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BackgroundMethamphetamine use could jeopardize the current efforts to address opioid use disorder and HIV infection. Evidence-based behavioral interventions (EBI) are effective in reducing methamphetamine use. However, evidence on optimal combinations of EBI is limited. This protocol presents a type-1 effectiveness-implementation hybrid design to evaluate the effectiveness, cost-effectiveness of adaptive methamphetamine use interventions, and their implementation barriers in Vietnam.MethodDesign: Participants will be first randomized into two frontline interventions for 12 weeks. They will then be placed or randomized to three adaptive strategies for another 12 weeks. An economic evaluation and an ethnographic evaluation will be conducted alongside the interventions.ParticipantsWe will recruit 600 participants in 20 methadone clinics.Eligibility criteria(1) age 16+; (2) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) scores ≥ 10 for methamphetamine use or confirmed methamphetamine use with urine drug screening; (3) willing to provide three pieces of contact information; and (4) having a cell phone.OutcomesOutcomes are measured at 13, 26, and 49 weeks and throughout the interventions. Primary outcomes include the (1) increase in HIV viral suppression, (2) reduction in HIV risk behaviors, and (3) reduction in methamphetamine use. COVID-19 response: We developed a response plan for interruptions caused by COVID-19 lockdowns to ensure data quality and intervention fidelity.DiscussionThis study will provide important evidence for scale-up of EBIs for methamphetamine use among methadone patients in limited-resource settings. As the EBIs will be delivered by methadone providers, they can be readily implemented if the trial demonstrates effectiveness and cost-effectiveness.Trial registrationClinicalTrials.gov NCT04706624. Registered on 13 January 2021. https://clinicaltrials.gov/ct2/show/NCT04706624.

Engagement in prevention services is crucial to reducing HIV risk among female entertainment and sex workers (FESW), and SMARTgirl is the national social marketing HIV prevention program for Cambodian women engaged in sex and entertainment work. Informed by the Behavioral Model of Vulnerable Populations, three multivariate logistic regression analyses examined correlates of three indices of engagement along the SMARTgirl HIV prevention continuum: (1) receipt of outreach services (past 3 months); (2) being registered as a SMARTgirl member; and (3) SMARTgirl club attendance (past year). Among the 1077 FESW enrolled in nine Cambodian provinces, women working in a brothel or freelance (adjusted odds ratio [aOR] 2.48; 95% CI 1.44-4.26) and those exchanging sex for drugs during the past 3 months (aOR 0.45; 95% CI 0.25-0.81) had significantly lower odds of contact with a SMARTgirl outreach worker. Women who reported having more than ten sexual partners in the past 3 months (aOR 0.54; 95% CI 0.32-0.89) and those who reported binge alcohol use (aOR 0.53; 95% CI 0.29-0.98) had significantly lower odds of being registered as SMARTgirl members. Exchanging sex for drugs was also associated with increased odds of attending a SMARTgirl club (aOR 2.03; 95% CI 1.04-3.98). Novel methods to deliver HIV prevention services are warranted to more effectively reach FESW who exchange sex for drugs, engage in binge alcohol use, report a greater number of sexual partners, and those not working in established work venues.

A solid-phase extraction (SPE) followed by gas chromatography-mass spectrometry (GC-MS) method was developed and validated for determination of seven amphetamine-type stimulants (ATSs) including amphetamine (AM), methamphetamine (MA), 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylendioxyethylamphetamine (MDEA), para-methoxyamphetamine (PMA), 4-bromo-2,5- dimethoxyamphetamine (DOB), and ketamine (KET), norketamine (NKT) in human hair. Ten milligrams of human hair was washed by water and methanol followed by soaking in a solution of 1% hydrochloric acid in methanol for 18 hours. The analytes from the methanolic extract were isolated by a SPE procedure before being derivatized using heptafluorobutyric anhydride (HFBA) at 80°C for 40 minutes. The selected ion monitoring (SIM) method was used for the quantification of the derivatized compounds. The linear range was from 0.5-40 ng/mg for all of the analytes with the coefficient of determination (R2)>0.9971. The intra-day and inter-day accuracies were in the range of 93.63-112.40% and 94.70-110.20%, respectively. The intra-day and inter-day precision (RSD%) were in the range of 8.72 and 9.73, respectively. Limit of detection (LOD) and limit of quantitation (LOQ) for each analyte were less than 0.10 and 0.32 ng/mg, respectively. The recoveries were in the range of 75.18-89.30%. The GC-MS was used for the hair analysis on 51 subjects suspected to be ATSs and ketamine user. The average content of all the analytes was in the range of 1.14-12.70 ng/mg. On the basis of these results, the method was proved to be effective for identification and quantitation of

BackgroundHIV prevention for female entertainment and sex workers (FESW) may be optimized by addressing individual and structural risks. We examined the impact of a sequentially delivered intervention to decrease sexual risk, amphetamine-type stimulant (ATS) use, and improve economic well-being in Cambodian FESW.MethodsA cluster randomized stepped-wedge trial was conducted in 10 Cambodian provinces to test multi-level intervention in high risk FESW. After baseline screening in 1198 women, those screening positive for ATS use disorder were allocated to a 12-week conditional cash transfer intervention followed by a 4-week cognitive-behavioural aftercare group (CCT + AC). At six months, ATS abstinent participants were offered a microenterprise (ME) opportunity. Co-primary outcomes assessed in 600 FESW at each 6-, 12- and 18-month follow-up assessments, included: 1) number of sexual partners (past three months); and 2) ATS urine toxicology positive (Tox+) results. Secondary outcomes included indicators of economic well-being.ResultsRelative to baseline, FESW reported fewer sexual partners at all follow-up assessments with a significant 50% decrease at 12-months (Adjusted Rate Ratio [ARR] = 0.50; 95%CI: 0.25, 0.95). Women had 60% lower odds of being ATS Tox+ (Adjusted Odds Ratio [AOR] = 0.40; 95%CI: 0.25, 0.65) at 6-months, and continued but non-significant reductions at 12- and 18-months. Improvements in economic well-being indicators were observed at 12- and 18-months.ConclusionsFindings support the robust effectiveness of the sequentially delivered CCT + AC and ME interventions for boosting HIV prevention for Cambodian FESW. Further research is needed to inform the scale up and improve durability of this comprehensive approach with FESW in Southeast Asia.

