanghai, Shanghai, China
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
- Med-X Center for Informatics, Sichuan University, Chengdu, China
| | - Yi Zhou
- Department of HIV/AIDS Prevention and Control, Zhuhai Center for Disease Control and Prevention, Zhuhai, China
| | - Dan Wu
- Department of Social Medicine and Health Education, School of Public Health of Nanjing Medical University, No. 101 Longmian Avenue Nanjing, Nanjing, 211166, Jiangsu, China.
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Whatnall M, Ashton L, Patterson A, Smith J, Duncan M, Burrows T, Kay-Lambkin F, Hutchesson M. Are health behaviors associated with academic performance among tertiary education students? A systematic review of cohort studies. J Am Coll Health 2024; 72:957-969. [PMID: 35549627 DOI: 10.1080/07448481.2022.2063024] [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] [Received: 07/21/2021] [Revised: 03/22/2022] [Accepted: 04/03/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To evaluate the association between health behaviors with academic performance among tertiary education students. METHODS Six databases were searched until July 2020 for prospective cohort studies evaluating the association between health behavior(s) (dietary intake, physical activity, sedentary behavior, alcohol intake, sleep, smoking or illicit drug use) and academic performance. RESULTS Thirty-four studies were included (18 assessed sleep, 16 alcohol intake, 12 illicit drug use, 10 physical activity, 8 diet, 4 smoking, 2 sedentary behavior). A consistent negative association with academic performance was demonstrated for sleep (12/18 studies), alcohol intake (13/16) and illicit drug use (9/12). Most (7/10) studies found no association between physical activity and academic performance. CONCLUSION Findings suggest interventions to mitigate the influence of poor sleep, high alcohol intake, and illicit drug use on academic performance may be needed. Further research of other health behaviors, along with their co-occurrence, with academic performance, is required.
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Affiliation(s)
- Megan Whatnall
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Lee Ashton
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
- School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, Australia
| | - Amanda Patterson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Jordan Smith
- School of Education, College of Human and Social Futures, University of Newcastle, Callaghan, Australia
| | - Mitch Duncan
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Tracy Burrows
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Frances Kay-Lambkin
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Melinda Hutchesson
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
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De Baerdemaeker K, Dines AM, Nefau T, Skapurova K, Giraudon I, Alachaher D, Archer JRH, Bentur Y, El Zahran T, Jovic-Stocic J, Omary A, Tahar AM, Thabet H, Thoma E, Vucinic S, Wood DM, Dargan PI. Comparison of recreational drug presentations to the emergency department in Europe, the Middle East and Northern Africa. Eur J Emerg Med 2024; 31:149-151. [PMID: 38416586 DOI: 10.1097/mej.0000000000001087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Affiliation(s)
- Klara De Baerdemaeker
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust
- Emergency Medicine, Guy's and St Thomas' NHS Foundation Trust, UK
| | - Alison M Dines
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust
| | - Thomas Nefau
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Katerina Skapurova
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Isabelle Giraudon
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | - Djamel Alachaher
- Emergency Department, University Hospital of Oran, Oran, Algeria
| | - John R H Archer
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Yedidia Bentur
- The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Tharwat El Zahran
- Emergency Department, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Asaad Omary
- The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ait Mouhab Tahar
- Emergency Department, Mohamed Liamine Debaghine Hospital, Bab El Oued University Hospital Center, Bab El Oued, Algeria
| | - Hafedh Thabet
- Emergency Department, Centre Mahmoud Yacoub d'assistance médicale urgente, Tunis, Tunisia
| | | | - Slavica Vucinic
- The National Poison Control Centre, Military Medical Academy, Belgrade, Serbia
| | - David M Wood
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Paul I Dargan
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust
- Faculty of Life Sciences and Medicine, King's College London, London, UK
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Vallecillo Sánchez G, Chen Quin J, Losada Parente A, Ochoa S, Smithson Amat A, Anaya S, Saubi Roca N, Supervía Caparrós A, Perello Carbonell R. Street drugs associated with acute poisoning: description and analysis of differences in women attended in a hospital emergency department. Emergencias 2024; 36:104-108. [PMID: 38597617 DOI: 10.55633/s3me/025.2023] [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: 04/11/2024]
Abstract
OBJECTIVES The prevalence of street drug abuse is difficult to establish in women because of stigma associated with the practice. The main objective of this study was to analyze possible differences between men and women in a sample of patients attended for emergencies due to acute poisonings. The secondary aim was to identify variables associated with severe poisonings defined arbitrarily as requiring intensive care for more than 12 hours after hospital admission. MATERIAL AND METHODS Retrospective study in 2 hospital EDs. We included patients over the age of 18 years attended for street drug poisonings between July 1, 2020, and July 31, 2023. Epidemiologic, clinical, and laboratory variables were analyzed. RESULTS A total of 1032 patients were studied; 191 (18.5%) were women. The mean (SD) age was 35 years, and the prevalences of acute mental illness and HIV infection were high at 32.2% and 35.7%, respectively. Drug use was recreational in most cases (90.9%). Cocaine, alcohol, and methamphetamines were the substances most often used. Multivariate analysis showed that the factors associated with the seriousness of poisoning were age, with an odds ratio (OR) of 1.03 (95% CI, 1.01-1.05; P = .003); HIV (OR, 2.10; 95% CI, 1.29-3.41; P = .003); use of benzodiazepines (OR, 3.48; 95% CI, 2.14-5.66; P .0001); and suicidal ideations (OR, 1.82; 95% CI, 1.25-3.79; P = .004). CONCLUSION Differences in poisoning characteristics in women were found, probably related to the younger ages of men in the sample and their higher frequency of alcohol consumption. Public health policies and campaigns to prevent drug abuse should take gender differences into consideration in order to adapt messages to the target populations.
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Affiliation(s)
- Gabriel Vallecillo Sánchez
- Servicio de Urgencias. Hospital Parc Salut Mar, Barcelona, España. Unidad VIH, Hospital Parc Salut Mar, Barcelona, España
| | | | | | - Sara Ochoa
- Servicio de Urgencias, Hospital Clínic, Barcelona, España
| | | | - Sara Anaya
- Servicio de Urgencias. Hospital Parc Salut Mar, Barcelona, España
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La Maida N, Di Giorgi A, Pichini S, Pellegrini M, Di Trana A, Elmo MG, Polselli GM, Casella P, Di Stefano A, Ducci G. Comprehensive Monitoring of Psychoactive Substances in Psychiatric Patients Using Liquid Chromatography-High-Resolution Mass Spectrometry: A Key Tool for Treatment Planning and Understanding Consumption Patterns in Rome, Italy. Ther Drug Monit 2024; 46:203-209. [PMID: 38018870 DOI: 10.1097/ftd.0000000000001163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/05/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND The comprehensive monitoring of licit and illicit drug consumption plays a crucial role in understanding the complexities of patient conditions and designing effective treatment strategies. In this study, the prevalence of psychoactive prescription drugs, classical illicit drugs, and new psychoactive substances (NPS) were objectively assessed in individuals diagnosed with drug-related psychiatric disorders or episodes. METHODS Blood, urine, and hair samples were collected from psychiatric patients admitted to the Mental Health Department and Drug Addiction Service of the North Rome Local Health Authority with declared or suspected psychoactive drug use. Comprehensive drug screening was conducted for all samples using ultra-high-performance liquid chromatography-high-resolution mass spectrometry. RESULTS A total of 71 blood and urine and 50 hair samples were analyzed to confirm the suitability of the ultra-high-performance liquid chromatography-high-resolution mass spectrometry method for the study purposes. The main substances found in blood and urine were antipsychotics (71.8% and 66.2%) and benzodiazepines (62.0% and 59.2%), respectively, whereas cocaine (84.0%) and antipsychotics (74.0%) was more evident in hair. Z-drugs were detected in blood (7.0%), urine (5.6%), and hair (24%) samples; amphetamines were mainly detected in hair samples (14.0%). Synthetic cathinones were the most frequently detected NPS in hair specimens (8.0%), whereas synthetic cannabinoids were mainly found in blood samples (11.3%). These analyses showed that patients were polydrug users (77.5% detected in blood and urine, and 94.0% in hair). CONCLUSIONS Comprehensive screening enabled the assessment of past, recent, and actual consumption of psychoactive substances, including licit and illicit drugs and NPS, by psychiatric patients. A thorough understanding of substance consumption patterns can enhance therapeutic interventions and management of psychiatric disorders associated with psychoactive substance use.
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Affiliation(s)
- Nunzia La Maida
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Alessandro Di Giorgi
- Department of Excellence of Biomedical Science and Public Health, University "Politecnica delle Marche" of Ancona, Ancona, Italy
| | - Simona Pichini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Manuela Pellegrini
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Annagiulia Di Trana
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Maria Giuseppa Elmo
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), San Filippo Neri Hospital, Rome, Italy
| | - Gian Marco Polselli
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), San Filippo Neri Hospital, Rome, Italy
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), S. Spirito Hospital, Rome, Italy
| | - Pietro Casella
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Drug Dipendence and Addiction Unit, Rome, Italy; and
| | - Adele Di Stefano
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Mental Health and Drug Dipendence Unit in prison, Rome, Italy
| | - Giuseppe Ducci
- Department of Mental Health, Azienda Sanitaria Locale (ASL) Roma 1-Servizio Psichiatrico di Diagnosi e Cura (SPDC), San Filippo Neri Hospital, Rome, Italy
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13
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Galust H, Seltzer JA, Hardin JR, Friedman NA, Salamat J, Clark RF, Harmon J. Adulterants present in the San Diego county fentanyl supply: a laboratory analysis of seized law enforcement samples. BMC Public Health 2024; 24:923. [PMID: 38553721 PMCID: PMC10981322 DOI: 10.1186/s12889-024-18459-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 03/26/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND The opioid overdose crisis is one of the worst public health crises ever to face the US and emerging evidence suggests its effects are compounded by the presence of drug adulterants. Here we report our efforts to characterize the adulterants present within the local fentanyl supply of San Diego County, obtained from undifferentiated drug samples seized by local law enforcement over the calendar year 2021. METHODS Thirty-two participating local law enforcement agencies across San Diego submitted 4838 unknown individual illicit drug samples (total of 312 kg) to the San Diego County Sheriff's Department Regional Crime Laboratory for identification. RESULTS Qualitative analysis of these samples via FTIR and GC-MS identified methamphetamine (38.7%), fentanyl (20.8%), diacetylmorphine (heroin) (10.2%), codeine (5.8%) and alprazolam (4.3%) as the most common illicit substances and the presence of 52 unique adulterants. The most common adulterants included 4-methylaminoantipyrine (4-MAAP) (10.9%), mannitol (9%), acetaminophen (8.5%), methamphetamine (4.2%), diacetylmorphine (heroin) (3.6%), tramadol (1.9%), and xylazine (1.7%). Several additional pharmacologically active adulterants and contaminants of interest were also identified. CONCLUSION This analysis is vital for public health use and harm reduction efforts at the level of the individual consumer. Continued direct surveillance of the drug supply is necessary for the detection of potentially harmful adulterants that may pose serious threats to the public.
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Affiliation(s)
- Henrik Galust
- Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 W. Arbor Dr. #8676, 92103, San Diego, CA, USA.
- VA San Diego Healthcare System, San Diego, CA, USA.
