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In this article, we explore the idea that music listening can achieve neurological and psychological effects that are somewhat similar to those facilitated by psychoactive substances. To motivate this claim, we delve into the mechanisms behind music perception, psychoactive substance use, and their mutual relationship, relying on recent developments in psychedelic therapy and neuropsychopharmacology. Using a comparative approach, we discuss some underlying mechanisms of peak experiences and their neurochemical properties and suggest that music may be regarded as an alternative psychoactive trigger, prompting neurochemical responses in the brain, with resulting feelings of coping, (aesthetic) pleasure, and reward. [ABSTRACT FROM AUTHOR]

Dopamine transmission in the striatum is a critical mediator of the rewarding and reinforcing effects of commonly misused psychoactive drugs. G protein‐coupled receptors (GPCRs) that bind a variety of neuromodulators including dopamine, endocannabinoids, acetylcholine and endogenous opioid peptides regulate dopamine release by acting on several components of dopaminergic circuitry. Striatal dopamine release can be driven by both somatic action potential firing and local mechanisms that depend on acetylcholine released from striatal cholinergic interneurons. GPCRs that primarily regulate somatic firing of dopamine neurons via direct effects or modulation of synaptic inputs are likely to affect distinct aspects of behaviour and psychoactive drug actions compared with those GPCRs that primarily regulate local acetylcholine‐dependent dopamine release in striatal regions. This review will highlight mechanisms by which GPCRs modulate dopaminergic transmission and the relevance of these findings to psychoactive drug effects on physiology and behaviour. [ABSTRACT FROM AUTHOR]

Background: The use of psychoactive substances to increase cognitive performance while studying has been termed 'pharmacological cognitive enhancement' (PCE). In previous years, several large-scale national surveys have focused on their use by students at university, including drug types, prevalence rates, and predictive factors. The recent coronavirus pandemic brought about widespread structural changes for UK universities, as students were forced to adapt to home-based learning and in many cases reduced academic support. No study has yet focused primarily on the impact of pandemic social restrictions on PCE in students and academic staff, and whether personality and demographic factors reveal user profiles that predict use during the pandemic period. Method: A convenience sample of 736 UK students and staff aged 18-54 (M = 22.2, SD = 5.2) completed a cross-sectional survey assessing PCE prevalence rates, polydrug use, perceived effects, academic self-efficacy and personality during the first year of social restrictions (March 2020 - February 2021) compared with the previous year (March 2019 - February 2020). Results: There was a significant self-reported rise in the use of all drug types (all ps < 0.001) during social restrictions, particularly with Modafinil (+42%), nutraceuticals (+30.2%) and microdose LSD (+22.2%). Respondents also indicated stronger PCE effects for all substances, except alcohol, in comparison to the previous year. Polydrug use with modafinil and other prescription stimulants increased the most during social restrictions. Personality factors and gender identity reliably predicted PCE use and lower agreeableness was often the strongest predictor, followed by identifying as male and lower conscientiousness. Academic self-efficacy and student/academic staff status were not consistent predictors. Conclusion: This is the first survey of UK students to investigate PCE during coronavirus social restrictions and to assess predictive factors. Findings reveal a rise in PCE use and polydrug use which we suggest is because of increased pressures on students created by the lockdown and reduced access to university resources. [ABSTRACT FROM AUTHOR]

Healthcare professionals are exposed to stressful situations that may favor substance use vulnerability. This systematic review aims to synthesize the risk and protective factors associated with use, abuse, and dependence of alcohol, tobacco, psychoactive drugs, and cannabis in healthcare professionals. Following PRISMA recommendations, a systematic search was performed in PsycINFO, Web of Science, PubMed/MEDLINE, Embase, Scopus, and Cochrane Library. The search yielded 1523 studies, of which 19 were selected. The identified risk factors were demographic factors (i.e. male gender, and single/divorced marital status), psychopathological factors, social factors, positive attitudes toward drugs, unhealthy lifestyle habits, the COVID-19 pandemic, and the coexistence of the use of several substances. The protective factors were demographic factors (i.e. ethnicity and having dependent children), healthy lifestyle habits, and workplace anti-drug policies (i.e. restriction of tobacco use). These findings highlight the need for preventive actions against drug use in healthcare professionals to improve their health and reduce the possible negative impact on their healthcare practice. Knowledge of modifiable risk and protective factors allows their incorporation as components in preventive actions, and non-modifiable factors (e.g. demographic variables) may contribute to the detection of groups of greater vulnerability to propose selective prevention actions in this population. [ABSTRACT FROM AUTHOR]

Purpose: Toxicological analyses of biological samples play important roles in forensic and clinical investigations. Ingested drugs are excreted in urine as conjugates with endogenous substances such as glucuronic acid; hydrolyzing these conjugates improves the determination of target drugs by liquid chromatography–tandem mass spectrometry (LC–MS/MS). In this study, we sought to improve the enzymatic hydrolysis of glucuronide conjugates of five psychoactive drugs (11-nor-9-carboxy-Δ9-tetrahydrocannabinol, oxazepam, lorazepam, temazepam, and amitriptyline). Methods: The efficiency of enzymatic hydrolysis of glucuronide conjugates in urine was optimized by varying temperature, enzyme volume, and reaction time. The hydrolysis was performed directly on extraction columns. This analysis method using LC–MS/MS was applied to forensic autopsy samples after thorough validation. Results: We found that the recombinant β-glucuronidase B-One® quantitatively hydrolyzed these conjugates within 3 min at room temperature directly on extraction columns. This on-column method saved time and eliminated the loss of valuable samples during transfer to the extraction column. LC–MS/MS-based calibration curves processed with this method showed good linearity, with r2 values exceeding 0.998. The intra- and inter-day accuracies and precisions of the method were 93.0–109.7% and 0.8–8.8%, respectively. The recovery efficiencies were in the range of 56.1–104.5%. Matrix effects were between 78.9 and 126.9%. Conclusions: We have established an LC–MS/MS method for five psychoactive drugs in urine after enzymatic hydrolysis of glucuronide conjugates directly on extraction columns. The method was successfully applied to forensic autopsy samples. The established method will have broad applications, including forensic and clinical toxicological investigations. [ABSTRACT FROM AUTHOR]

