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Aim: To address the need for additional education in the management of mental illness in the critical care setting by providing a broad overview of the interrelationship between critical illness and mental illness. The paper also offers practical advice to support critical care staff in managing patients with mental illness in critical care by discussing two hypothetical case scenarios involving aggressive and disorganised behaviour. People living with mental illness are over‐represented among critically unwell patients and experience worse outcomes, contributing to a life expectancy up to 30 years shorter than their peers. Strategic documents call for these inequitable outcomes to be addressed. Staff working in intensive care units (ICUs) possess advanced knowledge and specialist skills in managing critical illness but have reported limited confidence in managing patients with comorbid mental illness. Design & Methods: A discursive paper, drawing on clinical experience and research of the authors and current literature. Results: Like all people, patients with mental illnesses draw on their cognitive, behavioural, social and spiritual resources to cope with their experiences during critical illness. However, they may have fewer resources available due to co‐morbid mental illness, a history of trauma and social disadvantage. By identifying and sensitively addressing patients' underlying needs in a trauma‐informed way, demonstrating respect and maximising patient autonomy, staff can reduce distress and disruptive behaviours and promote recovery. Caring for patients who are distressed and/or display challenging behaviours can evoke strong and unpleasant emotional responses. Self‐care is fundamental to maintaining a compassionate approach and effective clinical judgement. Staff should be enabled to accept and acknowledge emotional responses and access support—informally with peers and/or through formal mechanisms as needed. Organisational leadership and endorsement of the principles of equitable care are critical to creation of the environment needed to improve outcomes for staff and patients. Relevance to clinical practice: ICU nurses hold an important role in the care of patients with critical illnesses and are ideally placed to empower, advocate for and comfort those patients also living with mental illness. To perform these tasks optimally and sustainably, health services have a responsibility to provide nursing staff with adequate education and training in the management of mental illnesses, and sufficient formal and informal support to maintain their own well‐being while providing this care. Patient and public involvement: This paper is grounded in accounts of patients with mental illness and clinicians providing care to patients with mental illness in critical care settings but there was no direct patient or public contribution. [ABSTRACT FROM AUTHOR]

Eosin Y is a potential new color test for use in detecting illicit drugs that has not been extensively studied. In the present study, a variety of drugs of abuse and fentanyl analogues were tested to determine which drugs will bind to eosin Y, which functional groups are capable of binding and eliciting a color change, and a mechanism for eosin Y binding to fentanyl. Further, these agents were combined with common cutting agents and other drugs of abuse in order to determine the fentanyl detection limit in a drug mixture using an eosin Y test strip. Additionally, cobalt thiocyanate was used to determine whether the combination of cobalt thiocyanate and eosin Y has the potential to identify fentanyl. Through the testing performed, we concluded that (i) Eosin Y is capable of detecting low amounts of fentanyl down to 1%, (ii) Eosin Y binds to select tertiary amines to produce an orange to pink color change, and (iii) Eosin Y binds to the nonpiperidine ring nitrogen of fentanyl as a primary binding site and the piperidine ring nitrogen as a secondary binding site. While the cobalt thiocyanate assay detected 1% fentanyl in some of the mixtures, eosin Y detected 1% fentanyl in all mixtures. Finally, eosin Y was able to detect fentanyl in forensic case samples containing heroin and various cutting agents. Based on our results, eosin Y has the potential to screen for fentanyl and fentanyl analogues and can detect fentanyl in low amounts when mixed with common cutting agents. [ABSTRACT FROM AUTHOR]

Rationale: Drug overdose deaths due to fentanyls and other novel psychoactive substances (NPS) are on the rise. The higher potencies of fentanyl analogs compared with morphine require new technologies to identify and quantitate NPS. Methods: Paper spray tandem mass spectrometry (MS/MS) and high‐resolution mass spectrometry were used to identify and measure fentanyl analogs as well as common drugs of abuse in urine samples from substance use disorder clinics. Ten‐microliter urine samples were deposited directly on paper spray cartridges previously loaded with internal standards, dried, and analyzed with no other sample treatment. Quantitative results were obtained using MS/MS. Individual drugs were identified using high‐resolution accurate mass spectrometry, and confirmed by data‐dependent MS/MS. Results: Calibration curves in urine were linear over a range of 0.5–50 ng/mL with R2 of 0.99 or better for eight representative fentanyl analogs. Cartridges preloaded with internal standards demonstrated satisfactory quantitative results compared with LC/MS. Direct identification and confirmation of fentanyl analogs and other common drugs of abuse in urine using high‐resolution accurate mass and MS/MS fragmentation were demonstrated at low picogram levels. Conclusions: Paper spray mass spectrometry can reliably identify and quantitate fentanyl analogs and other drugs of abuse in urine. Using paper spray cartridges as collection devices reduces exposure and transportation risks associated with biological fluids. Cartridges preloaded with labeled internal standards can be effective for targeted screening of fentanyl analogs and other drugs of abuse. [ABSTRACT FROM AUTHOR]

The National Institute on Drug Abuse Genetics and Epigenetics Cross‐Cutting Research Team convened a diverse group of researchers, clinicians, and healthcare providers on the campus of the University of California, San Diego, in June 2018. The goal was to develop strategies to integrate genetics and phenotypes across species to achieve a better understanding of substance use disorders through associations between genotypes and addictive behaviors. This conference (a) discussed progress in harmonizing large opioid genetics cohorts, (b) discussed phenotypes that are used for genetics studies in humans, (c) examined phenotypes that are used for genetics studies in animal models, (d) identified synergies and gaps in phenotypic analyses of human and animal models and (e) identified strategies to integrate genetics and genomics data with phenotypes across species. The meeting consisted of panels that focused on phenotype harmonization (Dr. Laura Bierut, Dr. Olivier George, Dr. Dan Larach and Dr. Sesh Mudumbai), translating genetic findings between species (Dr. Elissa Chesler, Dr. Gary Peltz and Dr. Abraham Palmer), interpreting and understanding allelic variations (Dr. Vanessa Troiani and Dr. Tamara Richards) and pathway conservation in animal models and human studies (Dr. Robert Hitzemann, Dr. Huda Akil and Dr. Laura Saba). There were also updates that were provided by large consortia (Dr. Susan Tapert, Dr. Danielle Dick, Dr. Howard Edenberg and Dr. Eric Johnson). Collectively, the conference was convened to discuss progress and changes in genome‐wide association studies. Cates et al present current gaps in the field of genetics of substance use disorders and offer insight as junior members of the field. [ABSTRACT FROM AUTHOR]