- California Poison Control System, San Diego, CA, USA.
| | - Justin A Seltzer
- Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 W. Arbor Dr. #8676, 92103, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- California Poison Control System, San Diego, CA, USA
| | - Jeremy R Hardin
- Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 W. Arbor Dr. #8676, 92103, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- California Poison Control System, San Diego, CA, USA
| | - Nathan A Friedman
- Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 W. Arbor Dr. #8676, 92103, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- California Poison Control System, San Diego, CA, USA
| | - Jeff Salamat
- San Diego County Sheriff's Crime Laboratory. John F. Duffy Administrative Center, 9621. Ridgehaven Ct, 92123, San Diego, CA, USA
| | - Richard F Clark
- Division of Medical Toxicology, Department of Emergency Medicine, UC San Diego Health, 200 W. Arbor Dr. #8676, 92103, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- California Poison Control System, San Diego, CA, USA
| | - Jennifer Harmon
- San Diego County Sheriff's Crime Laboratory. John F. Duffy Administrative Center, 9621. Ridgehaven Ct, 92123, San Diego, CA, USA
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Balamurugan TST, Stelmaszczyk P, Wietecha-Posłuszny R, Poltorak L. Electroanalytical characterization of clozapine at the electrified liquid-liquid interface and its detection in soft and hard drinks. Analyst 2024; 149:2073-2083. [PMID: 38415352 DOI: 10.1039/d3an02188b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Clozapine (CZ) is a prescribed benzodiazepine psychiatric drug that is often possessed as an illicit drug and is associated with drug-facilitated sexual assaults (DFSA) due to its strong sedative capabilities. Hence, we propose an electrified liquid-liquid interface (eLLI) based transducing element as an alternative electroanalytical platform for rapid screening of CZ in soft and hard drinks which is habitually associated with DFSA crimes. First, molecular partitioning and the effect of chemical composition, pH, and the presence of ethanol in the biphasic configuration of the aqueous phase on the interfacial behaviour and analytical performance of the CZ at the eLLI have been investigated with voltammetry. Next, the electrochemical profiles of various soft and hard drinks were studied at the eLLI. The eLLI-based CZ sensor has shown a broad dynamic range (15-150 μM), lower detection limits (1μM), and adequate reliability towards rapid CZ screening in spiked soft and hard drink samples with reference to the standard chromatographic analysis.
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Affiliation(s)
- Thangaraj S T Balamurugan
- Electrochemistry@Soft Interfaces Team, Department of Inorganic and Analytical Chemistry, Faculty of Chemistry, University of Lodz, Tamka 12, 91-403, Lodz, Poland.
| | - Paweł Stelmaszczyk
- Laboratory for Forensic Chemistry, Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Gronostajowa 2, 30-387, Krakow, Poland
- Doctoral School of Exact and Natural Sciences, Faculty of Chemistry, Jagiellonian University, Gronostajowa 2, 30-387, Krakow, Poland
| | - Renata Wietecha-Posłuszny
- Laboratory for Forensic Chemistry, Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, Gronostajowa 2, 30-387, Krakow, Poland
| | - Lukasz Poltorak
- Electrochemistry@Soft Interfaces Team, Department of Inorganic and Analytical Chemistry, Faculty of Chemistry, University of Lodz, Tamka 12, 91-403, Lodz, Poland.
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Teymouri A, Nasoori H, Fakheri M, Nasiri A. Features of biliary tract diseases in ketamine abusers: a systematic review of case reports. J Med Case Rep 2024; 18:84. [PMID: 38431685 PMCID: PMC10909254 DOI: 10.1186/s13256-024-04421-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 01/30/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND AND AIMS Anesthesiologists prefer ketamine for certain surgeries due to its effectiveness as a non-competitive inhibitor of the N-methyl-D-aspartate receptor in the brain. Recently, this agent has also shown promise as an antidepressant. However, ketamine can cause hallucinogenic effects and is sometimes abused as an illicit drug. Ketamine abuse has been associated with liver and bile duct complications. This systematic study aims to better understand cholangiopathy in ketamine abusers by reviewing case reports. METHODS AND MATERIAL In this systematic review, a comprehensive literature search was conducted with the terms "biliary tract diseases" and "ketamine". Case reports and case series of adult patients with documented ketamine abuse and reported cholangiopathy or biliary tract disease were included. We extracted the data of relevant information and the results were reported through narrative synthesis and descriptive statistics. RESULTS A total of 48 studies were initially identified, and 11 studies were finally included in the review. The mean age of the patients was 25.88 years. Of the 17 patients, 64.7% were men. Symptoms often included abdominal pain, nausea, and vomiting. Most patients were discharged with improved symptoms and liver function. Common bile duct dilation and other findings were observed in imaging results and other diagnostic studies. CONCLUSION This review highlights the diverse presentations and diagnostic modalities used in ketamine-induced cholangiography. These patients tend to be young men with deranged liver function tests and abdominal pain, which should be taken into consideration. These patients often require a multidisciplinary approach in their management.
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Affiliation(s)
- Alireza Teymouri
- Department of Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadis Nasoori
- Faculty of Pharmacy, Tehran Medical Science, Islamic Azad University, Tehran, Iran
| | - Maryamsadat Fakheri
- Department of Physical Medicine and Rehabilitation, School of Medicine, Shiraz University of Medical Sciences, Zand St., Shiraz, 71348-14336, Iran
| | - Aref Nasiri
- Department of Physical Medicine and Rehabilitation, School of Medicine, Shiraz University of Medical Sciences, Zand St., Shiraz, 71348-14336, Iran.
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Xavier JC, McDermid J, Buxton J, Henderson I, Streukens A, Lamb J, Greer A. People who use drugs' prioritization of regulation amid decriminalization reforms in British Columbia, Canada: A qualitative study. Int J Drug Policy 2024; 125:104354. [PMID: 38402802 DOI: 10.1016/j.drugpo.2024.104354] [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: 12/11/2023] [Revised: 01/30/2024] [Accepted: 02/04/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND North America and the province of British Columbia (BC), Canada, is experiencing an unprecedented number of overdose deaths. In BC, overdose has become the leading cause of death for people between the ages of 10-59 years old. In January 2023, BC decriminalized personal possession of a number of illegal substances with one aim being to address overdose deaths through stigma reduction and promoting access to substance use services. METHODS We conducted a qualitative study to understand people who use drugs' (PWUD) perceptions of the new decriminalization policy, immediately prior to its' implementation (October-December 2022). To contextualize decriminalization within broader drug policy, we also asked PWUD what they perceived as the priority issues drug policy ought to address and the necessary solutions. Our final sample included 38 participants who used illegal drugs in the past month. RESULTS We identified four themes: 1) The illicit drug supply as the main driver of drug toxicity deaths 2) Concerns about the impact of decriminalization on drug toxicity deaths 3) Views towards decriminalization as a policy response in the context of the drug toxicity crisis 4) Regulation as a symbol of hope for reducing drug toxicity deaths. CONCLUSION From our data it became clear that many anticipated that decriminalization would have minimal or no impact on the overdose crisis. Regulation was perceived as the necessary policy approach for effectively and candidly addressing the drivers of the ongoing overdose crisis. These findings are important as jurisdictions consider different approaches to moving away from prohibition-based drug policy.
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Affiliation(s)
- Jessica C Xavier
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, V5A 1S6, Canada; British Columbia Centre for Disease Control, 655W 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada
| | - Jennifer McDermid
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, V5A 1S6, Canada
| | - Jane Buxton
- School of Population and Public Health, University of British Columbia, 2206 E Mall, Vancouver, British Columbia, V6T 1Z8, Canada
| | - Iesha Henderson
- Professionals for the Ethical Engagement of Peers (PEEP), British Columbia Centre for Disease Control, 655W 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada
| | - Amber Streukens
- Professionals for the Ethical Engagement of Peers (PEEP), British Columbia Centre for Disease Control, 655W 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada
| | - Jessica Lamb
- Professionals for the Ethical Engagement of Peers (PEEP), British Columbia Centre for Disease Control, 655W 12th Avenue, Vancouver, British Columbia, V5Z 4R4, Canada
| | - Alissa Greer
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, British Columbia, V5A 1S6, Canada.
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Mutai KK, Stone J, Scheibe A, Fraser H, Johnson LF, Vickerman P. Trends and factors associated with illicit drug use in South Africa: Findings from multiple national population-based household surveys, 2002-2017. Int J Drug Policy 2024; 125:104352. [PMID: 38367327 DOI: 10.1016/j.drugpo.2024.104352] [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: 05/19/2023] [Revised: 01/12/2024] [Accepted: 02/02/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Illicit drug use results in considerable global morbidity, but there is little data on its trends and factors associated with it in sub-Saharan Africa. We consider these questions using national data from South Africa for 2002-2017. METHODS We analysed data among individuals aged 15 years or older from five national population-based household surveys in South Africa (2002-2017; n = 89,113). Recent drug use was defined as the last three-months use of illicit drugs, i.e., any use of cannabis, cocaine, amphetamine, inhalants, sedatives, hallucinogens, opioids, and/or other illicit drugs. Time trends in recent drug use were assessed using logistic regression. Multivariable logistic regression assessed the association between recent drug use and socio-demographic factors and between drug use and sexual risk behaviours, HIV-related and other well-being variables. RESULTS The prevalence of recent drug use increased from 1·5% to 10·0% from 2002 to 2017, driven by increases in cannabis use (1·5% to 7·8%) and use of opioids (0·01% to 1·6%), cocaine (0·02% to 1·8%), or amphetamines (0·1% to 1·5%). In adjusted analyses, male gender, younger age, living in urban areas, mixed-ancestry or white ethnicity (compared to black-African), and unemployment were positively associated with recent drug use. Recent drug use was associated with: multiple sexual partners (adjusted odds ratio [aOR] 2·13, 95% confidence interval [CI]: 1·80-2·51); sexual debut before 15 years old (aOR 1·70, 95%CI: 1·29-2·23); hazardous/harmful alcohol use (aOR 2·50, 95%CI: 2·14-2·93) or alcohol dependence (aOR 3·33, 95%CI 2·92-3·80); ever experiencing intimate partner violence (aOR 1·56, 95%CI 1·12-2·17); psychological distress (aOR 1·53, 95%CI: 1·28-1·82); and lower chance of ever testing for HIV (aOR 0·89, 95%CI 0·80-1·00). Recent drug use was not associated with HIV positivity, condom use or being on antiretroviral therapy. CONCLUSION Illicit drug use has increased substantially in South Africa and is associated with numerous socio-demographic characteristics, higher sexual risk behaviours and other well-being variables.
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Affiliation(s)
- Kennedy Kipkoech Mutai
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa.
| | - Jack Stone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Andrew Scheibe
- TB HIV Care, Cape Town, South Africa; Community Oriented Primary Care Research Unit, Department of Family Medicine, University of Pretoria, Pretoria, South Africa
| | - Hannah Fraser
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; NIHR Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol, Bristol, United Kingdom
| | - Leigh F Johnson
- Centre for Infectious Disease Epidemiology and Research, University of Cape Town, Cape Town, South Africa
| | - Peter Vickerman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; NIHR Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol, Bristol, United Kingdom
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Wilkinson ST, Palamar JJ, Sanacora G. The Rapidly Shifting Ketamine Landscape in the US. JAMA Psychiatry 2024; 81:221-222. [PMID: 38170542 DOI: 10.1001/jamapsychiatry.2023.4945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
This Viewpoint discusses changes in the use of ketamine as a medical therapeutic and a recreational substance, the potential risks of use, and the need for increased research and surveillance.
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Affiliation(s)
- Samuel T Wilkinson
- Yale Depression Research Program, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
- Interventional Psychiatry Service, Yale-New Haven Hospital, New Haven, Connecticut
| | - Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, New York
| | - Gerard Sanacora
- Yale Depression Research Program, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
- Interventional Psychiatry Service, Yale-New Haven Hospital, New Haven, Connecticut
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19
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Lee LYC, Lee YS, Tan J, Lee JY, Syn CKC. A study of DNA transfers onto plastic packets placed in personal bags. J Forensic Sci 2024; 69:430-436. [PMID: 38288847 DOI: 10.1111/1556-4029.15460] [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: 09/19/2023] [Revised: 11/06/2023] [Accepted: 01/03/2024] [Indexed: 03/07/2024]
Abstract
The ability to detect low level DNA brings with it the uncertainty of whether the detected DNA is a result of transfer. To address this uncertainty, a simulation study was conducted in which a mock illicit drug packet was placed into the personal bags of individuals. When the average transit time of the packets was increased from around 2 h to more than 14 h, the percentage of the DNA profiles recovered from the packets which could be attributed to the individuals increased greatly from 5.3% to 48.6%. We found that drug packers who were poor shedders could not be included as contributors to the DNA profiles from the drug packets at all and there was a higher chance that individuals other than themselves could be included as contributors to the DNA profile recovered from drug packets. We also found that it was equally likely that the drug packers who had direct contact with the drug packets and bag owners who did not, could be included as contributors to the DNA profiles recovered from the packets. The results in this study highlight the importance of taking into consideration the transit time of drug packet, the shedder status of the alleged packer and the history of an item, when evaluating DNA evidence in the context of illicit drug activities.
