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Background: The misuse of psychotropic medication has increased during the past decade, especially among adolescents. The aim of our study was to describe the prevalence and patterns of the nonmedical use of benzodiazepines (BDZ) and Z‐hypnotics among school‐aged adolescents through the lens of sex. In addition, we sought to analyze the temporal evolution of the nonmedical use of these drugs during the period 2016–2021. Methods: The temporal evolution of the nonmedical use of these drugs was analyzed based on survey data collected in 2016, 2018 and 2021, which includes the first years of the COVID‐19 pandemic. To assess the possible effect of the COVID‐19 pandemic, the year at survey was conducted was introduced as a categorical variable. We used data from the Spanish State Survey on Drug Use in Secondary Education, which covers drug use among students aged 14–18 years. Using multivariate logistic regression models, we estimated the independent effect of different variables (sociodemographic data, use of other psychoactive substances, risk perception and availability) on the nonmedical use of BDZ and Z‐hypnotics. Results: In total, survey data from 95,700 adolescents were included in our analysis. The nonmedical use of BDZ and Z‐hypnotics increased among adolescents during the study period. The adjusted odds ratio (AOR) from 2016 to 2018 was 1.11 (95% CI 0.94–1.31) and from 2018 to 2021 the AOR was 1.26 (95% CI 1.08–1.46), using 2016 and 2018, respectively, as reference years. The nonmedical use of BDZ and Z‐hypnotics was more likely in adolescent girls than boys (AOR = 2.11). The nonmedical use of prescription opioids (AOR = 3.44), novel psychoactive substances and other illicit psychoactive drugs (AOR = 4.10) were risk factors for the nonmedical use of BDZ and Z‐hypnotics in both sexes. Use of cannabis (AOR = 1.38) was a predictor of nonmedical use in female adolescents only. Conclusions: This study shows that the trend of the nonmedical use of BDZ and Z‐hypnotics among school‐aged adolescents in Spain increased between 2016 and 2021. Among adolescents aged 14 to 18, the probability of nonmedical use of these psychoactive substances was twice as high for female adolescents as for male adolescents. [ABSTRACT FROM AUTHOR]

This article discusses the emergence of a new synthetic cathinone called dipentylone in Spain's illicit drug landscape. Synthetic cathinones are being marketed as replacements for amphetamine-derivatives and are often mislabeled as MDMA or used as adulterants. Dipentylone is a stimulant with effects similar to amphetamine and is twice as potent at inhibiting dopamine uptake as cocaine or MDMA. The article presents two cases of patients who unknowingly consumed dipentylone and experienced adverse effects. The study highlights the importance of comprehensive toxicological analysis to identify substances involved in acute drug intoxications. [Extracted from the article]

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol 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.)

Drug use implies important challenges related to HIV management, particularly due to an increased risk of potential interactions between antiretroviral therapy (ART) and illicit drugs (pDDIs). This study analyses the prevalence and severity of pDDIs among people living with HIV (PLHIV). It also explores their awareness of pDDIs and their beliefs about the toxicity that they may cause, as well as the impact of pDDIs on selected health variables. We conducted an on-line cross-sectional survey across 33 Spanish hospitals and NGOs to collect demographics and clinical data. pDDIs were checked against the Interaction Checker developed by Liverpool University. The sample of the present study was composed of 694 PLHIV who used illicit drugs. They represented 49.5% of the 1,401 PLHIV that participated in the survey. After excluding 38 participants due to lack of information on their ART or illicit drug use, 335 (51.1%) participants consuming drugs presented with some potentially significant pDDIs between their ART and illicit drugs, with a mean of 2.1±1.7 (1–10) pDDIs per patient. The drugs most frequently involved in pDDIs were cocaine, cannabis, MDMA and nitrates ("poppers"). The prevalence of pDDIs across ART regimens was: protease inhibitors (41.7%); integrase inhibitor-boosted regimens (32.1%), and non-nucleoside reverse transcriptase inhibitors (26.3%). An awareness of pDDIs and beliefs about their potential toxicity correlated positively with intentional non-adherence (p<0.0001). Participants with pDDIs exhibited a higher prevalence of intentional non-adherence (2.19±1.04 vs. 1.93±0.94; p = 0.001). The presence of pDDIs was not associated with poorer results in the clinical variables analysed. A significant proportion of PLHIV who use drugs experience pDDIs, thereby requiring close monitoring. pDDIs should be considered in the clinical management of HIV patients. Adequate information about pDDIs and indicators about how to manage ART when PLHIV use drugs could improve ART non-adherence. [ABSTRACT FROM AUTHOR]

Objective: To explore the use of tobacco, alcohol, and illicit drugs and its associated factors among Chinese immigrants living in Spain. Design and Measures: A mixed‐method design, using surveys and semi‐structured interviews. Sample: A total of 133 Chinese immigrants and stakeholders were assessed in the quantitative study and 7 stakeholders were interviewed in the qualitative study. Results: The use of tobacco and alcohol was higher than the use of illicit drugs in Chinese immigrants. The prevalence of daily smokers was greater in men than in women (37.3% vs. 2.5%, p <.001). Men consumed more alcohol (76% vs. 50.6%, p =.004) and more frequently (21.6% daily vs. 2.4%, p =.024) than women. The use of illicit drugs was low and Cannabis was the most illicit drug consumed (4%). Qualitative data revealed that due to a great workload, the workers tended to avoid behaviors of illicit drug consumption, but not of alcohol and tobacco, in which the consumption is associated with business meetings and leisure. Conclusion: This study found that Chinese immigrants in Spain consume more alcohol and tobacco than illicit drugs and that men have a high consumption compared to women. These findings reveal important cultural differences that should be addressed by public health managers in order to develop strategies that consider the characteristics of this population. [ABSTRACT FROM AUTHOR]

Background: We aimed to report the prevalence and factors associated with non-medical use of BZD and Z-Drugs in adolescents and young adults residing in Spain from a gender perspective. Nationwide, cross-sectional study on the misuse of BZD and Z-Drugs by young adult population of both sexes. Method: We used individualized secondary data retrieved from the 2015–2016 Household Survey on Alcohol and Drugs in Spain. A total of 10,824 survey respondents aged 15 to 34 years. Results: Prevalence of non-medical use of BZD and Z-Drugs was.42%, 1% in men vs. 1.84% in women, p =.00. Zolpidem presents the highest misuse rate in young males (45.8%), females showing a greater misuse prevalence for Lormetazepam (35.8%). The variables associated with a greater probability of misuse were, smoking habit, consumption of an illicit drug other than marijuana during last year. Low-perceived risk for BZD and Z-Drug consumption, was the variable showing the greatest value in young population (aOR = 3.88, 95% CI 2.53–5.93). Conclusions: Spanish young women are more likely to misuse BZD and Z-Drugs than men. Differentiated consumption is observed for these substances. A low perception of consumption risk and negative perception of health are strongly associated with non-medical use of BZD and Z-Drug among young Spanish population. [ABSTRACT FROM AUTHOR]