The abuse of amphetamine-type stimulants (ATSs) has caused irreversible harm to public safety and ecosystems. A novel polymerized deep eutectic solvent modified magnetic pomelo peel biochar (PMBC) was prepared, and the differences in adsorption of four abused amphetamine-type stimulants (ATSs: AMP, MAMP, MDA and MDMA) were due to varying hydrogen bonds quantities and strengths. PMBC showed excellent chemical reactivity to MDMA, with a maximum adsorption capacity of 926.13 μg g−1, which was 3.25, 2.52 and 1.15 times higher than that of AMP, MAMP and MDA, respectively. Modern spectral analysis showed that there were a series of active centers (-COOH, -NH 2 and -OH) on the PMBC, which could form hydrogen bond networks with the nitrogen and oxygen functional groups of ATSs. In various chemical environments: pH level (4–11), inorganic ion and organic matter (humic acid), PMBC maintained high activity towards four ATSs. Additionally, the quantum chemical calculations revealed that the methylenedioxy bridge of ATSs can increase the active sites, and the -NH- and -NH 2 groups had different hydrogen bond formation capabilities, which together resulted in the adsorption order of PMBC on the four ATSs: MDMA > MDA > MAMP > AMP. Moreover, the hydrogen-bonding binding energies of several common hydrogen-bonding types were compared, including O-H····O, N-H····O/O-H····N and N-H···N. This study laid an empirical and theoretical foundation for the efficient capture of ATSs in water and contributed to the innovative design of materials. [Display omitted] • ATSs pose a serious threat to aquatic ecosystems and public safety. • The adsorption order of four ATs on PMBC was: MDMA > MDA > MAMP > AMP. • The adsorption differences was due to the number and strength of hydrogen bonds. • The hydrogen-bonding binding energy were calculated. • The experimental and quantum chemical calculations mutually confirm each other. [ABSTRACT FROM AUTHOR]

Abstract Background Methamphetamine use could jeopardize the current efforts to address opioid use disorder and HIV infection. Evidence-based behavioral interventions (EBI) are effective in reducing methamphetamine use. However, evidence on optimal combinations of EBI is limited. This protocol presents a type-1 effectiveness-implementation hybrid design to evaluate the effectiveness, cost-effectiveness of adaptive methamphetamine use interventions, and their implementation barriers in Vietnam. Method Design: Participants will be first randomized into two frontline interventions for 12 weeks. They will then be placed or randomized to three adaptive strategies for another 12 weeks. An economic evaluation and an ethnographic evaluation will be conducted alongside the interventions. Participants: We will recruit 600 participants in 20 methadone clinics. Eligibility criteria: (1) age 16+; (2) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) scores ≥ 10 for methamphetamine use or confirmed methamphetamine use with urine drug screening; (3) willing to provide three pieces of contact information; and (4) having a cell phone. Outcomes: Outcomes are measured at 13, 26, and 49 weeks and throughout the interventions. Primary outcomes include the (1) increase in HIV viral suppression, (2) reduction in HIV risk behaviors, and (3) reduction in methamphetamine use. COVID-19 response: We developed a response plan for interruptions caused by COVID-19 lockdowns to ensure data quality and intervention fidelity. Discussion This study will provide important evidence for scale-up of EBIs for methamphetamine use among methadone patients in limited-resource settings. As the EBIs will be delivered by methadone providers, they can be readily implemented if the trial demonstrates effectiveness and cost-effectiveness. Trial registration ClinicalTrials.gov NCT04706624. Registered on 13 January 2021. https://clinicaltrials.gov/ct2/show/NCT04706624

BackgroundAmphetamine-type stimulants (ATS) use has become popular in China. This study explored ATS use status and related risk factors of hepatitis C virus (HCV) infection among ATS users in Jinghong City, Xishuangbanna Prefecture, Yunnan Province, China.MethodsA cross-sectional study was conducted by questionnaires from January to July 2021 in border area in Yunnan. Respondent driving sampling and consecutive sampling was carried out among border drug users, and blood samples were tested for HCV antibodies. HCV infection and related risk factors among ATS users were measured. Descriptive, univariate and multivariate analysis were conducted separately by Software SPSS 26.0.ResultsThe ATS users accounted for 85.82% (345/402) among drug users, while anti-HCV antibody prevalence was 6.38% (22/345) among ATS users. The combined use of other types of drugs (OR = 7.29, 95%CI: 1.982–26.81, P = 0.003), injection drug use (OR = 6.823, 95%CI: 1.898–24.525, P = 0.003), average monthly income (OR = 4.825, 95%CI: 1.325–17.566, P = 0.017) might increase the risk of HCV infection among ATS users. ATS users with high school or above had higher HCV infection rates than those with primary school or below (OR = 5.718, 95%CI: 1.172–27.908, P = 0.031).ConclusionTaken together, among drug users using ATS in Jinghong City, Xishuangbanna Autonomous Prefecture, Yunnan Province, combined use of multiple drugs and intravenous drug use was the high risk factor for HCV infection. Therefore, corresponding education and intervention measures should be taken.