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Affiliation(s)
- Li Yen Candy Lee
- DNA Profiling Laboratory, Biology Division, Health Sciences Authority, Singapore, Singapore
| | - Yong Sheng Lee
- DNA Profiling Laboratory, Biology Division, Health Sciences Authority, Singapore, Singapore
| | - Jiayu Tan
- DNA Profiling Laboratory, Biology Division, Health Sciences Authority, Singapore, Singapore
| | - Jun Yu Lee
- DNA Profiling Laboratory, Biology Division, Health Sciences Authority, Singapore, Singapore
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20
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Fleming T, Ivsins A, Barker A, Mansoor M, Mayer S, Vakharia S, McNeil R. Perceptions of prospective pharmaceutical stimulant substitution treatments among people who use illicit stimulants in Vancouver, Canada. Int J Drug Policy 2024; 125:104336. [PMID: 38281384 PMCID: PMC11045237 DOI: 10.1016/j.drugpo.2024.104336] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/20/2023] [Accepted: 01/22/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Stimulant-involved overdose deaths are increasing, driven by polysubstance use and adulteration of the illicit drug supply. While emerging evidence for prescription stimulant substitution is promising, there are no approved treatment options for stimulant use disorder that address the realities of an unpredictable drug supply. This study explores treatment experiences of people who use illicit stimulants (PWUS) to identify gaps and perceptions of prospective pharmaceutical stimulant substitution treatments (SST). METHODS In-depth qualitative interviews were conducted with 86 PWUS in Vancouver, Canada. Thematic analysis focused on experiences of available treatment options for stimulant use and perceptions of prospective SST. RESULTS Participants identified how primarily behavioral treatment approaches do not meet the unique needs of PWUS, in contrast with the range of medical treatments available for opioid use disorder. Participants anticipated health and social benefits if they were able to access SST, including avoiding the toxic illicit stimulant supply, reduced engagement in criminalized activities, and greater economic security. Perceptions of prospective SST were informed by knowledge of existing opioid treatments. This led some participants to be unsupportive of SST, citing concerns around agency and highly regulated operational contexts that do not align with the lived realities of stimulant use. CONCLUSION Findings demonstrate the need for SST pilot programs in real-world settings and underscore the health and social advantages SST may offer; although drawing on existing opioid treatment models to implement SST pilots may limit success. Thus, any novel treatments for stimulant use must centre the lived realities of PWUS.
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Affiliation(s)
- Taylor Fleming
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada; Interdisciplinary Studies Graduate Program, University of British Columbia, 270-2357 Main Mall, Vancouver, BC V6T 1Z4, Canada
| | - Andrew Ivsins
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada; Department of Medicine, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada
| | - Allison Barker
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada
| | - Manal Mansoor
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada
| | - Samara Mayer
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada; Interdisciplinary Studies Graduate Program, University of British Columbia, 270-2357 Main Mall, Vancouver, BC V6T 1Z4, Canada
| | - Sheila Vakharia
- Drug Policy Alliance, 131 West 33rd Street, 15th Floor, New York, NY 10001, USA
| | - Ryan McNeil
- British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, BC V6Z 2A9, Canada; Department of Medicine, Yale School of Medicine, 367 Cedar Street, New Haven, CT 10001, USA; Program in Addiction Medicine, Yale School of Medicine, 367 Cedar Street, New Haven, CT 10001, USA.
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21
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Lee JJ, Kerani RP, Robles G, Sanchez TH, Katz DA. Reasons for Migration and Their Associations with HIV Risk and Prevention Among Cisgender Sexual Minority Men: A Latent Class Analysis. AIDS Behav 2024; 28:974-984. [PMID: 37812273 DOI: 10.1007/s10461-023-04204-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 10/10/2023]
Abstract
The immigrant population in the United States (U.S.) is rapidly growing; yet there is limited knowledge about how reasons for migrating to the U.S. are associated with HIV prevention behaviors. Using data from the American Men's Internet Survey (2018-2020), we performed a Latent Class Analysis (LCA) to identify patterns in reasons for migration among cisgender gay, bisexual, and other sexual minority men (SMM) who born outside the U.S. We used multivariable logistic regression controlling for demographic characteristics to assess class associations with the following in the past 12 months: condomless anal sex (CAS), illicit drug use, marijuana use, HIV testing, and PrEP use. LCA identified six distinct patterns in reasons for migration among the sample (n = 1,657): (1) Family and friends (14%); (2) Financial (17%); (3) Personal freedom related to being gay (10%); (4) Pursuit of opportunities while living openly as SMM (12%); (5) Educational purposes (18%); (6) Not my decision (29%). While HIV testing (range = 57.6-65.4%) and PrEP use (range = 15.6-21.4%) did not vary by class (p > .05 for all), CAS and illicit drug use were significantly different (p < .05). SMM who migrated to pursue opportunities while living openly and whose reasons were not their decision had greater odds of CAS than SMM who migrated for educational purposes (aOR:1.72, 95% confidence interval [95%CI]:1.15-2.59; 1.57, 1.13-2.19, respectively). Reasons for migration among SMM were associated with behaviors that can increase HIV risk, but not testing or PrEP. Push and pull factors related to migration should be considered when developing behavioral HIV interventions for immigrant SMM.
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Affiliation(s)
- Jane J Lee
- School of Social Work, University of Washington, 4101 15th Avenue NE, Seattle, WA, 98105, USA.
| | - Roxanne P Kerani
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Gabriel Robles
- School of Social Work, Rutgers University, New Brunswick, NJ, USA
| | | | - David A Katz
- Department of Global Health, University of Washington, Seattle, WA, USA
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22
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Chiao A, Hughes ML, Premkumar PK, Zoucha K. The Effects of Substance Misuse on Auditory and Vestibular Function: A Systematic Review. Ear Hear 2024; 45:276-296. [PMID: 37784231 PMCID: PMC10922573 DOI: 10.1097/aud.0000000000001425] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
BACKGROUND Chronic substance misuse is an ongoing and significant public health concern. Among a myriad of health complications that can occur, substance misuse potentially causes ototoxic effects. Case reports, retrospective chart data, and a few cohort studies suggest that certain prescription opioids and illicit drugs can have either temporary or permanent effects on auditory and/or vestibular function. Given the steady rise of people with a substance-use disorder (SUD), it is of growing importance that audiologists and otolaryngologists have an insight into the potential ototoxic effects of substance misuse. OBJECTIVES A systematic review was conducted to (1) synthesize the literature on the illicit drugs, prescription opioids, and alcohol misuse on the auditory and vestibular systems, (2) highlight common hearing and vestibular impairments for each substance class, and (3) discuss the limitations of the literature, the potential mechanisms, and clinical implications for clinicians who may encounter patients with hearing or vestibular loss related to substance misuse, and describe opportunities for further study. DESIGN Systematic searches were performed via PubMed, Scopus, and Google Scholar, and the final updated search was conducted through March 30, 2022. Inclusion criteria included peer-reviewed articles, regardless of study design, from inception until the present that included adults with chronic substance misuse and hearing and/or vestibular complaints. Articles that focused on the acute effects of substances in healthy people, ototoxicity from already known ototoxic medications, the relationship between hearing loss and development of a SUD, articles not available in English, animal work, and duplicates were excluded. Information on the population (adults), outcomes (hearing and/or vestibular data results), and study design (e.g., case report, cohort) were extracted. A meta-analysis could not be performed because more than 60% of the studies were single-case reports or small cohort. RESULTS The full text of 67 studies that met the eligibility criteria were selected for the review. Overall, 21 studies reported associations between HL/VL related to illicit drug misuse, 28 studies reported HL/VL from prescription opioids, and 20 studies reported HL/VL related to chronic alcohol misuse (2 studies spanned more than one category). Synthesis of the findings suggested that the misuse and/or overdose of amphetamines and cocaine was associated with sudden, bilateral, and temporary HL, whereas HL from the combination of a stimulant and an opioid often presented with greater HL in the mid-frequency range. Reports of temporary vertigo or imbalance were mainly associated with illicit drugs. HL associated with misuse of prescription opioids was typically sudden or rapidly progressive, bilateral, moderately severe to profound, and in almost all cases permanent. The misuse of prescription opioids occasionally resulted in peripheral VL, especially when the opioid misuse was long term. Chronic alcohol misuse tended to associate with high-frequency sudden or progressive sensorineural hearing loss, or retrocochlear dysfunction, and a high occurrence of central vestibular dysfunction and imbalance. CONCLUSIONS Overall, chronic substance misuse associates with potential ototoxic effects, resulting in temporary or permanent hearing and/or vestibular dysfunction. However, there are notable limitations to the evidence from the extant literature including a lack of objective test measures used to describe hearing or vestibular effects associated with substance misuse, small study sample sizes, reliance on case studies, lack of controlling for confounders related to health, age, sex, and other substance-use factors. Future large-scale studies with prospective study designs are needed to further ascertain the role and risk factors of substance misuse on auditory and vestibular function and to further clinical management practices.
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Affiliation(s)
- Amanda Chiao
- Department of Surgery, Paul L. Foster School of Medicine,
Texas Tech University Health Sciences Center El Paso, El Paso, TX, 79905
- Department of Special Education and Communication
Disorders, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Michelle L. Hughes
- Department of Special Education and Communication
Disorders, University of Nebraska-Lincoln, Lincoln, NE, USA
| | | | - Kenneth Zoucha
- Department of Psychiatry, University of Nebraska Medical
Center, Omaha, NE, USA
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Fursman H, Finch E, Xiao L, Lefrançois E, Gupta A, Bartlett M, Latimer J, Chadwick S, Roux C, Morelato M. A snapshot of injecting drug consumption from the analysis of used syringes within the Medically Supervised Injecting Centre in Sydney, Australia. Drug Alcohol Rev 2024; 43:787-798. [PMID: 38145366 DOI: 10.1111/dar.13803] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/26/2023]
Abstract
INTRODUCTION The administration of illicit drugs by injection is associated with considerable harm, including an increased risk of overdose. The chemical analysis of used syringes can enhance knowledge on injecting drug consumption beyond traditional data sources (self-report surveys). This additional information may be useful during significant global events like the COVID-19 pandemic. This study aimed to examine a snapshot of the drugs injected at the Medically Supervised Injecting Centre (MSIC) in Sydney, Australia, in 2019-2020. METHODS Used syringes were collected from MSIC across three periods throughout 2019 and 2020 (February 2019, March-April 2020 and June-September 2020). Drug residues were extracted from used syringes using methanol before detection by gas chromatography-mass spectrometry and ultra-performance liquid chromatography-tandem mass spectrometry. The chemical analysis results were compared to self-report data obtained from MSIC clients. RESULTS Heroin (46-53%), methamphetamine (24-34%) and pharmaceutical opioids (15-27%) were the most common drug residues detected. The chemically detected drugs had declining coherence with the drugs self-reported by MSIC clients across the time periods examined. DISCUSSION AND CONCLUSIONS There was no significant change in the drugs injected (heroin, methamphetamine and pharmaceutical opioids) across the three periods collected throughout varying COVID-19 lockdown restrictions. Changes in the frequency of other drugs injected and discrepancies between chemical analysis and self-report were potentially related to regulatory changes, degradation or misinformed sales. Routine chemical analysis of used syringes has provided an alternative information source to promote awareness of current drug trends and aid harm reduction.