Background: To explore the use of illicit drugs by people living with HIV (PLHIV) taking antiretroviral therapy (ART) and their relationship with variables relevant to the management of HIV infection, such as knowledge and beliefs about drug–drug interactions (DDIs), ART adherence, quality of life (QoL), and use of health-care resources. Methods: 21 PLHIV in Spain who concomitantly took illicit drugs and ART participated in this qualitative study. Eight experts collaborated in the design of the semi-structured interview guide which explored the following topics: illicit drug use, knowledge and beliefs about DDIs and their impact on ART adherence, the effects of using illicit drugs on health, QoL, and use of health-care resources. Four of those experts, who were PLHIV and members of the executive boards of non-government organizations (NGOs) from four Spanish regions, recruited the participants through their NGOs and carried out the face-to-face interviews. Content analysis of the qualitative data was conducted with the support of the MAXQDA 12 program. Results: Participants were mainly men (85.7%) and only 14.3% of them were heterosexual. Content analysis showed that the most frequently consumed illicit drugs were poppers, cocaine, and cannabis. Participants were polydrug users and this was, in many cases, prior to HIV diagnosis. Most participants presented theoretical potential moderate DDIs that would require monitoring. More than three quarters of them were not aware of these DDIs. Participants reported interactive toxicity beliefs that lead to intentional nonadherence behaviors. In most cases (n = 17), the participant's doctor knew about their drug use, however only six of them had had an open dialogue with their physician about it. Illicit drug use led to some health-related problems, mainly sexually transmitted infections. A positive QoL's self-perception was found among several participants that used recreational illicit drugs. Conclusions: Adequate information about DDIs and clues about how to manage ART when PLHIV are using illicit drugs could reduce the negative effects of such interactions and improve ART adherence and QoL. [ABSTRACT FROM AUTHOR]

Background: Driving under the influence of alcohol, illicit drugs and certain medicines is not allowed worldwide. Roadside drug testing is considered an important tool for determining such behavior. In Spain, mandatory roadside oral fluid drug testing is carried out regularly. The aim of this study was to determine the prevalence of benzodiazepines and benzodiazepines in combination with other drugs in drivers, examine benzodiazepine concentrations in drivers, and analyze the association of these factors with age and sex.Methods: This study assessed data on Spanish drivers with confirmed drug-positive results recorded by the Spanish National Traffic Agency (Dirección General de Tráfico) between 2011 and 2016, accounting for 179,645 tests and 65,244 confirmed drug-positive tests.Results: Benzodiazepines were confirmed in 4.3% of all positive roadside drug tests. In most of those cases (97.1%), other substances were also detected, particularly cocaine (75.3%) and cannabis (64.0%). The frequency of benzodiazepine-positive drivers (OR, 1.094; 95% CI, 1.088-1.100) increased with age, while the frequency of drivers who tested positive for benzodiazepines in conjunction with other substances, compared with drivers who tested positive for benzodiazepines alone, decreased with age (OR, 0.903; 95% CI, 0.825-0.988). Nordiazepam (54.8%) and alprazolam (46.9%) were the most common benzodiazepines detected.Conclusion: Concomitant use of benzodiazepines and other psychoactive substances was found to be a common behavior among drivers who tested positive on the road. It is important to raise awareness of all those involved in the consumption of driving-impairing substances (authorities, healthcare providers, patients and their families, etc.): roadside detection of driving-impairing substances is suggested, in addition to promoting the use of fewer driving-impairing medications and the provision of clear information to patients. [ABSTRACT FROM AUTHOR]

This work presents an analytical methodology based on a "Quick, easy, cheap, effective, rugged, and safe" (QuEChERS) extraction and liquid chromatography-tandem mass spectrometry detection (LC-MS/MS) for the simultaneous determination of 35 psychoactive substances in fresh mussel samples. The compounds investigated include illicit drugs, new psychoactive substances, commonly prescribed psychiatric pharmaceuticals, and caffeine. The methodology was validated in terms of recovery (relative recoveries 77–118%), repeatability (relative standard deviation values <20%), and sensitivity (limits of detection and quantification <2 ng/g fresh weight (f.w.) and <6.7 ng/g f.w., respectively, for most compounds). The method was applied to the analysis of 15 samples, covering both commercially available mussels purchased from local food markets and wild fresh mussels collected in the Northeast coast of Spain in the Mediterranean Sea. Only one sample corresponding to wild mussels was found to contain 2 of the target analytes, namely, sertraline (1.5 ng/g f.w.) and caffeine, (12.8 ng/g f.w.). Unlabelled Image • Analysis of 35 psychoactive drugs in fresh mussels with QuEChERS and LC-MS/MS • Rapid, inexpensive, and simple sample preparation • The use of isotopically labeled surrogate standards assures results reliability. • Method detection limits were below 10 ng/g f.w. for all compounds. • Caffeine (12.8 ng/g f.w.) and sertraline (1.5 ng/g f.w.) found in wild mussels. [ABSTRACT FROM AUTHOR]

This study assessed the prevalence and patterns of drug use among people living with HIV (PLHIV) in Spain. We conducted an observational cross-sectional study including 1401 PLHIV. Data were collected through 33 sites across Spain using an online computer-assisted self-administered interview. The survey measured use of illicit drugs and other substances, treatment adherence and health-related variables. To analyse patterns of drug use we performed cluster analysis in two stages. The most frequently consumed substances were: alcohol (86.7%), tobacco (55.0%), illicit drugs (49.5%), other substances (27.1%). The most prevalent illicit drugs used were cannabis (73.8%), cocaine powder (53.9%), and poppers (45.4%). Results found four clusters of PLHIV who used drugs. Two of them were composed mainly of heterosexuals (HTX): Cluster 1 (n = 172) presented the lowest polydrug use and they were mainly users of cannabis, and Cluster 2 (n = 84) grouped mostly men who used mainly heroin and cocaine; which had the highest percentage of people who inject drugs and presented the lowest level of treatment adherence (79.8±14.2; p < .0001). The other two clusters were composed mainly of men who have sex with men (MSM), who were mostly users of recreational drugs. Cluster 3 (n = 285) reported moderate consumption, both regarding frequency and diversity of drugs used, while Cluster 4 (n = 153) was characterized by the highest drug polyconsumption (7.4±2.2; p < .0001), and 4 grouped MSM who injected recreational drugs, and who reported the highest frequency of use of drugs in a sexual context (2.6±0.8; p < .0001) and rates of sexually transmitted infections (1.8±1.1; p < .01). This is the largest multi-centre cross-sectional study assessing the current prevalence and patterns of drug use among PLHIV in Spain. The highest prevalence of drug use was found among MSM, although HTX who used heroin and cocaine (Cluster 2) had the most problems with adherence to HIV treatment and the worst health status. [ABSTRACT FROM AUTHOR]

The aim of this study is to analyze the adulteration and contamination of cannabis resin obtained on the streets of Madrid, in order to establish whether it is suitable for human consumption. A total of 90 samples obtained through street vending in the Region of Madrid (CAM) were analyzed. Our results showed a direct relationship between the shape of the samples (acorn or ingot) and the presence of foreign elements, adulterants and microbiological contamination. Foreign elements were found in 64.7% of the ingot-shaped samples and in 30.2% of the acorn-shaped samples (p < 0.01); 25% of the samples were deliberately adulterated, 66.7% of which had an ingot shape. With regard to microbiological contamination, 93% of acorns were contaminated by E. coli, compared to 29.4% of ingots (p < 0.0001). In addition, all samples with fecal odor were acorns and were contaminated by E. coli. Ten per cent of the samples were contaminated by Aspergillus; of these, 66.7% had the shape of an acorn. Overall, our results showed that most (88.3%) of the hashish samples were not suitable for consumption. This percentage was significantly higher (p < 0.0001) in acorn than in ingot samples (100% vs. 58.8%). Hence, illegal street vending of hashish constitutes a public health issue. [ABSTRACT FROM AUTHOR]