Using the case of the campaign to establish a Supervised Injecting Facility (SIF) for people who use illicit drugs in Dublin, Ireland, this paper makes three related contributions to contemporary literatures. First, by detailing the history of the campaign and paying particular attention to the ways it was influenced by learning from models elsewhere in the world, the paper adds a spatial perspective to research on the intersections of public health and politics. Second, the paper addresses the policy mobilities literature's minimal engagement with the role of counterhegemonic ideas and national states in shaping inter‐local policy circulations. It provides detailed empirical analysis of the influence of counterhegemonic ideas and how activists reference those ideas through appeals to empathy, expert evidence, and experience as they build coalitions to influence formal state institutions, including the legal system and the national government. This discussion supports a call for engagement between policy mobilities and counterhegemonic social movement literatures. Third, the paper addresses ongoing discussions of 'failure' in policy‐making by arguing for a critical, contextual approach to the spatialities and temporalities of attempts to change entrenched policy and regulatory models. The case study is based on one author's direct involvement in the campaign for a SIF and on semi‐structured research interviews with 12 key actors conducted since 2015. The research also involved an analysis of relevant documentary materials spanning the period 2012–2021 and both authors' participation in a drug policy forum in Dublin in January 2017, involving local and international actors. [ABSTRACT FROM AUTHOR]

The article reports on the call of the organization American Academy of Addiction Psychiatry (AAAP) for concept articles that focused on the treatment of substance abuse, ontogenetics, and addictive disorders.

The article reports on the call of the journal for review articles that focused on etiology and treatment of substance abuse, and addiction psychiatry.

Presents a requesting note for the withdrawal of a paper on 'Addiction' by Ellemann Jensen from publication. Amendments on the text of the paper; Necessity for protection of the integrity of the science base; Connection of the paper with the tobacco industry.

The production of illicit synthetic drugs has undergone a significant shift from China to the Golden Triangle, profoundly impacting Southeast Asia's legal systems, drug enforcement and public health. This paper reviews the production, distribution and use of illicit synthetic drugs in the region, explaining their alignment with regulatory policies in China and Southeast Asia. The public health effects resulting from the increased production and use of synthetic drugs in Southeast Asia are reviewed, emphasizing the importance of public health protections such as harm reduction, treatment and rehabilitation. This study also discusses legal mechanisms to enhance control over illicit drug activities, mainly compound‐wide legislative prohibitions targeting present and future fentanyl and methamphetamine analogues. Moreover, it underscores the urgency for collaborative efforts between China and Southeast Asian states to mitigate the influence of Chinese cartels operating in the region. By elucidating the multifaceted challenges posed by the shifting drug production landscape, this paper highlights the importance of a comprehensive approach encompassing regulatory, law enforcement and public health measures. [ABSTRACT FROM AUTHOR]

A liquid chromatography–mass spectrometry method using dried oral fluid spots was developed and validated for the simultaneous quantification of cocaine, benzoylecgonine, cocaethylene, amphetamine, and 3,4‐methylenedioxymethamphetamine. The oral fluid was applied to a Whatman 903 grade paper and submitted to a drying time of 2.5 h. The extraction procedure was optimized by chemometric approach using simplex centroid design. Spots were extracted with a mixture of acetonitrile, buffer, and methanol. Calibration curves covered a linear concentration range of 40–500 ng/mL. Validation parameters of linearity, precision, accuracy, selectivity, carryover, matrix effects, and stability were evaluated and showed satisfactory results. Spot homogeneity was also satisfactory, with less than 15% of deviation from nominal concentration. Spot volume did not influence accuracy when less than 100 μL of the sample was applied to the spot. The validation of the proposed method suggests a potential application in different scenarios in toxicology. [ABSTRACT FROM AUTHOR]

Introduction: In honouring the legacy of Jude Byrne's life‐long advocacy for women and mothers who use drugs, this paper presents a case study of a group of women about whom we know little about and hear even less from: women who inject drugs in relatively affluent suburbs. Methods: Based on a 2020 qualitative study of people who inject drugs in an affluent area of Sydney known as 'The Beaches', we use in‐depth interview data to thematically explore the lived experiences of gendered stigma among women who inject drugs. Results: Even when women occupy the 'ideal' social position in terms of class (middle‐class) and race (White) they remain subject to harmful forms of gendered stigma related to injecting drug use. Participants had internalised negative attitudes around injection drug use as a form of failed femininity and, despite being part of 'good' families and neighbourhoods, participants experienced forced child removal. Discussion and Conclusions: Taking the lead from feminist intersectionality scholarship, our data illustrate how stigma and discrimination act as a form of structural violence against women who inject drugs in affluent communities. While the social relations of gender provide some degree of protection by 'performing proximity to Whiteness', gendered stigma and violence persist. [ABSTRACT FROM AUTHOR]

The use of drugs of abuse has grown significantly in recent decades. In forensic chemistry, methods of identifying and characterizing illicit drugs contribute to the interests of researchers, experts, and public security authorities. Among existing methods, portable Raman spectroscopy is notable for performing rapid, non‐destructive, and highly selective analysis in the laboratory or on‐site. When the resulting spectral data are paired with chemometric tools, methods of exploratory analysis and multivariate calibration can be developed. Thus, this work describes the application of Raman spectroscopy associated with principal component analysis (PCA) and interval principal component analysis (iPCA) to assessing trends in samples of cocaine (n = 40), crack (n = 33), and their main adulterants (n = 5) and diluents (n = 5), tablets of ecstasy (n = 14), designer drugs papers (n = 27), and alcoholic solutions adulterated with benzodiazepines (alprazolam and diazepam). In addition, competitive adaptive reweighted sampling (CARS) combined with partial least squares (PLS) regression (CARSPLS) was used to quantify adulterants (benzocaine, lidocaine, and procaine) in binary mixtures with crack (n = 21) and solutions of cachaça adulterated with bromazepam (n = 11). [ABSTRACT FROM AUTHOR]