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Affiliation(s)
- Harrison Fursman
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Eleanor Finch
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Linda Xiao
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Elodie Lefrançois
- School of Criminal Justice, Faculty of Law, Criminal Justice and Public Administration, University of Lausanne, Lausanne, Switzerland
| | - Anjali Gupta
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Mark Bartlett
- Uniting Medically Supervised Injecting Centre, Sydney, Australia
| | - Julie Latimer
- Uniting Medically Supervised Injecting Centre, Sydney, Australia
| | - Scott Chadwick
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Claude Roux
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
| | - Marie Morelato
- Centre for Forensic Science, University of Technology Sydney, Sydney, Australia
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24
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Vitorino LM, Tostes JG, Ferreira JCL, de Oliveira LAG, Possetti JG, Silva MT, Guimarães MVC, Alckmin-Carvalho F, Lucchetti G. Association between religiosity/spirituality and substance use among homeless individuals. Int J Soc Psychiatry 2024; 70:330-339. [PMID: 37982408 DOI: 10.1177/00207640231211495] [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] [Indexed: 11/21/2023]
Abstract
BACKGROUND Alcohol and illicit drug use are prevalent among homeless people. Religiosity and spirituality (RS) have been widely associated with lower consumption of substances. However, evidence of this relationship among homeless people is still scarce. AIMS To evaluate the associations between RS and alcohol and illicit drug consumption among homeless people in a large Brazilian urban center. METHOD This cross-sectional study was carried out in São Paulo city, Brazil. Aspects such as spirituality (FACIT-Sp12), religiosity (DUREL), spiritual-religious coping (Brief-RCOPE), and self-report questions concerning the current substance use (alcohol and illicit substances) were evaluated. Adjusted logistic regression models were used to assess the impact of RS beliefs on alcohol and illicit drug consumption. RESULTS A total of 456 homeless people were included, of an average age of 44.5 (SD = 12.6) years. More than half of the participants consumed alcohol (55.7%) weekly and 34.2% used illicit drugs weekly. Adjusted logistic regression models identified that aspects of RS were associated with lower likelihood factors for alcohol and illicit drug use; conversely, negative spiritual religious coping (SRC) strategies were associated with a higher likelihood to use both. CONCLUSION The prevalence of alcohol and illicit drug use among participants was high. RS and positive SRC were important protective factors for lower consumption of these substances. Conversely, negative SRC strategies were associated with risk factors.
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25
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Tan M, Park C, Goldman J, Biello KB, Buxton J, Hadland SE, Park JN, Sherman SG, Macmadu A, Marshall BDL. Association between willingness to use an overdose prevention center and probation or parole status among people who use drugs in Rhode Island. Harm Reduct J 2024; 21:54. [PMID: 38424553 PMCID: PMC10905878 DOI: 10.1186/s12954-024-00969-0] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Overdose prevention centers (OPCs) are being implemented in the United States as a strategy to reduce drug-related mortality and morbidity. Previous studies have suggested that people who use drugs (PWUD) with a history of criminal legal system (CLS) involvement (e.g. current probation/parole) are at greater risk of overdose but may also encounter significant barriers to OPC use. The objective of this study was to explore the association between willingness to use an OPC and probation/parole status in a sample of PWUD in Rhode Island. METHODS This study utilized data from the Rhode Island Prescription and Illicit Drug Study, which enrolled adult PWUD from August 2020 to February 2023. We used Pearson's chi-square and Wilcoxon rank-sum tests to assess bivariate associations between willingness to use an OPC and probation/parole status (current/previous/never), as well as other sociodemographic and behavioral characteristics. In multivariable Poisson analyses, we examined the association between willingness to use an OPC and probation/parole status, adjusting for key sociodemographic and behavioral characteristics. RESULTS Among 482 study participants, 67% were male, 56% identified as white, 20% identified as Hispanic/Latine, and the median age was 43 (IQR 35-53). Nearly a quarter (24%) had never been on probation/parole, 44% were not currently on probation/parole but had a lifetime history of probation and parole, and 32% were currently on probation/parole. Most participants (71%) reported willingness to use an OPC, and in both bivariate and multivariable analyses, willingness to use an OPC did not vary by probation/parole status. Crack cocaine use and lifetime non-fatal overdose were associated with greater willingness to use an OPC (all p < 0.05). CONCLUSIONS These data demonstrate high willingness to use OPC among PWUD in Rhode Island regardless of CLS-involvement. As OPCs begin to be implemented in Rhode Island, it will be imperative to engage people with CLS-involvement and to ensure access to the OPC and protection against re-incarceration due to potential barriers, such as police surveillance of OPCs.
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Affiliation(s)
- Michael Tan
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Carolyn Park
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Jacqueline Goldman
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Katie B Biello
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Jane Buxton
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Scott E Hadland
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ju Nyeong Park
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Susan G Sherman
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alexandria Macmadu
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA
| | - Brandon D L Marshall
- Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02903, USA.
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Walker S, Curtis M, Kirwan A, Thatcher R, Dietze P. "No-one just does drugs during business hours!": evaluation of a 24/7 primary needle and syringe program in St Kilda, Australia. Harm Reduct J 2024; 21:51. [PMID: 38402389 PMCID: PMC10894474 DOI: 10.1186/s12954-024-00960-9] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/09/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Primary needle and syringe programs (NSPs) have been integral for the prevention of blood-borne virus (BBV) transmission among people who inject drugs. Despite this, many people who inject drugs face barriers accessing these services, particularly after-hours when most services are closed. To our knowledge, the St Kilda NSP, in Melbourne, Victoria, is the only primary NSP providing 24/7 dedicated stand-alone face-to-face services for people who inject drugs in Australia. We conducted an evaluation of the St Kilda NSP to assess its role and effectiveness in meeting client needs. METHODS Mixed research methods were used to conduct the evaluation. We analysed four quantitative data sets including the Victorian Needle and Syringe Program Information System data; NSP 'snapshot' survey data; and St Kilda NSP records of after-hours contacts and naloxone training events. Qualitative interviews were conducted with 20 purposively selected NSP clients, which were focused on individual needs, expectations and experiences accessing the service. Interviews were audio recorded and transcribed, and data were analysed thematically. A convergent research design was used to merge the five data sets. RESULTS St Kilda NSP had 39,898 service contacts in 2018; 72% of contacts occurred outside business hours. Similarly, of 1,185,000 sterile needles and syringes dispatched, 71% were distributed outside business hours. Participants described valuing the after-hours service because drug use patterns did not always align with standard NSP opening hours and after-hours access afforded anonymity when collecting injecting equipment. Narratives highlighted several additional benefits of the 24/7 service, including: access to safer sex equipment; material support; naloxone training; referrals to specialist services; face-to-face emotional and social support from a non-judging worker; and for women involved in sex work in particular, being able to seek refuge when feeling unsafe on the streets. CONCLUSIONS Our study provides evidence of the social and health benefits (beyond that of preventing BBV transmission) that can be gained through the provision of 24/7 primary NSP services. Findings support the need for the establishment of after-hours primary NSPs in other areas of Australia where active street-based drug markets operate outside business hours and concentrated numbers of people who inject drugs live and spend time.
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Affiliation(s)
- Shelley Walker
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia.
- Burnet Institute, Melbourne, Victoria, Australia.
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Michael Curtis
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
- Burnet Institute, Melbourne, Victoria, Australia
| | - Amy Kirwan
- Burnet Institute, Melbourne, Victoria, Australia
| | - Rebecca Thatcher
- Access Health & 24/7 Needle and Syringe Program, Alcohol, Drugs and Other Addictions Stream, Victoria Social Mission Department, The Salvation Army Australian Territory, Melbourne, Victoria, Australia
| | - Paul Dietze
- National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
- Burnet Institute, Melbourne, Victoria, Australia
- Monash Addiction Research Centre, Monash University, Melbourne, Victoria, Australia
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Eassey C, Hughes CE, Wadds P, de Andrade D, Barratt MJ. A systematic review of interventions that impact alcohol and other drug-related harms in licensed entertainment settings and outdoor music festivals. Harm Reduct J 2024; 21:47. [PMID: 38383344 PMCID: PMC10882826 DOI: 10.1186/s12954-024-00949-4] [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: 11/30/2023] [Accepted: 01/26/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Harms associated with the use of alcohol and other drugs (AOD) in licensed entertainment settings (LES) and outdoor music festivals (OMF) are ongoing public health and criminal justice concerns. This systematic review provides a comprehensive, synthesized report on the evidence base of interventions that impact harm in these settings, and how they affect health, behavioral, and criminal justice outcomes. METHODS Nine databases were searched for experimental and observational studies published between 2010 and 2021. Studies were included if they were peer-reviewed, published in English, described interventions which could impact AOD-related harms in LES or OMF (and were delivered in these environments), and reported on health, criminal justice and/or behavioral outcomes. Methodological quality was assessed using the Effective Public Health Practice Project's Quality Assessment Tool for Quantitative Studies and the Critical Appraisal Skills Program for qualitative studies. A narrative synthesis was conducted to synthesize outcomes across studies. The review protocol was registered in PROSPERO (CRD42020140004). RESULTS Of the 48,303 studies screened, 100 met the inclusion criteria. 86 focused solely on reducing alcohol-related harm, 7 on reducing illicit drug-related harm, and 7 on both. Most (n = 88) focused on LES and evaluated changes in laws and regulations (n = 28) and/or multicomponent interventions/policies (n = 41). Multicomponent interventions showed the best results for both health (62% positive) and criminal justice (84% positive) outcomes, with 71% of studies being rated as strong quality. There was also good evidence to support the careful application of trading hour restrictions and limited but promising evidence to support medical services and drug checking. CONCLUSION The breadth, quality and volume of evidence regarding what works in reducing AOD-related harm in recreational settings have increased in the past decade, particularly regarding LES. Findings support onsite medical services (reducing ambulance transfer rates), multicomponent interventions targeting alcohol accessibility and availability (reducing assaults), and drug checking services, but suggest other interventions such as drug detection dogs may exacerbate harm. Further, higher quality research is required to address identified gaps in the evidence base, particularly on optimal interventions within OMF, around illicit drugs more broadly and in the Global South.
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Affiliation(s)
- Christopher Eassey
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Caitlin E Hughes
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
- Centre for Crime Policy and Research, Flinders University, Adelaide, Australia
| | - Phillip Wadds
- The School of Law, Society and Criminology, and Centre for Criminology, Law and Justice, Faculty of Law and Justice, UNSW Sydney, Sydney, Australia
| | - Dominique de Andrade
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- School of Psychology, University of Queensland, Brisbane, Australia
- Centre for Drug Use, Addictive and Anti-Social Behaviour Research, School of Psychology, Deakin University, Geelong, Australia
| | - Monica J Barratt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
- Social Equity Research Centre and Digital Ethnography Research Centre, RMIT University, 124 La Trobe Street, Melbourne, VIC, 3000, Australia.
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Bradford W, Figgatt M, Scott KS, Marshall S, Eaton EF, Dye DW. Xylazine co-occurrence with illicit fentanyl is a growing threat in the Deep South: a retrospective study of decedent data. Harm Reduct J 2024; 21:46. [PMID: 38378660 PMCID: PMC10880285 DOI: 10.1186/s12954-024-00959-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/08/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Xylazine is a dangerous veterinary sedative found mainly in illicit fentanyl in the Northeast and Midwest. Its role in the Deep South overdose crisis is not well-characterized. METHODS We conducted a retrospective review of autopsy data in Jefferson County, Alabama to identify trends in xylazine prevalence among people who fatally overdosed from June 2019 through June 2023. RESULTS 165 decedents met inclusion criteria. While the first identified xylazine-associated overdose was in June 2019, xylazine has become consistently prevalent since January 2021. All cases of xylazine-associated fatal overdoses were accompanied by fentanyl, and most (75.4%) involved poly-drug stimulant use. The average age was 42.2, and most decedents were white (58.8%) and male (68.5%). Overall, 18.2% of people were unhoused at the time of death. DISCUSSION Xylazine is prevalent in the Deep South. Efforts to promote harm reduction, publicly viewable drug supply trends, and legalization of drug checking and syringe service programs should be prioritized.