Yue Liu,1 Nina Liu,2 Wenwen Shen,1 Longhui Li,1 Wenhua Zhou,1 Leiting Xu3 1Department of Academic Research, Ningbo Kangning Hospital, Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, 315201, People’s Republic of China; 2Department of Basic Medicine, Ningbo College of Health Sciences, Ningbo, 315100, People’s Republic of China; 3Department of Basic Medicine, Ningbo University School of Medicine, Ningbo, 315211, People’s Republic of ChinaCorrespondence: Leiting XuDepartment of Basic Medicine, Ningbo University School of Medicine, Ningbo, 315211, People’s Republic of ChinaTel +86 18267417969Email leitingxu@yeah.netWenhua ZhouDepartment of Academic Research, Ningbo Kangning Hospital, Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, 315201, People’s Republic of ChinaTel +86 13777113984Email wenhuazhou@yeah.netObjective: The purpose of this study was to retrospectively investigate the abuse characteristics of amphetamine-type stimulants (ATS) in patients receiving methadone maintenance treatment (MMT) and buprenorphine maintenance treatment (BMT).Methods: A total of 58 MMT and 51 BMT patients abusing ATS were recruited from the drug maintenance treatment clinic of Ningbo Addiction Research and Treatment Center from January 2018 to December 2019. They were assessed using the amphetamine abuse questionnaire (AAQ), addiction severity index (ASI) and Barratt impulsiveness scale (BIS). Moreover, 40 MMT control patients, 40 BMT control patients and 20 healthy controls were also assessed using the BIS. All information was collected using the amphetamine abuse questionnaire (AAQ), Chinese version of addiction severity index (ASI-C) and Chinese version of Barratt impulsiveness scale (BIS-C) conducted by qualified psychologists.Results: The interval of amphetamine use in the MMT group was shorter than the BMT group (P < 0.05). The drug use subscale score of ASI was higher in the MMT group than the BMT group (P < 0.05). The respective and total scores of attentional impulsiveness, motor impulsiveness and non-planning impulsiveness in BIS in the MMT group were all higher than the MMT control group (P < 0.05). The scores of motor impulsiveness and non-planning impulsiveness in the BMT group were higher than the BMT control group (P < 0.05). The respective and total scores in BIS in the MMT control group and the BMT control group were all higher than those in the healthy controls.Conclusion: The patients showing amphetamine abuse in maintenance therapy had a greater impulsiveness than those having other simple maintenance treatments, and patients under MMT may be more addicted to amphetamines in comparison with those having BMT.Keywords: methadone maintenance treatment, buprenorphine maintenance treatment, amphetamine-type stimulants, impulsiveness, addiction

Environmental impact of toxic and corrosive synthesis waste generated by the clandestine production of amphetamine-type stimulants (ATS) is a known problem, which can even result in malfunction of wastewater treatment plants (WWTPs), e. g. in case of illegal discharge of large amounts of highly acidic chemical waste into the sewage system, which is generated in clandestine labs converting pre-precursors to the most prevalent ATS precursor benzyl methyl ketone (BMK). ATS synthesis-specific substances, precursor chemicals, intermediates and route-specific by-products may also support wastewater-based epidemiology (WBE) studies to explain abnormally high loads of drugs in wastewater by distinguishing whether these high loads were caused by consumption or disposal of synthesis waste into the sewage system. Although some of these synthesis-specific substances can be detected in traces in the final form of consumption of the product, these substances are removed from the drug product to a large extent during cleaning steps, e.g. the frequently applied steam distillation step to purify the amphetamine raw base after clandestine Leuckart synthesis. In contrast, these synthesis-specific by-products are very prominent in chemical synthesis wastes, whereby their detection in wastewater would prove a disposal of synthesis wastes instead of excretion after drug product consumption. As a prerequisite, such substances need to exhibit a certain chemical and biological stability in wastewater and, therefore, lab-scale experiments were performed in a mixture of WWTP effluent and activated sludge. Fourteen selected synthesis-specific substances, all related to the production of ATS, comprised pre-precursors (e.g. α-phenylacetoacetonitrile (APAAN) or α-phenylacetoacetamide (APAA)), precursors (e.g. BMK), intermediates (e.g. N-formylamphetamine (NFA)), synthesis by-products (e.g. N,N-di-(β-phenylisopropyl)amine (DPIA)) and final products (e.g. amphetamine (AMPH)). Stability of test substances was evaluated by targeted HPLC-MS/MS analysis, while HPLC-HRMS techniques were used for the identification of transformation products (TPs) of substances that have undergone primary degradation. All substances were detectable for five days minimum and seven out of 14 substances underwent at least primary degradation. A total of three TPs were identified: TP164 was formed by oxidation of ephedrine (EPHE) and was further transformed after maximum formation, while TP180-1 and TP180-2 were formed by reduction of APAA and both remained stable. This is the first study investigating the stability of ATS synthesis-specific substances in wastewater demonstrating sufficient stability for wastewater monitoring studies.

Conditional cash transfer (CCT) and cognitive-behavioral treatments are evidence-based approaches to reduce stimulant use and sexual risk taking. We describe the adaptation and implementation of sequential behavioral interventions for Cambodian female entertainment and sex workers (FESW) who use amphetamine-type stimulants (ATS): (1) a 12-week CCT intervention; and (2) a 4-week cognitive-behavioral aftercare (AC) group. An ongoing cluster randomized stepped wedge trial in 10 Cambodian provinces is enrolling FESW with confirmed recent ATS use to examine the effectiveness of CCT + AC. In the first six provinces, 138 of the 183 eligible FESW (75 %) enrolled in CCT and completed a median of 25 (interquartile range 9-32) of the 36 urine screening visits. Of the 84 participants who were eligible for AC, 79 completed at least one session (94 %) and 57 completed three or more sessions (68 %). Culturally tailored behavioral interventions to reduce ATS use and optimize HIV prevention are feasible in resource-limited settings.

Abstract Background HIIT has recently been widely used for health promotion in healthy people and patients with chronic diseases. Exercise can help SUD reduce drug cravings, enhance mental health and return to normal life. However, whether HIIT can bring better physical rehabilitation benefits to individuals with SUD than MICT is unclear. The study aimed to compare the effects of HIIT versus MICT on the physical fitness of individuals with SUD. Methods One hundred twenty individuals with amphetamine-type stimulant dependence voluntarily participated in this study. They were randomly assigned to the HIIT group and MICT group. Both groups received training three times a week. The intervention lasted from January 2019 to December 2019. Physical fitness was assessed at the baseline, 3 months, 6 months, 9 months and 12 months, including blood pressure (BP), vital capacity(VC), hand grip, push-up, sit-and-reach, one-leg standing with eyes closed and choice reaction time. The craving level was assessed using the Visual Analog Scale at baseline, 6 months and 12 months to see any change along with the improvement in physical fitness. Two-way repeated measures ANOVA was applied to analyse the differences in change by group (HIIT and MICT) and time (baseline, 3 months, 6 months, 9 months and 12 months). Results The within-group factor displayed significant changes in the HIIT and MICT groups in terms of systolic BP (F (4,336) = 12.799, P