In 2011, the Australian National Health and Medical Research Council (NHMRC) initiated an inquiry to determine whether there is a need for expanded ethical guidance in the form of a discrete guidance document for alcohol and other drug (AOD) research. An issues paper was developed to frame the inquiry. AOD researchers, Human Research Ethics Committees and others were invited to discuss whether there are distinctive ethical issues facing researchers and Human Research Ethics Committees in the AOD setting. Based on the public submissions, the NHMRC recommended that no AOD research-specific guidance is required. The inquiry and the NHMRC decision were not widely publicized, and we feel there is a need for further discussion. In order to do so, we have analysed the public inquiry submissions and described the central themes. Few submissions in the inquiry explicitly agreed AOD research warrants a specific guidance framework. Most were concerned that the NHMRC issues paper unfairly targeted people who use drugs as complex research participants. The inquiry highlights tensions around research governance and ethics review boards dealing with illicit and stigmatised behaviours. While we agree that a specific guidance framework for AOD research is not needed and could potentially be harmful and restrictive, we are concerned that the wholesale rejection of a guidance framework has closed the door to much needed debate. There remains, we argue, a need for alternative strategies and tools to support ethical research, inform and streamline institutional ethics approval, and engage and protect participants. [ABSTRACT FROM AUTHOR]

Background and aims: There are concerns that availability of recreational cannabis dispensaries (RCDs) and point‐of‐sale marketing may lead to increased cannabis use in jurisdictions where cannabis retail sale is legal. This paper examined whether the availability RCDs and the presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs were associated with cannabis use and risk perceptions. Design: Cross‐sectional, secondary data analysis. Setting: California, USA. Participants: A representative sample of 3385 adults in California who participated in the 2020 probability‐based Marijuana Use and Environment Survey. Measurements Binary outcomes included past‐month overall cannabis use, perceiving cannabis smoking as harmful and past‐month cannabis use by purpose (medical only, recreational only and dual). The objectively assessed predictors included proximity and density of RCDs and presence of storefront signage indicative of cannabis and signs promoting health benefits in RCDs. Findings In terms of proximity, thepresence of storefront signage in the nearest RCD was associated with smaller odds of perceiving cannabis smoking as harmful [odds ratio (OR) = 0.63, 95% confidence interval (CI) = 0.39, 0.99] if the RCD was located within 2 miles of home. Presence of health benefit signs in the nearest RCD was associated with greater odds of overall cannabis use (OR = 2.45, 95% CI = 1.17, 5.16) and recreational use (OR = 3.50, 95% CI = 1.027, 11.91) if the RCD was located within 2–4 miles of home. In terms of density, count of RCDs, count of RCDs with storefront signage and count of RCDs with health benefit signs within 2 miles of home were each separately associated with greater odds of overall cannabis use and cannabis use for dual purposes. Conclusions: The availability of recreational cannabis dispensaries within 2 miles of one's home and the presence of storefront signage indicating the availability of cannabis and signs promoting health benefits of cannabis appear to be associated with increased cannabis use and reduced risk perceptions among adults in California, USA. [ABSTRACT FROM AUTHOR]

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The article presents a summary of an interview with Australian psychologist Wayne Hall. It mentions his research in drug abuse, its impact on government policy, and presents an annotated bibliography of his publications.

Introduction: Current WHO guidelines recommend using methadone or buprenorphine as maintenance treatments for maternal opioid use disorder. However, buprenorphine‐naloxone, with a lower abuse risk than buprenorphine monotherapy or methadone, offers a potentially beneficial alternative, but scientific evidence on its effects on pregnancies, fetuses, and newborns is scarce. This paper compares the outcomes of the pregnancies, deliveries, and newborns of women on buprenorphine‐naloxone, buprenorphine, or methadone maintenance treatments. According to the hypothesis, as a maintenance treatment, buprenorphine‐naloxone does not have more adverse effects than buprenorphine, whereas methadone is more complicated. Material and methods: In this population‐based study, 172 pregnant women on medical‐assisted treatments were followed‐up at Helsinki University Women's Hospital (Finland). Women receiving the same opioid maintenance treatment from conception to delivery and their newborns were included. Consequently, 67 mother–child dyads met the final inclusion criteria. They were divided into three groups based on their opioid pharmacotherapy. The outcomes were compared among the groups and, where applicable, with the Finnish population. Results: The buprenorphine‐naloxone and buprenorphine groups showed similar outcomes and did not significantly differ from each other in terms of maternal health during pregnancies, deliveries, or newborns. Illicit drug use during the pregnancy was common in all groups, but in the methadone group it was most common (p = 0.001). Most neonates (96%) were born full‐term with good Apgar scores. They were of relatively small birth size, with those in the methadone group tending to be the smallest. Of the neonates 63% needed pharmacological treatment for neonatal opioid withdrawal syndrome. The need was lower in the buprenorphine‐based groups than in the methadone group (p = 0.029). Conclusions: Buprenorphine‐naloxone seems to be as safe for pharmacotherapy for maternal opioid use disorder as buprenorphine monotherapy for both mother and newborn. Hence it could be a choice for oral opioid maintenance treatment during pregnancy, but larger studies are needed before changing the official recommendations. Women on methadone treatment carry multifactorial risks and require particularly cautious follow up. Furthermore, illicit drug use is common in all treatment groups and needs to be considered for all patients with opioid use disorder. [ABSTRACT FROM AUTHOR]

The article introduces a series of papers published in the issue, including one on the epidemiology and etiology of drug abuse and another on drug use and sexual risk behavior among minorities.