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Affiliation(s)
- William Bradford
- Division of Infectious Diseases, University of Alabama at Birmingham, Boshell Diabetes Building 8th Floor 1808 7th Ave S, Birmingham, AL, 35233, USA.
| | - Mary Figgatt
- Division of Infectious Diseases, University of Alabama at Birmingham, Boshell Diabetes Building 8th Floor 1808 7th Ave S, Birmingham, AL, 35233, USA
| | - Karen S Scott
- Division of Laboratory Medicine, University of Alabama at Birmingham, Birmingham, USA
- Department of Pathology, University of Alabama at Birmingham, Birmingham, USA
| | - Stacy Marshall
- Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, USA
| | - Ellen F Eaton
- Division of Infectious Diseases, University of Alabama at Birmingham, Boshell Diabetes Building 8th Floor 1808 7th Ave S, Birmingham, AL, 35233, USA
| | - Daniel W Dye
- Jefferson County Coroner/Medical Examiner's Office, Birmingham, USA
- Department of Pathology, University of Alabama at Birmingham, Birmingham, USA
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Pérez-Pereira A, Carrola JS, Tiritan ME, Ribeiro C. Enantioselectivity in ecotoxicity of pharmaceuticals, illicit drugs, and industrial persistent pollutants in aquatic and terrestrial environments: A review. Sci Total Environ 2024; 912:169573. [PMID: 38151122 DOI: 10.1016/j.scitotenv.2023.169573] [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] [Received: 09/08/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 12/29/2023]
Abstract
At present, there is a serious concern about the alarming number of recalcitrant contaminants that can negatively affect biodiversity threatening the ecological status of marine, estuarine, freshwater, and terrestrial ecosystems (e.g., agricultural soils and forests). Contaminants of emerging concern (CEC) such as pharmaceuticals (PHAR), illicit drugs (ID), industrial persistent pollutants, such as polychlorinated biphenyls (PCBs) and polybrominated diphenyl ethers (PBDEs) and chiral ionic solvents are globally spread and potentially toxic to non-target organisms. More than half of these contaminants are chiral and have been measured at different enantiomeric proportions in diverse ecosystems. Enantiomers can exhibit different toxicodynamics and toxicokinetics, and thus, can cause different toxic effects. Therefore, the enantiomeric distribution in occurrence cannot be neglected as the toxicity and other adverse biological effects are expected to be enantioselective. Hence, this review aims to reinforce the recognition of the stereochemistry in environmental risk assessment (ERA) of chiral CEC and gather up-to-date information about the current knowledge regarding the enantioselectivity in ecotoxicity of PHAR, ID, persistent pollutants (PCBs and PBDEs) and chiral ionic solvents present in freshwater and agricultural soil ecosystems. We performed an online literature search to obtain state-of-the-art research about enantioselective studies available for assessing the impact of these classes of CEC. Ecotoxicity assays have been carried out using organisms belonging to different trophic levels such as microorganisms, plants, invertebrates, and vertebrates, and considering ecologically relevant aquatic and terrestrial species or models organisms recommended by regulatory entities. A battery of ecotoxicity assays was also reported encompassing standard acute toxicity to sub-chronic and chronic assays and different endpoints as biomarkers of toxicity (e.g., biochemical, morphological alterations, reproduction, behavior, etc.). Nevertheless, we call attention to the lack of knowledge about the potential enantioselective toxicity of many PHAR, ID, and several classes of industrial compounds. Additionally, several questions regarding key species, selection of most appropriate toxicological assays and ERA of chiral CEC are addressed and critically discussed.
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Affiliation(s)
- A Pérez-Pereira
- 1H-TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, 4585-116 Gandra, Portugal; University of Trás-os-Montes and Alto Douro (UTAD), Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Vila Real, Portugal
| | - J S Carrola
- University of Trás-os-Montes and Alto Douro (UTAD), Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), Vila Real, Portugal; Inov4Agro - Institute for Innovation, Capacity Building and Sustainability of Agri-food Production, Portugal
| | - M E Tiritan
- 1H-TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, 4585-116 Gandra, Portugal; Laboratory of Organic and Pharmaceutical Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal; Interdisciplinary Center of Marine and Environmental Research (CIIMAR), University of Porto, Edifício do Terminal de Cruzeiros do Porto de Leixões, Matosinhos, Portugal.
| | - C Ribeiro
- 1H-TOXRUN - One Health Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, 4585-116 Gandra, Portugal.
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Ning H, Fan Y, Chen H, Liu H, Huang Z, Ke X, Xu Y, She Y. Preparation of mixed-mode weak cation exchange magnetic solid-phase extraction sorbent and its application in the extraction of 21 illicit drugs from wastewater. J Hazard Mater 2024; 464:133007. [PMID: 37984142 DOI: 10.1016/j.jhazmat.2023.133007] [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] [Received: 09/07/2023] [Revised: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 11/22/2023]
Abstract
The detection of illicit drugs in wastewater can effectively monitor and evaluate the trend of illicit drug abuse. A novel mixed-mode cation exchange magnetic sorbent Fe3O4 @poly(ST/DVB/MA-COOH) was prepared and firstly applied as magnetically dispersed solid phase extraction material to efficiently, rapidly, and selectively extract 21 illicit drugs from wastewater. The selectivity of the sorbent was mainly attributed to the electrostatic interaction. The effects of Fe3O4 @poly(ST/DVB/MA-COOH) preparation and extraction conditions on the adsorption performance were thoroughly discussed. Among the 21 illicit drugs, the absolute extraction recovery values for 19 illicit drugs were greater than 80 % and the entire adsorption process could be achieved in one minute. Subsequently, the Fe3O4 @poly(ST/DVB/MA-COOH) sorbent combined with UHPLC-MS/MS was used to establish a quantitative method for the effectively extracted 19 illicit drugs in wastewater. The method had a good determination coefficient in the range of 0.2-200 ng/L and the limits of detection of the method were 0.03-0.67 ng/L. The spiked recovery values were in the range of 87.0-119.6 %. Finally, the method was successfully applied to the detection of 19 illicit drugs in wastewater samples and also compared with the commonly used SPE method. The obtained results indicate that Fe3O4 @poly(ST/DVB/MA-COOH) has great advantages in the detection of illicit drugs in wastewater.
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Affiliation(s)
- Hongyu Ning
- College of Chemical Engineering, Zhejiang University of Technology, Hangzhou 310014, China
| | - Yilei Fan
- Key Laboratory of Drug Prevention and Control Technology of Zhejiang Province, Zhejiang Police College, Hangzhou 310053, China
| | - Hao Chen
- Key Laboratory of Drug Prevention and Control Technology of Zhejiang Province, Zhejiang Police College, Hangzhou 310053, China
| | - Huijun Liu
- College of Chemical Engineering, Zhejiang University of Technology, Hangzhou 310014, China
| | - Zhongping Huang
- College of Chemical Engineering, Zhejiang University of Technology, Hangzhou 310014, China.
| | - Xing Ke
- Key Laboratory of Drug Prevention and Control Technology of Zhejiang Province, Zhejiang Police College, Hangzhou 310053, China
| | - Yu Xu
- Key Laboratory of Drug Monitoring and Control of Zhejiang Province, National Anti-Drug Laboratory Zhejiang Regional Center, Hangzhou 310053, China
| | - Yuanbin She
- College of Chemical Engineering, Zhejiang University of Technology, Hangzhou 310014, China.
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Liblik SA, Rocha da Cunha T, Liblik CSDFK, Biscioni DN, Girardi DR. [Ethics in the use of psychedelics: The definition of illicit drugs from the perspective of critical bioethics]. Salud Colect 2024; 20:e4630. [PMID: 38381110 DOI: 10.18294/sc.2024.4630] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/05/2024] [Indexed: 02/22/2024] Open
Abstract
This essay, situated in the field of bioethics, examines the prohibition of psychedelic use, exploring arguments surrounding the growing evidence of their therapeutic potential and their millennia-long history of cultural and spiritual uses. It initially discusses the historical context of psychedelics and the various terms used to describe them. The essay problematizes the definition of "drugs," highlighting the lack of objective criteria for distinguishing between legal and illicit substances. Drawing on concepts and theoretical frameworks of critical bioethics, it analyzes how the prohibitionist moral discourse is sustained more by political and economic interests than by scientific justifications, leading to stigmatization and vulnerability. The essay advocates for the end of the prohibition of psychedelics based on ethical arguments, emphasizing their importance in reducing individual and collective suffering. The work contributes to a deeper reflection on this socially controversial topic, integrating interdisciplinary knowledge.
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Affiliation(s)
- Sergio Alexandre Liblik
- Magíster en Bioética. Profesor, Pontifícia Universidade Católica do Paraná, Curitiba, Brasil
| | - Thiago Rocha da Cunha
- Doctor en Bioética. Profesor, Programa de Pós-grado em Bioética, Pontifícia Universidade Católica do Paraná, Curitiba, Brasil
| | - Carmem Silvia da Fonseca Kummer Liblik
- Doctora en Históra. Investigadora, Grupo de Pesquisa CNPq/PUCPR Bioética, Saúde Global e Direitos Humanos, Pontifícia Universidade Católica do Paraná, Curitiba, Brasil
| | - Diego Nicolás Biscioni
- Magíster en Salud Pública. Profesor, Departarmento de Salud y Actividad Física, Universidad Nacional de Avellaneda, Avellaneda, Argentina
| | - Dennys Robson Girardi
- Magíster en Tecnología en Salud. Doctorando em Direito Empresarial e Cidadania, Centro Universitário Curitiba, Curitiba, Brasil
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Tomsone LE, Neilands R, Kokina K, Bartkevics V, Pugajeva I. Pharmaceutical and Recreational Drug Usage Patterns during and Post COVID-19 Determined by Wastewater-Based Epidemiology. Int J Environ Res Public Health 2024; 21:206. [PMID: 38397695 PMCID: PMC10888181 DOI: 10.3390/ijerph21020206] [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] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
Wastewater-based epidemiology (WBE) was applied to evaluate the consumption trends of pharmaceuticals (i.e., antibiotics, non-steroidal anti-inflammatory drugs, antiepileptics, antihypertensives, and others), as well as recreational drugs (caffeine, alcohol, and nicotine), in Latvia from December 2020 to July 2023. The time period covers both the COVID-19 pandemic and the post-pandemic periods; therefore, the impact of the implemented restrictions and the consequences of the illness in terms of the usage of pharmaceuticals thereon were investigated. Additionally, the seasonality and impact of the seasonal flu and other acute upper respiratory infections were studied. The results revealed that the pandemic impacted the consumption of alcohol, nicotine, and caffeine, as well as several pharmaceuticals, such as antihypertensives, antidepressants, psychiatric drugs, and the painkiller ibuprofen. The findings suggest that the imposed restrictions during the pandemic may have had a negative effect on the population's health and mental well-being. Distinct seasonal trends were discovered in the consumption patterns of caffeine and alcohol, where lower use was observed during the summer. The seasonal consumption trends of pharmaceuticals were discovered in the case of antibiotics, the antiasthmatic drug salbutamol, and the decongestant xylometazoline, where higher consumption occurred during colder seasons.
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Affiliation(s)
- Laura Elina Tomsone
- Institute of Food Safety, Animal Health and Environment “BIOR”, Lejupes Street 3, LV-1076 Riga, Latvia; (L.E.T.)
| | - Romans Neilands
- Faculty of Natural Sciences and Technology, Riga Technical University, Kipsalas Street 6B, LV-1048 Riga, Latvia
| | - Kristina Kokina
- Faculty of Natural Sciences and Technology, Riga Technical University, Kipsalas Street 6B, LV-1048 Riga, Latvia
| | - Vadims Bartkevics
- Institute of Food Safety, Animal Health and Environment “BIOR”, Lejupes Street 3, LV-1076 Riga, Latvia; (L.E.T.)
| | - Iveta Pugajeva
- Institute of Food Safety, Animal Health and Environment “BIOR”, Lejupes Street 3, LV-1076 Riga, Latvia; (L.E.T.)