Substance use and mental ill health constitute a major public health burden, and a key global policy priority is to reduce illicit and other harmful substance use. Amphetamine-type stimulants (ATS) are the second most used class of illicit drugs and a range of mental health issues have been documented amongst users. This paper explores the relationship between mental health and ATS use, through a thematic analysis of qualitative interviews with n = 18 current and former ATS users in England. The findings are presented by trajectory point of; (1) Initiation of ATS use; (2) continued and increased ATS use and (3) decreased and remitted ATS use. This work helps to develop understanding around the complex and bi-directional relationship between ATS use and mental health. Many ATS users lead chaotic lives and engage in multiple risk behaviours, however there is a need to better understand and conceptualise the dynamic interaction between different individual, social, environment and cultural factors that determine individuals' mental health and substance use. There is no 'one size fits all' approach to prevention and treatment, and these findings highlight the need for more joined-up, tailored and holistic approaches to intervention development. [ABSTRACT FROM AUTHOR]

BackgroundAlthough amphetamine-type stimulant (ATS) use is an important issue that has caused growing concerns in China as well as other countries, the knowledge of long-term patterns of ATS use in China is limited. This study explored long-term patterns of ATS use in Shanghai, China, and compared the differences by ATS use trajectory groups, seeking to identify risk factors that have implications for the development of targeted intervention programs.MethodsA total of 377 ATS users were recruited from the Compulsory Isolation Center for Drug Rehabilitation in Shanghai. Group-based trajectory modeling was applied to identify distinctive trajectories of ATS use over 8 years at the time of interviews conducted in 2012. The mean number of days using ATS per month over a year from years 2005 to 2012 was analyzed with a censored normal model.ResultsThree distinctive groups were identified: high-use (19.1%), low-use (66.0%), and increasing-use (14.9%). Relative to the low-use group, the high-use and increasing-use groups were more likely to report having used opiate-type drugs and to have more craving experiences. Psychiatric symptoms following ATS use were frequently reported, with ATS users in the increasing-use and high-use groups more likely to report depression symptoms and suicide behaviors compared to the low-use group. The low-use and increasing-use groups reported more months in drug abuse treatment programs compared to the high-use group.ConclusionsAddressing ATS use should take into consideration patients' use-related psychiatric symptoms as well as other risk factors, particularly among those with persistent high-level ATS use trajectories.

BackgroundAlthough the interaction of brain volume with amphetamine-type stimulants (ATS) and cocaine has been investigated in chronically dependent individuals, little is known about structural differences that might exist in individuals who consume ATS and cocaine occasionally but are not dependent on these drugs.MethodsRegional brain volumes in 165 college aged occasional users of ATS (namely: amphetamine, methamphetamine, methylphenidate, and 3,4-methylenedioxymethamphetamine; MDMA) and cocaine were compared by voxel-based morphometry with 48 ATS/cocaine-naive controls.ResultsGrey matter volume was significantly higher in the left ventral anterior putamen of occasional users, and lower in the right dorsolateral cerebellum and right inferior parietal cortex. A regression in users alone on lifetime consumption of combined ATS (namely: amphetamine, methamphetamine, methylphenidate and MDMA) and cocaine use revealed that individuals who used more ATS/cocaine had greater volume in the right ventromedial frontal cortex. A second regression on lifetime consumption of ATS with cocaine as a covariate revealed that individuals with a greater history of ATS use alone had more grey matter volume in the left mid-insula. Interestingly, structural changes in the ventromedial prefrontal cortex, insula and striatum have been consistently observed in volumetric studies of chronic ATS and cocaine dependence.ConclusionThe present results suggest that these three brain regions may play a role in stimulant use even in early occasional users.

Background: HIIT has recently been widely used for health promotion in healthy people and patients with chronic diseases. Exercise can help SUD reduce drug cravings, enhance mental health and return to normal life. However, whether HIIT can bring better physical rehabilitation benefits to individuals with SUD than MICT is unclear. The study aimed to compare the effects of HIIT versus MICT on the physical fitness of individuals with SUD. Methods: One hundred twenty individuals with amphetamine-type stimulant dependence voluntarily participated in this study. They were randomly assigned to the HIIT group and MICT group. Both groups received training three times a week. The intervention lasted from January 2019 to December 2019. Physical fitness was assessed at the baseline, 3 months, 6 months, 9 months and 12 months, including blood pressure (BP), vital capacity(VC), hand grip, push-up, sit-and-reach, one-leg standing with eyes closed and choice reaction time. The craving level was assessed using the Visual Analog Scale at baseline, 6 months and 12 months to see any change along with the improvement in physical fitness. Two-way repeated measures ANOVA was applied to analyse the differences in change by group (HIIT and MICT) and time (baseline, 3 months, 6 months, 9 months and 12 months). Results: The within-group factor displayed significant changes in the HIIT and MICT groups in terms of systolic BP (F (4,336) = 12.799, P < 0.001,η2 = 0.204), diastolic BP (F(4,336) = 9.495, P < 0.001, η2 = 0.16), VC (F(4,336) = 18.121, P < 0.001, η2 = 0.177), hand grip (F(4,336) = 34.815, P < 0.001, η2 = 0.293), sit-and-reach (F(4,336) = 13.871, P < 0.001, η2 = 0.142), push-up (F(4,336) = 28.805, P < 0.001, η2 = 0.255), one-leg standing with eyes closed (F(4,336) = 14.495, P < 0.001, η2 = 0.156) and choice reaction time (F(4,336) = 20.603, P < 0.001, η2 = 0.197). The craving level decreased after 12 months of intervention in both groups (F(2,168) = 11.25, P < 0.001, η2 = 0.118), but no significant differences in physical fitness and craving level were found in between groups and the interactions of group × time. Conclusions: After 12 months of intervention, physical fitness improved while craving level decreased in the two groups. These findings suggest that both HIIT and MICT have positive effects on individuals with SUD in terms of physical fitness. Trial registration: ChiCTR1900022158 Chinese Clinical Trial Registry: Registered 27th March, 2019. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to estimate nationally representative prevalence rates of amphetamine-type stimulant (ATS) use and to identify consumption-associated factors, proposing a conditional model of direct and indirect consumption paths. Method: Using data from the Second Brazilian National Alcohol and Drugs Survey, this cross-sectional study analyzed a subsample of 3,828 participants between 15 and 64 years old, gathering information on the use of psychoactive substances in a probabilistic sample of the Brazilian household population. Results: Rates of lifetime and last-year ATS use were, respectively, 4.1 and 1.6%. Economically privileged individuals and users of other substances were more at risk for using ATS. The results suggest that higher education decreases the chances of ATS consumption. The conditional model showed that higher income increased ATS use, higher education lowered the odds of such an increase, and cocaine use cancelled that associative effect. Conclusion: Brazil presents high rates of ATS use. Prevention and treatment strategies should focus on the protective effect of higher education levels and should target polydrug use. Knowledge of ATS-associated factors and user profiles is the starting point for developing effective treatments and tailored prevention strategies.