Multi-residue methods for the determination of the myriad of compounds of emerging concern (CECs) entering in the environment are key elements for further assessment on their distribution and fate. Here, we have developed an analytical protocol for the simultaneous analysis of 195 prescription, over-the-counter, and illicit drugs by using a combination of solid phase extraction (SPE) and determination by liquid chromatography coupled to high resolution mass spectrometry (LC-HRMS). The method was applied to the analysis of influent sewage samples from 3 wastewater treatment plants (WWTPs) from Cadiz Bay (SW Spain), enabling the quantification of more than 100 pharmaceuticals, 19 of them at average concentrations higher than 1 μg L−1, including caffeine (92 μg L−1), paracetamol (72 μg L−1), and ibuprofen (56 μg L−1), as well as several illicit drugs (e.g., cocaine). Wastewater based epidemiology (WBE) was applied for 27 of the detected compounds to establish their consumption in the sampling area, which has been never attempted before. Caffeine, naproxen, and salicylic acid stood out because of their high consumption (638, 51, and 20 g d−1·1000pop−1, respectively). Regarding illicit drugs, cocaine showed the highest frequency of detection and we estimated an average consumption of 3683 mg d−1·1000pop−1 in Cadiz Bay. The combination of new HRMS methods, capable of discriminating thousands of chemicals, and WBE will allow for a more comprehensive characterization of chemical substances and their consumption in urban environments in the near future. • More than 100 pharmaceutical compounds were measured in 3 cities of Cadiz Bay. • 19 of them had a concentration higher than 1ug·L-1 and 64 of them had a frequency of detection higher than 50%. • Differences in concentrations were detected between cities that were attenuated when normalized with load. • Consumption was calculated for 27 drugs that did not present significant variations during the week. • Slight differences related to consumption were found between the cities studied. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance The different species of the genus Datura have been used traditionally by some pre-Columbian civilizations, as well as in medieval rituals linked to magic and witchcraft in both Mexico and Europe. It is also noteworthy the use of different alkaloids obtained from the plants for medicinal purposes in the treatment of various groups of diseases, especially of the respiratory and muscularskeletal systems. Aim of the study A review of the ethnobotanical uses of the genus Datura in Mexico and Spain has been conducted. We focus on the medicinal and ritualistic uses included in modern ethnobotanical studies, emphasizing the historical knowledge from post-colonial American Codices and medieval European texts. Datura's current social emergency as a drug of recreation and leisure, as well as its link to crimes of sexual abuse is also considered. The work is completed with some notes about the distribution and ecology of the different species and a phytochemical and pharmacological review of Datura alkaloids, necessary to understand their arrival in Europe and the ethnobotanical uses made since then Materials and methods A literature review and compilation of information on traditional medicinal uses of the genus has been carried out from the main electronic databases. Traditional volumes (codices) have also been consulted in libraries of different institutions. Consultations have been made with the National Toxicological Services of Spain and Mexico for toxicological data. Results A total of 118 traditional uses were collected in both territories, 111 medicinal ones to be applied in 76 conditions or symptoms included in 13 pathological groups. Although there are particular medicinal uses in the two countries, we found up to 15 similar uses, of which 80% were previously mentioned in post-Colonial American codices. Applications in the treatment of asthma and rheumatism are also highlighted. Apart from medicinal uses, it is worth noting their cultural and social uses, in the case of Mexico relating to diseases such as being scared, astonishment or falling in love, and in the case of Spain, as a recreational drug and lately, for criminal purposes. Conclusions This review highlights the variety of uses traditionally given to the different species in both territories. The fact that most of the coincident or similar uses in both countries also appear in the classical codices can be found an example of the flow, not only of the plants from America to Europe, but also of their associated information. It is also relevant that particular uses have derived in both countries, reflecting the difference in the cultural factors and traditions linked to rituals and cultural practices. Finally, the significant growth of Datura consumption in recent years as a drug of leisure and recreation, as well as in crimes of sexual submission, should be considered as research of maximum relevance in the field of forensic botany and toxicology. [ABSTRACT FROM AUTHOR]

Background: Driving under the influence of certain drugs is not allowed, and roadside drug testing is being considered an important tool for deterring driving under the influence of them. This study aimed to assess the presence and concentration of opioids, as well as their combined use with other drugs (laboratory confirmation after the on-road screening) in Spanish drivers between 2011 and 2016.Methods: In Spain, mandatory roadside breath alcohol and oral fluid drug testing (screening) are carried out by the Traffic Police using Dräger Alcotest® 6810 device, and Dräger DrugTest® 5000, DrugWipe®, or Alere™ DDS®2 Mobile Test System. For positive cases in the period covered, 65,244, confirmation analysis and quantification using chromatographic techniques were performed.Results: Opioids were confirmed in 8.6% of positive cases, being 7.2% positives to 6-acetylmorphine (6-AM), 6.5% to morphine, 5.4% to codeine, and 4.1% to methadone. The majority of the confirmed tests for morphine (96.5%), codeine (88.4%) and methadone (81.9) were also positive for 6-AM. The presence of other drugs, particularly cocaine and cannabis, was very common. Concentration values reached important levels. Positive results for morphine (0.1%), codeine (0.6%) or methadone (0.4%) alone were very infrequent.Conclusions: Drivers with a confirmed positive roadside test for morphine, codeine, and methadone had also consumed heroin and/or other illicit drugs, such as cocaine and/or THC, and at relevant concentrations. Improving interventions to combat the problem of driving under the influence of driving-impairing substances is a priority. [ABSTRACT FROM AUTHOR]

The implementation of the points-based driving license helps to change the drivers' behavior and is related to a reduction of traffic accidents and fatalities. In Spain, when a driver loses all points, the driving license is revoked, so the driver must enroll on a Driver Awareness and Re-education (DARE) course. However, at the moment offenders are not submitted to any test to confirm absence of alcohol or drugs of abuse consumption, even when 9% of Spanish drivers lose their driving license for driving under the influence (DUI). The objective of this pilot study was the comparison of the usefulness of psychological tests and hair analysis to identify those individuals with a chronic consumption of alcohol and drugs of abuse among drivers performing DARE courses. Volunteers were submitted to the AUDIT and DAST-10 tests. Also a hair sample was collected and analyzed for ethylglucuronide (EtG) (LOQ 5pg/mg) and 35 licit and illicit drugs (LOQ 5-50pg/mg) by LC-MS/MS. Sixty-one participants with a mean age of 37.2±11.6years, and mainly men (90.2%), were recruited and performed AUDIT and DAST-10 tests. All hair samples were analyzed for EtG and 17 samples for licit and illicit drugs. Mean AUDIT score was 9.6 (SD=7.5), showing a value ≥8 (indicator of hazardous and harmful alcohol use) in 52.4% of cases. Mean DAST-10 score was 2.9 (SD=3.3), but a score ≥6 was detected in 21.3% of cases (indicating drug abuse or dependence). Twenty-two samples were positive for EtG, 8 for drugs of abuse (8 cocaine, 2 opioids, 1 amphetamines, 1 cannabis), and 3 for medicines. EtG concentration (20.7-1254.1pg/mg) was higher than the Society of Hair Testing (SoHT) cut-off for chronic alcohol consumption (≥30pg/mg) in 21 cases. All positive cases for methadone and cannabis, and half of positive cases for opioids and cocaine presented higher concentrations than SoHT cut-offs for chronic consumption. Higher AUDIT score and higher EtG concentration in hair were statistically associated with declaration of alcohol consumption ≥4 times/month and with previous fine for DUI of alcohol. In addition, AUDIT scores and EtG concentration in hair had a moderate but significant Spearman correlation (r=0.331, p<0.05). The combination of psychological tests and hair analysis seems to be a promising tool to identify individuals with chronic and problematic consumption of alcohol and drugs of abuse. Moreover, their application during driving license regranting procedures could increase the effectiveness of DARE courses, reduce recidivism and improve road safety. [ABSTRACT FROM AUTHOR]