The use of benzodiazepines is strongly associated with an increased risk of traffic accidents due to their side effects of sedation and drowsiness, which can significantly impair driving performance. The main aim of our study was to investigate the trend of benzodiazepine use over nine years (2015–2023) in a population of 15,988 subjects who had their license suspended for driving under the influence (DUI) of alcohol or drugs. Among the 15,988 users accessed to our laboratory, 924 tested positive for at least one benzodiazepine. An increase in the number of positive-testing users was observed in the period 2015–2018, followed by a slight decrease in 2019. Overall, the trend of benzodiazepine use was stable over the next four years (2020–2023), with the highest incidence in 2022. The most common benzodiazepines, and/or metabolites, found in urine samples were α-OH-alprazolam (28.66%; n = 366) and oxazepam (27.25%; n = 348). Several cases of mixed positivity were observed in the study population. The main substances taken with benzodiazepines were cocaine and Δ9-tetrahydrocannabinol. Our findings suggest that people taking benzodiazepines should be monitored, as these have a relevant impact on driving ability in addition to significant interindividual differences in the behavioral effects of benzodiazepines on driving performance. [ABSTRACT FROM AUTHOR]

Copyright of Sante Mentale au Quebec is the property of Revue Sante Mentale au Quebec and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BackgroundThe use of psychoactive substances to increase cognitive performance while studying has been termed ‘pharmacological cognitive enhancement’ (PCE). In previous years, several large-scale national surveys have focused on their use by students at university, including drug types, prevalence rates, and predictive factors. The recent coronavirus pandemic brought about widespread structural changes for UK universities, as students were forced to adapt to home-based learning and in many cases reduced academic support. No study has yet focused primarily on the impact of pandemic social restrictions on PCE in students and academic staff, and whether personality and demographic factors reveal user profiles that predict use during the pandemic period.MethodA convenience sample of 736 UK students and staff aged 18–54 (M = 22.2, SD = 5.2) completed a cross-sectional survey assessing PCE prevalence rates, polydrug use, perceived effects, academic self-efficacy and personality during the first year of social restrictions (March 2020 – February 2021) compared with the previous year (March 2019 – February 2020).ResultsThere was a significant self-reported rise in the use of all drug types (all ps

Frontotemporal lobe abnormalities are linked to neuropsychiatric disorders and cognition, but the role of cellular heterogeneity between temporal lobe (TL) and frontal lobe (FL) in the vulnerability to genetic risk factors remains to be elucidated. We integrated single-nucleus transcriptome analysis in ‘fresh’ human FL and TL with genetic susceptibility, gene dysregulation in neuropsychiatric disease and psychoactive drug response data. We show how intrinsic differences between TL and FL contribute to the vulnerability of specific cell types to both genetic risk factors and psychoactive drugs. Neuronal populations, specifically PVALB neurons, were most highly vulnerable to genetic risk factors for psychiatric disease. These psychiatric disease-associated genes were mostly upregulated in the TL, and dysregulated in the brain of patients with obsessive-compulsive disorder, bipolar disorder and schizophrenia. Among these genes, GRIN2A and SLC12A5, implicated in schizophrenia and bipolar disorder, were significantly upregulated in TL PVALB neurons and in psychiatric disease patients’ brain. PVALB neurons from the TL were twofold more vulnerable to psychoactive drugs than to genetic risk factors, showing the influence and specificity of frontotemporal lobe differences on cell vulnerabilities. These studies provide a cell type resolved map of the impact of brain regional differences on cell type vulnerabilities in neuropsychiatric disorders.

Copyright of SMAD Revista Electronica Salud Mental, Alcohol y Drogas is the property of Universidade de Sao Paulo, Escola de Enfermagem de Ribeirao Preto and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Aled: Revista Latinoamericana de Estudios del Discurso is the property of Asociacion Latinoamericana de Estudio del Discurso and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Professional society guidelines recommend limiting the use of antipsychotics in older patients with postoperative delirium. How these recommendations affected the use of antipsychotics and other psychoactive drugs in the postoperative period has not been studied. Methods: This retrospective cohort study included patients 65 years or older without psychiatric diagnoses who underwent major surgery in community hospitals (CHs) and academic medical centers (AMCs) in the United States. The outcome was the rate of hospital days exposed to antipsychotics, antidepressants, antiepileptics, benzodiazepines, hypnotics, and selective alpha‐2 receptor agonist dexmedetomidine in the postoperative period by hospital type. Results: The study included 4,098,431 surgical admissions from CHs (mean age 75.0 [standard deviation, 7.1] years; 50.8% female) during 2008–2018 and 2,310,529 surgical admissions from AMCs (75.0 [7.4] years; 49.4% female) during 2009–2018. In the intensive care unit (ICU) setting, the number of exposed days per 1000 hospital‐days declined for haloperidol (CHs: 33–21 days [p < 0.01]; AMCs: 24–15 days [p < 0.01]) and benzodiazepines (CHs: 261–136 days [p < 0.01]; AMCs: 150–77 days [p < 0.01]). The use of atypical antipsychotics, antidepressants, antiepileptics, and dexmedetomidine increased, while hypnotic use varied by the hospital type. In the non‐ICU setting, the rate declined for haloperidol in CHs but not in AMCs (CHs: 10–6 days [p < 0.01]; AMCs: 4–3 days [p = 0.52]) and for benzodiazepines in both settings (CHs: 126–56 days [p < 0.01]; AMCs: 30–27 days [p < 0.01]). The use of antiepileptics and antidepressants increased, while the use of atypical antipsychotics and hypnotics varied by the hospital type. Conclusions: The use of haloperidol and benzodiazepines in the postoperative period declined at both CHs and AMCs. These trends coincided with the increasing use of other psychoactive drugs. [ABSTRACT FROM AUTHOR]