Background: South Asia generally reports low levels of amphetamine-type stimulant (ATS) use, with few studies on the pattern of ATS use. We assessed the pattern of ATS use and associated high-risk behavior in Manipur, a north-eastern state of India., Methods: 209 adult male ATS users (mean age 28.8 years) from three districts of Manipur were interviewed. Data were collected on the patterns of high-risk behavior with ATS use, health consequences, and help-seeking. The severity of use with various substances was assessed using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). Depression and anxiety were assessed by the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scale, respectively., Results: The mean duration of ATS use was 3.7 years (SD 2.3). The majority used ATS almost daily (88%) and depended on ATS (77%). Methamphetamine (99.5%) was the most used ATS orally. Around 87% also suffered from opioid dependence. About 76% injected drugs, most commonly heroin. Almost three-fourths (78%) used ATS before their sexual intercourse, 31% of whom did not use condoms. Most reported physical problems with ATS and had above-cut-off scores on PHQ-9 and GAD-7. The majority (95%) reported that they could procure ATS easily. Also, the majority (93%) had thought of quitting ATS use., Discussion: Most ATS users start using ATS at a young age and have comorbid other drug use, including heroin. ATS use is associated with various physical and psychological problems. Focusing on ATS use in India and developing strategies to address this problem is essential., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© 2024 The Author(s).)

Objective· To test the mechanism of mindfulness-based intervention in patients with amphetamine-types stimulants disorders. Methods· Forty participants a drug rehabilitation center in Shanghai who had amphetamine-type stimulants disorders were enrolled in this randomized controlled trial and randomly divided into either the intervention group or control group. The control group only received the normal treatment, while the intervention group received mindfulness-based intervention as well as normal treatment. Resting state electroencephalogram and mindfulness attention awareness were assessed before and after the intervention. Results· Compared with the control group, the scores of mindfulness attention awareness improved significantly in the intervention group (P0.000), and functional connectivity of frontal cortex (F4 and F5) under the eye-open state and parietal-occipital cortex (P7 and O2) under the mindfulness state increased significantly in the intervention group in β oscillations (P0.000). Moreover, the functional connectivity of parietal-occipital cortex was significantly correlated with the mindfulness attention awareness scores in the intervention group (P0.000). Conclusion· Mindfulness-based intervention is effective in improving the mindfulness attention awareness and increasing the electroencephalogram functional connectivity of partial frontal and parietal-occipital cortex for patients with amphetamine-type stimulants disorders. [ABSTRACT FROM AUTHOR]

Parkinson’s Disease (PD) is currently the most rapid growing neurodegenerative disease and over the past generation, its global burden has more than doubled. The onset of PD can arise due to environmental, sporadic or genetic factors. Nevertheless, most PD cases have an unknown etiology. Chemicals, such as the anthropogenic pollutant 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) and amphetamine-type stimulants, have been associated with the onset of PD. Conversely, cannabinoids have been associated with the treatment of the symptoms’. PD and medical cannabis is currently under the spotlight, and research to find its benefits on PD is on-going worldwide. However, the described clinical applications and safety of pharmacotherapy with cannabis products are yet to be fully supported by scientific evidence. Furthermore, the novel psychoactive substances are currently a popular alternative to classical drugs of abuse, representing an unknown health hazard for young adults who may develop PD later in their lifetime. This review addresses the neurotoxic and neuroprotective impact of illicit substance consumption in PD, presenting clinical evidence and molecular and cellular mechanisms of this association. This research area is utterly important for contemporary society since illicit drugs’ legalization is under discussion which may have consequences both for the onset of PD and for the treatment of its symptoms.

Previous studies provide evidence that Tai Chi (TC) can reduce the symptoms of sleep problems and be of benefit for the rehabilitation of substance abusers. In this study, we investigated if TC practice can improve sleep quality and mood of females who are dependent on amphetamine-type stimulant (ATS). Eighty subjects were randomly assigned to TC intervention and standard care (SC) for 6 months. We applied analysis of variance on repeated-measure with the year of drug dependence as the covariate to test the changes of the self-rated Pittsburg Sleep Quality Index (PSQI), Self-Rating Depression Scale (SDS), as well as fitness after 3 and 6 months. Relapse investigation was conducted by checking the database of China's National Surveillance System on Drug Abuse and that of the Shanghai Drug Control Committee's illicit drug dependents. Our investigation focused on the relapse of participants who had undergone and completed treatment in the Shanghai Mandatory Detoxification and Rehabilitation Center in 2015. The result showed that the PSQI scores of sleep duration [F(2, 92) = 9.86], need for sleep medications [F(2, 92) = 36.44] and daytime dysfunction [F(2, 92) = 5.15] were found to have a significant difference by time × group interaction after 6 months. SDS showed no significant difference between the two groups; however, the score of SDS in TC decreased after 6-month intervention, and no changes were observed in SC. Pulse rate had significantly decreased in the TC group compared with the SC group after 6 months. 9.5% (4) ATS dependents in TC and 26.3% (10) ATS dependents in SC were found to have relapsed. Our result suggested that TC had positive effects on sleep quality, depression and fitness. Long-term study demonstrated that TC may be a cheap and potential supplementary treatment for ATS-dependent individuals. TC may also be considered as an alternative exercise to escalate abstinence for ATS-dependent females.Clinical trial registration: ChiCTR-IPR-14005343 chictr. org.cn