Background: There is growing experience with the not-for-profit, consumer-driven cannabis social club (CSC) model that builds on self-supply, self-organization and harm-reduction; these are principles upon which people who use drugs (PWUD) have been engaging for decades. Recent legalization of cannabis in a number of jurisdictions and the related challenges in regulating production, sale, taxation and health-related matters have raised interest in non-commercial models of cannabis supply. The "codes of conduct" (CsoC) of CSC federations in Spain might reveal whether a consumer-based model could overcome these challenges.Methods: To examine the content of the CSC auto-regulatory documents, an online search using key terms to identify the CsoC was conducted. Six documents were found; analysis of the main thematic categories and overarching themes was conducted. It was discussed how these corresponded to the areas of cannabis policy regulation and what the main limitations of the CSC model were.Results: The CsoC detailed the rules for CSC administration, not-for-profit aims, "invitation only" and other conditions of membership, collective cultivation and security as well as for operation of the consumption venue and health-related initiatives. The themes in the CsoC overlapped with cannabis regulatory areas as outlined internationally. Concern over cannabis prices and potency was missing in the CsoC. The potential strengths of the CSC model might include safe environment for peer-delivered harm reduction practice, preventing illicit transactions, quality control, shifting economic surplus to the consumers and increased consumer responsibility. The limitations of the CSC model include high threshold, disguised motives, tax revenue and the risk of both under- and over-regulation.Conclusion: CSCs represent an opportunity to enhance consumer agency and responsibility. The right "to be self-supplied" with psychoactive substances can be granted to consumer associations - but authorities need to provide a framework to facilitate this voluntary self-organization, including minimum standards around public health and safety, and to involve consumers in the development of these regulations. [ABSTRACT FROM AUTHOR]

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol 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.)

Illicit and legal drugs of abuse, including alcohol, continue to be in the focus of many governmental national and international studies due to the important consequences of their consumption at both individual and social level. Estimation of drug use at the community level from the concentrations of the drugs themselves or their major metabolites measured in wastewater has become an increasingly accepted and extended tool, complementary to the methods traditionally used for this purpose. The present work describes the application of this approach, generally known as wastewater epidemiology, to investigate the latest drug consumption patterns and trends in the European city of Barcelona. To this end, a total of 19 selected drugs of abuse and metabolites were monitored at the inlet of one of the main wastewater treatment plants of Barcelona every day during one week in March between 2011 and 2015. Analysis of the selected drugs and metabolites in the wastewater samples was performed by means of two methodologies based on liquid chromatography-tandem mass spectrometry (LC-MS/MS), and the concentrations obtained were translated into consumption data. In agreement with official records, alcohol, followed by cannabis, cocaine, amphetamine-like compounds, and methadone were the most consumed drugs. Alcohol, cannabis, and cocaine consumption were on average 18 mL(14 g)/day/inhabitant (> 15), 38 g/day/1000 inhabitants aging 15–64, and 2.4 g/day/1000 inhabitants aging 15–64, respectively. As for drug use trends, consumption increased over the 5 years monitored for all drugs, but for heroin and diazepam. Weekly profiles characterized by higher consumption over the weekend as compared to weekdays were observed only for alcohol, cocaine, and MDMA. Extrapolation of the data obtained for the area under study to the national Spanish territory yields consumption figures of 142 t of illicit drugs per year and > 2500 million euro turnover per year in the black market. [ABSTRACT FROM AUTHOR]

• High consumption rates of NPS and drugs of abuse were discovered at Festivals. • A dynamic change in NPS use (presence/absence) was found in a period of six months. • Significant differences (p < 0.05) were seen for drugs (Festivals vs normal week) • N,N-dimethylpentylone is reported in a WBE study for the first time. • 3-Methylmethcathinone and 3-chloromethcathinone were consumed during the Festivals. The market for illicit drugs and new psychoactive substances (NPS) has grown significantly and people attending festivals have been identified as being at high risk (high extent and frequency of substance use). Traditional public health surveillance data sources have limitations (high costs, long implementation times, and ethical issues) and wastewater-based epidemiology (WBE) can cost-effectively support surveillance efforts. Influent wastewater samples were analyzed for NPS and illicit drug consumption collected during New Year period (from 29-Dec-2021 to 4-Jan-2022) and a summer Festival (from 29-June-2022 to 12-July-2022) in a large city in Spain. Samples were analyzed for phenethylamines, cathinones, opioids, benzodiazepines, plant-based NPS, dissociatives, and the illicit drugs methamphetamine, MDA, MDMA, ketamine, heroin, cocaine, and pseudoephedrine by liquid chromatography mass spectrometry. High consumption rates of specific NPS and established illicit drugs were identified at the peak of each event. Furthermore, a dynamic change in NPS use (presence and absence of substances) was detected over a period of six months. Eleven NPS, including synthetic cathinones, benzodiazepines, plant-based NPS and dissociatives, and seven illicit drugs were found across both the New Year and summer Festival. Statistically significant differences (p < 0.05) were seen for 3-MMC (New Year vs summer Festival), eutylone (New Year vs summer Festival), cocaine (summer Festival vs normal week and summer Festival vs New Year), MDMA (New Year vs normal week and summer Festival vs normal week), heroin (summer Festival vs New Year) and pseudoephedrine (summer Festival vs New Year). This WBE study assessed the prevalence of NPS and illicit drugs at festivals following the reduction of the COVID-19 pandemic restrictions highlighting the high use of specific substances at the peak of each event. This approach identified in a cost-effective and timely manner without any ethical issues the most used drugs and changes in use patterns and, thus, can complement public health information. [ABSTRACT FROM AUTHOR]

• Drugs consumption in Valencia over 10 years was assessed by wastewater-based epidemiology. • Cannabis, tobacco, and cocaine are the most used drugs. • Consumption of cocaine, ecstasy, and heroin was increased during the weekends. • MDMA, cocaine, amphetamine, methamphetamine use was higher during "Las Fallas" (local festivity). Wastewater-based epidemiology (WBE) approach provides objective, quantitative, near real-time profiles of illicit drug consumption by monitoring the concentration of unchanged parent drugs or their metabolites entering the municipal sewage system. Valencia is the third most populous city in Spain (an important country for the use and transit of several of these drugs). Estimations of consumption over long periods of time will help get better understanding of spatial and temporal trends in the use of licit and illicit drugs. Accordingly, applying the "best practice" protocol, 16 drugs of abuse and metabolites were monitored in this study, and 8 were daily measured during one-two weeks between 2011 and 2020 at the inlet of three wastewater treatment plants of Valencia City. Analysis of the selected compounds was performed by liquid chromatography-triple quadrupole mass spectrometry, and the concentrations obtained were used to back-calculate the consumption data. Cannabis, tobacco, and cocaine were the most consumed drugs whereas opioids were less used. Cannabis and cocaine consumption are on average 2.7–23.4 and 1.1–2.3 g/day/1000inh, respectively, and their use tended to increase since 2018. Weekly profiles were characterized by higher consumption of cocaine, ecstasy, and heroin during weekends compared to weekdays. Similarly, during "Las Fallas" (main local festivity), increased use of cocaine and amphetamine-type stimulants, mainly MDMA, was measured. WBE proved to be an objective and useful methodology to get more insight on temporal drugs of abuse consumption, and the changes derived from local festivities. [Display omitted] [ABSTRACT FROM AUTHOR]

Background: Illegal drugs consumption not only has a notable impact on the population's health, but also leads to major socio-economic costs. A significant characteristic of drug consumers is that the majority are of working age. The main aim of this study is to estimate the economic impact of drug consumption in Spain from a social perspective.Methods: A cost-of-illness methodology is carried out and a distinction is made between health-related and non-health related direct costs, as well as indirect costs. Among the direct health care costs included are hospitalisations, primary and emergency care, support programmes and HIV outpatient care. Expenditure on prevention, law enforcement and research was included as direct costs falling outside of health care. Productivity losses due to premature deaths attributed to substance abuse and patient hospitalisation formed part of indirect costs.Results: For 2012, the total social cost related to drug consumption in Spain was somewhere between 1,436 and 1,651 million euros. The minimum cost of this consumption represented 0.14% of Spain's GDP for that year.Conclusion: The present cost estimations provide a measure of the social burden that illegal drug consumption represents for the community. When it comes to allocating resources, the obtained results quantify the potential economic returns that could be achieved from effective policies and programmes aimed at reducing the consumption of illegal drugs. [ABSTRACT FROM AUTHOR]

