Search

Background and Purpose: New psychoactive substances such as N‐ethylpentylone (NEP) are continuously emerging in the illicit drug market, and knowledge of their effects and risks, which may vary between sexes, is scarce. Our present study compares some key effects of NEP in male and female mice. Experimental Approach: Psychostimulant, rewarding and reinforcing effects were investigated by tracking locomotor activity, conditioned place preference (CPP) paradigm and through a self‐administration (SA) procedure, respectively, in CD1 mice. Moreover, the expression of early genes (C‐fos, Arc, Csnk1e, Pdyn, Pp1r1b and Bdnf in addiction‐related brain areas) was assessed by qPCR. Finally, serum and brain levels of NEP were determined by UHPLC‐MS/MS. Key Results: NEP‐treated males experimented locomotor sensitisation and showed higher and longer increases in locomotion as well as higher hyperthermia after repeated administration than females. Moreover, while preference score in the CPP was similar in both sexes, extinction occurred later, and reinstatement was more easily established for males. Female mice self‐administered more NEP than males at a higher dose. Differences in early gene expression (Arc, Bdnf, Csnk1e and Ppp1r1b) were found, but the serum and brain NEP levels did not differ between sexes. Conclusion and Implications: Our results suggest that male mice are more sensitive to NEP psychostimulant and rewarding effects. These differences may be attributed to different early gene expression but not to pharmacokinetic factors. Moreover, males appear to be more vulnerable to the hyperthermic effects of NEP, while females might be more prone to NEP abuse. [ABSTRACT FROM AUTHOR]

Introduction: Harm reduction strategies at music festivals seek to create a safer environment for patrons. The Emerging Drugs Network of Australia–Victoria (EDNAV) project is a state‐wide toxicosurveillance network that derives drug intelligence from a sample of patients presenting to hospital with illicit drug‐related toxicity. This publication describes the preliminary outcomes of conducting toxicosurveillance for critically unwell festival patrons within on‐site medical facilities. Methods: Blood samples were collected from patrons who presented with severe illicit drug‐related toxicity across three festivals (2022/2023). Blood samples were analysed via liquid chromatography–tandem mass spectrometry for over 700 pharmaceutical and illicit drugs. Results: There were 1603 individual medical encounters across the festivals, 228 of which were illicit drug related. A blood sample was collected for 24 patients, with a median age of 22 years (range 18–39 years). A median of two drugs (range 1–5 drugs) were reported and four drugs (range 0–8 drugs) were analytically confirmed per patient. The most frequently reported exposures were congruent with analytical results, 3,4‐methylenedioxymethamphetamine (reported n = 17, detected n = 20), ketamine (reported n = 9, detected n = 13) and cocaine (reported n = 9, detected n = 12). An unreported illicit drug and/or new psychoactive substance (NPS) was detected in 18 patients, including methylamphetamine (n = 10), a cathinone (n = 7), benzodiazepine‐type NPS (n = 6), N‐ethylamphetamine (n = 1), 3‐hydroxyphencyclidine (n = 1) and/or 4‐hydroxy‐N‐methyl‐N‐isopropyltryptamine (n = 1). Discussion and Conclusions: EDNAV toxicosurveillance serves as an additional tool within a multi‐faceted approach to harm reduction at festivals. Continued data collection will allow for the characterisation of high‐risk drug use patterns to provide evidence‐based messaging to festival patrons and key stakeholders. [ABSTRACT FROM AUTHOR]

Various samples—including two vials with a pharmaceutical appearance—were submitted to the laboratory for identification. The aim of this work was to describe the unique characteristics observed during the analysis of the powder contained in the vial. Samples were submitted to HPLC‐DAD, UHPLC‐TOF‐MS, and/or UPLC‐MS–MS analysis. The majority of the samples were easily identified as standard drugs of abuse. The main difficulty lay in identifying the powder in the vials. No match was found in the library through HPLC‐DAD analysis. Fortunately, the vials were labeled as "Melanotan II", although the UV spectrum was not available. Mass spectrometric analysis of melanotan II was challenging, as it is a small peptide with a molecular weight of 1024 Da, which is significantly heavier than classical drugs that the laboratory usually handles. As a result, mass spectrometer's parameters can be limited to detect masses up to 1000 Da. Additionally, melanotan II is multi‐charged which is also unusual for compounds typically targeted in our daily work. Finally, the reference standard allowed us to confirm the identification with both instruments, and determine the purity of 30%. Melanotan II is not approved on the market due to safety concerns. It is used illegally mainly for tanning, explaining its nickname "Barbie drug". To conclude, analysis of melanotan II was challenging as it is heavy and doubly charged. Moreover, its UV spectrum was initially not available in the literature. The difficulties faced by forensic scientists in detecting this drug may explain its popularity on the illicit market. [ABSTRACT FROM AUTHOR]

AbstractIntroductionMethodsResultsDiscussionConclusionsClinicians managing patients with acute recreational drug or new psychoactive substance toxicity typically depend on self-reported drug(s) used. This study compares patient self-report (and/or from other sources) to the substance(s) that were subsequently identified in serum.A prospective sample of 1,000 adults presenting to a tertiary care, urban emergency department in London, United Kingdom, with acute recreational drug/new psychoactive substance toxicity was collected from 1 February 2019 to 2 February 2020. A total of 939 appropriate samples underwent qualitative analysis by high-resolution mass spectrometry with comparison to a database of drugs/metabolites. Data on the stated drug(s) used were extracted from the routine medical chart/records; results were batched by drug class, when appropriate, and analysis was performed using R software.Seven hundred and ninety-nine (85.1%) patients were male with a median (IQR) age of 34 years (27 to 42 years). Six hundred and thirty-five (67.6%) patients reported using two or more drugs. The median (IQR) positive predictive value of a self-report substance having been taken was 0.68 (IQR: 0.44–0.86); conversely, the median negative predictive value of a substance having not been taken was 0.90 (IQR: 0.53–0.95). There was variability in the accuracy of reporting. For example, self-reported opioid use had a 90.5% likelihood that opioids were detected on analysis, whereas hallucinogens were only detected in 18.8% of samples when use was reported. Individuals were also mostly accurate in not underreporting substances. For example, those not explicitly reporting gamma-hydroxybutyrate use were 97.5% truly negative.Overall, most users were relatively accurate in their self-report of what class of drugs they had used, although there was variability in this accuracy. However, other drugs were present even when not reported, for example, opioids with disproportionate detection of prescription and over-the-counter (non-prescription) opioids that were unreported.Self-report (and/or collateral reports) had overall relatively high concordance with the likelihood that a substance was, or was not, recently used. Therefore, clinicians can make initial treatment decisions based on the self-reported drug(s) used in most cases. [ABSTRACT FROM AUTHOR]

Rationale: The potent synthetic opioid fentanyl, and its analogs, continue to drive opioid-related overdoses. Although the pharmacology of fentanyl is well characterized, there is little information about the reinforcing effects of clandestine fentanyl analogs (FAs). Objectives: Here, we compared the effects of fentanyl and the FAs acetylfentanyl, butyrylfentanyl, and cyclopropylfentanyl on drug self-administration in male and female rats. These FAs feature chemical modifications at the carbonyl moiety of the fentanyl scaffold. Methods: Sprague-Dawley rats fitted with intravenous jugular catheters were placed in chambers containing two nose poke holes. Active nose poke responses resulted in drug delivery (0.2 mL) over 2 s on a fixed-ratio 1 schedule, followed by a 20 s timeout. Acquisition doses were 0.01 mg/kg/inj for fentanyl and cyclopropylfentanyl, and 0.03 mg/kg/inj for acetylfentanyl and butyrylfentanyl. After 10 days of acquisition, dose-effect testing was carried out, followed by 10 days of saline extinction. Results: Self-administration of fentanyl and FAs was acquired by both male and female rats, with no sex differences in acquisition rate. Fentanyl and FAs showed partial inverted-U dose-effect functions; cyclopropylfentanyl and fentanyl had similar potency, while acetylfentanyl and butyrylfentanyl were less potent. Maximal response rates were similar across drugs, with fentanyl and cyclopropylfentanyl showing maximum responding at 0.001 mg/kg/inj, acetylfentanyl at 0.01 mg/kg/inj, and butyrylfentanyl at 0.003 mg/kg/inj. No sex differences were detected for drug potency, efficacy, or rates of extinction. Conclusions: Our work provides new evidence that FAs display significant abuse liability in male and female rats, which suggests the potential for compulsive use in humans. [ABSTRACT FROM AUTHOR]

