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Background and aim: To understand the use of psychoactive substances, one must consider the context and the social circumstances in which the substance use occurs. This paper discusses alcohol use from a socio‐cultural perspective, based on the use of alcoholic beverages among the Portuguese servicemen who fought in the Portuguese Colonial War (1961–74). Method: In‐depth interviews were carried out with 17 former Portuguese soldiers. Simultaneously, extensive bibliographic and documentary research was carried out based on a broad set of biographical and autobiographical texts by former military personnel. Finally, an on‐line survey (n = 210) was conducted among ex‐combatants of the Portuguese Colonial War. Results: Alcohol drinking among Portuguese servicemen was high during the Portuguese Colonial War. Socio‐cultural factors (such as regarding alcohol consumption as therapeutic and affirming masculinity) explain why alcohol drinking was so intense and frequent, and why repeated drunken behaviour was tolerated and undervalued by the military authorities, who considered it normal and not a health problem or disorder. Conclusion: The use of alcohol in the Portuguese Colonial War is an empirical example of how what is considered 'acceptable', 'normal' or 'pathological' may depend more on socio‐cultural norms than on objective and measurable criteria, including clinical criteria. [ABSTRACT FROM AUTHOR]

Abstract: Background and Aims: Chronic skin and soft tissue infections (SSTI) among people who inject drugs (PWID) can lead to AA amyloidosis: a serious, yet neglected, multi‐organ disease. We aim to synthesize findings on the epidemiology, risk factors, clinical outcomes, screening recommendations and challenges to treatment for AA amyloidosis among PWID. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). We searched the following bibliographic databases in July 2017: CINAHL Plus, Embase, Global Health, MEDLINE, PsycEXTRA, PsycINFO and SCOPUS. Studies were included if they investigated AA amyloidosis in PWID. Studies were not restricted to location, study type, year or language of publication. Study heterogeneity precluded meta‐analysis; we present a narrative review of the literature. Results: Thirty‐seven papers from eight countries met inclusion criteria. A total of 781 PWID are reported on, of whom 177 had AA amyloidosis. Where disease causality is established, it is attributed to chronic inflammation caused by injecting‐related SSTIs. Most (88.7%) PWID with AA amyloidosis had SSTIs. The proportion of PWID with AA amyloidosis at post‐mortem ranged from 1.6% (Germany) to 22.5% (Serbia). Biopsy studies reported from 5.26% (Portugal) to 50% (Germany) of AA amyloidosis in PWID with suspected or known kidney disease. Following diagnosis, the typical trajectory for PWID with AA amyloidosis was rapid deterioration of renal function requiring haemodialysis. Treatment difficulties, end‐stage renal failure and premature death from sepsis were observed. Good outcomes, including reversibility of AA amyloidosis, are attributed to rapid treatment of the underlining inflammation and injecting cessation. Notably, given the population in question, no studies were published in addiction or harm reduction journals; most (92%) appeared in specialist nephrology and medical journals. Conclusion: There is strong evidence of an association between skin and soft tissue infections (SSTIs) and AA amyloidosis. Among people who inject drugs, injecting‐related SSTIs are a significant cause of morbidity and premature mortality and there is evidence of increasing SSTI prevalence. Limitations in the literature make it difficult to estimate AA amyloidosis prevalence among people who inject drugs. [ABSTRACT FROM AUTHOR]

The article offers news briefs related to drugs. Bhutan has restricted smoking through Tobacco Control Act of 2010 which has declared five-year prison sentence for carrying cigarettes that are not declared to customs. The Dutch government is planning to put cannabis in the category of cocaine containing more than 15 percent tetrahydrocannabinol (THC). In England, sales of cigarettes through vending machines is prohibited.