Physical victimization and substance use are common behaviors inside prisons. Yet little is known about whether there is an association between substance use and physical victimization among male inmates. We examined the absolute and relative association between substance use (prior to, during, and both prior to and during incarceration) and physical victimization while incarcerated. For this study, 2484 men (mean age of 36.3years; SD=11.1) were sampled from eight prisons located in Spain. Information was collected using self-report questionnaires probing experiences of physical victimization while incarcerated and substance use prior to prison and during the past six months in prison. We found that the rates and likelihood of physical victimization were greater for male inmates who used substances at any time, compared to non-consumers of substances but were highest for male inmates who used exclusively in prison or both prior to and in prison. These findings suggest the need for immediate prevention steps including comprehensive screening and segregation practices; better drug interdiction practices; and more evidence-based substance abuse treatment with and without integrated trauma treatment to ensure public health and safety. [ABSTRACT FROM AUTHOR]

The present work investigates the occurrence of 22 drugs of abuse (DAs) and metabolites in surface water from four Spanish River basins: Llobregat, Ebro, Jucar and Guadalquivir. To this end, samples were collected from 77 selected sites in two sampling campaigns conducted in 2010 and 2011. Analyses were performed by means of on-line solid phase extraction-liquid chromatography-electrospray-tandem mass spectrometry (on-line SPE-LC-ESI-MS/MS). Cocaine, its metabolite benzoylecgonine, ephedrine, MDMA (ecstasy), and methadone and its metabolite EDDP were the most ubiquitous compounds, being present in more than 50% of the samples. Overall, DAs were present at low ng/L levels, showing comparatively higher concentrations in small tributary rivers impacted by wastewater treatment plant effluents. The results obtained did not show a clear relationship between the concentrations of DAs and the hydrological conditions of the river basins. Differences in the occurrence of DAs between river basins were observed, but only for MDMA this finding could be confirmed in both sampling campaigns. These results overall suggest similar drugs consumption in the studied areas. Estimation of potential ecotoxicological effects using Hazard Quotient (HQ) ratios and a concentration addition model showed that in four samples the presence of DAs could represent certain risk to aquatic organisms. [ABSTRACT FROM AUTHOR]

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol 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 and Aims: There is a lack of instruments for measuring ketamine substance use disorders. The aims were (i) to estimate the reliability and provide evidence of validity of the Severity of Dependence Scale (SDS) in a sample of recreational users, and (ii) propose a cut-off point to determine the presence of dependence.Methods: We conducted a web-based cross-sectional survey with recreational users who accessed webs related to recreational drug use and harm reduction. 264 recreational ketamine users who had taken it in the past month participated in the study. The Spanish version of the SDS was used. Information on ketamine use-related problems and ketamine use patterns was also collected.Results: The reliability estimation calculated by the Cronbach's alpha coefficient was 0.776. SDS showed evidence of convergent validity based on relationships with other variables. Two comparisons were made in this study to analyze the Receiver Operating Characteristic Curve. For frequency of use in the last month the area under curve (AUC) was 0.835 (CI=0.775-0.895) with optimal discrimination at an SDS score of 3. For having been in treatment for decreasing or quitting ketamine use the AUC was 0.902 (CI=0.840-0.963) and the cut-off point was 4. Confirmatory factor analysis showed a one-dimensional structure when Items 3 and 4 were correlated.Conclusions: This study has provided evidence of reliability and validity of the ketamine version of the SDS for recreational users. Considering that ketamine use is linked to young people and its strong potential for causing serious impairment, a cut-off of 3 is proposed as indicative of dependence. [ABSTRACT FROM AUTHOR]

Background: Cannabis social clubs (CSCs) in Spain are non-profit organisations that connect regular adult cannabis users. One of their functions is to supply cannabis to the closed circuit of members. The CSCs do not breach any international treaties. The aim of the paper is to present the findings of a qualitative study among Spanish CSCs in order to assess their potential for minimising the harm resulting from cannabis use (such as respiratory and mental health risks, the risk of dependence, and social risks).Method: A convenience sample of 11 CSCs was selected from four regions of Spain - the Basque country, Catalonia, the Balearic Islands, and Galicia. 94 respondents took part in 14 focus groups (FGs). The number of participants in a FG ranged from two to 12. A semi-structured interview guide and a structured questionnaire were used in the FG.Findings: Members described a variety of risk minimising features of the CSCs: the availability of a quality product and mechanisms for its control, availability of different strains of cannabis and knowledge about their different psychoactive effects, increased control over personal cannabis use, informal information sharing and interaction, reduced stigma, and reduced criminal risks.Conclusions: The fact that the CSCs have no incentive to increase members' consumption means that they should be considered to be feasible spaces for the implementation of public health policies. Policy objectives could include a requirement that CSC members have control over the quality of cannabis, that different strains of cannabis are available together with information on their effects, that quantity of cannabis at intake is restricted and planned for each member, and that harm minimisation activities are both formally and informally implemented in the clubs. [ABSTRACT FROM AUTHOR]

The occurrence of psychotropic substances (PSs) in the air is known since long time. Recently, attention was paid to illicit PS, with most investigations undertaken in Italy and Spain. In general, collection of illicit substances was performed through aspirating airborne particulates onto filters; afterwards, gas chromatography or high-performance liquid chromatography coupled with mass spectrometry were applied for the PS evaluation. Over twenty substances could be characterized simultaneously. Cocaine concentrations up to 17 ng m − 3 were observed in Latin America, while this substance was absent (< 0.003 ng m − 3 ) in Algiers (Algeria) and Pančevo (Serbia). Cannabinoids (comprising the psycho-active principle Δ 9 -tetrahydrocannabinol [THC]) were high in the winter and very low in the summer (up to 6 ng m − 3 and < 0.1 ng m − 3 , respectively). Many other substances (e.g., heroin, ephedrine and drug by-products) occurred less frequently and at lesser extents (< 20 pg m − 3 ). In Rome (Italy), investigations were carried out in interiors of dwellings, schools, an office and a coffee bar, all sites resulting affected by drugs. Besides, solid phase microextraction methods were applied to detect ketamine and methamphetamine in interiors. The PS concentrations depended on substance, physical–chemical contour, and internal or external type of locations. Air monitoring allows detecting the drug consumption or preparation, because illicit substances prevail in sites frequented by abusers. [ABSTRACT FROM AUTHOR]

The existence of pharmaceuticals and illicit drugs (PIDs) in environmental waters has led many analytical chemists to develop screening methods for monitoring purposes. Water samples can contain a huge number of possible contaminants, commonly at low concentrations, which makes their detection and identification problematic. Liquid chromatography coupled with high resolution mass spectrometry (LC-HRMS) has proven itself effective in the screening of environmental contaminants. The present work investigates the use of the most popular HRMS instruments, quadrupole time-of-flight and linear trap quadrupole-Orbitrap, from two different laboratories. A suspect screening for PIDs was carried out on wastewater (influent and effluent) and surface water samples from Castellón, Eastern Spain, and Cremona, Northern Italy, incorporating a database of 107 PIDs (including 220 fragment ions). A comparison between the findings of both instruments and of the samples was made which highlights the advantages and drawbacks of the strategies applied in each case. In total, 28 compounds were detected and/or identified by either/both instruments with irbesartan, valsartan, benzoylecgonine and caffeine being the most commonly found compounds across all samples. [Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