Mesolimbic dopamine (DA) transmission is believed to play a critical role in mediating reward responses to drugs of abuse, including alcohol (EtOH). The neurobiological mechanisms underlying EtOH-seeking behavior and dependence are not fully understood, and abstinence remains the only effective way to prevent alcohol use disorders (AUDs). Here, we developed novel RGS6fl/fl; DAT-iCreER mice to determine the role of RGS6 in DA neurons on EtOH consumption, reward, and relapse behaviors. We found that RGS6 is expressed in DA neurons in both human and mouse ventral tegmental area (VTA), and that RGS6 loss in mice upregulates DA transporter (DAT) expression in VTA DA neuron synaptic terminals. Remarkably, loss of RGS6 in DA neurons significantly reduced EtOH consumption, preference, and reward in a manner indistinguishable from that seen in RGS6−/− mice. Strikingly, RGS6 loss from DA neurons before or after EtOH behavioral reward is established significantly reduced (~ 50%) re-instatement of reward following extinguishment, demonstrating distinct roles of RGS6 in promoting reward and relapse susceptibility to EtOH. These studies identify DA neurons as the locus of RGS6 action in promoting EtOH consumption, preference, reward, and relapse. RGS6 is unique among R7 RGS proteins in promoting rather than suppressing behavioral responses to drugs of abuse and to modulate EtOH behavioral reward. This is a result of RGS6's pre-synaptic actions that we hypothesize promote VTA DA transmission by suppressing GPCR-Gαi/o-DAT signaling in VTA DA neurons. These studies identify RGS6 as a potential therapeutic target for behavioral reward and relapse to EtOH. [ABSTRACT FROM AUTHOR]

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]

North American police responses to the 'drug issue' have long been shaped by a crime control rather than a harm reduction imperative. Consequently, police officers' responses to safe consumption sites (SCSs), where people who use illicit drugs can reduce personal health risks by administering previously obtained drugs in the presence of trained staff, were initially hostile. This paper draws on interview data from police officers in two western Canadian cities to highlight an apparent softening in attitudes, perhaps due to the current fentanyl-driven drug poisoning crisis. While some officers clearly recognized their public health benefits, others accepted SCSs, acknowledging the futility of a continued 'war on drugs'. Some voiced reservations about SCSs, but not because of a generic 'drugs are bad' sentiment. Rather, they worried about specific downstream implications for communities and police work. These findings, reflecting apparent changes in police officers' responses to SCSs, are discussed in the context of contemporary debates about police culture and the possibilities and desirability of pursuing police reform. [ABSTRACT FROM AUTHOR]

We studied opioid agonist treatment (OAT) status before buprenorphine-related death in Finland, where buprenorphine is the principal OAT medicine and also the most misused opioid, through a retrospective population-based study using medico-legal cause-of-death investigation and OAT patient records. The study included all death cases (N = 570) between 2018 and 2020 with a buprenorphine or norbuprenorphine finding in post-mortem toxicology and with known drug misuse history or concomitant findings of illicit drugs. Of the deceased, 10% had received OAT in the year before death. Less than 1% of individuals < 25 years had received OAT, whereas the proportion in individuals ≥ 25 years was 13% (p < 0.001). There were significantly more females and more fatal poisonings (p < 0.001) among those < 25 years than among those ≥ 25 years. OAT medication at the time of death was sublingual buprenorphine-naloxone in 74% and subcutaneous buprenorphine in 23%. Except for significantly fewer benzodiazepine findings among those receiving OAT, minimal differences were found in terms of age, gender, cause and manner of death, or concomitant substance use between the deceased in and outside of OAT. Concomitant misuse of benzodiazepines, psychostimulants, alcohol, and gabapentinoids was frequent both in and outside of OAT and likely contributed to the death. These results suggest that access to OAT especially for young people and treatment of multiple addictions should be improved. Comprehensive information from medico-legal cause-of-death investigation as a starting point, combined with subsequent ante-mortem patient records, proved to be a successful approach to shed light on the Finnish scene of buprenorphine mortality. [ABSTRACT FROM AUTHOR]

Parental illicit substance use is associated with increases in both interparental conflict frequency and children's externalizing behaviors. There is a paucity of research examining the pathways linking these constructs. Assessing parental illicit substance use and interparental conflict frequency simultaneously can illustrate a process that potentially undermines children's behavioral adjustment. Using a sample of stable, long-term couples and their children from the Future of Families and Child Wellbeing Study (n = 1,011), the current study used path modeling and a multi-informant approach to examine the link between parental substance use and children's later externalizing behaviors and if interparental conflict frequency mediated this association. Results indicated that parental substance use, assessed at the couple-level, was not associated with children's later externalizing behavior, nor did interparental conflict frequency mediate this association. Post-hoc exploratory analyses found that mothers' substance use was associated with children's later externalizing behaviors, and this effect was stronger than fathers' substance use, which was not associated with children's later functioning. These results highlight the importance of examining how various aspects of substance use and different dimensions of interparental conflict might differentially impact children's outcomes. [ABSTRACT FROM AUTHOR]

Objectives. To examine drug overdoses in Colombia by type of substance, sex, age, and intent using data from a health surveillance system from 2010 to 2021. Methods. We characterized data by year, type of substance, and sociodemographic variables. We calculated age-adjusted overdose rates by substance type, sex, age groups, and intent. We used Poisson regression models to examine trend differences across sex and age groups. Results. Age-adjusted rates of drug overdoses increased from 8.51 to 40.52 per 100 000 during 2010 to 2021. Men, compared with women, had higher overdose rates for every substance, except for opioids and psychotropics. Drug overdose rates involving cannabis and stimulants increased steadily until 2017 but decreased afterward. Overdose rates involving psychotropic medication increased greatly during 2018 to 2021, mainly because of intentional overdoses in young women. Conclusions. Overdoses involving illegal drugs decreased in recent years in Colombia; however, the continuous increase in intentional psychotropic overdose rates highlights the need for prevention efforts to curb this trend. Health surveillance systems are an important tool that can guide overdose prevention efforts in countries with limited data resources. (Am J Public Health. 2024;114(11):1252–1260. https://doi.org/10.2105/AJPH.2024.307786) [ABSTRACT FROM AUTHOR]

Background: Substance use carries a wide range of negative consequences, impacting both the individual using the substances and others. In recent years, there have been multiple efforts to assess the harm caused by drugs and to rank them, with each taking a distinctive approach to the matter. Objectives: This study seeks to introduce a new model for assessing the harm index and ranking of drugs. Methods: This prospective study involved the evaluation of 277 male drug users, assessing substance use harm on four separate occasions throughout the span of 1 year. Various aspects of harm were quantified through the utilization of the Duke Health Profile (DUKE) and the Addiction Severity Index (ASI) questionnaire. The pharmaceutical properties of each drug were incorporated into the study. The relationship between the combined variables in a mixed statistical model was determined at a significance level of.05 using the Rsoftware. This procedure facilitated the establishment of models and the definition of harm index ranges for each substance. Result: The results indicated that heroin had the highest harm index at 71.2 (95% CI69.6–72.8), while pure methadone scored the lowest at 36.5 (95% CI31.7–41.7), along with methadone combined with methamphetamine, which scored 35 (95% CI33–37.1). Conclusion: The variables utilized in this study can help estimate the approximate harm index range for both traditional and novel substances. Furthermore, the harm model designed in this study has the capability to predict the extent of harm to a drug user. [ABSTRACT FROM AUTHOR]