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Greer A, Xavier J, Loewen OK, Kinniburgh B, Crabtree A. Awareness and knowledge of drug decriminalization among people who use drugs in British Columbia: a multi-method pre-implementation study. BMC Public Health 2024; 24:407. [PMID: 38331771 PMCID: PMC10851533 DOI: 10.1186/s12889-024-17845-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/22/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND In January 2023, British Columbia implemented a three-year exemption to Controlled Drugs and Substances Act, as granted by the federal government of Canada, to decriminalize the personal possession of small amounts of certain illegal drugs. This decriminalization policy, the first in Canada, was announced in response to the overdose emergency in British Columbia as a public health intervention that could help curb overdose deaths by reducing the impact of criminalization and increasing access to health and social services through stigma reduction. METHODS The current multi-method study examines people who use drugs' awareness and knowledge of British Columbia's decriminalization model through cross-sectional quantitative surveys and qualitative interviews among people who use drugs from September-November 2022, immediately prior to the implementation of decriminalization. RESULTS Quantitative findings show that two-thirds (63%) of people who use drugs were aware of the policy, but substantial knowledge gaps existed about the legal protections afforded (threshold amount, substances included, drug trafficking, confiscation). The qualitative findings suggest that people who use drugs misunderstood the details of the provincial decriminalization model and often conflated it with regulation. Results suggest that information sharing about decriminalization were minimal pre-implementation, highlighting areas for knowledge dissemination about people who use drugs' rights under this policy. CONCLUSIONS Given that decriminalization in British Columbia is a new and landmark reform, and that the success of decriminalization and its benefits may be undermined by poor awareness and knowledge of it, efforts to share information, increase understanding, and empower the community, may be required to promote its implementation and benefits for the community.
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Affiliation(s)
- Alissa Greer
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A1S6, Canada.
| | - Jessica Xavier
- School of Criminology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A1S6, Canada
- British Columbia Center for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
| | - Olivia K Loewen
- Public Health Agency of Canada, Sinclair Centre Federal Building, 218-757 Hastings St. West, Vancouver, BC, V6C 1A1, Canada
| | - Brooke Kinniburgh
- British Columbia Center for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
| | - Alexis Crabtree
- British Columbia Center for Disease Control, 655 W 12th Ave, Vancouver, BC, V5Z 4R4, Canada
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Russell AB, Slater J, Woods N. Regulation of the illicit drugs industry will save lives and reduce misery. BMJ 2024; 384:q304. [PMID: 38325887 DOI: 10.1136/bmj.q304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
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Haupt MR, Cuomo R, Cui M, Mackey TK. Is This Safe? Examining Safety Assessments of Illicit Drug Purchasing on Social Media Using Conjoint Analysis. Subst Use Misuse 2024; 59:999-1011. [PMID: 38319039 PMCID: PMC11019931 DOI: 10.1080/10826084.2024.2310507] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Background: Illicit substance sales facilitated by social media platforms are a growing public health issue given recent increases in overdose deaths, including an alarming rise in cases of fentanyl poisoning. However, little is known about how online users evaluate what features of social media posts convey safety, which can influence their intent to source illicit substances. Objectives: This study adapts conjoint analysis which assessed how attributes of social media posts (i.e., features) influence safety evaluations of mock posts selling illicit substances. 440 participants were recruited online for self-reporting use or purchase of controlled substances or prescription medicines recreationally. The following attributes were tested: drug packaging, drug offerings, profile photo of seller, payment info provided, and use of emojis. Results: Packaging was ranked the most important attribute (Average Importance =43.68, Offering=14.94, Profile=13.86, Payment=14.11, Emoji=13.41), with posts that displayed drugs in pill bottles assessed as the most safe. Attribute levels for advertising multiple drugs, having a blank profile photo, including payment information, and including emojis also ranked higher in perceived safety. Rankings were consistent across tested demographic factors (i.e., gender, age, and income). Survey results show that online pharmacies were most likely to be perceived as safe for purchasing drugs and medications. Additionally, those who were younger in age, had higher income, and identified as female were more likely to purchase from a greater number of platforms. Conclusions: These findings can assist in developing more precise content moderation for platforms seeking to address this ongoing threat to public safety.
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Affiliation(s)
- Michael Robert Haupt
- Department of Cognitive Science, University of California San Diego, 9500 Gilman Dr, La Jolla, CA, 92093, USA
- Global Health Policy & Data Institute, San Diego, CA USA
| | - Raphael Cuomo
- Global Health Policy & Data Institute, San Diego, CA USA
- Department of Anesthesiology, University of California, San Diego School of Medicine, San Diego, CA USA
| | - Manying Cui
- Global Health Policy & Data Institute, San Diego, CA USA
| | - Tim K. Mackey
- Global Health Policy & Data Institute, San Diego, CA USA
- Global Health Program, Department of Anthropology, University of California, San Diego, CA USA
- S-3 Research LLC, San Diego, CA USA
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Mansouri B, Azadi N, Drebadami AH, Nakhaee S. Trace element levels: How Substance Use Disorder (SUD) contributes to the alteration of urinary essential and toxic element levels. PLoS One 2024; 19:e0294740. [PMID: 38315674 PMCID: PMC10843129 DOI: 10.1371/journal.pone.0294740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 11/07/2023] [Indexed: 02/07/2024] Open
Abstract
Increasing illicit drug use is one of the main problems in most countries or societies. Monitoring heavy metals and trace elements in this vulnerable group seems to be necessary. Therefore, we assessed the urinary trace element and toxic metals/metalloids concentrations (Zinc (Zn), Iron (Fe), Copper (Cu), Chromium (Cr), Lead (Pb), Cadmium (Cd), Arsenic (As), Nickel (Ni), and Mercury (Hg)) in opium, tramadol, and cannabis users compared to healthy subjects. In this cross-sectional study, patients with substance use disorder (SUD) (n = 74) were divided into four groups: cannabis, tramadol, opium, and mixed (simultaneous use of more than one of the three studied substances), along with a healthy group (n = 60). Urine samples were prepared by dispersive liquid-liquid microextraction method so that heavy metals/metalloids could be measured by ICP-MS. The mean urinary concentration of Cu (48.15 vs. 25.45; 89.2%, p<0.001), Hg (1.3 vs. 0.10; 1200%, p < 0.001), and Zn (301.95 vs. 210; 43.8%, p < 0.001) was markedly lower among patients with SUD. The mean urinary concentration of other elements including As (1.9 vs. 4.1; 115.8%), Cd (0.1 vs. 1.10; 1000%), Cr (6.80 vs. 11.65; 71.3%), Ni (2.95 vs. 4.95; 67.8%), and Pb (1.5 vs. 7.9; 426.6%) were significantly higher among patients with SUD compared to healthy subjects. When sub-groups were compared, no significant differences were observed between their trace element levels (Kruskal-Wallis test, p > 0.05). This can be an indication that regardless of the type of drug, the levels of trace elements are changed with respect to healthy individuals. Our results showed that illicit drug use causes changes in urinary trace element/heavy metal/metalloid levels and highlights the need for monitoring heavy metals and trace elements in individuals with substance use disorder. Assessment of different elements in biological samples of drug dependents may be useful for implementing new prevention and treatment protocols. In case of changes in their levels, complementary recommendations, attention to diet, and periodic assessment of toxic metal levels within treatment programs will be needed.
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Affiliation(s)
- Borhan Mansouri
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nammamali Azadi
- Biostatistics Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Arezo Hashemi Drebadami
- State Welfare Organization of Kermanshah, Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah, Iran
| | - Samaneh Nakhaee
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Southern Khorasan, Iran
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Santos GM, Hernandez C, Lam E, Hern J, Rowe C. Racial/Ethnic Disparities in Club Drug Use, Situational Club Drug Use during Sex, and Sexual Risk Behaviors among Alcohol-Using Men Who Have Sex with Men (MSM) in San Francisco. Subst Use Misuse 2024; 59:895-901. [PMID: 38307836 DOI: 10.1080/10826084.2024.2310480] [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] [Indexed: 02/04/2024]
Abstract
BACKGROUND Club drug use-including 3,4-Methylenedioxymethamphetamine, ketamine, crack/cocaine, hallucinogens, gamma hydroxybutyrate, volatile nitrites, and methamphetamine-has been linked to sexual risk behaviors among MSM. Few studies examine how the use of club drugs and the association between club drug use during sex and sexual risk may differ by race/ethnicity. METHODS Using data from a cross-sectional study among alcohol-using MSM in San Francisco (n = 252), we examined the associations between the interaction of race/ethnicity and club drug use during sex, and the following behavioral outcomes: any condomless anal intercourse (CAI), insertive CAI, receptive CAI, and any serodiscordant sex in the past six months. All models controlled for income, HIV status, relationship status, age, and current use of a biomedical HIV prevention tool (i.e., Pre-Exposure Prophylaxis [PrEP] or antiretroviral therapy). RESULTS There were significant racial differences in club drug use (p < 0.001) and club drug use during sex (p = 0.01). Asian/Pacific Islander (API) and Latino participants reported using club drugs the most at 78.8% and 79%, respectively. Among users of club drugs, club drug use during sex was most common among Black (100%), and Latino MSM (93%). Significant interactions between race/ethnicity and club drug use during sex were observed for CAI (p = 0.02), insertive CAI (p = 0.01), and receptive CAI (p = 0.01). API participants who used club drug during sex had higher odds of reporting CAI (aOR = 15.27, CI = 1.50-155.34), insertive CAI (aOR = 21.11, CI = 2.04-218.10), and receptive CAI (aOR = 21.11, CI = 2.04-218.10). CONCLUSIONS Given the differing rates of club drug use during sex by race/ethnicity and the role race/ethnicity plays in modifying the relationships between club drug use during sex and sexual risk behaviors, culturally-tailored interventions may be needed to address the needs of ethnically-diverse, club drug-using MSM.
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Affiliation(s)
| | | | - Eric Lam
- Boston University School of Public Health, Boston, MA, USA
| | - Jaclyn Hern
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Christopher Rowe
- San Francisco Department of Public Health, San Francisco, CA, USA
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Yazdani K, Dhillon N, Tung A, Ye M, Trigg J, Stanley C, Ni Gusti Ayu N, McLinden T, Lima VD, Barrios R, Hogg R, Montaner JSG, Salters K. Dynamics of overdose and non-overdose mortality among people living with HIV amidst the illicit drug toxicity crisis in British Columbia. AIDS Care 2024; 36:263-271. [PMID: 37094365 DOI: 10.1080/09540121.2023.2195605] [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: 01/07/2022] [Accepted: 03/20/2023] [Indexed: 04/26/2023]
Abstract
We sought to characterize overdose and non-overdose mortality among PLWH amidst the illicit drug toxicity crisis in British Columbia, Canada. A population-based analysis of PLWH (age ≥19) in British Columbia accessing healthcare from April 1996 to March 2017 was conducted using data from the Seek and Treat for Optimal Prevention of HIV/AIDS (STOP HIV/AIDS) cohort linkage. Underlying causes of deaths were stratified into overdose and non-overdose causes. We compared (bivariate analysis) health-related characteristics and prescription history between PLWH died of overdose and non-overdose causes between April 2009 and March 2017. Among 9,180 PLWH, we observed 962 deaths (142 [14.7%] overdoses; 820 [85.2%] other causes). Compared to those who died from other causes, those who died of overdose were significantly younger (median age [Q, Q3]: 46 years [42, 52] vs. 54 years [48, 63]); had an indication of chronic pain (35.9% vs. 27.1%) and hepatitis C virus (64.8% vs. 50.4%), but fewer experienced hospitalization in the year before death. PLWH who died were most likely to be prescribed with opioids (>50%) and least likely with opioid agonist therapy (<10%) in a year before death. These findings highlight the syndemic of substance use, HCV, and chronic pain, and how the crisis is unqiuely impacting females and younger people.