Background: The study's aim was to estimate the self-reported prevalence of Human Immunodeficiency Virus (HIV) and Hepatitis C Virus (HCV), and to describe their associated risk factors in a population of users of illicit drugs recruited in Catalonia- Spain, during 2012.Methods: Cross-sectional study. People with illicit drugs use were selected in three different types of healthcare centres. The questionnaire was a piloted, structured ad hoc instrument. An analysis was made to identify factors associated to self-reported HCV, HIV and co-infection. Correlates of reported infections were determined using univariate and multivariate Poisson regression (with robust variance).Results: Among 512 participants, 39.65% self-reported positive serostatus for HCV and 14.84% for HIV, co-infection was reported by 13.48%. Among the 224 injecting drug users (IDUs), 187 (83.48%), 68 (30.36%) and 66 (29.46%) reported being positive for HCV, HIV and co-infection, respectively. A higher proportion of HIV-infected cases was observed among women, (18.33% vs. 13.78% in men). Prevalence of HCV, HIV and co-infection were higher among participants with early onset of drug consumption, long periods of drug injection or who were unemployed. A positive serostatus was self-reported by 21(7.34%) participants who did not report any injection; among them 16 and eight, reported being positive for HCV and HIV, respectively; three reported co-infection. Only two people declared exchanging sex for money. For those that reported a negative test, the median time since the last HIV test was 11.41 months (inter-quartile range (IQR) 4-12) and for the HCV test was 4.5 months (IQR 2-7).Conclusions: Among drug users in Catalonia, HIV, HCV and co-infection prevalence are still a big issue especially among IDUs. Women and drug users who have never injected drugs are groups with a significant risk of infection; this might be related to their high-risk behaviours and to being unaware of their serological status. [ABSTRACT FROM AUTHOR]

Background: The literature shows how gender mandates contribute to differences in exposure and vulnerability to certain health risk factors. This paper presents the results of a study developed in the south of Spain, where research aimed at understanding men from a gender perspective is still limited. Objective: The aim of this paper is to explore the lay perceptions and meanings ascribed to the idea of masculinity, identifying ways in which gender displays are related to health. Design: The study is based on a mixed-methods data collection strategy typical of qualitative research. We performed a qualitative content analysis focused on manifest and latent content. Results: Our analysis showed that the relationship between masculinity and health was mainly defined with regard to behavioural explanations with an evident performative meaning. With regard to issues such as driving, the use of recreational drugs, aggressive behaviour, sexuality, and body image, important connections were established between manhood acts and health outcomes. Different ways of understanding and performing the male identity also emerged from the results. The findings revealed the implications of these aspects in the processes of change in the identity codes of men and women. Conclusions: The study provides insights into how the category 'man' is highly dependent on collective practices and performative acts. Consideration of how males perform manhood acts might be required in guidance on the development of programmes and policies aimed at addressing gender inequalities in health in a particular local context. [ABSTRACT FROM AUTHOR]

Aim To determine predictors of changes in amount of cocaine use among regular users outside treatment services. Design Longitudinal study-we estimated the proportion of subjects who increased or decreased cocaine use and assessed possible predictors related to these changes among a street-recruited cohort of young regular cocaine users ( RCU). Setting Three Spanish cities: Barcelona, Madrid and Seville Participants A total of 720 RCU aged 18-30 years not regularly using heroin were recruited in the community during 2004-06 (Itinere Project). Follow-up interviews ( n = 501) were carried out at 12-24 months. Measurements The average amount of cocaine used weekly was calculated taking into account the number of days of use and the usual quantity (g/day). A multinomial logistic regression approach was used to investigate the association between changes in amount of cocaine use (i.e. difference exceeded 33.3% of baseline level) after 12-24 months, and baseline socio-demographic characteristics, nightlife, patterns of cocaine use and use of alcohol and other psychoactive drugs. Findings Cocaine use baseline average level was 2.14 g/week [95% confidence interval ( CI) = 2.02-2.42]. It decreased in 71.5% of subjects and increased in 14.1%. In multinomial analysis, negative associations were found between decreasing cocaine use and high levels of alcohol consumption and using an increasing number of psychoactive drugs. Moreover, low education level, having used cocaine frequently in houses and reporting cocaine binges were associated with increasing cocaine use. Conclusions A street-recruited cohort of cocaine users in Spain showed a significant reduction in cocaine use over a period of 12-24 months. High consumption of alcohol and increasing use of other psychoactive drugs decreased the probability of reducing cocaine use. [ABSTRACT FROM AUTHOR]

Introduction: The concealment of packets of illegal substances within body cavities is a common technique for drug smuggling worldwide. The goal of our study was to analyze the results of conservative treatment of 'body packers', indications for surgical intervention, and postoperative morbidity. Methods: This is a retrospective study of patients admitted to our hospital and diagnosed as body packers. The diagnostic protocol included an abdominal X-ray and urinalysis for toxic substances. Only patients with gastrointestinal symptoms, signs of intoxication, or a positive urinalysis were admitted for observation. Conservative management included bowel rest and serial abdominal radiographs to confirm the passage per rectum of all foreign bodies. Asymptomatic patients were given laxatives in the emergency department (ED) to promote bowel movements and were not admitted to the hospital. Results: A total of 763 body packers were admitted to the hospital, all of whom were initially treated conservatively. Of these patients, 47 (6 %) developed complications: 28 with bowel obstruction, three with bowel perforation, and 16 with substance intoxication. In patients developing complications, urinalysis for toxic substances was negative in 19 (40 %). Sixteen (34 %) patients who developed complications were successfully managed nonoperatively. Three (6 %) other patients died before surgery: two deaths resulted from acute toxicity (one of them with an acute onset and a negative urinalysis) and the third patient died of bowel perforation. Laparotomy was required in 28 (3.5 %) body packers admitted for observation. Enterotomy and/or gastrotomy to remove the packets were the most frequently performed procedures. Postoperative morbidity occurred in 57 % of patients, with wound infection being the most frequent complication. Conclusions: Conservative management was effective in 94 % of symptomatic patients. A laparotomy was required in only 3.5 % of cases. The mortality rate in this series was low, resulting from either severe cocaine poisoning from ruptured packets or bowel perforation. [ABSTRACT FROM AUTHOR]

The Mediterranean wetlands are unique in biological diversity and provide multiple benefits, constituting a great water reserve for the planet and producing biomass and nutrients for the trophic chain. However, the increasing human impact and socio-economic development in recent decades have caused important losses in these ecosystems. This work was carried out in the Natural Park of L'Albufera (Valencia, Spain), which includes a coastal lagoon, marshlands, dunes and pinewoods, surrounded by rice fields and orchard in its non-urbanized part. Despite this great ecological value, it suffers impacts derived from the high human and industrial occupation and the hydrological contributions of the connected irrigation systems. The study focused on the development of a combined methodology, based on environmental forensics principles, with the aim of identifying the presence, flow paths and spatial distribution of illicit drugs entering the Natural Park. It is organized around two major procedures: analysis of 16 water samples and application of Geographical Information Systems (GIS) integrating different sources and data formats, as analysis of 14 drugs of abuse by Liquid Chromatography-Mass Spectrometry techniques, and social and environmental data in either GIS layers or tabular digital formats. Results show that, at present, most analyzed drugs have been identified in all sample points. Besides the population distribution pattern, the traditional irrigation system connected to sewage treatment plant (STP) locations is the way by which illicit substances are introduced into the Natural Park waters. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to report on the barriers to reintegration for Gitano (Gypsy) communities in one northern Spanish city. Design/methodology/approach – The article is based on ethnographic research undertaken in Gitano communities throughout 2010. Findings – Over the last 30 years, the city has witnessed vast commercial and residential expansion, resulting in the spatial and social exclusion of Gitanos to the outskirts of the city. Here they have had to survive by reduced access to their livelihoods in city markets and increasingly through illicit drug markets and crime. It is only recently that there have been attempts to relocate these people back into the city. Yet the social reintegration efforts have only perpetuated the social exclusion of the Gitanos and there is significant community opposition to their relocation. Social implications – The council need to take more care in consulting Gitanos and seek to build the fragile relations they have with them before deciding on what "best to do about them". Originality/value – No ethnographic research has been undertaken in this city in the context of Gitanos. [ABSTRACT FROM AUTHOR]

Copyright of Psychologia is the property of Universidad de San Buenaventura 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.)