Burgeoning literature demonstrates that monoamine transporters with high transport capacity but lower substrate affinity (i.e., uptake 2) contribute meaningfully to regulation of monoamine neurotransmitter signalling. However, studying behavioural influences of uptake 2 is hindered by an absence of selective inhibitors largely free of off‐target, confounding effects. This contrasts with study of monoamine transporters with low transport capacity but high substrate affinity (i.e., uptake 1), for which there are many reasonably selective inhibitors. To circumvent this dearth of pharmacological tools for studying uptake 2, researchers have instead employed mice with constitutive genetic deficiency in three separate transporters. By studying baseline behavioural shifts, plus behavioural responses to environmental and pharmacological manipulations—the latter primarily targeting uptake 1—investigators have been creatively characterizing the behavioural, and often sex‐specific, influences of uptake 2. This non‐systematic mini review summarizes current uptake 2 behaviour literature, highlighting emphases on stress responsivity in organic cation transporter 2 (OCT2) work, psychostimulant responsivity in OCT3 and plasma membrane monoamine transporter (PMAT) investigations, and antidepressant responsivity in all three. Collectively, this small but growing body of work reiterates the necessity for development of selective uptake 2‐inhibiting drugs, with reviewed studies suggesting that these might advance personalized treatment approaches. [ABSTRACT FROM AUTHOR]

College students are vulnerable to suffering from anxiety and depression. Moreover, mental disorders can contribute to drug consumption or inappropriate use of prescribed drugs. Studies on this topic in Spanish college students are limited. This work analyses anxiety and depression and psychoactive drug intake pattern in the post-COVID era in college students. An online survey was conducted among college students from UCM (Spain). The survey collected data including demographic, academic student perception, GAD-7 and PHQ-9 scales, and psychoactive substances consumption. A total of 6798 students were included; 44.1 % (CI95%: 42.9 to 45.3) showed symptoms of severe anxiety and 46.5 % (CI95%: 45.4 to 47.8) symptoms of severe or moderately severe depression. The perception of these symptoms did not change after returning to face-to-face university classes in the post-COVID19 era. Despite the high percentage of cases with clear symptoms of anxiety and depression, most students never had a diagnosis of mental illnesses [anxiety 69.2 % (CI95%: 68.1 to 70.3) and depression 78.1 % (CI95%: 77.1 to 79.1)]. Regarding psychoactive substances, valerian, melatonin, diazepam, and lorazepam were the most consumed. The most worrying issue was the consumption of diazepam, 10.8 % (CI95%: 9.8 to 11.8), and lorazepam, 7.7 % (CI95%: 6.9 to 8.6) without medical prescription. Among illicit drugs, cannabis is the most consumed. The study was based on an online survey. The high prevalence of anxiety and depression aligned with poor medical diagnosis and high intake of psychoactive drugs should not be underestimated. University policies should be implemented to improve the well-being of students. • College students have severe anxiety. • College students show symptoms of severe or moderately severe depression. • Most students never had a diagnosis of mental illnesses. • The most psychoactive drugs consumed: valerian, melatonin, diazepam and lorazepam • Benzodiazepines are commonly consumed without medical prescription. [ABSTRACT FROM AUTHOR]

Aims: The harms arising from psychoactive drug use are complex, and harm reduction strategies should be informed by a detailed understanding of the extent and nature of that harm. Drug harm is also context specific, and so any comprehensive assessment of drug harm should be relevant to the characteristics of the population in question. This study aimed to evaluate and rank drug harms within Aotearoa New Zealand using a multi-criteria decision analysis (MCDA) framework, and to separately consider harm within the total population, and among youth. Methods: Two facilitated workshops involved the separate ranking of harm for the total population, and then for youth aged 12–17, by two expert panels. In the total population workshop, 23 drugs were scored against 17 harm criteria, and those criteria were then evaluated using a swing weighting process. Scoring and weighting were subsequently updated during the youth-specific workshop. All results were recorded and analysed using specialised MCDA software. Results: When considering overall harm, the MCDA modelling results indicated that alcohol, methamphetamine and synthetic cannabinoids were the most harmful to both the overall population and the youth, followed by tobacco in the total population. Alcohol remained the most harmful drug for the total population when separately considering harm to those who use it, and harm to others. Conclusions: The results provide detailed and context-specific insight into the harm associated with psychoactive drugs use within Aotearoa New Zealand. The findings also demonstrate the value of separately considering harm for different countries, and for different population subgroups. [ABSTRACT FROM AUTHOR]

Although many researchers in psychology, religious studies, and psychiatry recognize that there is overlap in the experiences their subjects recount, disciplinary silos and challenges involved in comparing reported experiences have left us with little understanding of the mechanisms, whether biological, psychological, and/or sociocultural, through which these experiences are represented and differentiated. So-called mystical experiences, which some psychologists view as potentially sui generis, provide a test case for assessing whether we can develop an expanded framework for studying unusual experiences across disciplines and cultures. Evidence for the special nature of "mystical experience" rests on the operationalization of a metaphysically untestable construct in two widely used self-report scales: the Mysticism Scale and the Mystical Experiences Questionnaire. Consideration of the construct in light of research on alterations in sense of self induced by psychoactive drugs and meditation practices suggests that "positive experiences of undifferentiated unity" are not sui generis, but rather a type of "ego dissolution." To better understand the nature and effects of unusual experiences, such as alterations in the sense of self, we need self-report measures that distinguish between generically worded experiences and the way they are appraised in terms of valence, significance, cause, and long-term effects in different contexts.

Abstract Background Interest in the health and well-being of university students has increased in the UK and Ireland in the past two decades as their numbers have grown. Recent high-profile deaths of students after using illicit drugs have highlighted the importance of the topic for policy makers. This scoping review maps the state of the existing literature evaluating use of illicit drugs in university students in the UK and Ireland. It aims to highlight research gaps and inform policy. Method We conducted a systematic search of papers related to psychoactive drug use in university students in the UK and Ireland published before August 2021. The 18 extracted study characteristics included author(s); year of publication; journal; location of data collection; study design; delivery method (e.g., online survey, in-person, postal survey); number of participants; response rate; participant course of study, year of study, degree level (i.e., undergraduate, postgraduate), gender and age; time-period assessed (e.g., lifetime, current use, past 12 months); primary aim; primary outcome; ethical approval; and funding source. Results The PRISMA-guided search strategy identified 1583 papers for abstract review; of 110 papers retained for full-text review, 54 studies met criteria for inclusion for this paper. Primary outcomes were coded into five groups: prevalence and patterns of drug use; factors associated with drug use; attitudes and knowledge about, and motivation for, drug use; supply of drugs; consequences of drug use. The results show that there is no coherent body of research in this area. The prevalence of reported drug use has crept up and the range of substances reported has broadened over time, and attitudes to drugs on average have normalised. However, there are significant methodological limitations that limit the utility of these findings. There was little evidence of published work on prevention of, or intervention to reduce, drug-related harms. Conclusion The domains identified offer a framework for university administrators, researchers and policy makers to understand the potential response to drug use in university students in the UK and Ireland. Recommendations are made to fill the gaps in the research evidence base.