Addictive, illicit drugs pose a high threat of relapse. The deaths related to illicit drugs have substantially increased in the last decade. Globally, the illicit drug trade poses a significant challenge to public health and law enforcement. It is essential to utilize advanced analytical methodologies that can characterize illegal substances precisely to monitor these drugs. Surfaced-enhanced Raman spectroscopy (SERS) has become a valuable tool, providing distinct capabilities for analyzing illegal substances. Surface enhancement enables far more sensitive detection and identification of illicit drugs by suppressing the fluorescence and enhancing the Raman signals. In this regard, a simple method with limited sample processing has been established to characterize illicit drugs that include methamphetamine (MAMP) (ice), bhang, marijuana (cannabis), opium, and diacetylmorphine (heroin). Moreover, principal component analysis (PCA) was employed for the identification of the characteristic SERS spectral features of these drugs. This article examines the potential application of SERS in the characterization of illicit substances, focusing on its ability to contribute significantly to law enforcement and forensic investigation. [ABSTRACT FROM AUTHOR]

In Brazil, ethnic-racial inequalities exist in all fields, obstructing access to goods, services, and opportunities, including healthcare services. However, there are no apparent studies that assess, at a national level, ethnic-racial disparities in poisoning cases, emphasizing skin color as a determining factor. The study aimed to examine the relationship between race/ethnicity and general poisoning cases, by medications, pesticides, and drug of abuse in Brazilian states. Poisoning cases data were extracted for the years 2017, 2018, and 2019. Notification data for general poisoning cases and toxic agents were collected: medications, pesticides, and drugs of abuse. Data were categorized between whites and non-whites (blacks, browns, and indigenous) and without information on skin color/ethnicity. Rates of poisonings amongst ethnic-racial groups and cases of not declared skin color as well as relative risk (RR) of poisoning among non-whites were calculated. All states in the North, Northeast (states with the worst Human Development Index), Midwest, and 2 states in the Southeast exhibited higher rates of poisoning cases per 100,000 inhabitants among non-whites. The RR values for nonwhite individuals were higher in the North and Northeast regions for all types of poisonings. The type of poisoning cases that presented the highest RR for non-whites over the 3 years was drugs of abuse (2–2.44), when compared to other types of poisonings from pesticides (2–2.33) and medications (1.5–1.91). The spatial distribution of poisoning cases rates and RR of nonwhite population support public policies to reduce socioeconomic and environmental inequalities. [ABSTRACT FROM AUTHOR]

Introduction: Substance abuse is a major public health problem. In recent years, ketamine, which is a parenteral anesthetic, has been consumed increasingly as an illicit drug together with alcohol, although little is known of how this association alters brain activity. The present study investigated the influence of progressive doses of ketamine, associated with alcohol, on electrophysiological activity. Methods: For this, 72 late-adolescent (8–10-week-old) male Wistar rats received either ketamine only, at low (10 mg/kg), intermediate (20 mg/kg) or high (30 mg/kg) doses via intraperitoneal injection, or alcohol (2 mL/100 g) via oral gavage followed by ketamine (at low, intermediate, and high doses). Electroencephalograms (EEG) and electromyographic recordings were obtained 5 min after the final application of the drug. Results: When administered alone, ketamine resulted in an increase in delta, theta, beta, and gamma brainwaves, with a more pronounced effect being detected at the highest dose (30 mg/kg) in the case of the delta, beta, and gamma waves. The amplitude of the alpha brainwaves was reduced at all doses of ketamine, but less intensively at the highest dose. When administered alone, alcohol reduced all the brainwaves, with the reduction in the alpha waves being exacerbated by ketamine at all doses, and that of the theta and beta waves being boosted at the lowest dose. The intermediate dose of ketamine (20 mg/kg) reverted the alcohol-induced reduction in the theta and gamma waves, whereas the high dose increased delta, theta, beta, and gamma bandpower. Discussion: Overall, then, while ketamine enhances the depressant effects of alcohol on the alpha brainwave at all doses, a low dose intensified this effect on the theta and beta 175 waves, whereas a high dose produces neuronal hyperexcitability in the theta and 176 gamma bandpower. [ABSTRACT FROM AUTHOR]

Introduction: Substance abuse is a major public health problem. In recent years, ketamine, which is a parenteral anesthetic, has been consumed increasingly as an illicit drug together with alcohol, although little is known of how this association alters brain activity. The present study investigated the influence of progressive doses of ketamine, associated with alcohol, on electrophysiological activity. Methods: For this, 72 late-adolescent (8–10-week-old) male Wistar rats received either ketamine only, at low (10 mg/kg), intermediate (20 mg/kg) or high (30 mg/kg) doses via intraperitoneal injection, or alcohol (2 mL/100 g) via oral gavage followed by ketamine (at low, intermediate, and high doses). Electroencephalograms (EEG) and electromyographic recordings were obtained 5 min after the final application of the drug. Results: When administered alone, ketamine resulted in an increase in delta, theta, beta, and gamma brainwaves, with a more pronounced effect being detected at the highest dose (30 mg/kg) in the case of the delta, beta, and gamma waves. The amplitude of the alpha brainwaves was reduced at all doses of ketamine, but less intensively at the highest dose. When administered alone, alcohol reduced all the brainwaves, with the reduction in the alpha waves being exacerbated by ketamine at all doses, and that of the theta and beta waves being boosted at the lowest dose. The intermediate dose of ketamine (20 mg/kg) reverted the alcohol-induced reduction in the theta and gamma waves, whereas the high dose increased delta, theta, beta, and gamma bandpower. Discussion: Overall, then, while ketamine enhances the depressant effects of alcohol on the alpha brainwave at all doses, a low dose intensified this effect on the theta and beta 175 waves, whereas a high dose produces neuronal hyperexcitability in the theta and 176 gamma bandpower. [ABSTRACT FROM AUTHOR]

Background: On January 31st, 2023, the province of British Columbia (BC), Canada, was granted a federal exemption allowing adults (aged 18 +) to possess up to 2.5 g of select illicit drugs. The exemption will be in place for three years (2023–2026), marking the first formal decriminalization of illicit drug policy reform in Canada. BC's decriminalization initiative is premised on several goals. This project seeks to evaluate each of these goals and their individual and combined contributions to determine the overall success of this policy. Methods: The following protocol paper provides a detailed outline of a five-year (2022-2027) national evaluation of BC's decriminalization initiative, as well as the specific objectives, methodologies, and planned analyses for eight interrelated sub-studies that comprise the evaluation. These sub-studies fall under the following five topical areas of research: 1) people who use drugs (PWUD), 2) the police and the criminal justice system, 3) the general public, 4) the health services system, and 5) an economic analysis. Additional research activities may also be explored. Results: The overall evaluation and specific sub-study designs were informed by intensive stakeholder engagement. The evaluation was developed in collaboration with an international expert committee who came together to undertake a nominal group technique to decide on the final evaluation design and corresponding logic model. The evaluation will also employ an advisory board and individual sub-study working groups comprised of experts and PWUD who will oversee the development and implementation of the overall evaluation as well as each sub-study. Discussion: This evaluation will draw on implementation science research practices to evaluate and understand the full impacts of this novel drug policy experiment. Results will be widely disseminated through manuscripts, reports, presentations, and infographics, which will be adapted and tailored for specific audiences. The protocol identifies several anticipated challenges and limitations. This evaluation's evidence-based findings will be poised to offer pivotal insights that can shape and refine the discourse on drug policy and will serve as a critical resource for understanding the multifaceted impacts of decriminalization. [ABSTRACT FROM AUTHOR]

Background: The prevalence of xylazine, a non-opioid tranquilizer not for human consumption, in illicitly manufactured fentanyl is increasing in the United States. However, little is known about xylazine awareness and attitudes among people who use drugs. Methods: A cross-sectional survey of people who use drugs in Ohio was conducted from November 2023 – May 2024 to identify xylazine awareness and attitudes in rural and urban counties across the state. Study participants were recruited from naloxone distribution sites, including health departments, syringe service programs, and community-based organizations. Results: Among 630 people who use drugs in Ohio, more than one-half (53.5%) were unaware of xylazine being in "street drugs," regardless of urbanicity. Among individuals who were aware of xylazine, most (73.0%) indicated they did not want to use the drug and try to avoid it. In addition, 75.8% of this group felt it was "very" or "extremely" important to know if xylazine was in their drugs. Discussion: This research found that many people who use drugs in Ohio are unaware of xylazine and its risks. An important finding of this study is that most individuals who had heard of xylazine did not want to use it and were concerned about knowing whether xylazine was in their drugs. [ABSTRACT FROM AUTHOR]