The COVID-19 pandemic spread rapidly worldwide in the year 2020, which was initially restrained by drastic mobility restrictions. In this work, we investigated the use of illicit drugs (amphetamine, methamphetamine, ecstasy, cocaine and cannabis), and licit substances of abuse (alcohol and tobacco) during the earlier months (March-July 2020) of the pandemic restrictions in four Spanish (Bilbao and its metropolitan area, Vitoria-Gasteiz, Castellón and Santiago de Compostela) and two Portuguese (Porto and Vila do Conde) locations by wastewater-based epidemiology (WBE). The results show that no methamphetamine was detected in any of the locations monitored, while amphetamine use was only detectable in the two locations from the Basque Country (Bilbao and its metropolitan area and Vitoria-Gasteiz), with high estimated average usage rates (700-930 mg day -1 1000 inhabitant -1 ). The remaining substances were detected in all the investigated catchment areas. In general, no remarkable changes were found in population normalized loads compared to former years, except for cocaine (i.e. its main metabolite, benzoylecgonine). For this drug, a notable decrease in use was discernible in Castellón, while its usage in Porto and Santiago de Compostela seemed to continue in a rising trend, already initiated in former years. Furthermore, two events of ecstasy (3,4-methylenedioxymethamphetamine, MDMA) dumping in the sewage network were confirmed by enantiomeric analysis, one in Santiago de Compostela just prior the lockdown and the second one in the Bilbao and its metropolitan area in July after relieving the more stringent measures. The latter could also be associated with a police intervention. The comparison of WBE with (web) survey data, which do not provide information at a local level, points towards contradictory conclusions for some of the substances, thereby highlighting the need for stable WBE networks capable of near real-time monitoring drug use., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)

Abstract: This paper reviewed the presence of emerging organic contaminants (EOCs) that have been found in the groundwater in Spain in both, rural and urban areas. The list of compounds included pesticides, pharmaceutical active compounds (PhACs), selected industrial compounds, drugs of abuse (DAs), estrogens, personal care products and life-style compounds. The main sources of pollution and possible pathways have been summarised in this review. EOCs are likely to enter to the aquifer mainly through the effluents of waste water treatment plants (WWTPs) and are present in groundwater at concentrations of ng/L to μg/L. The most studied compounds in Spanish groundwater were pesticides followed by industrial compounds and PhACs. It is important to mention that compared to other water bodies, such as rivers, groundwater is considerably less contaminated, which may be indicative of the natural attenuation capacity of the aquifers. However, some EOCs have sometimes been detected at higher concentration levels in the aquifer than in the rivers, indicating the need for further research to understand their behaviour in the aquifers. For a wide array of compounds, their maximum concentrations show values above the European groundwater quality standard for individual pesticides (0.1μg/L). Therefore, to preserve groundwater quality against deterioration it is necessary to define environmental groundwater thresholds for the non-regulated compounds. [Copyright &y& Elsevier]

Abstract: This work investigates for the first time the occurrence of drugs of abuse and metabolites in surface waters from the Tagus River on its way through the province of Toledo (downstream Madrid metropolitan area) and in drinking waters in two nearby cities. Some of the studied drugs are used for therapeutic purposes but they can also be consumed as illicit drugs. The results of this preliminary study have revealed the presence of 12 out of 22 drugs of abuse analyzed in fluvial water at concentrations ranging from 1.14 to 40.9ng/L. The largest concentrations corresponded to the anxiolytics diazepam and lorazepam, the cocaine metabolite benzoilecgonine, the amphetamine-like compound ephedrine, and the methadone metabolite EDDP. All these substances, except for lorazepam, were detected in all the sampling points. Traces of methadone and ephedrine were detected in some samples of tap water. Despite the low concentrations of these pollutants, effects on wildlife or human health cannot be disregarded, especially on vulnerable population. Thus, the treatment of these substances using a heterogeneous photo-Fenton process has been evaluated, rendering a remarkable effectiveness for their degradation. [Copyright &y& Elsevier]

Abstract: This study is concerned with drugs of abuse (DAs) and their metabolites in urban groundwater at field scale in relation to (1) the spatial distribution of DAs in Barcelona''s groundwater, (2) the depth of the groundwater samples, (3) the presence of DAs in recharge sources, and (4) the assessment of the fate of DAs in Barcelona aquifers. To this end, 37 urban groundwater samples were collected in the city of Barcelona and a total of 21 drugs were analyzed including cocainics, amphetamine-like compounds, opioids, lysergics and cannabinoids and the prescribed drugs benzodiazepines. Overall, the highest groundwater concentrations (around 200ng/L in SAP-4) and the largest number of detected DAs were found in zones basically recharged by a river that receives large amounts of effluents from waste water treatment plants (WWTPs). In contrast, the urbanized areas yielded not only lower concentrations but also a much smaller number of drugs, which suggests a local origin. In fact, cocaine and its metabolite were dominant in more prosperous neighborhoods, whereas the cheaper MDMA was the dominant DA in poorer districts. Measured concentrations were consistently smaller than those estimated from the waste water fraction in groundwater samples, suggesting that DAs undergo removal processes in both reducing and oxidizing conditions. [Copyright &y& Elsevier]

To estimate the prevalence of alcohol, tobacco and illicit drug consumption (through the self- report) in adult Latin-American immigrants of Seville, a cross-sectional descriptive study was carried out in a representative sample of 190 immigrants. The results showed that 61.4% of the participants had consumed alcohol in previous month before data collection, although 13.2% of them were at risk of alcoholism. Moreover, 30.0% were smokers. In addition, 5.3% of the interviewed people had consumed illicit psychoactive substances in the previous six months (Marihuana: 3.7%, hashish: 1.1% and cocaine: 0.5%). For all substances under analysis, the consumption prevalence was much higher in men from 25 to 39 years of age. In conclusion, prevalence levels of this consumption were high among the studied immigrants. Nurses could train the population in the prevention of these risk behaviors through preventive practices. [ABSTRACT FROM AUTHOR]

Introduction: Despite regulations, tobacco consumption in schools is still very common. The objective was to evaluate the relationship of personal, family, and school-level contextual factors with smoking on school premises. Methods: A representative survey was undertaken of students in the 4th year of secondary education in the Madrid region (Spain), including 79 schools and 3,622 individuals. The student questionnaire gathered information about personal and family variables. The contextual factors were type of school, perception of compliance with the law, smoking policy, existence of complaints against smoking, and undertaking of educational activities regarding smoking. Analysis was carried out in the smoking population (n = 1,179) using multilevel logistic regression models. Results: During the last 30 days, 50.6% of smokers had smoked on school premises. Having a father with a university education (in comparison with fathers who have not attained any educational level) reduces this probability (odds ratio [OR]: 0.43; 95% CI: 0.19–0.96), whereas smoking a larger number of cigarettes (p < .001), illicit drug consumption (p < .001), and low academic achievement (p = .052) increases it. The probability is reduced when there is no parental permission to smoke (OR: 0.66; 95% CI: 0.43–1.01) and is lower both in nonsubsidized private schools (OR: 0.29; 95% CI: 0.12–0.67) and in state subsidized private schools (OR: 0.17; 95% CI: 0.09–0.34) than in public schools. Conclusions: A very low level of educational attainment by the father, smoking a higher number of cigarettes, as well as illicit drug consumption, low academic achievement, having parental permission to smoke, and attending public schools are all related to a higher probability of smoking on school premises. [ABSTRACT FROM PUBLISHER]