Aims: To determine trends in 3,4 methylenedioxymethamphetamine (MDMA)‐related death rates across Australia, Finland, Portugal and Turkey and to analyse the toxicology and causes of death across countries. Design Analysis of MDMA‐related deaths extracted from a national coronial database in Australia (2001–19) and national forensic toxicology databases in Finland (2001–17), Portugal (2008–19) and Turkey (2007–17). Presentation of MDMA use and seizure data (market indicators). Setting: Australia, Finland, Portugal and Turkey. Cases All deaths in which MDMA was considered by the forensic pathologist to be contributory to death. Measurements Information collected on cause and circumstances of death, demographics and toxicology. Findings A total of 1400 MDMA‐related deaths were identified in Turkey, 507 in Australia, 100 in Finland and 45 in Portugal. The median age ranged from 24 to 27.5 years, and males represented between 81 and 94% of the deaths across countries. Standardized mortality rates significantly increased across all four countries from 2011 to 2017 during a period of increased purity and availability of MDMA. The underlying cause of death was predominantly due to drug toxicity in Australia (n = 309, 61%), Finland (n = 70, 70%) and Turkey (n = 840, 60%) and other causes in Portugal (n = 25, 56%). Minorities of all deaths across the countries were due to MDMA toxicity alone (13–25%). These deaths had a significantly higher blood MDMA concentration than multiple drug toxicity deaths in Australia, Finland and Turkey. Drugs other than MDMA commonly detected were stimulants (including cocaine, amphetamine and methamphetamine) (Australia 52% and Finland 61%) and alcohol (Australia 46% and Portugal 49%). In addition to MDMA toxicity, benzodiazepines (81%) and opioids (64%) were commonly identified in these deaths in Finland. In comparison, synthetic cannabinoids (15%) and cannabis (33%) were present in a minority of deaths in Turkey. Conclusions: Deaths related to 3,4 methylenedioxymethamphetamine (MDMA) increased in Australia, Finland, Portugal and Turkey between 2011 and 2017. Findings show MDMA toxicity alone can be fatal, but multiple drug toxicity remains more prevalent. [ABSTRACT FROM AUTHOR]

Background and aims: The World Health Organization's (WHO's) proposed International Classification of Diseases, 11th edition (ICD‐11) includes several major revisions to substance use disorder (SUD) diagnoses. It is essential to ensure the consistency of within‐subject diagnostic findings throughout countries, languages and cultures. To date, agreement analyses between different SUD diagnostic systems have largely been based in high‐income countries and clinical samples rather than general population samples. We aimed to evaluate the prevalence of, and concordance between diagnoses using the ICD‐11, The WHO's ICD 10th edition (ICD‐10) and the Diagnostic and Statistical Manual of Mental Disorders, 4th and 5th editions (DSM‐IV, DSM‐5); the prevalence of disaggregated ICD‐10 and ICD‐11 symptoms; and variation in clinical features across diagnostic groups. Design Cross‐sectional household surveys. Setting: Representative surveys of the general population in 10 countries (Argentina, Australia, Brazil, Colombia, Iraq, Northern Ireland, Poland, Portugal, Romania and Spain) of the World Mental Health Survey Initiative. Participants: Questions about SUDs were asked of 12 182 regular alcohol users and 1788 cannabis users. Measurements Each survey used the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview version 3.0 (WMH‐CIDI). Findings Among regular alcohol users, prevalence (95% confidence interval) of life‐time ICD‐11 alcohol harmful use and dependence were 21.6% (20.5–22.6%) and 7.0% (6.4–7.7%), respectively. Among cannabis users, 9.3% (7.4–11.1%) met criteria for ICD‐11 harmful use and 3.2% (2.3–4.0%) for dependence. For both substances, all comparisons of ICD‐11 with ICD‐10 and DSM‐IV showed excellent concordance (all κ ≥ 0.9). Concordance between ICD‐11 and DSM‐5 ranged from good (for SUD and comparisons of dependence and severe SUD) to poor (for comparisons of harmful use and mild SUD). Very low endorsement rates were observed for new ICD‐11 feature for harmful use ('harm to others'). Minimal variation in clinical features was observed across diagnostic systems. Conclusions: The World Health Organization's proposed International Classification of Diseases, 11th edition (ICD‐11) classifications for substance use disorder diagnoses are highly consistent with the ICD 10th edition and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM‐IV). Concordance between ICD‐11 and the DSM 5th edition (DSM‐5) varies, due largely to low levels of agreement for the ICD harmful use and DSM‐5 mild use disorder. Diagnostic validity of self‐reported 'harm to others' is questionable. [ABSTRACT FROM AUTHOR]

Reports an analysis of regional and temporal covariation of suicide rates and indicators of alcohol use and abuse in Portugal. Presence of a positive relationship between the two variants; Comparison of results found in France and Denmark.