Carbon nanotubes (CNTs) have attracted a lot of attention as effective sorbents due to their strong sorption properties and several potential applications in many fields. In this work, the acid oxidized multiwalled carbon nanotubes (MWCNTs-COOH) was coated onto a stainless steel wire by a simple physical adhesion approach to develop solid-phase microextraction (SPME) fibers. By combination of the MWCNTs-COOH coated fiber-based headspace SPME and gas chromatography-mass spectrometry (GC-MS), the developed method demonstrates a good enhancement factor (288-651), low limits of detection (LODs, 0.2-1.3μg/L) for determination of amphetamine-type stimulant drugs (ATSs) in urine samples. The recoveries of the spiked ATSs (5, 50 and 500μg/L) were in the range of 88-107%, the calibration curve was linear for concentrations of analytes in the range from 0.5 to 1000μg/L (R=0.963-0.999). Furthermore, single fiber repeatability and fiber-to-fiber reproducibility were in the range of 2.3%-6.2% (n=6) and 5.7%-9.8% (n=3), respectively. The MWCNTs-COOH coated fiber is highly thermally stable and can be used over 150 times. The method was successfully applied to the forensic determination of amphetamine (AMP) and methamphetamine (MAMP) in human urine samples and satisfactory results were achieved. [ABSTRACT FROM AUTHOR]

Previous studies provide evidence that Tai Chi (TC) can reduce the symptoms of sleep problems and be of benefit for the rehabilitation of substance abusers. In this study, we investigated if TC practice can improve sleep quality and mood of females who are dependent on amphetamine-type stimulant (ATS). Eighty subjects were randomly assigned to TC intervention and standard care (SC) for 6 months. We applied analysis of variance on repeated-measure with the year of drug dependence as the covariate to test the changes of the self-rated Pittsburg Sleep Quality Index (PSQI), Self-Rating Depression Scale (SDS), as well as fitness after 3 and 6 months. Relapse investigation was conducted by checking the database of China's National Surveillance System on Drug Abuse and that of the Shanghai Drug Control Committee's illicit drug dependents. Our investigation focused on the relapse of participants who had undergone and completed treatment in the Shanghai Mandatory Detoxification and Rehabilitation Center in 2015. The result showed that the PSQI scores of sleep duration [ F (2, 92) = 9.86], need for sleep medications [ F (2, 92) = 36.44] and daytime dysfunction [ F (2, 92) = 5.15] were found to have a significant difference by time × group interaction after 6 months. SDS showed no significant difference between the two groups; however, the score of SDS in TC decreased after 6-month intervention, and no changes were observed in SC. Pulse rate had significantly decreased in the TC group compared with the SC group after 6 months. 9.5% (4) ATS dependents in TC and 26.3% (10) ATS dependents in SC were found to have relapsed. Our result suggested that TC had positive effects on sleep quality, depression and fitness. Long-term study demonstrated that TC may be a cheap and potential supplementary treatment for ATS-dependent individuals. TC may also be considered as an alternative exercise to escalate abstinence for ATS-dependent females. Clinical trial registration: ChiCTR-IPR-14005343 chictr. org.cn [ABSTRACT FROM AUTHOR]

Approximately 35.7 million people world-wide use amphetamine-type stimulants (ATS) leading to a high demand for effective treatment. Understanding the motives behind ATS use is a necessary basis for preventive and therapeutic treatment. The objective of this study is to develop the Amphetamine-Type stimulants Motive Questionnaire (AMQ) and to confirm its construct and concurrent validity in respect to the first and the latest month of ATS use based on answers of 233 patients with ATS disorders (74.2% male; mean age: 31.1 years). Confirmatory factor analyses were employed to test for the construct validity of the AMQ. Nested models of confirmatory factor analyses with increasing constraints for gender and age were estimated to test the equivalence of the factor structure in different subgroups. Independent sample t-tests were conducted to test for mean differences in the motive dimensions. A structural equation model was estimated to confirm the concurrent validity using the latent four motive factors (i.e., enhancement, coping, social, and conformity motives) as independent variables and frequency of ATS use in the first and the latest month of use as a dependent variable. The results confirmed the AMQ’s four-dimensional factor structure in general, and across gender and age groups for both periods of time. Men (first month: M = 4.21, SD = 0.75; latest month: M = 3.86, SD = 0.93) use ATS more frequently due to enhancement motives than women (first month: M = 3.85, SD = 1.12; latest month: M = 3.46, SD = 1.29) at both periods of time [first month: t(77) = −2.33, p = 0.022; latest month: t(80) = −2.19, p = 0.031]. Structural equation modeling confirmed an association between coping motives and use frequency, for both periods of time (first and latest month: β = 0.32, p

Abstract: Methamphetamine (METH) is the primary drug within amphetamine‐type stimulants which are the second most abused group of drugs worldwide. There is no pharmacological treatment addressed specifically to METH addiction, and behavioral therapy is shadowed by poor long‐term recovery and relapse. Therefore, novel approaches to manage METH addiction are an urgent need. This review aims to describe the current state of physical exercise use on methamphetamine addiction management. The following searching terms in PubMed were used: (“physical exercise” OR “exercise”) AND “methamphetamine.” Relevant references from key publications and gray literature were also reviewed to identify additional citations for inclusion. Original investigation regarding physical exercise and methamphetamine addiction (clinical data) or neurobiological mechanisms of physical exercise in animal models of methamphetamine administration (preclinical data) was included. Overall, METH users demonstrated improvements, including better fitness and emotional measures, lower relapse rates, and sustained abstinence when compared to nonexercised individuals. The neurobiological mechanisms of physical exercise in METH users seem to reflect an interplay of several agents, including neurochemicals, oxidative stress, neurogenesis, gliogenesis, and blood‐brain barrier as disclosed by preclinical data. Exercise‐based interventions alone or as a conjoint therapy may be a useful tool for managing METH addiction. [ABSTRACT FROM AUTHOR]