Aims Alexander T. Shulgin is widely thought of as the ‘father’ of +/−3,4-methylenedioxymethamphetamine (MDMA). This paper re-assesses his role in the modern history of this drug. Methods We analysed systematically Shulgin's original publications on MDMA, his publications on the history of MDMA and his laboratory notebook. Results According to Shulgin's book PIHKAL (1991), he synthesized MDMA in 1965, but did not try it. In the 1960s Shulgin also synthesized MDMA-related compounds such as 3,4-methylenedioxyamphetamine (MDA), 3-methoxy-4,5-methylenedioxyamphetamine (MMDA) and 3,4-methylenedioxyethylamphetamine (MDE), but this had no impact on his rediscovery of MDMA. In the mid-1970s Shulgin learned of a ‘special effect’ caused by MDMA, whereupon he re-synthesized it and tried it himself in September 1976, as confirmed by his laboratory notebook. In 1977 he gave MDMA to Leo Zeff PhD, who used it as an adjunct to psychotherapy and introduced it to other psychotherapists. Conclusion Shulgin was not the first to synthesize MDMA, but he played an important role in its history. It seems plausible that he was so impressed by its effects that he introduced it to psychotherapist Zeff in 1977. This, and the fact that in 1978 he published with David Nichols the first paper on the pharmacological action of MDMA in humans, explains why Shulgin is sometimes (erroneously) called the ‘father’ of MDMA. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To conduct a systematic review and meta‐analysis of studies in order to estimate the effect of US medical marijuana laws (MMLs) on past‐month marijuana use prevalence among adolescents. Methods: A total of 2999 papers from 17 literature sources were screened systematically. Eleven studies, developed from four ongoing large national surveys, were meta‐analyzed. Estimates of MML effects on any past‐month marijuana use prevalence from included studies were obtained from comparisons of pre–post MML changes in MML states to changes in non‐MML states over comparable time‐periods. These estimates were standardized and entered into a meta‐analysis model with fixed‐effects for each study. Heterogeneity among the study estimates by national data survey was tested with an omnibus F‐test. Estimates of effects on additional marijuana outcomes, of MML provisions (e.g. dispensaries) and among demographic subgroups were abstracted and summarized. Key methodological and modeling characteristics were also described. Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed. Results: None of the 11 studies found significant estimates of pre–post MML changes compared with contemporaneous changes in non‐MML states for marijuana use prevalence among adolescents. The meta‐analysis yielded a non‐significant pooled estimate (standardized mean difference) of −0.003 (95% confidence interval = −0.012, +0.007). Four studies compared MML with non‐MML states on pre‐MML differences and all found higher rates of past‐month marijuana use in MML states pre‐MML passage. Additional tests of specific MML provisions, of MML effects on additional marijuana outcomes and among subgroups generally yielded non‐significant results, although limited heterogeneity may warrant further study. Conclusions: Synthesis of the current evidence does not support the hypothesis that US medical marijuana laws (MMLs) until 2014 have led to increases in adolescent marijuana use prevalence. Limited heterogeneity exists among estimates of effects of MMLs on other patterns of marijuana use, of effects within particular population subgroups and of effects of specific MML provisions. [ABSTRACT FROM AUTHOR]

This paper provides a personal memoir of historical work at the Addiction Research Unit, in particular the genesis of the book Opium and the People. This topic had policy significance for US drug policy and a competing US study was funded. The development of the substance use history field is surveyed, and its expansion in recent times through a focused professional association and a critical mass of researchers in the area, covering a wide range of topics. The politics of using history in this area can be problematic. History now sits at the policy table more easily, but there is still a tendency for professionals in the field to use (and misuse) it, rather than calling on the interpretive and challenging approach they would obtain from professional historians. The paper calls for historians and others to move beyond a substance specific focus and to avoid the tendency for 'naive history' implicit in using only digitized industry archives as the sole source. [ABSTRACT FROM AUTHOR]

Over the past few years, there has been increasing evidence highlighting the strong connection between gut microbiota and overall well‐being of the host. This has led to a renewed emphasis on studying and addressing substance use disorder from the perspective of brain‐gut axis. Previous studies have suggested that alcohol, food, and cigarette addictions are strongly linked to gut microbiota and faecal microbiota transplantation or the use of probiotics achieved significant efficacy. Unfortunately, little is known about the relationship between drug abuse and gut microbiota. This paper aims to reveal the potential correlation between gut microbiota and drug abuse and to develop an accurate identification model for drug‐related faeces samples by machine learning. Faecal samples were collected from 476 participants from three regions in China (Shanghai, Yunnan, and Shandong). Their gut microbiota information was obtained using 16S rRNA gene sequencing, and a substance use disorder identification model was developed by machine learning. Analysis revealed a lower diversity and a more homogeneous gut microbiota community structure among participants with substance use disorder. Bacteroides, Prevotella_9, Faecalibacterium, and Blautia were identified as important biomarkers associated with substance use disorder. The function prediction analysis revealed that the citrate and reductive citrate cycles were significantly upregulated in the substance use disorder group, while the shikimate pathway was downregulated. In addition, the machine learning model could distinguish faecal samples between substance users and nonsubstance users with an AUC = 0.9, indicating its potential use in predicting and screening individuals with substance use disorder within the community in the future. [ABSTRACT FROM AUTHOR]

Objective Magnolia bark contains magnolol, metabolized to tetrahydromagnolol and honokiol, with both GABA-ergic/cannabimimetic activities, hence of possible attraction to vulnerable individuals/recreational misusers. Methods A literature review, assessment of related anecdotal online Magnolia misuse's reports and an overview of Magnolia products' online acquisition possibilities has been here described. Results No peer-reviewed papers about Magnolia abuse/misuse/dependence/addiction were identified. Conversely, from a range of websites emerged potentially 3 groups of Magnolia misusers: (a) subjects with a psychiatric history already treated with benzodiazepines, being attracted to Magnolia bark as a 'natural sedative'; (b) polydrug misusers, ingesting Magnolia with a range of other herbs/plants, attracted by the GABA-ergic/cannabimimetic activities; (c) subjects naive to the misusing drugs' scenario, perceiving Magnolia as a natural dietary supplement/weight-control compound. Conclusions To the best of our knowledge, this is the first paper commenting on the possible Magnolia derivatives' potential of misuse. Magnolia's recent increase in popularity, mainly as a sedative, may be arguably due to its peculiar pharmacological properties/acceptable affordability levels/virtually worldwide favorable legal status and customers' attraction to a product being perceived as 'natural' and hence somehow 'safe.' Future/potent/synthetic magnolol and honokiol structural analogues could however contribute to increasing the number of synthetic GABA-ergic/cannabimimetic misusing compounds. [ABSTRACT FROM AUTHOR]