Although psychoactive drugs have their therapeutic values, they have been implicated in the pathogenesis of male infertility. This study highlights psychoactive drugs reported to impair male fertility, their impacts, and associated mechanisms. Published data from scholarly peer-reviewed journals were used for the present study. Papers were assessed through AJOL, DOAJ, Google Scholar, PubMed/PubMed Central, and Scopus using Medical Subjects Heading (MeSH) indexes and relevant keywords. Psychoactive drugs negatively affect male reproductive functions, including sexual urge, androgen synthesis, spermatogenesis, and sperm quality. These drugs directly induce testicular toxicity by promoting ROS-dependent testicular and sperm oxidative damage, inflammation, and apoptosis, and they also suppress the hypothalamic-pituitary–testicular axis. This results in the suppression of circulating androgen, impaired spermatogenesis, and reduced sperm quality. In conclusion, psychoactive drug abuse not only harms male sexual and erectile function as well as testicular functions, viz., testosterone concentration, spermatogenesis, and sperm quality, but it also alters testicular histoarchitecture through a cascade of events via multiple pathways. Therefore, offering adequate and effective measures against psychoactive drug-induced male infertility remains pertinent. [ABSTRACT FROM AUTHOR]

This article deals with teacher interventions in crisis situations regarding a direct threat of students using psychoactive drugs on school premises, particularly in the difficult period of adolescence: 12–16 years of age. The focus of the research was on teacher interventions in situations where students are threatened by psychoactive substances. The research problem was whether the age and experience of the teacher were determinants of such an intervention. It investigated the relevance that a teacher’s age and experience have on their attitude and manner of intervening on behalf of a student when there is an imminent threat from psychoactive substances. The research investigated the importance of a teacher’s age and work experience in their attitude and the manner in which they intervene. It was carried out from 2017 to 2019 among teachers at middle schools in Bielsko-Biala, using the diagnostic survey method and a questionnaire. Statistical analysis of the results showed no statistically significant difference in teachers’ declarations of readiness for intervention. Regardless of age and tenure, the respondents declared a high readiness to intervene. On the other hand, there were statistically significant differences according to the teachers’ age and seniority in how the intervention was carried out. Teachers from different age and seniority groups (defined by a specific length of service) more often or less often took some of the actions envisaged in the intervention procedure. Thus, it is feasible to speak of a readiness, or lack thereof, to take certain intervention actions.

As a necessary part of physiological and emotional well-being, sleep is often overlooked or undervalued in Western society, in spite of the role restorative sleep plays in growth, healing and recovery, immune response, and emotional regulation. The effect of psychoactive drugs on sleep, including pharmacological substances meant to assist in sleep, is notable and profound, especially in their disruption of REM sleep, the stage of sleep associated with dreaming. This article provides an overview of sleep stages, the brain and sleep, sleep disorders, and the effect of various psychoactive drugs on sleep architecture and hygiene. Future research that treats substance use and sleep as bi-directional in nature and longitudinally explores sleep-related interventions in treatment and longer-term recovery that are sustainable and person-centered is merited. [ABSTRACT FROM AUTHOR]

In this paper, we examine the case of psychedelic medicine for Alzheimer's disease and related dementias (AD/ADRD). These "mind-altering" drugs are not currently offered as treatments to persons with AD/ADRD, though there is growing interest in their use to treat underlying causes and associated psychiatric symptoms. We present a research agenda for examining the ethics of psychedelic medicine and research involving persons living with AD/ADRD, and offer preliminary analyses of six ethical issues: the impact of psychedelics on autonomy and consent; the impact of "ego dissolution" on persons experiencing a pathology of self; how psychedelics might impact caregiving; the potential exploitation of patient desperation; institutional review boards' orientation to psychedelic research; and methods to mitigate inequity. These ethical issues are magnified for AD/ADRD but bear broader relevance to psychedelic medicine and research in other clinical populations. [ABSTRACT FROM AUTHOR]

MDMA (3,4-methylenedioxymethamphetamine) is a chiral psychoactive recreational drug sold in illicit markets as racemate. Studies on the impact of MDMA on aquatic organisms are scarce. While enantioselectivity in toxicity in animals and humans has been reported, none is reported on aquatic organisms. This study aimed to investigate the ecotoxicological effects of MDMA and its enantiomers in Daphnia magna. For that, enantiomers (enantiomeric purity > 97%) were separated by liquid chromatography using a homemade semipreparative chiral column. Daphnids were exposed to three concentrations of (R,S)-MDMA (0.1, 1.0 and 10.0 µg L−1) and two concentrations of (R)- and (S)-enantiomers (0.1 and 1.0 µg L−1) over the course of 8 days. Morphophysiological responses were dependent on the substance form and daphnia development stage, and they were overall not affected by the (R)-enantiomer. Changes in swimming behaviour were observed for both the racemate and its enantiomers, but enantioselective effects were not observed. Reproductive or biochemical changes were not observed for enantiomers whereas a significant decrease in acetylcholinesterase and catalase activity was noted at the highest concentration of (R,S)-MDMA (10 µg L−1). Overall, this study showed that sub-chronic exposure to MDMA racemate and its enantiomers can interfere with morphophysiological and swimming behaviour of D. magna. In general, the (R)-enantiomer demonstrated less toxicity than the (S)-enantiomer. [ABSTRACT FROM AUTHOR]