The actual illicit market for synthetic drugs is characterized by a wide variety of psychoactive substances of different chemical and pharmacological classes, such as amphetamine-type stimulants and new psychoactive substances. The knowledge about its chemical composition, as well as the nature and quantity of the active substances present, is important for emergency care in intoxication cases by these substances and to establish adequate chemical and toxicological analysis procedures in forensic laboratories. The aim of this work was to study the prevalence of amphetamine-type stimulants and new psychoactive substances in the states of Bahia and Sergipe, in the northeast region of Brazil, involving samples of drugs seized by the local police forces from 2014 to 2019. In a total of 121 seized and analyzed samples, in which ecstasy tablets predominated (n = 101), nineteen substances were identified using GC-MS and 1D NMR techniques, comprising classical synthetic drugs and new psychoactive substances (NPS). In order to determine the composition of ecstasy tablets, an analytical method based on GC-MS was applied after validation. Analyzes of 101 ecstasy tablets showed that MDMA was the main substance, being found in 57% of the samples, in amounts between 27.3 and 187.1 mg per tablet. In addition, mixtures of MDMA, MDA, synthetic cathinones and caffeine were observed in 34 samples. These results demonstrate that the variety of substances found and the composition of seized materials in northeast Brazil is similar to other studies carried out previously in other Brazilian regions. [Display omitted] • Synthetic drugs comprise substances of different chemical and pharmacological classes. • This work studies the prevalence of ATS and NPS in two Brazilian northeastern states. • In a total of 121 samples, 19 substances were identified using GC-MS and 1D NMR. • The results were similar to other previously carried in other Brazilian regions. [ABSTRACT FROM AUTHOR]

A method for the statistical comparison of mass spectral data is demonstrated for applications in controlled substance analysis. The method uses an unequal variance t-test at each mass-to-charge ratio in the scan range to determine if two spectra are statistically associated or discriminated. If the two spectra are associated, a random-match probability is calculated to estimate the likelihood that the mass spectral fragmentation pattern in question occurs by random chance alone. If the two spectra are discriminated, the fragment ions responsible for the discrimination are determined. In this work, mass spectral data from case samples containing amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxymethamphetamine (MDMA), phentermine, and psilocin were investigated. All spectra were collected in an accredited forensic laboratory using routine methods for controlled substance analysis. Using the statistical method, spectra of case samples were statistically associated to the corresponding reference standard at the 99.9% confidence level. In these instances, random-match probabilities ranged from 10-39 to 10-29, indicating the probability that the characteristic fragmentation pattern occurred by random chance is extremely small. Further, spectra of case samples were discriminated from other reference standards at the 99.9% or 99.0% confidence level, with 1-26 ions responsible for discrimination in each comparison. [ABSTRACT FROM AUTHOR]

Background: China, as other Southeast Asian countries, has witnessed an increased use in amphetamine-type stimulants (ATS) amongst urban youth. Amongst female adolescents who both sell sex and use ATS, risk behaviours are compounded resulting in even poorer health outcomes. However, limited knowledge exists on ATS use patterns and ATS-related risk behaviours, particularly in this context. This research aimed to improve the understanding of these issues amongst female adolescents who use ATS and sell sex, and to inform future programming. Method: This study utilised monthly focus group discussions (four in total) with the same study participants in Yunnan, China. From within a drug-treatment programme, female adolescents who reported both a history of drug use and selling sex were purposively enrolled in the study. Results: Participating adolescent females were aged 17-19 years and were all internal-migrants with low literacy. All reported polydrug use (mainly methamphetamine and heroin, whereas ecstasy and ketamine have been infrequently employed). Being less informed about risks of drug use and lack of sexual and reproductive health knowledge seemed to contribute to problematic drug use, rough and prolonged sexual intercourse, inconsistent condom use and ineffective contraceptive practice. For their income, participants largely relied on selling sex, which was frequently coupled with drug sharing services to clients. However, despite the practices, women did not self-identify as sex workers, and therefore did not think that existing intervention services targeting female sex workers were relevant to them. Moreover, criminalization and stigmatisation of drug use and selling sex impeded their access to care services. Conclusion: Current harm reduction and HIV/sexually transmitted infection (STI) prevention services are unlikely to address the demand of female adolescents engaged in drug use and commercial sex. Our findings highlight that a comprehensive and coordinated harm reduction and sexual and reproductive health response should be conducted involving these most vulnerable adolescents. [ABSTRACT FROM AUTHOR]

Introduction: HIV infections and the use of amphetamine-type stimulants (ATS) among men who have sex with men (MSM) have been increasing internationally, but the role of ATS use as a co-factor for HIV infection remains unclear. We aimed to summarize the association between ATS use and HIV infection among MSM. Methods: We conducted a systematic search of MEDLINE, EMBASE, GLOBAL HEALTH and PsycINFO for relevant English, peerreviewed articles of quantitative studies published between 1980 and 25 April 2013. Pooled estimates of the association - prevalence rate ratios (PRR, cross-sectional studies), odds ratio (OR, case-control studies) and hazard ratio (HR, longitudinal studies), with 95% Confidence Intervals (CI) - were calculated using random-effects models stratified by study design and ATS group (meth/amphetamines vs. ecstasy).We assessed the existence of publication bias in funnel plots and checked for sources of heterogeneity using meta-regression and subgroup analysis. Results: We identified 6710 article titles, screened 1716 abstracts and reviewed 267 full text articles. A total of 35 publications were eligible for data abstraction and meta-analysis, resulting in 56 records of ATS use. Most studies (31/35) were conducted in high-income countries. Published studies used different research designs, samples and measures of ATS use. The pooled association between meth/amphetamine use and HIV infection was statistically significant in all three designs (PRR = 1.86; 95% CI: 1.57-2.17; OR = 2.73; 95% CI: 2.16-3.46 and HR = 3.43; 95% CI: 2.98-3.95, respectively, for cross-sectional, case-control and longitudinal studies). Ecstasy use was not associated with HIV infection in cross-sectional studies (PRR = 1.15; 95% CI: 0.88-1.49; OR = 3.04; 95% CI: 1.29-7.18 and HR = 2.48; 95% CI: 1.42-4.35, respectively, for cross-sectional, case-control and longitudinal studies). Results in cross-sectional studies were highly heterogeneous due to issues with ATS measurement and different sampling frames. Conclusions: While meth/amphetamine use was significantly associated with HIV infection among MSM in high-income countries in all study designs, evidence of the role of ecstasy in HIV infection was lacking in cross-sectional studies. Crosssectional study design, measurement approaches and source populations may also be important modifiers of the strength and the direction of associations. Event-specific measure of individual drug is required to establish temporal relationship between ATS use and HIV infection. HIV prevention programmes targeting MSM should consider including interventions designed to address meth/amphetamine use. [ABSTRACT FROM AUTHOR]