Issues: Alcohol and other drug use among adolescents is a serious concern, and effective prevention is critical. Research indicates that expanding school-based prevention programs to include parenting components could increase prevention outcomes. This paper aims to identify and describe existing combined student- and parent-based programs for the prevention of alcohol and other drug use to evaluate the efficacy of existing programs.Approach: The PsycINFO, Medline, Central Register of Controlled trials and Cochrane databases were searched in April 2015 and additional articles were obtained from reference lists. Studies were included if they evaluated a combined universal intervention for students (aged 11-18 years old) and their parents designed to prevent alcohol and/or other drug use, and were delivered in a school-based setting. Risk of bias was assessed by two independent reviewers. Because of the heterogeneity of the included studies, it was not possible to conduct a meta-analysis and a qualitative description of the studies was provided.Key Findings: From a total of 1654 screened papers, 22 research papers met inclusion criteria, which included 13 trials of 10 programs. Of these, nine programs demonstrated significant intervention effects in terms of delaying or reducing adolescent alcohol and/or other drug use in at least one trial.Conclusion: This is the first review of combined student- and parent-based interventions to prevent and reduce alcohol and other drug use. Whilst existing combined student- and parent-based programs have shown promising results, key gaps in the literature have been identified and are discussed in the context of the development of future prevention programs. [Newton NC, Champion KE, Slade T, Chapman C, Stapinski L, Koning I, Tonks Z, Teesson M. A systematic review of combined student- and parent-based programs to prevent alcohol and other drug use among adolescents. Drug Alcohol Rev 2017;36:337-351]. [ABSTRACT FROM AUTHOR]

Background In 1977 the World Health Organization (WHO) published a report entitled ‘Alcohol-Related Disabilities’. The crucial contribution of this report was to differentiate between alcohol dependence, on one hand, and alcohol-related disabilities (or problems) on the other hand. Essentially, it offered a bi-axial mapping of the field of concern. Aims This paper seeks to identify the multiple influences which shaped the evolution of this report. Methods Use is made of unpublished archival material and recall of personal involvement, together with relevant published material. Results Three major influences made it possible to move beyond the confines of previous WHO thinking on alcohol: the multi-disciplinary nature of the input; the internationality of the enterprise; and the expectations set that the concepts developed should speak to the practical world. Conclusions The arena of drug and alcohol policy has, for more than a century, been rich in its reports. This case study, although limited in its immediate content, points to the need for further analysis of the history of such reports. [ABSTRACT FROM AUTHOR]

Little is known about the processes that underlie changes in smoking that occur between the first use of a cigarette, subsequent regular use and eventual addictive use. At present, assessments of those critical processes are poorly developed and not strongly informed by contemporary models of drug dependence. The preceding three papers in this special issue address explicitly how modern drug-dependence theories describe the emergence of drug dependence and the implications of those theories for assessment. The papers covered three domains of theories: negative reinforcement, positive reinforcement, and cognitive and social learning. In this paper, we summarize these reviews and extract general themes and issues that emerge across all the articles. These include: (1) the importance of learning processes; (2) limitations of self-report measures; (3) the view of dependence as a process and not a state; (4) the conception of dependence on a continuum in contrast to the conventional perspective of tobacco dependence as a natural category; (5) the ontological status of the dependence concept; (6) limitations of backward extrapolations from adult assessments; (7) the possibility of multiple dimensions or forms of dependence; and (8) the value of a transdisciplinary approach when studying the emergence of tobacco dependence. [ABSTRACT FROM AUTHOR]

Several abstracts of research papers presented at the Australasian Professional Society on Alcohol & other Drugs Conference 2015 are presneted including Losing Your License to drink: Insights From Rand Evaluations of 24/7 Sobriety Programs, Impact of alcohol use on suicidal behaviors: Research and Prevention and Utilizing technology to address substance use and violence in fast paced clinical settings. [ABSTRACT FROM AUTHOR]

This paper describes the rationale, practical details, and laboratory lore relevant to conducting an acute dose-effect crossover evaluation for abuse liability of a novel anxiolytic/hypnotic compound relative to a standard compound. Basic principles underlying meaningful abuse liability assessments are presented and illustrated with examples from a comparative evaluation of the hypnotics zolpidem and triazolam. These principles include using a double-blind placebo-controlled design, selecting an appropriate comparison compound, evaluating a wide range of doses including supratherapeutic doses, using subjects with histories of sedative drug abuse, and using a range of dependent measures. The dose-effect crossover evaluation is proposed as a crucial first step in any rigorous drug abuse liability evaluation of a novel anxiolytic or hypnotic drug. Such a study can be expected to generate a broad data base which not only provides a prediction about the likelihood of abuse of the novel compound, but provides an assessment of some of the adverse consequences of recreational abuse. The crossover study also establishes parameters for subsequent studies such as direct assessment of reinforcing effects with drug self-administration testing. [ABSTRACT FROM AUTHOR]

This paper provides a methodological survey of research or 1253 experiments on the acute effects of drugs used for non-medical purposes on human performance. 305 different tasks were tested, but only 118 tasks were used in more than two experiments. While the majority of experiments did have control conditions and measured drug effects at more than one time point after drug administration, they varied widely on other protocol details: I) subject populations. 2) training on the tasks prior to drug administration, and 3) number of active test doses that were tested. Administration of stimulants either had no effect, or improved performance. In contrast, administration of marijuana, alcohol, or benzodiazepines had no effect, or impaired performance. In order to maximize comparability and utility, future protocols should use control groups, train subjects prior to participation, test more than one drug dose, and test performance before, and several times after, drug administration, A greater range of subject populations should also be studied. Finally, task standardization including type of instructions to subjects, duration of performance testing, feedback to subjects, motivational conditions, and inclusion of a benchmark task should also be used to enhance comparisons across studies. [ABSTRACT FROM AUTHOR]

Pharmacogenomics (PGx) is a key area of precision medicine, which is already being implemented in some health systems and may help guide clinicians toward effective therapies for individual patients. Over the last 2 decades, the Pharmacogenomics Knowledgebase (PharmGKB) has built a unique repository of PGx knowledge, including annotations of clinical guideline and regulator‐approved drug labels in addition to evidence‐based drug pathways and annotations of the scientific literature. All of this knowledge is freely accessible on the PharmGKB website. In the first of a series of PharmGKB tutorials, we introduce the PharmGKB coronavirus disease 2019 (COVID‐19) portal and, using examples of drugs found in the portal, demonstrate some of the main features of PharmGKB. This paper is intended as a resource to help users become quickly acquainted with the wealth of information stored in PharmGKB. [ABSTRACT FROM AUTHOR]