Abstract: A total of seventy samples of drinking water were tested for non-controlled and illicit drugs. Of these, 43 were from Spanish cities, 15 from seven other European countries, three from Japan and nine from seven different Latin American countries. The most frequently detected compounds were caffeine, nicotine, cotinine, cocaine and its metabolite benzoylecgonine, methadone and its metabolite EDDP. The mean concentrations of non-controlled drugs were: for caffeine 50 and 19ngL−1, in Spanish and worldwide drinking water respectively and for nicotine 13 and 19ngL−1. Illicit drugs were sparsely present and usually at ultratrace level (<1ngL−1). For example, cocaine has mean values of 0.4 (Spain) and 0.3ngL−1 (worldwide), whereas for benzoylecgonine, these mean values were 0.4 and 1.8ngL−1, respectively. Higher concentrations of benzoylecgonine were found in Latin American samples (up to 15ngL−1). No opiates were identified in any sample but the presence of methadone and EDDP was frequently detected. Total mean values for EDDP were 0.4ngL−1 (Spain) and 0.3ngL−1 (worldwide). Very few samples tested positive for amphetamines, in line with the reactivity of chlorine with these compounds. No cannabinoids, LSD, ketamine, fentanyl and PCP were detected. [Copyright &y& Elsevier]

Abstract: The presence of cocaine, heroin, cannabinoids and amphetamines, among other drugs of abuse, was detected in airborne particulates in urban environments in Spain. The levels of these compounds were determined at air quality monitoring sites by the application of a novel and specifically targeted analytical methodology, by which mean daily concentrations of cocaine (204–480pg/m3, up to one order of magnitude higher than in Italy and Portugal), cannabinoids (THC, 27–44pg/m3), amphetamine (1.4–2.3pg/m3) and heroin (9–143pg/m3) were determined in the atmosphere. Results allowed detecting common temporal consumption patterns between cocaine and cannabis (with week-end maxima), but markedly distinct consumer groups. Personal exposure to the levels of all the drugs detected may be considered negligible, posing no harm for human health. Given the worldwide scarcity of data on drug levels in atmospheric particulates, we present this methodology as a fast, economic and reliable tool to obtain high quality data for the monitoring of drug abuse and drug dealing in cities. Applications include the detection of changes in drug consumption trends, the mapping of drug consumption and/or dealing areas in cities, and the identification of new emerging drugs. [Copyright &y& Elsevier]

Abstract: Drugs of abuse and their metabolites have been recently recognized as environmental emerging organic contaminants. Assessment of their concentration in different environmental compartments is essential to evaluate their potential ecotoxicological effects. It also constitutes an indirect tool to estimate drug abuse by the population at the community level. The present work reports for the first time the occurrence of drugs of abuse and metabolites residues along the Ebro River basin (NE Spain) and also evaluates the contribution of sewage treatment plants (STPs) effluents to the presence of these chemicals in natural surface waters. Concentrations measured in influent sewage waters were used to back calculate drug usage at the community level in the main urban areas of the investigated river basin. The most ubiquitous and abundant compounds in the studied aqueous matrices were cocaine, benzoylecgonine, ephedrine and ecstasy. Lysergic compounds, heroin, its metabolite 6-monoacetyl morphine, and Δ9-tetradhydrocannabinol were the substances less frequently detected. Overall, total levels of the studied illicit drugs and metabolites observed in surface water (in the low ng/L range) were one and two orders of magnitude lower than those determined in effluent (in the ng/L range) and influent sewage water (µg/L range), respectively. The investigated STPs showed overall removal efficiencies between 45 and 95%. Some compounds, such as cocaine and amphetamine, were very efficiently eliminated (>90%) whereas others, such as ecstasy, methamphetamine, nor-LSD, and THC-COOH where occasionally not eliminated at all. Drug consumption estimates pointed out cocaine as the most abused drug, followed by cannabis, amphetamine, heroin, ecstasy and methamphetamine, which slightly differs from national official estimates (cannabis, followed by cocaine, ecstasy, amphetamine and heroin). Extrapolation of the consumption data obtained for the studied area to Spain points out a total annual consumption of drugs of abuse of the order of 36 tonnes, which would translate into 1100million Euros in the black market. [Copyright &y& Elsevier]

Spain is one of the European countries with the highest prevalence of cannabis and cocaine use among young people. The aim of this study was to investigate the factors related to the consumption of cocaine and cannabis among adolescents. A questionnaire was administered to 9,284 students between 14 and 18 years of age in Palma de Mallorca (47.1% boys and 52.9% girls) whose mean age was 15.59 years. Logistic regression and decision trees were carried out in order to model the consumption of cannabis and cocaine. The results show the use of legal substances and committing fraudulence or theft are the main variables that raise the odds of consuming cannabis. In boys, cannabis consumption and a family history of drug use increase the odds of consuming cocaine, whereas in girls the use of alcohol, behaviours of fraudulence or theft and difficulty in some personal skills influence their odds of consuming cocaine. Finally, ease of access to the substance greatly raises the odds of consuming cocaine and cannabis in both genders. Decision trees highlight the role of consuming other substances and committing fraudulence or theft. The results of this study gain importance when it comes to putting into practice effective prevention programmes. [ABSTRACT FROM AUTHOR]

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Aims To estimate the annual incidence of heroin use in Spain. Participants and design Data on individuals' year of first heroin use (from 1971 to 2005), year of first heroin treatment between 1991 and 2005 and most frequent route of heroin administration when presenting to treatment were obtained from the Spanish Drug Observatory Register and used to calculate the delay between onset and treatment. By using a log-linear model approach it was possible to correct for missing observations (heroin users who presented for treatment before 1991 and those who had still not presented by the end of 2005) and to estimate heroin incidence over time. Findings The estimated incidence of problematic heroin use in the population aged 15–44 peaked at 190 per 100 000 in 1980—after rising rapidly from less than 40 per 100 000 in 1971—and fell subsequently to about 8 per 100 000 in 2005. On average, incidence was five times higher in men. Injecting heroin incidence peaked and declined rapidly from 1980; as heroin smoking did not decline as rapidly, from 1985 onwards its estimated incidence has remained above that of heroin injecting. The delay between starting heroin use and entering treatment had a median of 3 years. Conclusions We demonstrate the utility of a method to estimate heroin incidence from analysis of observed trends in presentations at specialist drug treatment facilities. The estimates suggest that incidence of heroin use, especially injecting, has fallen since 1980 and is now lower than in the early 1970s. [ABSTRACT FROM AUTHOR]

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The present work describes the first fully automated method, based on on-line solid-phase extraction (SPE)-liquid chromatography-electrospray-tandem mass spectrometry, developed for the determination of drugs of abuse (17 compounds and metabolites belonging to the classes of amphetaminics, cannabinoids, cocainics, opiates, and lysergics) in sewage waters. On-line SPE is performed by passing 5 mL of the water sample through a PLRP-s cartridge for analytes measured in positive ionization mode (all but cannabinoids) and through an Oasis HLB cartridge for analytes measured in negative ionization mode (cannabinoids). For unequivocal identification and confirmation two selected reaction monitoring transitions are registered per compound, thus achieving the four identification points requested by the European Union for banned substances. Quantitation is performed by the internal standard method, indispensable to correct for matrix effects. The main advantages of the method developed are high sensitivity (limits of determination between 0.69 and 5.97 ng/L), selectivity and reliability of results, minimum sample manipulation, full automation, and fairly high throughput (analysis time per sample is 2 × 35 min). As a part of the validation procedure, the method developed has been applied to the analysis of various influent and effluent samples from four Spanish sewage treatment plants. [ABSTRACT FROM AUTHOR]