Xylazine is a potent sedative used in veterinary medicine. Recently, recreational drugs such as fentanyl have been found to contain xylazine, increasing the risk of respiratory depression and death. Despite a similar presentation to opioid overdose, patients who ingest xylazine do not respond to treatment with Narcan. Therefore, rapid detection of xylazine could improve patient management and prevent adverse outcomes.We evaluated the XYL500 one-step xylazine drug of abuse test for its ability to detect xylazine in 152 urine samples from patients on chronic opioid therapy for pain management or in treatment for substance use disorder. Results were compared to LC-MS/MS as the reference method. Precision, cross-reactivity, interference and stability studies were performed.Pooled patient samples were consistently negative or positive when tested five times on the same day and over three days of testing. The diagnostic sensitivity, specificity and accuracy of the XYL500 assay were 74, 98, and 82 % respectively, as compared with LC-MS/MS. XYL500 detected 77 of the 104 LC-MS/MS positive samples identified in our initial evaluation, including some that contained low levels of xylazine (n=8), <10 ng/mL. Minimal cross-reactivity with other opioid analgesics and commonly encountered drugs was seen with only one false positive result. Interferences by common urine contaminants were negligible. Specimens were stable up to 160 days refrigerated and up to 80 days at room temperature.XYL500 allows for rapid detection of xylazine, illustrating its utility in monitoring patients who ingested recreational drugs containing the additive, xylazine, and its potential to improve patient management. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionsCurrently, there are great hopes for psychedelic substances in treating psychiatric conditions and improving well-being. These substances are illegal in many countries, and we lack knowledge of how conflicting discourses shape psychedelic use in naturalistic settings. This study explores how psilocybin use is made meaningful by participants and staff at a retreat including psychedelic ceremonies aimed at personal growth.Ethnographic fieldwork was conducted at a psychedelic retreat with participants from Sweden. The material was organized using Zinberg’s model of drug, set, and setting. Theoretical work related to comparisons was utilized to elucidate how psilocybin use was distinguished from other illicit drug use.The participants’ desires to be fundamentally transformed, combined with the staff’s staging of the setting as a haven primed the participants to approach psilocybin as an inherently benevolent substance. Positive experiences during the ceremonies were attributed to the substance, and negative experiences to personal shortcomings.The staff and participants combined different discourses to define the meaning of psilocybin, all of which condemned using it for purely recreational purposes. The psilocybin use at the retreat was considered an improvement and wholly unrelated to illegal drug use, dissociating this practice from such use to establish legitimate transgression. [ABSTRACT FROM AUTHOR]

The document from Drug & Alcohol Review features keynote abstracts from various presenters discussing topics related to emerging drugs, drug use in older adults, decriminalization of drug possession, and harm reduction strategies for anabolic-androgenic steroids. Presenters share insights on the use of novel substances, challenges faced by older drug users, and the impact of decriminalization on public health. The presentations emphasize the importance of informed decision-making, harm reduction, and respectful engagement with individuals who use drugs. The document provides a diverse range of perspectives on drug-related issues from different regions and disciplines. [Extracted from the article]

The text discusses various symposiums and programs in Australia focused on drug and alcohol-related issues, including drug checking services, decriminalization of illicit drugs, and treatment for culturally diverse populations. The programs aim to provide value-based healthcare, culturally inclusive treatment, and support for CALD communities in accessing services. The research emphasizes the importance of culturally competent approaches and tailoring treatment programs to meet the unique needs of diverse populations. [Extracted from the article]

Social theory plays an important role in the nursing discipline and nursing inquiry as it helps conceptually embed nursing in the larger picture of the social world. For example, a broad category of critical theory provides a unique lens for uncovering social conditions of inequity and oppression. Among the sociological theories, actor‐network theory (ANT) is an approach to research and analysis that has recently gained interest among nurse philosophers and researchers. Studies guided by ANT seek to understand phenomena of interest as constituted within the relationships between human and nonhuman actors to understand how care practices are co‐created/enacted and how they can be made more humane. In this paper, we describe the benefits of ANT for examining healthcare access for incarcerated individuals with life‐limiting illnesses accessing palliative care and for people using illicit drugs. We argue that attention to the materiality of care practices can contribute to efforts of advancing health equity for these groups. [ABSTRACT FROM AUTHOR]

Occasionally, obtaining an adequate or acceptable postmortem blood specimen for drug analysis is not possible due to factors such as decomposition, exsanguination, or embalming. Submandibular salivary gland tissue, one of three major types of salivary gland tissue in the oral cavity of humans, has been reported to be a viable alternative postmortem specimen for toxicological testing. In this study, we evaluated the performance of the Randox Evidence Investigator instrument and Randox DOA (Drugs of Abuse) Ultra Whole Blood Array for the semi-quantitative determination of 21 immunoassays in an alternative matrix, submandibular salivary gland tissue. We analyzed 132 submandibular salivary gland tissue specimens and compared the generated results to concomitantly collected postmortem whole blood specimen results. Oxycodone 2, meprobamate, barbiturate, benzodiazepine assay 1, zolpidem, and buprenorphine all showed perfect agreement (Cohen's kappa score = 1.00) between the submandibular salivary gland tissue results and the postmortem whole blood results; dextromethorphan, fentanyl, benzoylecgonine, methamphetamine, tricyclic antidepressants, oxycodone 1, and opiate showed an almost perfect agreement (Cohen's kappa score = 0.81–0.99); methadone, generic opioids, and amphetamine exhibited substantial agreement (Cohen's kappa score = 0.61–0.80). Tramadol demonstrated fair agreement (Cohen's kappa score = 0.41–0.60). The lowest measure of agreement was observed with cannabinoids, meeting criteria for slight agreement (Cohen's kappa score = 0.01–0.20). An application of the techniques described in this study could be implemented in postmortem toxicology laboratories as well as medical examiners offices to provide preliminary drugs of abuse test results that can be used to direct additional testing. This study highlights the successful integration of a novel specimen matrix and an "off-label" use of an established analytical technique. [ABSTRACT FROM AUTHOR]

The emergence of new psychoactive substances (NPS) and the number of new chemically diverse substances in the global illicit drug market have significantly increased over the last few years. Designer benzodiazepines are some of the most misused NPS worldwide, contributing to both nonfatal and fatal drug overdose cases. The use of desalkylgidazepam and bromazolam has recently emerged, and their prevalence has been internationally reported. In this study, we quantified desalkylgidazepam and bromazolam using gas chromatography coupled with mass spectrometry (GC–MS) in the postmortem specimens of a subject found deceased due to suspected drug overdose. A 24-year-old white male with a history of drug use was found unresponsive and not breathing in his home with drug paraphernalia nearby. A yellow powdery substance and prescription tablets were also found at the scene. The GC–MS analysis of the postmortem blood and urine samples confirmed the presence of fentanyl, desalkylgidazepam, and bromazolam. The desalkylgidazepam concentration was 1100 ng/mL in the blood, which was higher than previous reports in the literature, and estimated to be 89 ng/mL in the urine. The bromazolam concentration was 352 ng/mL in the blood and estimated to be 398 ng/mL in the urine. Additionally, fentanyl was detected in the blood (11 ng/mL), and fentanyl, norfentanyl, and gabapentin were detected in the urine. The present study aims to provide the toxicological community with information regarding a fit-for-purpose analysis of two NPS benzodiazepines. [ABSTRACT FROM AUTHOR]