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Affiliation(s)
- Kiana Yazdani
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Nalin Dhillon
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Audrey Tung
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Monica Ye
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Jason Trigg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Cole Stanley
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Nanditha Ni Gusti Ayu
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Taylor McLinden
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
| | - Viviane D Lima
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Rolando Barrios
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Vancouver Coastal Health, Vancouver, Canada
| | - Robert Hogg
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Julio S G Montaner
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Kate Salters
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
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van den Hoek TC, Verhagen IE, de Boer I, Terwindt GM. Substance use in a Dutch migraine cohort compared with the general population. Headache 2024; 64:141-148. [PMID: 38299699 DOI: 10.1111/head.14663] [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: 08/07/2023] [Revised: 11/21/2023] [Accepted: 11/26/2023] [Indexed: 02/02/2024]
Abstract
OBJECTIVE To evaluate self-reported substance user profiles for individuals with migraine and compare these to the general population. BACKGROUND There is increasing attention to lifestyle influences such as substance use as presumed migraine triggers. METHODS Data on substance use were collected by survey in a large migraine cohort and from the biannual survey in the general Dutch population for substances. A representative cohort of Dutch patients with migraine (n = 5176) and the Dutch general population (n = 8370) was included. Patients with migraine were subdivided into episodic (EM) and chronic migraine (CM). Substance consumption was compared between the general population and patients with migraine, and between migraine subgroups after standardization for sex and level of education. RESULTS Included patients with migraine were 83.4% female (4319/5176) and had a mean (standard deviation) age of 44.8 (11.3) years. Patients with migraine reported less illicit drug use (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.42-0.55; p < 0.001), less current and lifetime smoking (OR 0.60, 95% CI 0.55-0.65; p < 0.001 and OR 0.75, 95% CI 0.71-0.79; p < 0.001), and less current alcohol consumption (OR 0.66, 95% CI 0.62-0.70; p < 0.001) compared with the general population. Prevalence of substance use was compared between CM and EM participants and showed higher illicit drug use (OR 1.73, 95% CI 1.11-2.69; p = 0.011), higher current smoking (OR 1.61, 95% CI 1.22-2.11; p < 0.001) but less alcohol use (OR 0.54, 95% CI 0.43-0.68; p < 0.001) for participants with CM compared with EM. No differences were found for a history of smoking (OR 1.18, 95% CI 0.92-1.50, p = 0.19). CONCLUSIONS Individuals with migraine are less likely to use illicit drugs, smoke, or drink alcohol compared with the general population. Patients with CM less often consume alcohol, while they more often use illicit drugs and smoke compared to those with EM.
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Affiliation(s)
| | - Iris E Verhagen
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Irene de Boer
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands
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40
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Lasco G, Yu VG. Pampalibog: chemsex, desire and pleasure in the Philippines. Cult Health Sex 2024; 26:143-158. [PMID: 37000038 DOI: 10.1080/13691058.2023.2192256] [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] [Received: 09/23/2022] [Accepted: 03/14/2023] [Indexed: 04/01/2023]
Abstract
This article draws from qualitative interviews to provide the first in-depth exploration of reasons for engaging in chemsex in the Philippines. It articulates the many forms that drugs assume as pampalibog, or enhancers of libido, demonstrating the multidimensional pleasures of chemsex along overlapping sensorial and affective planes. By showing the inextricability of the corporeal to the affective, and of the emotional to the erotic, we contend that chemsex also involves the embodied and performed attainment of pleasure. As such, chemsex is both central to modern sexual scripts yet also a negotiable aspect of any sexual encounter. In constructing this rare account of drug use in settings of pleasure in the Philippines, we situate chemsex within a historical pattern of bodily tinkering and, more significantly, demystify people who use drugs by departing not only from global public health's pathologising approach to chemsex, but also from the scholarly tendency to locate drug use in the country within scenes of hardship and marginalisation.
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Affiliation(s)
- Gideon Lasco
- Development Studies Program, School of Social Sciences, Ateneo de Manila University, Quezon City, Philippines
- Department of Anthropology, University of the Philippines Diliman, Quezon City, Philippines
| | - Vincen Gregory Yu
- Development Studies Program, School of Social Sciences, Ateneo de Manila University, Quezon City, Philippines
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Ujváry I. Hexahydrocannabinol and closely related semi-synthetic cannabinoids: A comprehensive review. Drug Test Anal 2024; 16:127-161. [PMID: 37269160 DOI: 10.1002/dta.3519] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [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: 04/19/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 06/04/2023]
Abstract
Since the early 2000s, there has been a turmoil on the global illicit cannabinoid market. Parallel to legislative changes in some jurisdictions regarding herbal cannabis, unregulated and cheap synthetic cannabinoids with astonishing structural diversity have emerged. Recently, semi-synthetic cannabinoids manufactured from hemp extracts by simple chemical transformations have also appeared as recreational drugs. The burst of these semi-synthetic cannabinoids into the market was sparked by legislative changes in the United States, where cultivation of industrial hemp restarted. By now, hemp-derived cannabidiol (CBD), initially a blockbuster product on its own, became a "precursor" to semi-synthetic cannabinoids such as hexahydrocannabinol (HHC), which appeared on the drug market in 2021. The synthesis and cannabimimetic activity of HHC were first reported eight decades ago in quest for the psychoactive principles of marijuana and hashish. Current large-scale manufacture of HHC is based on hemp-derived CBD extract, which is converted first by cyclization into a Δ8 /Δ9 -THC mixture, followed by catalytic hydrogenation to afford a mixture of (9R)-HHC and (9S)-HHC epimers. Preclinical studies indicate that (9R)-HHC has THC-like pharmacological properties. The animal metabolism of HHC is partially clarified. The human pharmacology including metabolism of HHC is yet to be investigated, and (immuno)analytical methods for the rapid detection of HHC or its metabolites in urine are lacking. Herein, the legal background for the revitalization of hemp cultivation, and available information on the chemistry, analysis, and pharmacology of HHC and related analogs, including HHC acetate (HHC-O) is reviewed.
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Costa ADA, Almeida MTC, Maia FA, Rezende LFD, Saeger VSDA, Oliveira SLN, Mangabeira GL, Silveira MF. Maternal and paternal licit and illicit drug use, smoking and drinking and autism spectrum disorder. Cien Saude Colet 2024; 29:e01942023. [PMID: 38324818 DOI: 10.1590/1413-81232024292.01942023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/22/2023] [Indexed: 02/09/2024] Open
Abstract
The aim of this study was to investigate the association between maternal and paternal licit and illicit drug use, smoking and drinking and autism spectrum disorder (ASD). We conducted a case-control study with children and adolescents diagnosed with ASD and neurotypical individuals. The data were collected using a semi-structured questionnaire administered during interviews with the children's mothers or guardians. The following variables were analyzed: child sex and age; maternal and parental age; use of medicines before and during pregnancy; classes of medicines used during pregnancy; maternal and paternal smoking; maternal and paternal drinking; maternal and paternal illicit drug use. The data were analyzed using logistic regression and crude and adjusted odds ratios (OR). After adjustment, the results showed an association between maternal use of antipyretics/pain killers during pregnancy (OR = 2.26; 95%CI 1.29-3.95; p < 0.040) and ASD. No association was found between maternal and paternal smoking, drinking and illicit drug use before and during pregnancy and ASD. The findings suggest that the development of ASD is influenced by environmental factors.
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Affiliation(s)
- Amanda de Andrade Costa
- Superintendência Regional de Saúde de Montes Claros. R. Corrêa Machado 1333, Vila Santa Maria. 39400-090 Montes Claros MG Brasil.
| | - Maria Tereza Carvalho Almeida
- Departamento de Fisiopatologia, Centro de Ciências Biológicas, Universidade Estadual de Montes Claros. Montes Claros MG Brasil
| | - Fernanda Alves Maia
- Departamento de Fisiopatologia, Centro de Ciências Biológicas, Universidade Estadual de Montes Claros. Montes Claros MG Brasil
| | - Luiz Fernando de Rezende
- Departamento de Fisiopatologia, Centro de Ciências Biológicas, Universidade Estadual de Montes Claros. Montes Claros MG Brasil
| | | | - Steffany Lara Nunes Oliveira
- Comviver - Núcleo de Desenvolvimento, Pesquisa e Inclusão. Montes Claros MG Brasil
- Faculdades FUNORTE. Montes Claros MG Brasil
| | | | - Marise Fagundes Silveira
- Programa de Pós-Graduação em Cuidados Primários de Saúde, Universidade Estadual de Montes Claros. Montes Claros MG Brasil
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43
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Fischer B, Robinson T, Jutras-Aswad D. Three noteworthy idiosyncrasies related to Canada's opioid-death crisis, and implications for public health-oriented interventions. Drug Alcohol Rev 2024; 43:562-566. [PMID: 38098180 DOI: 10.1111/dar.13796] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/25/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023]
Abstract
Canada has been experiencing a prolonged public health-crisis of high rates of overdose deaths caused by exceptionally potent/toxic, illicit opioid use. While many key features of this drug death epidemic are well-documented, several idiosyncratic aspects with relevance for public health-oriented interventions are not adequately recognised. These include: (i) the discrepant opioid patterns pan-Canada, with large majorities of opioid deaths caused by illicit fentanyl drugs in Western, but not Eastern regions where prescription-type opioid prevail; (ii) the environments of overdose deaths, where vast majorities occur in 'residential' or other shelter-type settings, presenting barriers for emergency interventions rather than health protection; and (iii) shifting drug use modes, where now majorities of overdose deaths are associated with drug 'inhalation' (instead of 'injection') in contexts of potent/toxic drug supply. We briefly describe these factors and related implications for intervention programming towards an improved response to the drug death-crisis.
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Affiliation(s)
- Benedikt Fischer
- Research & Graduate Studies, University of the Fraser Valley, Abbotsford, Canada
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of Psychiatry, Federal University of Sao Paulo, São Paulo, Brazil
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Tessa Robinson
- Department of Health Research Methods, Evidence & Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Didier Jutras-Aswad
- Research Centre, Centre Hospitalier de l'Université de Montréal, Montreal, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, Canada
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Takeuchi J, Chan C, MacGibbon J, Broady TR, Lea T, Mao L, Bavinton BR, Holt M. Trends in illicit drug use and their association with HIV transmission risks from behavioural surveillance of Australian gay and bisexual men. Drug Alcohol Rev 2024; 43:539-550. [PMID: 38010830 DOI: 10.1111/dar.13781] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/22/2023] [Accepted: 10/29/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Investigating drug trends among Australian gay and bisexual men (GBM) is crucial for understanding levels of use and the potential for harm, including HIV transmission risk. METHOD Using repeated, national, cross-sectional survey data collected between 2012 and 2021 (69,567 surveys), trends of recent (previous 6 months) and frequent (weekly) drug use were analysed, using logistic regression models. The last round of data from each jurisdiction (6709 surveys) was used to compare GBM who reported no use, infrequent (less than weekly) use and frequent (at least weekly) use of party drugs to investigate the association between party drug use and HIV transmission risk, using multinomial logistic regression models. RESULTS There was a significant upward trend in any recent drug use (from 58.4% in 2012 to 64.1% in 2021; p < 0.001). Frequent party drug use remained a minority practice over the period (consistently less than 3%). In cross-sectional analysis, frequent party drug users were more likely to report behaviours with HIV transmission risks, such as condomless anal intercourse without biomedical prevention strategies (30.0% vs. 13.1%; adjusted relative risk ratio [aRRR], 2.08; 95% CI, 1.24-3.47), weekly group sex (16.3% vs. 0.6%; aRRR, 12.36; 95% CI, 5.75-26.56) and more than 20 recent sexual partners (42.5% vs. 5.0%; aRRR, 21.44; 95% CI, 5.82-78.89), compared with GBM who did not use party drugs. DISCUSSION AND CONCLUSION Our findings suggest that the frequent use of party drugs remains a marker of HIV transmission risk among Australian GBM, despite the increased adoption of biomedical HIV prevention strategies over the past few years.