Objective: Alternatives to conventional acute hospitalizations have been particularly useful during the COVID-19 pandemic. However, little is known on the management and outcomes of COVID-19 in older patient admitted to non-acute settings. The main aim of this study was to determine the effect of geriatrics syndromes on functional outcomes in older COVID-19 patients cared in sub-acute units. Methods: Prospective multicenter observational cohort study of patients aged 65 years and older with COVID-19, admitted to sub-acute units in Italy and Spain. Multivariable logistic regression models were used to test the association between geriatric syndromes and other clinical variables, and the functional status at discharge, defined by a Barthel Index > = 80. Results: A total of 158 patients were included in the study with a median age of 82 [Interquartile Range 81, 83]; of these 102 (65%) patients had a Barthel Index ≥ 80 at discharge. In the main multivariable logistic regression model a higher severity of frailty-measured with the Clinical Frailty Scale—(OR 0.30; CI 0.18–0.47), and the presence of delirium (OR 0.04; CI 0.00–0.35) at admission were associated with lower odds of a higher functional status at discharge. Other variables associated with lower functional status were female gender (OR 0.36; CI 0.13–0.96), and a higher number of comorbidities (OR 0.48; CI 0.26–0.82). Conclusion: The study reports a relatively high prevalence of functional recovery for older COVID-19 patients admitted to sub-acute units. Additionally, it underlines the importance of targeting geriatrics syndromes, in particular frailty and delirium, for their possible effects on functional recovery. [ABSTRACT FROM AUTHOR]

This article deals with teacher interventions in crisis situations regarding a direct threat of students using psychoactive drugs on school premises, particularly in the difficult period of adolescence: 12-16 years of age. The focus of the research was on teacher interventions in situations where students are threatened by psychoactive substances. The research problem was whether the age and experience of the teacher were determinants of such an intervention. It investigated the relevance that a teacher's age and experience have on their attitude and manner of intervening on behalf of a student when there is an imminent threat from psychoactive substances. The research investigated the importance of a teacher's age and work experience in their attitude and the manner in which they intervene. It was carried out from 2017 to 2019 among teachers at middle schools in Bielsko-Biala, using the diagnostic survey method and a questionnaire. Statistical analysis of the results showed no statistically significant difference in teachers' declarations of readiness for intervention. Regardless of age and tenure, the respondents declared a high readiness to intervene. On the other hand, there were statistically significant differences according to the teachers' age and seniority in how the intervention was carried out. Teachers from different age and seniority groups (defined by a specific length of service) more often or less often took some of the actions envisaged in the intervention procedure. Thus, it is feasible to speak of a readiness, or lack thereof, to take certain intervention actions. [ABSTRACT FROM AUTHOR]

Background objective indicators of sleep and mental health problems in family caregivers have rarely been reported. Objective to study the use of prescription benzodiazepines and related drugs (BZDRD) in Finnish family caregivers and matched controls. Design prospective follow-up in 2012–17. Setting nationwide register-linkage study. Subjects all individuals who received family caregiver's allowance in Finland in 2012 (N  = 42,256; mean age 67 years; 71% women) and controls matched for age, sex and municipality of residence (N  = 83,618). Methods information on purchases of prescription BZDRD, including the number of defined daily doses (DDDs), between 2012 and 2017 was obtained from the Dispensations Reimbursable under the National Health Insurance Scheme register. Background information was obtained from national registers. Results more caregivers than controls used BZDRD, both among women (users per 100 person-years: 17.2 versus 15.2, P  < 0.001) and men (14.6 versus 11.8, P  < 0.001). These differences were largely explained by hypnotic BZDRD use. There were also more long-term BZDRD users per 100 person-years among caregivers than controls, both among women (5.0 versus 4.3, P  = 0.001) and men (5.3 versus 3.8, P  < 0.001). Use of hypnotic BZDRD in number of DDDs was higher in caregivers than in controls, particularly among men above 50 years. Caregivers used more anxiolytic BZDRD than controls from middle age to 75 years but less in the oldest age groups. Conclusions higher level of BZDRD use among caregivers indicates that caregivers have more sleep and mental health problems than non-caregivers. Adequate treatment of these problems and support for caregiving should be ensured for caregivers. [ABSTRACT FROM AUTHOR]

The needle-spiking scares in the UK and France are discussed and contextualized through comparison with former outbreaks linked to social fears. The contradictions of our attitudes towards psychoactive drugs, both coveted and feared, are outlined and lead to an analysis of the scares in a folkloric perspective that centers on the notion of ostensive action.

The Global Mental Health (GMH) movement aims to provide urgently needed treatment to those with mental illness, especially in low- and middle-income countries. Due to the complexity of providing mental health services to people from various cultures, there is much debate among GMH advocates regarding the best way to proceed. While biomedical interventions offer some degree of help, complementary approaches should focus on the social/community aspects. Many cultures conduct traditional rituals involving the communal use of psychoactive plants. We propose that these practices should be respected, protected, and promoted as valuable tools with regard to mental health care at the community level. The traditional use of psychoactive plants promotes community engagement and participation, and they are relatively affordable. Furthermore, the worldviews and meaning-making systems of local population are respected. The medical systems surrounding the use of psychoactive plants can be explained in biomedical terms, and many recently published clinical trials have demonstrated their therapeutic potential. Psychoactive plants and associated rituals offer potential benefits as complementary aspects of mental health services. They should be considered as such by international practitioners and advocates of the GMH movement. [ABSTRACT FROM AUTHOR]

Ketamine is a common medical anesthetic and analgesic but is becoming more widely used as a recreational drug. Significant side effects on the urinary tract are associated with frequent recreational ketamine use most notably ketamine-induced cystitis (KIC). Regular ketamine consumption has been shown to increase the risk of cystitis symptoms by 3- to 4-fold, and cessation of ketamine use is usually associated with improvement of symptoms. Common KIC-related problems are urinary pain and discomfort, bladder epithelial barrier damage, reduced bladder storage and increased pressure, ureter stenosis, and kidney failure, all of which significantly impact patients' quality of life. Furthermore, it becomes a vicious cycle when KIC patients attempt to manage their urinary pain with increased ketamine use. The precise pathophysiology of KIC is still unknown but several theories exist, most of which highlight the inflammatory signaling pathways leading to bladder epithelium damage due to presence of ketamine in the urine. Empirical treatment options for KIC are available and consist of ketamine cessation, noninvasive therapies, and surgery, and should be decided upon based on the time course and severity of the disease. Of note, cessation of use is strongly recommended for all KIC patients, and should be supplemented with motivational interviews and psychological and social support. It is crucial for clinicians to be familiar with KIC diagnosis and treatment, and to be prepared to have informed discussions with ketamine-using patients about the potential health consequences of ketamine. [ABSTRACT FROM AUTHOR]