Gold nanoparticles have excellent optical and plasmon properties and have enormous research potential when they combine with different ligands. Functionalized gold nanoparticles are widely used in drug delivery, biological detection, sensors, and even clinical treatment. At present, with the rapid development of functionalized gold nanoparticles, we think it is necessary to sort out the recent research results. In this paper, the synthesis, characteristics, and biological applications of the three aspects are introduced. Firstly, the synthetic methods of functionalized gold nanoparticles are reviewed, and the improvement of the commonly used synthetic methods is summarized. Then, the catalytic properties, oxidation resistance, and chirality optical properties are summarized in detail. Finally, we summarize the research progress in the field of biology in recent years. [ABSTRACT FROM AUTHOR]

Male factor accounts for about 30–50% of infertility. A common cause of male infertility is drug abuse; either illicit or prolonged use of prescribed drugs. This study provides a review of the physiology of the hypothalamic–pituitary–gonadal axis and recent literature on drugs that have been linked to male infertility and the associated mechanisms. Relevant peer‐reviewed papers were assessed online using PubMed/PubMed Central, Scopus, AJOL, Google Scholar and DOAJ databases using Medical Subjects Headings (MeSH) indexes and relevant key word searches. Although drugs are beneficial when used at therapeutic levels, the abuse leads to impairment of hypothalamic–pituitary–gonadal functions, increased sperm DNA fragmentation and apoptosis, and reduced sperm quality. A good knowledge of the physiology of the hypothalamic–pituitary–gonadal axis and the influence of drugs on male fertility will guide healthcare providers in managing cases of infertility. [ABSTRACT FROM AUTHOR]

Issues. To reduce the occurrence and costs related to substance use and associated harms it is important to intervene early. Although a number of international school-based prevention programs exist, the majority show minimal effects in reducing drug use and related harms. Given the emphasis on early intervention and prevention in Australia, it is timely to review the programs currently trialled in Australian schools. This paper reports the type and efficacy of Australian school-based prevention programs for alcohol and other drugs. Approach. Cochrane, PsychInfo and PubMed databases were searched. Additional materials were obtained from authors, websites and reference lists. Studies were selected if they described programs developed and trialled in Australia that address prevention of alcohol and other drug use in schools. Key Findings. Eight trials of seven intervention programs were identified. The programs targeted alcohol, cannabis and tobacco and most were based on social learning principles. All were universal. Five of the seven intervention programs achieved reductions in alcohol, cannabis and tobacco use at follow up. Conclusion. Existing school-based prevention programs have shown to be efficacious in the Australian context. However, there are only a few programs available, and these require further evaluative research. This is critical, given that substance use is such a significant public health problem. The findings challenge the commonly held view that school-based prevention programs are not effective.[Teesson M, Newton NC, Barrett EL. Australian school-based prevention programs for alcohol and other drugs: A systematic review. Drug Alcohol Rev 2012;31:731-736] [ABSTRACT FROM AUTHOR]

The ever‐growing number of novel psychoactive substances (NPS) that have been surfacing globally, as well as related changes in drug abuse trends, undoubtedly constitute a difficult and multifaceted challenge for psychiatry. The intake and abuse of such substances has been linked to a risk of psychopathological disturbances, which stem from imbalances of a range of neurotransmitter pathways and receptors. Through an analysis of relevant research articles and reviews (particularly those outlining NPS neurological and cerebral mechanisms of action and psychopathological consequences arising from NPS abuse; research papers more closely focused on chemical/pharmacological aspects have been ruled out), through a systematic analysis of Pubmed, Medline, PsycLIT and EMBASE literature, as well as data released by health care institutions and drug enforcement agencies (among which the World Health Organization, the United Nations Office on Drugs and Crime, the European Monitoring Centre for Drugs and Drug Addiction, Eurojust, the Novel Psychoactive Treatment UK Network, the Court of Justice of the European Union), the authors aimed to elaborate on the most relevant data relative to NPS‐related psychiatric effects, focusing on the conceptual and definition‐related complexities inherent to NPS, clinical management and motivations for NPS use; moreover, an effort has been made to highlight the possible measures in order to tackle the unremitting rise of such elusive and potentially harmful substances. [ABSTRACT FROM AUTHOR]

Poor aqueous solubility and dissolution of drug candidates drive key decisions on lead series optimization during drug discovery, on formulation optimization, and clinical studies planning during drug development. The interpretation of the in vivo relevance of early pharmaceutical profiling is often confounded by the multiple factors affecting oral systemic exposure. There is growing evidence that in vitro drug solubility may underestimate the true in vivo solubility and lead to drug misclassification. Based on 10 poorly water‐soluble tyrosine kinase inhibitors, this paper demonstrates the use of physiologically‐based pharmacokinetic (PK) analysis in combination with early clinical PK data to identify drugs whose absorption is truly limited by solubility in vivo and, therefore, expected to exhibit food effect. Our study supports a totality of evidence approach using early clinical data to guide decisions on conducting drug interaction studies with food and acid‐reducing agents. [ABSTRACT FROM AUTHOR]

There is a lack of evidence of effective and appropriate drug and alcohol treatment for Aboriginal and Torres Strait Islander peoples. This paper contributes to addressing the evidence gap by examining the feasibility and acceptability and conducting a pre/post‐evaluation of the Aboriginal‐adapted Community Reinforcement Approach (CRA) delivered in New South Wales, Australia. Aboriginal and non‐Aboriginal clients (n = 55) received tailored CRA delivery between March and November 2013. Compared to the original US version, tailored CRA had reduced technical language, reduced number of treatment sessions, and the addition of group delivery option. An Australian training manual with local case studies was developed. Alcohol, Smoking and Substance Involvement Test (ASSIST), Kessler‐5 (K‐5) and the Growth Empowerment Measure were used. 58% of participants were followed‐up at 3 months. Tailored CRA was feasible to deliver in a rural, community‐based health setting, and rated by clients as highly effective and acceptable. CRA was associated with statistically significant reductions in the use of alcohol, tobacco, cannabis, amphetamine and over the counter medication, and levels of psychological distress, and an increase in levels of empowerment for Aboriginal and non‐Aboriginal clients. This study provides evidence for the feasibility and acceptability of an Aboriginal‐adapted psychological intervention addressing drug, alcohol and mental health outcomes. [ABSTRACT FROM AUTHOR]