For the past 60 years, benzodiazepines such as chlordiazepoxide, diazepam, and alprazolam have been used as pharmaceutical medications for the treatment of myriad conditions including anxiety, seizures, and insomnia. In more recent years, novel benzodiazepine derivatives have emerged as illicit substances in powders and counterfeit tablets on the illicit drug market. In 2016, bromazolam, a brominated derivative of alprazolam, emerged on the illicit drug market in Europe, but the substance was not reported in the USA until 2019–2020. In this study, we report the emergence and subsequent prevalence of bromazolam in postmortem blood in the state of Indiana during 2023. Analysis was completed by a solvent protein precipitation extraction with acetonitrile and detection by liquid chromatography with quadrupole time of flight mass spectrometry. During 2023, bromazolam was detected in 94 cases across 25 counties in Indiana. It was never the sole substance detected and was commonly detected alongside fentanyl (83 cases), norfentanyl (77 cases), 4-anilino- N -phenethylpiperidine (76 cases), acetylfentanyl (49 cases), methamphetamine (32 cases), naloxone (25 cases), 11-nor-9-carboxy-tetrahydrocannabinol (24 cases), and benzoylecgonine (20 cases). After official query with the Indiana Department of Health, it was found that bromazolam was specifically included in the cause of death certification in 31 fatalities (32.9%). Due to the scarcity of information regarding this novel benzodiazepine derivative in postmortem toxicology and its involvement in fatalities, it is important that forensic toxicology laboratories consider adding bromazolam to their comprehensive scope of analysis. [ABSTRACT FROM AUTHOR]

Background: illegal drugs significantly contribute to global health issues, with health complications often occurring not only in regular users with Substance Use Disorders (SUDs) but also in first-time and occasional users. Methods: this study examines five clinical cases from a public hospital in Ibiza, Spain, where patients presented with acute psychiatric symptoms due to recreational drug use. Results: Contrary to previous studies on SUDs, our patients typically had higher education levels and stable employment. Most of them used multiple substances, with cannabis, cocaine, and alcohol being the most frequently used. There was also a common occurrence of consuming drugs with uncertain contents. Upon admission, typical symptoms included aggression, hallucinations, mood swings, and disorientation in time and space. Conclusions: Our findings underscore the significant mental health risks posed by illicit drugs, even for individuals with no prior psychiatric history. Factors like the drug's potency, frequency and amount of use, past mental health issues, personality traits, and previous traumatic experiences might influence the onset of these symptoms. [ABSTRACT FROM AUTHOR]

Methamphetamine (METH) is a drug of abuse, which induces behavioral sensitization following repeated doses. Since METH alters blood pressure, in the present study we assessed whether systolic and diastolic blood pressure (SBP and DBP, respectively) are sensitized as well. In this context, we investigated whether alterations develop within A1/C1 neurons in the vasomotor center. C57Bl/6J male mice were administered METH (5 mg/kg, daily for 5 consecutive days). Blood pressure was measured by tail-cuff plethysmography. We found a sensitized response both to SBP and DBP, along with a significant decrease of catecholamine neurons within A1/C1 (both in the rostral and caudal ventrolateral medulla), while no changes were detected in glutamic acid decarboxylase. The decrease of catecholamine neurons was neither associated with the appearance of degeneration-related marker Fluoro-Jade B nor with altered expression of α-synuclein. Rather, it was associated with reduced free radicals and phospho-cJun and increased heat shock protein-70 and p62/sequestosome within A1/C1 cells. Blood pressure sensitization was not associated with altered arterial reactivity. These data indicate that reiterated METH administration may increase blood pressure persistently and may predispose to an increased cardiovascular response to METH. These data may be relevant to explain cardiovascular events following METH administration and stressful conditions. [ABSTRACT FROM AUTHOR]

Background: Unaccompanied minor refugees are a high risk group for trauma-related disorders. Although these disorders pose a risk for unhealthy substance use, research of substance use among young refugees is lacking. Methods: This study investigated substance use in a total of 102 refugees between 16 and 21 years of age who arrived as unaccompanied minors in Germany. Participants were asked about their religious beliefs and substance use within the last three months and prior to leaving their countries of origin. Unhealthy substance use was assessed by drug-specific questionnaires. Results: Overall, 38% of the study participants met the criteria for unhealthy substance use (12% solely for unhealthy tobacco use). According to self-ratings, 21% of the refugees met the criteria for unhealthy alcohol use, 25% for unhealthy tobacco use and 12% for unhealthy cannabis use. Young refugees who had already used drugs in their country of origin were more susceptible to developing unhealthy substance use. Identifying as religious seems to reduce the risk for unhealthy substance use. Conclusion: The results reveal that unaccompanied refugees are highly vulnerable for unhealthy substance use. Special programs for unhealthy substance use prevention are needed for this group. [ABSTRACT FROM AUTHOR]

Objective: Intergenerational studies have identified relations between adolescents' and their future offspring's cannabis and alcohol use, but rarely have examined the association for other illicit drug use. Given the low prevalence of such use in community populations, we pooled data from three prospective intergenerational studies to test this link. Method: Participants were 1,060 children of 937 parents who had been repeatedly assessed since early adolescence. Children and parents reported on their use of cocaine, stimulants, hallucinogens, sedatives/tranquilizers, and opiates/narcotics from ages 10 to 18 years. Intergenerational similarities in any versus no use of these drugs were formally modeled using logistic regression. Patterns also were descriptively analyzed. Results: Parent illicit substance use was associated with significantly higher odds of child use (adjusted odds ratio [95% confidence interval] = 2.682 [1.328–5.416], p = 0.006). However, intergenerational continuity was modest; 87% of children whose parent used illicit drugs in adolescence did not use such drugs, and 77% of parents of children who used illicit drugs had not themselves used these drugs during adolescence. Conclusions: The use of illicit substances by parents during their teenage years poses a risk for their offspring's similar behaviors. However, the discontinuity of these behaviors across generations implies children are largely resilient to or protected from this risk, and conversely that other aspects of parents' and children's experiences or characteristics may be more powerful risks for children's illicit drug use than this transgenerational influence. Public Health Significance: (a) Parents' use of illicit drugs during adolescence significantly increased risk that their adolescent children would use such drugs. (b) However, most parents who used illicit drugs did not have children who used illicit drugs, and conversely, the majority of adolescents who used illicit drugs did not have parents who had used such drugs in their adolescence. (c) Distinct prevention strategies may be needed to disrupt intergenerational continuities in illicit drug use via selective prevention, and also to avert drug use by offspring of parents who abstained in adolescence through universal approaches. [ABSTRACT FROM AUTHOR]

Substance-involved rape is increasing among college students, particularly women (Koss et al., 2022). Addressing rape requires first measuring it accurately in surveys to understand its true scope and nature. We used cognitive interviews with 40 young adults to qualitatively test the construct validity of an alcohol- and other drugs (AOD)-involved rape item in the Sexual Experiences Survey by asking participants to comment on different operationalizations of this construct. Our findings revealed that different phrasings elicited different interpretations of the items by participants. Specifically, the results indicated that (1) respondents viewed the different operationalizations as a sequence of events with varying severity; (2) some participants focused on the intentionality and responsibility of the perpetrator as opposed to opportunistic perpetration; and (3) study participants consistently chose one of the operationalizations as describing "being roofied" (being drugged without consent). Participants also contributed additional scenarios not described in the questionnaire and shared their interpretations of the items. The results underscore the importance of refining survey language to properly measure AOD-involved rape and allow us to understand how to tailor appropriate questions for best comprehension. The findings indicate the benefit in including several items about AOD-involved rape in questionnaires such as the Sexual Experiences Survey, with each item addressing different scenarios of victim intoxication. The results could also have important implications for sexual violence prevention programs, which should discuss consent, intentions, and responsibility specifically in the context of AOD consumption. [ABSTRACT FROM AUTHOR]