Objective:Abuse of psychoactive drugs for therapeutic purposes is becoming more common due to their addiction potential. In many studies, quetiapine has been reported to be abused with illicit drugs. We aimed to point to the abuse and addiction potential of quetiapine by the rates of quetiapine abuse in blood samples of 4,293 cases who came to our Forensic Toxicology Laboratory by using liquid chromatography-tandem mass spectrometry method.Methods:All cases who were caught by law enforcement officers while using or trading drugs as a requirement of the judicial process initiated were drug users or dealers and then they were brought to our forensic toxicology laboratory to obtain blood and urine samples. Quantification in blood samples was performed in routine laboratory analysis. The cases were asked whether they used any prescription drugs. The therapeutic drug users were excluded in this study.Results:Quetiapine was positive in 50 of 4,293 cases (1.16%). 93.8% (n=4028) of all cases and all of the positive quetiapine were male. While quetiapine was used alone in 11 of 50 cases with quetiapine positivity, quetiapine was used simultaneously with one or more groups of illicit drugs in the remaining 39 cases.Conclusion:In this study, the most common use of cannabis and quetiapine was determined in cases with drugs of abuse. The monitoring of quetiapine is essential for preventing drug abuse especially in prone population such as illicit drug abusers and addicts. Forensic Toxicology Laboratories play an important role in taking necessary preventions related to drug abuse.

Aim: The article examines the relationship between new psychoactive drugs and segregation in one city (Miskolc), showing the mechanism of its effects. The study indicates that deprived social milieu, poverty, and hopelessness are excellent breeding grounds for this new form of drug crime by structuring drug crime into a crime involving new psychoactive substances (NPS), affordable for the poorer classes, and classic drugs. Methodology: Given the purpose of the research, the study was based primarily on literature and historical data, a review of legal sources, and an analysis of police headquarters case statistics and CSO data. The regulatory efforts of urban decision-makers to address the problem have also been analyzed. With regard to the purpose of the research, the study was based primarily on literature and historical data, a review of legal sources, and analysis of police headquarters case statistics and CSO data. The regulatory efforts made by city policymakers to address the problem were also analyzed. Findings: New psychoactive drugs target slums, thus structuring the drug market. The poor have easy access to NPS, while the wealthier classes turn to classic drugs (cocaine, MDMA, etc.). The presence of NPS in a given area alters the crime trend and perpetuates underdevelopment. In the long term, it slows down improvement. Law enforcement and judicial instruments are not sufficient to address and reduce it. In addition, the law threatens to lower penalties for dealing in NPS so that even the risk premium is not built into the price of such substances, ensuring easy access for the impoverished. Meanwhile, such chemicals' health and social dangers are at least if not higher than those of traditional drugs. Value: The results may be helpful for city policymakers, crime prevention professionals, and police management. The study has the potential to inform the broader scientific community about the complex dangers of NPS. The study can be an essential starting point for further research into new phenomena of drug crime and the extent of health and social harm associated with new psychoactive substances. As well as to develop new methods and criminological recommendations for law enforcement.

Abstract Predator‐inducible defenses constitute a widespread form of adaptive phenotypic plasticity, and such defenses have recently been suggested linked with the neuroendocrine system. The neuroendocrine system is a target of endocrine disruptors, such as psychoactive pharmaceuticals, which are common aquatic contaminants. We hypothesized that exposure to an antidepressant pollutant, fluoxetine, influences the physiological stress response in our model species, crucian carp, affecting its behavioral and morphological responses to predation threat. We examined short‐ and long‐term effects of fluoxetine and predator exposure on behavior and morphology in crucian carp. Seventeen days of exposure to a high dose of fluoxetine (100 µg/L) resulted in a shyer phenotype, regardless of the presence/absence of a pike predator, but this effect disappeared after long‐term exposure. Fluoxetine effects on morphological plasticity were context‐dependent as a low dose (1 µg/L) only influenced crucian carp body shape in pike presence. A high dose of fluoxetine strongly influenced body shape regardless of predator treatment. Our results highlight that environmental pollution by pharmaceuticals could disrupt physiological regulation of ecologically important inducible defenses.

The needle-spiking scares in the UK and France are discussed and contextualized through comparison with former outbreaks linked to social fears. The contradictions of our attitudes towards psychoactive drugs, both coveted and feared, are outlined and lead to an analysis of the scares in a folkloric perspective that centers on the notion of ostensive action [ABSTRACT FROM AUTHOR]

This multicenter study was conducted in French memory clinics during the first COVID-2019 lockdown (March–May 2020). The objective was to evaluate the effect of a telemedicine consultation on treatment modification in dementia care. Among 874 patients who had a telemedicine consultation, 103 (10.7%) had treatment modifications, in particular those living with a relative or diagnosed with Alzheimer's disease. A control group of patients referred March–May 2019 was also included. Treatment modification rate was similar between periods with an adjusted percentage difference of –4% (p = 0.27). Telemedicine consultations allowed treatment modifications with only a minor short-term negative impact on therapeutic strategies. [ABSTRACT FROM AUTHOR]

Aim: The article examines the relationship between new psychoactive drugs and segregation in one city (Miskolc), showing the mechanism of its effects. The study indicates that deprived social milieu, poverty, and hopelessness are excellent breeding grounds for this new form of drug crime by structuring drug crime into a crime involving new psychoactive substances (NPS), affordable for the poorer classes, and classic drugs. Methodology: Given the purpose of the research, the study was based primarily on literature and historical data, a review of legal sources, and an analysis of police headquarters case statistics and CSO data. The regulatory efforts of urban decision-makers to address the problem have also been analyzed. With regard to the purpose of the research, the study was based primarily on literature and historical data, a review of legal sources, and analysis of police headquarters case statistics and CSO data. The regulatory efforts made by city policymakers to address the problem were also analyzed. Findings: New psychoactive drugs target slums, thus structuring the drug market. The poor have easy access to NPS, while the wealthier classes turn to classic drugs (cocaine, MDMA, etc.). The presence of NPS in a given area alters the crime trend and perpetuates underdevelopment. In the long term, it slows down improvement. Law enforcement and judicial instruments are not sufficient to address and reduce it. In addition, the law threatens to lower penalties for dealing in NPS so that even the risk premium is not built into the price of such substances, ensuring easy access for the impoverished. Meanwhile, such chemicals' health and social dangers are at least if not higher than those of traditional drugs. Value: The results may be helpful for city policymakers, crime prevention professionals, and police management. The study has the potential to inform the broader scientific community about the complex dangers of NPS. The study can be an essential starting point for further research into new phenomena of drug crime and the extent of health and social harm associated with new psychoactive substances. As well as to develop new methods and criminological recommendations for law enforcement. [ABSTRACT FROM AUTHOR]