Introduction. This paper reviews epidemiological information about methamphetamine production and use in North America. Methods. Information is drawn from a range of sources, including, but not limited to, historical accounts, peer-reviewed papers, population surveys and large national databases. Results. Methamphetamine and amphetamine use in North America is characterised by geographic variations, with different types of the drug, different routes of administration and different types of users at various times. Unlike some other drug use patterns in North America, the nature of methamphetamine use in Canada, Mexico and the United States has been linked closely in terms of production and supply of the drug. According to their national household surveys, the annual prevalence for 'speed' use in Canada was 0.8% in 2004, 0.3% for 'anfetaminas' and 0.1% for 'metanfetaminas' in Mexico in 2002, and 1.4% for 'stimulants' in the United States in 2006. Discussion. Although the data sources in the three North American countries are not consistent in methodology, terminology or frequency of reporting, all show similar trends. The type of stimulant most used has shifted from non-medical use of pharmaceutical amphetamine to use of powder methamphetamine and then to use of 'ice'. The indicators show the problem is greatest in the western parts of the countries and is moving eastward, but the decreased availability of pseudoephedrine may have a significant impact on the nature of the epidemic in the future. Nevertheless, use of methamphetamine poses a number of risks for users and specialised treatment resources for these various populations are needed. [Maxwell JC, Rutkowski BA. The prevalence of methamphetamine and amphetamine abuse in North America: a review of the indicators, 1992 - 2007. Drug Alcohol Rev 2008;27:229-235] [ABSTRACT FROM AUTHOR]

Introduction: Intra‐articular injections of various drugs are commonly used in patients with degenerative osteoarthritis and also in haemophilic patients. Haemophilic arthropathy is a particular type of secondary osteoarthritis (OA), but the degeneration of strong synovial, cartilaginous and subchondral constituents is provoked by the direct action of iron and blood in the joint. Aim of the study: The aim of this study is to review the literature regarding the use of various intra‐articular drugs in joints affected by haemophilic arthropathy. Methods: We reviewed the data from the literature; the search was performed on three medical electronic databases (PubMed, Cochrane Library and Scopus Web of Science) by three authors (B. E., A. M. and V. N.) from 3 December 2018 till 15 December 2018. The search string was as follows: (hyaluronic acid OR viscosupplementation OR platelet‐rich plasma OR corticosteroid OR mesenchymal stem cells) AND (haemophilia OR haemophilic arthropathy OR haemophilic arthritis). Results: Once the research was performed, a total of 300 articles were identified. 47 selected articles were analysed by the reviewers, and the eligibility of the study inclusion was assessed independently. Twelve papers were included based on clear fulfilment of the inclusion criteria. Thirty‐five articles were excluded for the following reasons: no full text or accessible data for 14 of them, 15 involved surgery or rehabilitation therapy as the primary topic and 6 were systematic reviews (the main topics were beyond the haemophilic arthropathy). Conclusion: Although the degree of scientific evidence of the publications on intra‐articular injections of various drugs (hyaluronic acid, corticosteriods, PRP and MSCs) in haemophilia is very low, it seems that intra‐articular injections of hyaluronic acid can relieve joint pain for months and can be repeated every 6‐12 months, which is why they can be recommended. Corticosteroid injections seem to relieve joint pain for a few weeks, but their routine use is not recommended in haemophilia. The efficacy of PRP and MSCs in haemophilic arthropathy is pending confirmation, which is why they are not currently recommended. [ABSTRACT FROM AUTHOR]

This paper uses data on the social context of drug-related harms in the Melbourne Aboriginal Community to inform an alternative model of harm minimisation, and discusses its potential application in programme development. The paper involves a secondary analysis of interviews and focus group discussions with 62 Community members who participated in a qualitative injecting drug use study conducted at the Victorian Aboriginal Health Service in Melbourne. Individuals and families within the Melbourne Aboriginal Community experience significant levels of harm associated with injecting drug use, and face restricted access to appropriate service options. This experience of drug use contributes to a broad range of values within the Community around harm minimisation approaches to programme delivery. We propose a fundamentally distinct harm minimisation model which explicitly acknowledges this range of conflicting values, and reflects the need for a breadth of services and programmes that address these tensions. Policies and funding must support Aboriginal Communities to negotiate through these conflicting Community values to actively create spaces in the service system for both using and non-using Community members. This includes the development of regional approaches which articulate an appropriate mix of services and the roles of Aboriginal and mainstream services in their delivery. [van der Sterren AE, Anderson IP, Thorpe LG. ‘Individual’ harms, Community ‘harms’: reconciling Indigenous values with drug harm minimisation . Drug Alcohol Rev 2006;25:219 – 225] [ABSTRACT FROM AUTHOR]

This paper is part of a series that has the goal of identifying potential approaches toward developing new instruments for assessing tobacco dependence among adolescents. The fundamental assumption underlying the series is that contemporary theories of drug dependence offer a rich source of opportunities for the development of theoretically based assessment tools. The present paper focuses on cognitive and social-learning models of drug dependence and the implications of these models for novel assessment instruments. In particular, the paper focuses on Mark Goldman's model of drug expectancies, Albert Bandura's model of self-efficacy, Thomas Wills's model of stress and coping and Stephen Tiffany's cognitive-processing model of drug urges and cravings. In addition to traditional self-report measures, naturalistic and laboratory-based assessments are identified that may yield information relevant to multi-dimensional measurement of tobacco dependence. [ABSTRACT FROM AUTHOR]

This paper presents a review of the recent economics literature in the area of illicit drug use. Particular attention is paid to the economics of addiction and the rational addiction model, the welfare economics framework for analysing the social costs of drug use, and the attempts that have been made by economists to evaluate recent or proposed policy interventions. A dominant theme in this review is the problem of poor data availability. This is particularly true when it comes to implementing the Rational Addiction model, but it is also apparent in the literature on estimating the costs of illicit drug use to society as a whole. One of the main conclusions of this review is that until recently public policy has not been particularly influenced by research carried out by economists. It is not clear whether this is because economists have had to grapple with inadequate data, and hence their conclusions are couched in uncertainty, or whether it is because drugs researchers have assumed a very limited role for economists in their analysis. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To investigate the ways in which pre-teenage children anticipate and deal with the offer of drugs. Design A qualitative study based on semi-structured interviews with 10–12-year-old schoolchildren. Setting The cities of Glasgow (Scotland) and Newcastle (England), UK. Participants A sample of 216 pre-teenage children. Forty-three had used drugs on at least one occasion, 42 had been offered but had not used drugs and 131 had neither used drugs nor been offered them. Most of the results reported in the paper relate to the experiences of the 42 children who had declined the offer of drugs. Findings While children who had not been exposed to drug offers expressed a high degree of confidence in their ability to deal with them, those who had actually had to cope with such offers experienced a variety of difficulties. The ease with which an offer could be declined appeared to depend upon two main factors: who was making the offer and the context in which it was being made. According to the children, offers from people with whom they had a close relationship and those in which pressure or encouragement were involved were particularly difficult to deal with. Conclusions The paper concludes that there is a need to equip young people better with the interpersonal tools they require to deal with the various situations they are likely to encounter in which drugs may be offered. It is suggested that a broadly based life skills approach to drug education may provide the best way of helping young people to deal with these situations. [ABSTRACT FROM AUTHOR]