Objective. To compare the prevalence and trajectories of risky health behaviors in sexual minority (SM; lesbian/gay/bisexual/questioning/asexual) versus heterosexual undergraduates across their first year of post-secondary. Participants. First-year undergraduates (N = 704, Mage=17.97 years, 24% SM) from a midsized Canadian university. Methods. Students completed monthly (September-April) online questionnaires assessing substance use (binge drinking, tobacco, cannabis, illicit drug use) and disordered eating (binge eating, fasting, purging). Results. At the outset of the academic year, SM students endorsed more frequent cannabis use, illicit drug use, fasting, and binge eating, but less frequent tobacco use, versus heterosexual students. Over the year, SM students' binge drinking frequency declined less than that of heterosexual students, but their illicit drug use decreased while that of their heterosexual peers increased, and all students reported declining disordered eating frequency. Conclusions. Campus wellness initiatives for SM students should offer prevention and harm-reduction strategies prior to or shortly after their arrival on campus. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to explore how stakeholders perceive illicit drugs at licensed premises, existing and potential prevention interventions, and to identify facilitators and barriers to reduce illicit drugs at these locations. Methods: Semi-structured interviews with police officers, licensed premises owners, security staff and municipality officials (n = 28) in seven counties in middle Sweden were conducted and analysed using qualitative content analysis. Results: The informants reported frequent illicit drug use and dealing at licensed premises, causing a negative influence on the restaurant environment. Efforts to prevent illicit drugs varied with respect to type and intensity but included environmental and situational changes as well as education and training, policy implementation and law enforcement. Facilitators for the reduction of illicit drugs are confidence that sufficient resources are allocated, motivated and skilled stakeholders who see benefits of prevention and collaborate closely, along with visible results. General societal prevention was also seen as important. Identified barriers were perceived drug-positive norms and high availability and use in the society, perceived lack of prioritisation and resources, difficulties to collaborate due to e.g., secrecy between organisations, lack of action among stakeholders due to financial considerations, perceived confusion about roles and mandate, and owner's and staff's fear of threats and violence from criminals or own involvement in crime. Conclusion: To maximise the potential of successful prevention, authorities should support owners of licensed premises to act firmly against illicit drugs by providing training, ensure that they apply a strict policy, work for increased stakeholder collaboration and provide appropriate police resources. Authorities should also investigate criminal activities among owners and staff as well as combat organised crime and availability of illicit drugs in the society. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate substance use and its association with eating attitudes and behaviors among male Palestinian refugees. Methods: In a cross-sectional study, male Palestinian refugees(N = 566) were recruited to fill out self-administrated questionnaire on eating attitudes and behaviors (EAT-26) and to give urine samples to test current illicit drug use. Results: The response rate was 47.7%. Substance use was highly prevalent among participants (28.9%). The percentage of participants with eating disorders (ED) among substance users was as follows: Any illicit drug (30.8%), benzodiazepine (32.6%), methamphetamines(40.7%), amphetamine (39.3%), tetrahydrocannabinol (25.8%), barbiturates (20%),and alcohol (12.50%). Obese participants were at higher risk of having ED(OR = 2.344, p <.05) than underweight participants. Binge eaters were more likely to be tetrahydrocannabinol users (OR = 2.745, p <.05). Increased riskof self-induced vomiting behavior was associated with binge behavior (OR = 5.97, p <.05, laxative use (OR = 26.38, p <.01), barbiturates use (OR = 59.36, p <.05), waterpipe smoking (OR = 8.62, p <.05), vape smoking (OR = 10.37, p <.05), and inversely associated with age (OR = 0.832, p <.001). Conclusion: Findings from this study demonstrated a substantially increased frequency of substance use among Palestinian refugees with ED and unhealthy weight control behaviors. This study highlighted new challenge for the health system to deal with new emerging health conditions among male refugees. [ABSTRACT FROM AUTHOR]

Objectives: We determine the factors related to the attitudes toward substance users and how these factors predict attitudes. Methods: The research was a field study. The control variables were gender and occupation. Health workers, teachers, prison guards, shopkeepers, university students, bartenders, and professional athletes were chosen by lottery method of simple random sampling. 350 people were reached. Fagerström Nicotine Dependence Test, Addiction Profile Index Risk Scanning Scale-Alcohol, and Addictive Material Attitude Scale were used. T-test, ANOVA, Bonferroni post hoc test, analysis of effect size, and linear regression model were used. Results: Gender (1%), marital status (2%), residence (4%), occupation (9%), NUD (2%), risky alcohol use (12%), having people with AUD in the social circle (1%), having a substance user in the social circle (20%), being in a substance use environment (16%); neighborhood characteristics as crime (9%), drug use (5%), illicit drug selling (7%) were found predictors of the attitude. Conclusions: Demographical factors like being single, being a bartender, living with friends; substance-related risk factors; neighborhood characteristics like high crime, substance use, and illicit drug selling were predictors of positive attitude. Identifying the factors explaining the positive attitude will guide the determination of prevention and protection programs for society. [ABSTRACT FROM AUTHOR]

Drug use, mental distress, and other psychosocial factors threaten HIV care for youth living with HIV (YLWH). We aimed to identify syndemic psychosocial patterns among YLWH and examine how such patterns shape HIV outcomes. Using baseline data from 208 YLWH enrolled in an HIV treatment adherence intervention, we performed latent class analysis on dichotomized responses to 9 psychosocial indicators (enacted HIV stigma; clinical depression and anxiety; alcohol, marijuana, and illicit drug misuse; food and housing insecurity; legal history). We used multinomial logistic regression to assess latent class-demographic associations and the automatic Bolck-Croon-Hagenaars method to assess HIV outcomes by class. Mean age of participants was 21 years; two thirds identified as cis male, 60% were non-Hispanic Black, and half identified as gay. Three classes emerged: "Polydrug-Socioeconomic Syndemic" (n = 29; 13.9%), "Distress-Socioeconomic Syndemic" (n = 35, 17.1%), and "Syndemic-free" (n = 142, 69.0%). Older, unemployed non-students were overrepresented in the "Polydrug-Socioeconomic Syndemic" class. Missed/no HIV care appointments was significantly higher in the "Polydrug-Socioeconomic Syndemic" class (81.4%) relative to the "Syndemic-free" (32.8%) and "Distress-Socioeconomic Syndemic" (31.0%) classes. HIV treatment nonadherence was significantly higher in the "Polydrug-Socioeconomic Syndemic" class (88.5%) relative to the "Syndemic-free" class (59.4%) but not the "Distress-Socioeconomic Syndemic" class (70.8%). Lack of HIV viral load suppression was non-significantly higher in the "Polydrug-Socioeconomic Syndemic" class (29.7%) relative to the "Syndemic-free" (16.2%) and "Distress-Socioeconomic Syndemic" (15.4%) classes. Polydrug-using, socioeconomically vulnerable YLWH are at risk for adverse HIV outcomes, warranting tailored programming integrated into extant systems of HIV care. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the prevalence, sociobehavioral factors and clinical-laboratory consequences of late presentation among people living with HIV (PLHIV) in the Brazilian Amazon region. In total, 402 HIV + individuals treated at reference units in Belém city (Pará, Brazil) between 2018 and 2019 were evaluated. Late presentation was defined as a first-collection LTCD4+ count below 350 cells/µL. Sociodemographic, behavioral and clinical data were obtained from questionnaires or medical records. Th1, Th2 and Th17 cytokine profiles were evaluated by flow cytometry. Longitudinal data on viral load, T lymphocytes, and antiretroviral therapy administration were obtained from control and logistic databases. Approximately 52.73% of the participants were late presenters and sought medical care 7–12 + months after their primary HIV diagnosis. Sociobehavioral factors associated with late presentation included illicit drug use for more than 5 years, polyamory, no alcohol consumption, homosexuality, and sexual inactiveness after HIV diagnosis. Clinically, late presentation was associated with coinfection rate; polysymptomatology; high IFN-ɣ, IL-6 and IL-10 levels; nonresponse to antiretroviral therapy; and virological failure- and tuberculosis coinfection-motivated changes to therapy. In summary, the prevalence of late presentation in Pará in the Brazilian Amazon region is high. Delays in seeking specialized care after a primary HIV diagnosis cause medium/long-term changes in the life expectancy and health of PLHIV. [ABSTRACT FROM AUTHOR]