The increasing presence of pharmaceutical products in municipality wastewaters has raised serious environmental concerns. Ozonation is one of the advanced oxidation processes that can degrade these substances, instead of simply transferring them from aqueous to another phase. Treatability studies applying ozonation to degrade benzodiazepine drugs are scarce. The aim of this investigation was to apply design of experiments (DoE) to optimize ozonation processes for removal of bromazepam, clonazepam, and diazepam from two effluents of municipal wastewater treatment plants (WWTP1 and WWTP2) both located in Rio de Janeiro City, Brazil. During a preliminary study using ultrapure water, OHº radicals were more efficient (removal efficiency greater than 99% (< LOQ) at pH = 10, 15 min) than O3 in degrading all psychoactive drugs (removal efficiency from 46 to 85% at pH = 4, 15 min). The optimum values for the tested variables were pH = 8.03; O3 specific dose = 4.8 mgO3.mgDOC−1; and O3 mass flow rate = 22.07 mgO3.min−1. The WWTP1 and WWTP2 effluents were treated under optimized conditions by ozonation in two effluent volumes (5L and 8L). When 8 L effluent was treated, the degradation of all benzodiazepine drugs was improved, due to the higher water column used, which favors the mass transfer of O3 from the gas phase to the liquid phase, promoting greater contact between oxidant and target compounds. Using a specific dose of 1.8 mgO3.mgDOC−1, more than 93% of all anxiolytic drugs were removed from 8 L of WWTP2 effluent, whereas for the WWTP1, more than 90% were removed using 2.7 times higher specific dose (4.8 mgO3.mgDOC−1). [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND: People have been using psychoactive substances for a long time. Over the last few years, this practice has spread among university students, who use these substances to improve their academic performance, relieve stress and increase concentration and memory. OBJECTIVES: To estimate the use of psychoactive drugs among healthcare students at a higher education institution in the city of Passo Fundo (RS), Brazil, and to ascertain the associated demographic and lifestyle factors. DESIGN AND SETTING: Cross-sectional study in a higher education institution. METHODS: We included 287 undergraduate medicine and dentistry students in this study. They answered a self-administered questionnaire regarding sociodemographic, lifestyle and health variables. The statistical analysis used univariate and bivariate analyses with Pearson’s chi-square test (P-value < 0.05). Multivariate analyses were used to estimate odds ratios (OR) and their respective 95% confidence intervals. The SPSS software, version 20.0, was used. RESULTS: The prevalence of use of psychoactive substances among the students was 24.7%. Among these students, high frequencies of psychoactive drugs had been prescribed by physicians (95.8%) and for the purpose of relaxation or stress relief (73.2%). Women, medical students (compared with dental students) and participants with lower academic performance were more likely to use psychoactive drugs. After the multivariate adjustment, the “course” and “academic performance” remained associated with use of psychoactive drugs. CONCLUSION: There was high prevalence of psychoactive drug use among the students at the higher education institution investigated. Some variables (female sex, medical students and low academic performance) were associated with the outcome.

As the emerging contaminants, the environmental risks of drug-derived pollutants have attracted extensive attention. Citalopram (CTP) and mirtazapine (MTP) are commonly used as modern antidepressant drugs. Previous studies had proved that CTP and MTP entered the aquatic environment, but less reported the negative effects of the drugs on aquatic organisms. Herein, the effects on the feeding rate of Daphnia magna (D. magna) induced by psychotropic drugs CTP and MTP were investigated, which the possible mechanisms were analyzed with the oxidative stress and damage. Generally, the feeding rates of exposed D. magna under all concentrations of CTP and 1.03 mg/L of MTP were significantly decreased after exposure (p

Small molecules with polar functional groups, including substituted phenethylamines, are commonly analyzed by liquid chromatography‐mass spectrometry (LC‐MS) with electrospray ionization (ESI). Analyte molecules are mostly detected in protonated and cation‐adducted forms through positive‐ion electrospray ionization‐mass spectrometry (ESI‐MS). However, the ESI of substituted phenethylamines commonly provides an intense signal of fragment ions by ESI in‐source collision‐induced dissociation (IS‐CID), which hinders the unambiguous identification of phenethylamines. This phenomenon was approximated as a unimolecular dissociation model, and the dissociation efficiency was evaluated by various quantum chemistry calculations to determine the ESI IS‐CID efficiency. The calculated results were consistent with the experimental data, when the dissociation threshold energy of phenethylamines was calculated using the post‐Hartree‐Fock (post‐HF) method, CCSD(t)/cc‐pVTZ//MP2(full)/6‐311++G(d,p). In contrast to post‐HF methods, the utilization of density functional theory calculations with a suitable functional is recognized as an accurate and competitive low‐cost approach. In particular, ωB97‐XD, M06‐2X‐D3, and recently developed Minnesota functionals, such as M11, MN12‐SX, and MN15, provided reliable results, as in the case of the post‐HF method. The results obtained by the recently developed double hybrid functionals, DSD‐PEBP86‐D3(BJ), PBE0‐DH, and PBE‐QIDH, were also reliable. The consideration of ESI IS‐CID can facilitate the identification of analyte molecules because most phenethylamines, except for N‐methylated analogs, provide an intense signal in the ESI mass spectrum. [ABSTRACT FROM AUTHOR]