This paper presents results from a study investigating relapse prevention options for indigenous clients of alcohol and drug intervention services. The study has 63 'stories' collected through a survey of nine substance misuse services. An adapted version of the Marlatt Relapse Prevention Model was developed to interview clients who had quit drinking but later relapsed into heavy use. The study identified situations influencing the decision to quit, obstacles and dilemmas arising during periods of abstinence, and major triggers associated with relapse into substance misuse. The paper analyses these major triggers and discusses the crucial issues of motivation to quit and maintenance of abstinence. The community environments where indigenous drinkers use alcohol strongly influence successful or unsuccessful attempts to quit. Relapse prevention should be part of a range of public health strategies for tackling substance misuse problems with Indigenous drinkers, and should be included at the minimal intervention level. [ABSTRACT FROM AUTHOR]

The use of peer interviewers with privileged access to a particular population group, which is difficult to reach via more conventional methods, has been acknowledged in recent research. This paper explores a number of key issues relating to the employment of peer interviewers by reflecting on a project designed to explore the views and experiences of parents who use illegal drugs. The project presented the research team with a number of challenges. These included the need to provide on-going support for the interviewers, a sense of distance felt by the researchers from the raw data they collected, and the difficulties of gaining from the skills and experiences of peer interviewers without exploiting their labour. The paper also explores the advantages of involving peer interviewers closely in research work and reflects on the nature and boundaries of expert knowledge that can become evident in such collaborations. The need for a certain amount of flexibility over the roles and domains of control that lay experts and researchers traditionally inhabit is suggested. In conclusion, it is argued that the involvement of peer interviewers in research can be a valuable means of enhancing our knowledge and understanding of a variety of population groups who tend to live beyond the gaze of more orthodox researchers. [ABSTRACT FROM AUTHOR]

The use of illicit drugs by American youth rose dramatically during the 1990s. Reducing these trends is an important policy objective. However, for policies to be effective it is important to understand the key causal links that lead to substance use and abuse. Policy makers must understand whether attempts to reduce the demand for one drug have impacts on the current and future use of other drugs. This paper overviews an economic approach to modeling drug use, addiction and gateway effects, emphasizing the potential of this method for identifying causal links in consumption. The paper demonstrates how this multi-substance theory of drug use leads to empirical specifications that can identify the impact of consumption of one drug on the contemporaneous and future consumption of other drugs. This is followed by a discussion of what types of data would be needed to estimate these effects. [ABSTRACT FROM AUTHOR]

Introduction: Daily oral HIV pre‐exposure prophylaxis (PrEP) with tenofovir/emtricitabine (TDF/FTC) is recommended for people who inject drugs (PWID) but coverage is low. The real‐life effectiveness of PrEP among PWID is unknown as previous studies were conducted in controlled settings and mainly relied on self‐report. Analysis of PrEP metabolites—tenofovir diphosphate (TFVdp) and emtricitabine triphosphate (FTCtp)—offers an objective measure of adherence. Methods: To analyse longitudinal patterns of PrEP adherence among PWID in Ukraine, we used data from a community‐based implementation trial conducted in Kyiv between July 2020 and March 2021 to test the efficacy of SMS reminders to improve adherence. Among 199 enrolled participants, 156 (78.4%) were retained through 6 months. Based on TFVdp/FTCtp levels assessed at 3 and 6 months, we identified groups with various adherence patterns (adherent at ≥2 doses/week, improved, worsened, non‐adherent). Correlates of adherence were analysed using multinomial logistic regression. Results: Most participants (53.8%, n = 84/156) had no detectable metabolites at both assessments; 7.1% (n = 11/156) were consistently taking ≥2 doses/week; 1.3% (n = 2/156) were consistently taking ≥4 doses/week; 13.5% (n = 21/156) exhibited improved and 21.8% (n = 34/156) had worsened adherence at 6 compared to 3 months. "White coat compliance" (increased dosing prior to assessment) was common. Consistent adherence was associated with SMS reminders, younger age, employment, lower income, longer injection drug use duration, recent high‐risk injecting (receptive syringe sharing, using pre‐filled syringe, back‐ or front‐loading, container sharing), absence of overdose in the past 6 months, perceived HIV risk through sexual intercourse and higher PrEP self‐efficacy. Alcohol consumption was associated with inconsistent PrEP use. Groups with improved and worsened adherence did not differ. Conclusions: Daily oral PrEP may not achieve the desired effectiveness among PWID as a standalone intervention, calling for testing of alternative PrEP formulations and innovative integrated risk reduction strategies, especially in the context of HIV epidemics associated with injection drug use in eastern Europe and central Asia and the public health crisis in Ukraine caused by the war with Russia. SMS reminders may be effective among PWID who prioritize PrEP. Our findings offer practical guidance in identifying PWID who are likely to benefit from PrEP and those who need additional support. [ABSTRACT FROM AUTHOR]

GLO:80N/15apr21:ejn14704-toc-0001.jpg PHOTO (COLOR): . gl GLO:80N/15apr21:ejn14704-fig-0001.jpg PHOTO (COLOR): . gl It is our pleasure to introduce Dr. Marisela Morales, the next investigator for the series "Profiles of Women In Science" (Helmreich, Bolam & Foxe, 2017). Dr. Morales is the Branch Chief of the Integrative Neuroscience Research Branch at the National Institute on Drug Abuse (NIDA). [Extracted from the article]

Editorial. Explores the role of economics in addiction studies and its relation to other disciplines. Main roles for economists studying alcohol abuse; Potential role for economists in appraising public policy in the alcohol and tobacco markets; Use of demand models in determining the factors that influence the consumption of alcohol and tobacco; Data used to discuss the supply and demand of illicit drugs.