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Affiliation(s)
- Jumpei Takeuchi
- School of Clinical Medicine, Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Curtis Chan
- The Kirby Institute, Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - James MacGibbon
- Centre for Social Research in Health, Faculty of Arts, Design & Architecture, UNSW Sydney, Sydney, Australia
| | - Timothy R Broady
- Centre for Social Research in Health, Faculty of Arts, Design & Architecture, UNSW Sydney, Sydney, Australia
| | - Toby Lea
- Centre for Social Research in Health, Faculty of Arts, Design & Architecture, UNSW Sydney, Sydney, Australia
| | - Limin Mao
- Centre for Social Research in Health, Faculty of Arts, Design & Architecture, UNSW Sydney, Sydney, Australia
| | | | - Martin Holt
- Centre for Social Research in Health, Faculty of Arts, Design & Architecture, UNSW Sydney, Sydney, Australia
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Arrington-Sanders R, Galai N, Falade-Nwulia O, Hammond C, Wirtz A, Beyrer C, Arteaga A, Celentano D. Patterns of Polysubstance Use in Young Black and Latinx Sexual Minority Men and Transgender Women and Its Association with Sexual Partnership Factors: The PUSH Study. Subst Use Misuse 2024; 59:317-328. [PMID: 38146133 DOI: 10.1080/10826084.2023.2267655] [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] [Indexed: 12/27/2023]
Abstract
Background: Adult studies have demonstrated that polysubstance use increases HIV acquisition risk through increased sexual behaviors, however, few studies have examined polysubstance in young Black and Latinx sexual minority men (SMM) and transgender women (TW). Methods: We used cross-sectional data from 466 young Black and Latinx SMM and TW living in four high HIV-burden US cities enrolled in the PUSH Study, a status-neutral randomized control trial to increase HIV prevention and treatment adherence. We examined data for patterns of polysubstance use comparing age differences of use and explored associations between substance use and sexual partnership factors - inconsistent condom use, pressure to have condomless anal sex, and older partner, using bivariate and multivariate analyses. Results: Most participants described prior substance use with alcohol and cannabis being most common (76% each) and 23% described other illicit drug use, including stimulants, cocaine, hallucinogens, sedatives, opioids, and inhalants. Polysubstance use was common with nearly half (47%) of participants reporting alcohol and cannabis use, 20% reporting alcohol, cannabis, and one other illicit drug use, and 19% reporting alcohol or cannabis use plus one other illicit drug use. Polysubstance use was associated with greater adjusted odds of pressure to have condomless anal sex, older partner (>5 years older), and inconsistent condom use. Conclusions: Associations of polysubstance use with sexual practices and sexual partnerships that are known predictors of HIV acquisition or transmission among Black and Latinx SMM and TW underscore the need for combination interventions that include substance use treatment alongside antiretroviral-based and partner-based HIV prevention and treatment interventions.Trial Registration: ClinicalTrials.gov Identifier: NCT03194477.
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Affiliation(s)
- Renata Arrington-Sanders
- Department of Pediatrics, Division of Adolescent & Young Adult Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Medicine, Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Craig-Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia Perelman School of Medicine, University of Pennsylvania
| | - Noya Galai
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Statistics, University of Haifa, Mt Carmel, Israel
| | - Oluwaseun Falade-Nwulia
- Department of Medicine, Division of Infectious Disease, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Christopher Hammond
- Department of Pediatrics, Division of Adolescent & Young Adult Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Andrea Wirtz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Chris Beyrer
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Aubrey Arteaga
- Department of Pediatrics, Division of Adolescent & Young Adult Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David Celentano
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Ganson KT, Sinicropi E, Nagata JM. Analyzing Social Media Policies on Muscle-Building Drugs and Dietary Supplements. Subst Use Misuse 2024; 59:380-387. [PMID: 37919881 DOI: 10.1080/10826084.2023.2275557] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND Use of legal and illegal muscle-building drugs and dietary supplements has been linked to many adverse health and social outcomes. Research has shown that social media use is associated with the use of these drugs and dietary supplements; however, it remains unknown whether social media companies have specific policies related to the content and advertising of muscle-building drugs and dietary supplements on their platforms. Therefore, this study aimed to assess the content and advertising policies of eight popular social media companies related to muscle-building drugs and dietary supplements. METHODS Content and advertising policies for YouTube, TikTok, Instagram, Snapchat, Facebook, Twitter, Twitch, and Reddit were analyzed in November 2022 to determine whether there were any provisions related to legal (e.g., whey protein) and illegal (e.g., anabolic-androgenic steroids) muscle-building drugs and dietary supplements. Policies were classified as either none, restricted, or prohibited. RESULTS All eight social media platforms had explicit policies prohibiting user-generated content and advertising of illicit drugs and substances (e.g., anabolic-androgenic steroids). User-generated content and advertising policies related to legal muscle-building dietary supplements across the platforms varied; however, none of the eight social media companies had a specific policy regarding user content. CONCLUSIONS Findings underscore the need for stronger social media content and advertising policies related to legal muscle-building dietary supplements.
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Affiliation(s)
- Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Eliana Sinicropi
- Munk School of Global Affairs and Public Policy, University of Toronto, Toronto, ON, Canada
| | - Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
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Moore R, Wood R. Illegal drugs in the UK-we need better screening and surveillance. BMJ 2024; 384:q2. [PMID: 38167269 DOI: 10.1136/bmj.q2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
- Rob Moore
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton and Hove, UK
| | - Rebecca Wood
- Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton and Hove, UK
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Zellers S, Alexander J, Ellingson JM, Schaefer JD, Corley RP, Iacono W, Hewitt JK, Hopfer CJ, McGue MK, Vrieze S. Limited psychological and social effects of lifetime cannabis use frequency: Evidence from a 30-year community study of 4,078 twins. J Psychopathol Clin Sci 2024; 133:115-128. [PMID: 38147055 PMCID: PMC10751959 DOI: 10.1037/abn0000867] [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] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
BACKGROUND Cannabis use is associated with outcomes like income, legal problems, and psychopathology. This finding rests largely on correlational research designs, which rely at best on statistical controls for confounding. Here, we control for unmeasured confounders using a longitudinal study of twins. METHOD In a sample of 4,078 American adult twins first assessed decades ago, we used cotwin control mixed effects models to evaluate the effect of lifetime average frequency of cannabis consumption measured on substance use, psychiatric, and psychosocial outcomes. RESULTS On average, participants had a lifetime cannabis frequency of about one to two times per month, across adolescence and adulthood. As expected, in individual-level analyses, cannabis use was significantly associated with almost all outcomes in the expected directions. However, when comparing each twin to their cotwin, which inherently controls for shared genes and environments, we observed within-pair differences consistent with possible causality in three of the 22 assessed outcomes: cannabis use disorder symptoms (βW-Pooled = .15, SE = .02, p = 1.7 × 10-22), frequency of tobacco use (βW-Pooled = .06, SE = .01, p = 1.2 × 10-5), and illicit drug involvement (βW-Pooled = .06, SE = .02, p = 1.2 × 10-4). Covariate specification curve analyses indicated that within-pair effects on tobacco and illicit drug use, but not cannabis use disorder, attenuated substantially when covarying for lifetime alcohol and tobacco use. CONCLUSIONS The cotwin control results suggest that more frequent cannabis use causes small increases in cannabis use disorder symptoms, approximately 1.3 symptoms when going from a once-a-year use to daily use. For other outcomes, our results are more consistent with familial confounding, at least in this community population of twins. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Stephanie Zellers
- Department of Psychology, University of Minnesota
- Institute for Molecular Medicine Finland, University of Helsinki
| | | | - Jarrod M. Ellingson
- Department of Psychiatry, University of Colorado Anschutz Medical Campus
- Institute for Behavioral Genetics, University of Colorado Boulder
| | | | - Robin P. Corley
- Institute for Behavioral Genetics, University of Colorado Boulder
| | | | - John K. Hewitt
- Institute for Behavioral Genetics, University of Colorado Boulder
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Christian J. Hopfer
- Department of Psychiatry, University of Colorado Anschutz Medical Campus
- Institute for Behavioral Genetics, University of Colorado Boulder
| | | | - Scott Vrieze
- Department of Psychology, University of Minnesota
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Scott D, Clinton Frazee C, Garg U. Quantification of Phencyclidine (PCP) in Urine, Serum, or Plasma by Gas Chromatography-Mass Spectrometry (GC-MS). Methods Mol Biol 2024; 2737:405-412. [PMID: 38036841 DOI: 10.1007/978-1-0716-3541-4_37] [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] [Indexed: 12/02/2023]
Abstract
Phencyclidine (PCP), a dissociative anesthetic, is a commonly abused recreational drug. In the 1950s, initially tested as an intravenous anesthetic, PCP was discontinued for clinical use due to its severe adverse effects. Since then, it has gained popularity as a recreational drug due to its ability to induce hallucinations and alter perception. PCP can be detected in urine, serum, or plasma by immunoassays and quantified and its presence confirmed by gas or liquid chromatography-mass spectrometry. In the method described here, a deuterated internal standard is added to the sample and the drug is extracted under alkaline conditions. Analysis is conducted using gas chromatography-mass spectrometry (GC-MS). Selected ion monitoring is used for quantitation of PCP.
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Affiliation(s)
- David Scott
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO, USA
| | - C Clinton Frazee
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO, USA
| | - Uttam Garg
- Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, Kansas City, MO, USA.
- University of Missouri School of Medicine, Kansas City, MO, USA.
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50
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Dusing GJ, Kim C, Nielsen A, Chum A. Disparities in alcohol- and substance-related hospitalizations and deaths across sexual orientations in Canada: a longitudinal study. Public Health 2024; 226:32-38. [PMID: 37995410 DOI: 10.1016/j.puhe.2023.10.001] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/28/2023] [Accepted: 10/02/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES We aim to quantify disparities in substance-related acute events (i.e. hospitalizations and deaths for substances, including alcohol, cannabis, opioids, narcotics, and/or illicit drugs) across sexual orientations based on health administrative data. STUDY DESIGN This was a longitudinal analysis from six waves of the Canadian Community Health Survey (2009-2014) linked to hospitalization/mortality data in Ontario, Canada. METHODS The study sample consisted of survey respondents aged ≥15 (weighted n = 15,406,000) who provided a valid response to the question about sexual orientation. The primary outcome was substance-related acute events, including hospitalizations and deaths due to alcohol, cannabis, opioids, narcotics, and/or illicit drugs. Disparities in substance-related acute events across sexual orientation and gender were examined using flexible parametric survival analysis. RESULTS Bisexual women had hazard ratios of 2.46 (95% confidence interval: 1.46-4.15) for any substance-related acute event and 2.67 (95% confidence interval: 1.42-5.00) for non-alcohol substance acute events compared to heterosexual women. Lesbian women did not exhibit significant differences in acute event risk compared to heterosexual women. Gay and bisexual men demonstrated elevated but not statistically significant risks compared to heterosexual men. CONCLUSIONS Bisexual women face higher risks of substance-related acute events, potentially due to self-medication of unique stressors brought on by discrimination and isolation. Enhanced education and training for healthcare professionals are essential to increase awareness and sensitivity toward the heightened substance use risk among lesbian, gay, and bisexual individuals. Targeted interventions aimed at reducing substance use problems among bisexual individuals warrant increased funding and research.
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Affiliation(s)
- G J Dusing
- York University, School of Kinesiology and Health Sciences, Canada
| | - C Kim
- York University, School of Kinesiology and Health Sciences, Canada
| | - A Nielsen
- Canadian Institute of Health Information, Canada
| | - A Chum
- York University, School of Kinesiology and Health Sciences, Canada; University of Toronto, Dalla Lana School of Public Health, Canada.
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