Objectives: Before drawing conclusions on the contribution of an effective intervention to daily practice and initiating dissemination, its quality and implementation in daily practice should be optimal. The aim of this process evaluation was to study these aspects alongside a randomized controlled trial investigating the effects of a multidisciplinary biannual medication review in long-term care organizations (NTR3569).Design: Process evaluation with multiple measurements.Setting: Thirteen units for people with dementia in six long-term care organizations in the Netherlands.Participants: Physicians, pharmacists, and nursing staff of participating units.Intervention: The PROPER intervention is a structured and biannually repeated multidisciplinary medication review supported by organizational preparation and education, evaluation, and guidance.Measurements: Web-based questionnaires, interviews, attendance lists of education sessions, medication reviews and evaluation meetings, minutes, evaluation, and registration forms.Results: Participation rates in education sessions (95%), medication reviews (95%), and evaluation meetings (82%) were high. The intervention's relevance and feasibility and applied implementation strategies were highly rated. However, the education sessions and conversations during medication reviews were too pharmacologically oriented for several nursing staff members. Identified barriers to implementation were required time, investment, planning issues, and high staff turnover; facilitators were the positive attitude of professionals toward the intervention, the support of higher management, and the appointment of a local implementation coordinator.Conclusion: Implementation was successful. The commitment of both higher management and professionals was an important factor. This may partly have been due to the subject being topical; Dutch long-term-care organizations are pressed to lower inappropriate psychotropic drug use. [ABSTRACT FROM AUTHOR]

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Abstract Cannabis products (marijuana, weed, hashish) are among the most widely abused psychoactive drugs in the world, due to their euphorigenic and anxiolytic properties. Recently, hair analysis is of great interest in analytical, clinical, and forensic sciences due to its non-invasiveness, negligible risk of infection and tampering, facile storage, and a wider window of detection. Hair analysis is now widely accepted as evidence in courts around the world. Hair analysis is very feasible to complement saliva, blood tests, and urinalysis. In this review, we have focused on state of the art in hair analysis of cannabis with particular attention to hair sample preparation for cannabis analysis involving pulverization, extraction and screening techniques followed by confirmatory tests (e.g., GC–MS and LC–MS/MS). We have reviewed the literature for the past 10 years’ period with special emphasis on cannabis quantification using mass spectrometry. The pros and cons of all the published methods have also been discussed along with the prospective future of cannabis analysis.

Raphaële Bachtarzi,1 Anne Sophie Boureau,1 Charlotte Mascart,1 Eric Batard,2,3 Emmanuel Montassier,2,3 Pascale Bémer,2,4 Céline Bourigault,2 Gilles Berrut,1 Laure de Decker,1,2 Guillaume Chapelet1,21Centre Hospitalier Universitaire de Nantes, Clinical Gerontology Department, Nantes F-44000, France; 2Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance bacterienne), Institut de Recherche en Santé (IRS2), Nantes F-44200, France; 3Centre Hospitalier Universitaire de Nantes, Emergency Department, Nantes F-44000, France; 4Centre Hospitalier Universitaire de Nantes, Bacteriology Department, Nantes F-44000, FranceBackground: The worldwide dissemination of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has become a major health concern. Previous studies have shown that psychoactive drugs have intrinsic antimicrobial activity and may play a role in the dissemination of antibiotic resistance. The objective of this study was to assess the association between prescriptions for psychoactive drug and urine colonization with ESBL-producing Enterobacteriaceae.Subjects: Ninety-five patients were included; 19 cases (urine colonization with an ESBL-producing Enterobacteriaceae) and 76 controls (urine colonization with non ESBL-producing Enterobacteriaceae); and were matched for age and gender.Methods: A retrospective 1:4 matched case–control study design was used. All patients colonized with an Enterobacteriaceae isolate in Nantes University Hospital from March to November 2014, were screened before inclusion in the study. Prescriptions data for psychoactive drugs were collected from the electronic medical records. Univariate and multivariate conditional logistic regression analyses were performed.Results: Thirty-seven patients (38.9%) were treated with psychoactive drugs, of whom 10 (52.6%) were in the ESBL-producing group and 27 (35.5%) were in the non-ESBL group. Mean (SD) age was 71.2 (23.1) years. In multivariate analyses, previous antimicrobial therapy within 6 months (OR=7.12, 95% CI 1.15–44.18; p=0.035) and previous colonization with an ESBL-producing organism (OR=44.87, 95% CI 1.26–1594.19; p=0.037) were associated with urine colonization with ESBL-producing Enterobacteriaceae.Conclusions: Our findings revealed that a history of previous antimicrobial therapy and previous colonization with ESBL-producing organisms are important risk factors in an elderly population. Psychoactive drugs were not associated with urinary carriage of ESBL-producing Enterobacteriaceae. Further studies are required to explore the relationship between psychoactive drugs and colonization with ESBL-producing Enterobacteriaceae.Keywords: ESBL, psychoactive drugs, antimicrobial resistance, elderly

BackgroundA common screening instrument for substance use disorders (SUDs) is the Drug Use Disorders Identification Test (DUDIT) which includes a short form regarding only drug consumption (DUDIT-C). We aim to assess if a German version of the DUDIT, adapted for adolescents, is a suitable screening instrument in a sample of adolescent psychiatric patients.MethodsN = 124 (54 female) German adolescent (M = 15.6 + 1.5 years) psychiatric patients completed the DUDIT and received a diagnostic interview (MINI-KID) assessing DSM-5 SUD criteria. A confirmatory factor analysis (CFA), receiver operating characteristic (ROC) curves, the area under the curve (AUC), and Youden’s Index were calculated.ResultsA two-factor model of the DUDIT shows the best model fit (CFI = 0.995, SRMR = 0.055, RMSEA = 0.059, WRMR = 0.603). The DUDIT as well as the DUDIT-C show high diagnostic accuracy, with AUC = 0.95 and AUC = 0.88, respectively. For the DUDIT a cut-off value of 8.5 was optimal (sensitivity = 0.93, specificity = 0.91, J = 0.84), while for the DUDIT-C the optimal cut-off value was at 1.5 (sensitivity = 0.86, specificity = 0.84, J = 0.70).ConclusionThis is the first psychometric evaluation of the DUDIT in German, adolescent psychiatric outpatients, using the DSM-5 diagnostic criteria. The DUDIT as well as the DUDIT-C are well suited for use in this population. Since in our sample only few patients presented with a mild or moderate SUD, our results need to be replicated in a sample of adolescents with mild SUD.