The increasing use of illicit drugs has become a major global concern. Illicit drugs interact with the brain and the body altering an individual's mood and behavior. As the substance-of-abuse (SOA) crisis continues to spread across the world, in order to reduce trafficking and unlawful activity, it is important to use point-of-care devices like biosensors. Currently, there are certain conventional detection methods, which include gas chromatography (GC), mass spectrometry (MS), surface ionization, surface-enhanced Raman spectroscopy (SERS), surface plasmon resonance (SPR), electrochemiluminescence (ECL), high-performance liquid chromatography (HPLC), etc., for the detection of abused drugs. These methods have the advantage of high accuracy and sensitivity but are generally laborious, expensive, and require trained operators, along with high sample requirements, and they are not suitable for on-site drug detection scenarios. As a result, there is an urgent need for point-of-care technologies for a variety of drugs that can replace conventional techniques, such as a biosensor, specifically an immunosensor. An immunosensor is an analytical device that integrates an antibody-based recognition element with a transducer to detect specific molecules (antigens). In an immunosensor, the highly selective antigen–antibody interaction is used to identify and quantify the target analyte. The binding event between the antibody and antigen is converted by the transducer into a measurable signal, such as electrical, optical, or electrochemical, which corresponds to the presence and concentration of the analyte in the sample. This paper provides a comprehensive overview of various illicit drugs, the conventional methods employed for their detection, and the advantages of immunosensors over conventional techniques. It highlights the critical need for on-site detection and explores emerging point-of-care testing methods. The paper also outlines future research goals in this field, emphasizing the potential of advanced technologies to enhance the accuracy, efficiency, and convenience of drug detection. [ABSTRACT FROM AUTHOR]

For centuries, cannabinoids have been utilized for their medicinal properties, particularly in Asian and South-Asian countries. Cannabis plants, known for their psychoactive and non-psychoactive potential, were historically used for spiritual and remedial healing. However, as cannabis became predominantly a recreational drug, it faced prohibition. Recently, the therapeutic potential of cannabinoids has sparked renewed research interest, extending their use to various medical conditions, including cancer. This review aims to highlight current data on the involvement of cannabinoids in cancer signaling pathways, emphasizing their potential in cancer therapy and the need for further investigation into the underlying mechanisms. A comprehensive literature review was conducted using databases such as PubMed/MedLine, Google Scholar, Web of Science, Scopus, and Embase. The search focused on peer-reviewed articles, review articles, and clinical trials discussing the anticancer properties of cannabinoids. Inclusion criteria included studies in English on the mechanisms of action and clinical efficacy of cannabinoids in cancer. Cannabinoids, including Δ9-THC, CBD, and CBG, exhibit significant anticancer activities such as apoptosis induction, autophagy stimulation, cell cycle arrest, anti-proliferation, anti-angiogenesis, and metastasis inhibition. Clinical trials have demonstrated cannabinoids' efficacy in tumor regression and health improvement in palliative care. However, challenges such as variability in cannabinoid composition, psychoactive effects, regulatory barriers, and lack of standardized dosing remain. Cannabinoids show promising potential as anticancer agents through various mechanisms. Further large-scale, randomized controlled trials are essential to validate these findings and establish standardized therapeutic protocols. Future research should focus on elucidating detailed mechanisms, optimizing dosing, and exploring cannabinoids as primary chemotherapeutic agents. [ABSTRACT FROM AUTHOR]

Background: A substantial number of hospital admissions end in patient-initiated departure before medical treatment is complete. Whether "before medically advised" (BMA) discharge increases the risk of subsequent drug overdose remains uncertain. Methods: We performed a retrospective cohort study using administrative health data from a 20% random sample of residents of British Columbia, Canada. We focused on nonelective, nonobstetric hospital stays occurring between 2015 and 2019. We used survival analysis to compare the rate of fatal or nonfatal illicit drug overdose in the first 30 days after BMA discharge versus the rate after physician-advised discharge. Results: Overall, 6440 of 189 808 (3.4%) hospital stays ended in BMA discharge. Among 820 overdoses occurring in the first 30 days after any hospital discharge, 755 (92%) involved patients with a history of substance use disorder. Unadjusted overdose rates were 10-fold higher after BMA discharge than after physician-advised discharge, and BMA discharge was associated with subsequent overdose even after adjustment for potential confounders (crude incidence, 2.8% v. 0.3%; adjusted hazard ratio [HR] 1.58; 95% confidence interval [CI] 1.31–1.89). Before medically advised discharge was associated with increases in subsequent emergency department visits (adjusted HR 1.92; 95% CI 1.83–2.02) and unplanned hospital readmissions (adjusted HR 2.07; 95% CI 1.96–2.19), but there was no significant association with the uncommon outcomes of fatal overdose and all-cause mortality. Interpretation: Before medically advised departure is associated with an increased risk of drug overdose in the first 30 days after discharge. Improved treatment of substance use disorder, expanded access to overdose prevention services, and new means of postdeparture outreach should be explored to reduce this risk. [ABSTRACT FROM AUTHOR]

Background: Finding new strategies to treat cognitive disorders is a challenging task. Medication must defeat the blood-brain barrier. Cannabidiol (CBD), a nonintoxicating compound of the cannabis plant, has gained recognition as a nutraceutical for its potential effectiveness in treating anxiety, oxidative stress, convulsions, and inflammation. However, the dose, tolerable upper intake, formulation, administration routes, comorbidities, diet, and demographic factors to reverse cognitive impairments have not been completely explored. Trials using CBD as a primary intervention have been conducted to alleviate cognitive issues. This review evaluates the benefits of CBD supplementation, research design, formulations, and outcomes reported in randomized clinical trials. Methods: An evidence-based systematic literature review was conducted using PUBMED and the Florida International University Research Library resources. Fourteen randomized trials were selected for review, and their designs and outcomes were compared conceptually and in the form of resume tables. Results: CBD showed improvement in anxiety and cognitive impairments in 9 out of 16 analyzed trials. However, the variability could be justified due to the diversity of the trial designs, underpowered studies, assayed population, uncontrolled results for comorbidities, medications, severity of drug dependence, compliances, and adherences. Overall, oral single doses of 200 mg-1,500 mg or vaporized 13.75 mg of CBD were shown to be effective at treating anxiety and cognition with a good safety profile and no drug addiction behaviors. Conversely, results that did not have a significant effect on treating cognitive impairments can be explained by various factors such as THC or other abuse drugs masking effect, low dose, and unknown purity of CBD. Furthermore, CBD shows potential properties that can be tested in the future for Alzheimer's disease. Conclusion: As medical cannabis becomes more accessible, it is essential to understand whether medication rich in CBD exerts a beneficial effect on cognitive disorders. Our study concludes that CBD is a promising candidate for treating neurocognitive disorders; however, more studies are required to define CBD as a therapeutic candidate for managing cognitive disorders. [ABSTRACT FROM AUTHOR]

Presumptive drug screening enables timely procurement of search and arrest warrants and represents a crucial first step in crime scene analysis. Screening also reduces the burden on forensic laboratories which often face insurmountable backlogs. In most scenarios, on-site presumptive drug screening relies on chemical field tests for initial identification. However, even when used appropriately, these test kits remain limited to subjective colorimetric analysis, produce false positive or negative results with excessive sample quantities, and are known to cross-react with numerous innocuous substances. Previous efforts to develop microfluidic devices that incorporate these chromogenic indicator reagents address only a few of the many challenges associated with these kits. This is especially true for samples where the drug of interest is present as a lacing agent. This work describes the development of a centrifugal microfluidic device capable of integrating facile sample preparation, by way of a 3D printed snap-on cartridge amenable to microwave assisted extraction, followed by chromatographic separation and chromogenic detection on-disc. As cannabis is among the most widely used controlled substance worldwide, and displays strong interference with these indicator reagents, mock samples of laced marijuana are used for a proof-of-concept demonstration. Post extraction, the microdevice completes high throughput metering just prior to simultaneous reaction with four of the most commonly employed microchemical tests, followed by objective image analysis in CIELAB (a device-independent color model). Separation and recovery of a representative controlled substance with 93% efficiency is achieved. Correct identification, according to hierarchical cluster analysis, of three illicit drugs (e.g., heroin, phencyclidine, and cocaine) in artificially laced samples is also demonstrated on-disc. The cost effective microdevice is capable of complete automation post-extraction, with a total analysis time (including extraction) of <8 min. Finally, sample consumption is minimized, thereby preventing the complete destruction of forensic evidence. [ABSTRACT FROM AUTHOR]