Brazil is one of the world's highest users of anorectic drugs, mainly diethylpropione, fenproporex and sibutramine. The present work focuses on physical and chemical characteristics of 17 counterfeited capsules containing amphetamine-type stimulants (ATS) from three seizures conducted by Brazilian Federal Police. The physical profile was useful in indicating forgery, bring complementary information, but the use of this data singly was not sufficient to distinguish between authentic and counterfeited medicines. The chemical analysis revealed that the seizures capsules labeled as Desobesi-M® (fenproporex 25 mg), actually contained the active pharmaceutical ingrediente (API) sibutramine. The amount of this API ranged from 1/3 to 2 times the amount of drug found in commercial product, may reach twice the recommended daily dose. Multivariate analysis with application of principal component analysis on data from spectroscopy attenuated total reflectance Fourier transform infrared classified the samples according to their similarities, indicating that two seizures had common origin. This study represents the first step in the elucidation of falsification of ATS in Brazil. Considering the forensic intelligence these information are valuable in order to develop and establish a database that enables correlate samples from different locations and/or suppliers and to map the profile and trends of trafficking. [ABSTRACT FROM AUTHOR]

We examined the applicability of chemically modified capillaries on the chiral capillary electrophoresis of essential compounds for methamphetamine (MA) profiling (MA, amphetamine, ephedrine, pseudoephedrine, norephedrine, and norpseudoephedrine) using highly sulfated γ-cyclodextrin as a chiral selector. Four types of chemically modified capillaries, namely, FunCap-CE/Type D (possessing diol groups), Type A (amino groups), Type C (carboxyl groups), and Type S (sulfate groups), were evaluated. Repeatability, speed, and good chiral resolution sufficient for routine MA profiling were achieved with the Type S capillary. [ABSTRACT FROM AUTHOR]

Abstract: A gas chromatography–mass spectrometry (GC–MS) method was developed and validated for the simultaneous qualification and quantification of methamphetamine (MA), amphetamine (AP), 3,4-methylenedioxy-N-methylamphetamine (MDMA), 3,4-methylenedioxy-N-amphetamine (MDA), ketamine (KET) and norketamine (NKT) in fingernails. Fingernail samples (20mg) were washed with distilled water and methanol, digested with 1.0M sodium hydroxide at 95°C for 30min, and then extracted with ethyl acetate. Extract solutions were evaporated to dryness, derivatized using heptafluorobutyric anhydride (HFBA) at 60°C for 30min, and analyzed by GC–MS. The linear ranges were 0.1–20.0ng/mg for AP, MDMA and NKT, 0.2–20.0ng/mg for MA and MDA, and 0.4–20.0ng/mg for KET, with the coefficients of determination (r 2 ≥0.9989). The intra- and inter-day precisions were within 7.1% and 10.6%, respectively. The intra- and inter-day accuracies were −10.9% to 0.8% and −4.3% to 4.5%, respectively. The limits of detections (LODs) and the limits of quantifications (LOQs) for each analyte were lower than 0.094ng/mg and 0.314ng/mg, respectively. The recoveries were in the range of 72.3–94.9%. The average fingernail growth rates of two subjects for three years and six subjects for two months were 3.12mm/month and 3.16mm/month, respectively. The method proved to be suitable also for the simultaneous detection and quantification of MA, MDMA, KET and their metabolites in fingernails. [Copyright &y& Elsevier]

Abstract: The aim of this work was to study the influence of hair bleaching on the enantiomeric ratios of amphetamine-type stimulants (ATS), including amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine, 3,4-methylenedioxymethamphetamine and 3,4-methylenedioxyethylamphetamine. Hair specimens from 14 STA users were treated with a commercial bleaching product during 40min. After alkaline digestion and solid-phase extraction of bleached and non-bleached hair, the STA enantiomers were derivatised with an in-house synthesised chiral reagent, the (2S,4R)-N-heptafluorobutyryl-4-heptafluorobutoyloxy-prolyl chloride. The diastereoisomers were quantified by GC/MS-NCI. The results showed that the concentrations of all enantiomers decreased in bleached hair in comparison with the non-treated hair (median values between 20 and 39%). The enantiomeric ratios of the STA in bleached hair were not significantly different from those determined in non-treated hair. Our findings pointed out that bleaching treatments decrease concentrations of STA in hair without influencing their enantiomeric ratios. [Copyright &y& Elsevier]

Abstract: In Hong Kong, ecstasy tablets are more commonly known as “Fing Tau Yuen”, literally meaning “Shake Head Pills”. The tablets contain mainly amphetamine-type stimulants (ATS) including 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), methamphetamine (MA) and/or ketamine. Adulterant such as caffeine was also detected in the tablets. This paper reports a study on the impurity profiles of ecstasy tablets from 89 seizures in Hong Kong from 2002 to early 2004. Tablet samples were extracted by diethyl ether under alkaline condition and then analyzed by gas GC–MS. The chromatograms obtained were compared. A total of 19 identified impurities were selected as markers for impurity profiling. They are different precursors, intermediates and by-products. The data matrices were examined by hierarchical cluster analysis (HCA), and then the ecstasy tablets were classified into different groups. Cluster analysis of ecstasy tablets is shown to be capable of providing intelligence on clandestine laboratory networks. [Copyright &y& Elsevier]

Abstract: The applicability of capillary electrophoresis (CE) with a UV detector using highly sulfated γ-cyclodextrin as a chiral selector was examined for analysis of impurities in seized methamphetamine. Samples of methamphetamine-hydrochloride dissolved in water at a high concentration (20mg/mL) were analyzed. Electrokinetic injection has an advantage over hydrodynamic injection for improving the detection of trace impurities. Small peaks of the precursor impurities, such as (1R,2S)-(−)-ephedrine and (1S,2S)-(+)-pseudoephedrine, were detected and quantified without extraction. The seized drugs could be classified into three groups based on the contents of the two impurities. [Copyright &y& Elsevier]