Background: In the Northern Territory (NT) of Australia, there are significant evidence gaps about illicit drug use and harms, despite having established monitoring and reporting systems. This paper reports on illicit drug use, associated harms, contributing factors, service needs and priorities in the NT from the perspective and experiences of key stakeholders engaged in providing services for, or advocating on behalf of, people who use illicit drugs in the NT. Methods: Face-to-face and online qualitative interviews were conducted with stakeholders across urban and remote locations in the NT. Key stakeholders were service providers, including acute and primary care clinicians, representatives of Aboriginal community controlled health organisations, lived experience advocates, peak body representatives and public health executives. Qualitative data were analysed thematically. Results: Four researchers interviewed 21 participants across urban (62%), and remote areas (38%) of the NT. Themes identified were: (1) Illicit drug use and harms are diverse and distinct; (2) Client support needs are complex and influenced by co-morbidities, socio-demographic and cultural factors; (3) Priority population sub-groups need targeted strategies; (4) Local service strengths can be further developed and enhanced; (5) Local services need better resourcing; (6) Invest in progressive legislative and policy reforms; and (7) Improve routine monitoring and evaluation. Conclusions: Key stakeholders described illicit drug use, harms and contributing factors, which provided insights into the local challenges. Participants emphasised that clients have complex care needs, and further investment into targeted strategies are required to improve service engagement with priority groups. Service needs included greater understanding the role of dual diagnosis and its implementation and enhancing integrated and collaborative care in both primary health and acute care contexts. The voices of people with lived experience captured in this paper must inform local strategy and policy development relating to illicit drug use, in alignment with national strategy. [ABSTRACT FROM AUTHOR]

Background: Fentanyl is increasingly pervasive in the unregulated drug supply and is a driver of drug overdose deaths in the United States. The aims of this study were to characterize and identify correlates of fentanyl preference among people who use drugs (PWUD) in Rhode Island (RI). Methods: Using bivariate analysis, we examined associations between fentanyl preference and sociodemographic and psychosocial characteristics at baseline among participants enrolled in the RI Prescription Drug and Illicit Drug Study from August 2020-February 2023. Fentanyl preference was operationalized based on responses to a five-point Likert scale: "I prefer using fentanyl or drugs that have fentanyl in them." Participants who responded that they "strongly disagree," "disagree," or were "neutral" with respect to this statement were classified as not preferring fentanyl, whereas participants who responded that they "agree" or "strongly agree" were classified as preferring fentanyl. Results: Among 506 PWUD eligible for inclusion in this analysis, 15% expressed a preference for fentanyl or drugs containing fentanyl as their drug of choice. In bivariate analyses, preference for fentanyl was positively associated with younger age, white race, lifetime history of overdose, history of injection drug use, past month enrollment in a substance use treatment program, past month treatment with medications for opioid use disorder, and preferences for heroin and crystal methamphetamine (all p < 0.05). Descriptive data yielded further insight into reasons for fentanyl preference, the predominant having to do with perceived effects of the drug and desire to avoid withdrawal symptoms. Conclusions: Only a relatively small subset of study participants preferred drugs containing fentanyl. Given the increased prevalence of fentanyl contamination across substances within the unregulated drug market, the result for PWUD is increasingly less agency with respect to choice of drug; for example, people may be forced to use fentanyl due to restricted supply and the need to mitigate withdrawal symptoms, or may be using fentanyl without intending to do so. Novel and more effective interventions for PWUD, including increased access to age-appropriate harm reduction programs such as fentanyl test strips and overdose prevention centers, are needed to mitigate fentanyl-related harms. [ABSTRACT FROM AUTHOR]

Background: Substance use is a global health concern and early onset among adolescents increases health risks. We explore national overall trends in prevalence and trends in socioeconomic inequalities in past year alcohol intoxication, cannabis use, and use of other illicit drugs among Norwegian adolescents (ages ∼ 15–19 years of age) between 2014 and 2022. Method: The present study builds on data from a nationwide repeated cross-sectional survey collected in 2014–2016 (T1), 2017–2019 (T2), 2021 (T3) and 2022 (T4). In total 415,560 adolescents (50.3% girls) completed the questionnaire during the study period. Trends in socioeconomic inequalities were assessed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). Results: While the prevalence of alcohol intoxication remained fairly stable, the prevalence of cannabis and other illicit drug use increased between 2014 and 2022 among upper secondary school boys (13.3–17.6%, and 2.0–5.2%, respectively) and girls (8.8–12.8%, and 1.1–2.7%, respectively). Similar trends were observed among 10th-grade adolescents. Boys were more likely than girls to use cannabis or other illicit drugs, but the gender gap in cannabis use narrowed during the study period. Among upper secondary girls, use of cannabis and other illicit drugs was higher among those from less affluent backgrounds, with absolute and relative inequalities in cannabis use increasing between 2014 and 2022. Small inequalities in cannabis use and decreasing relative inequalities in the use of other illicit drug were observed among upper secondary boys. Conclusions: The increasing use of cannabis and other illicit drugs among Norwegian adolescents is concerning. Future studies should explore the underlying causes of this rise and explore the complex factors influencing adolescent substance use behaviours. A comprehensive understanding of these factors is essential for developing targeted and effective interventions. [ABSTRACT FROM AUTHOR]

Background and aims Design and setting Cases Measurements Findings Conclusion Drugs sold on cryptomarkets are thought to have lower levels of adulteration and higher strength compared with those sourced off‐line. The present study aimed to determine whether cryptomarket and off‐line‐sourced 3,4‐methylenedioxy‐N‐methamphetamine (MDMA), cocaine, amphetamine, methamphetamine and lysergic acid diethylamide (LSD) differed in adulteration and strength.A between‐groups design was used to compare cryptomarket versus off‐line‐sourced drugs. Regression analyses controlling for year and service were conducted. Drug‐checking services were conducted in Spain (Energy Control) and the Netherlands (Drugs Information and Monitoring System).The cases comprised drug samples that underwent drug checking between 2016 and 2021 and were expected to contain MDMA (tablets; n = 36 065; powder: n = 6179), cocaine (n = 11 419), amphetamine (n = 6823), methamphetamine (n = 293) and LSD (n = 1817).Drugs were measured for (1) matching the advertised substance (i.e. containing any amount of the expected substance); (2) strength; (3) presence of adulteration; and (4) number of adulterants.The expected drug was more likely to be identified when sourced from cryptomarkets versus off‐line for MDMA tablets [adjusted odds ratio (AOR) = 2.10, 95% confidence interval (CI) = 1.28–3.43], MDMA powder (AOR = 2.64, CI = 1.55–4.51), cocaine (AOR = 3.65, CI = 1.98–6.71) and LSD (AOR = 1.75, CI = 1.13–2.72). Cryptomarket‐sourced MDMA powder (β = 0.03, P = 0.012), cocaine (β = 0.08, P < 0.001) and methamphetamine (β = 0.15, P = 0.028) were statistically significantly higher in strength than substances from off‐line sources. Conversely, MDMA tablets (β = −0.01, P = 0.043) and amphetamine (β = −0.07, P < 0.001) from cryptomarkets were statistically significantly lower in strength than from off‐line sources. MDMA powder (AOR = 0.53, CI = 0.33–0.86) and cocaine (AOR = 0.66, CI = 0.55–0.79) were statistically significantly less likely to be adulterated if sourced from cryptomarkets. However, amphetamine (AOR = 1.54, CI = 1.25–1.90) and LSD (AOR = 1.31, CI = 1.00–1.71) were found to be more likely to be adulterated when purchased from cryptomarkets. Cocaine from cryptomarkets exhibited fewer adulterants (incidence rate ratio = 0.71, CI = 0.60–0.85).The relationship between on‐line drug market‐places and substance quality varies depending on both the specific substance and the dynamics of the cryptomarket. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionResearchers have investigated drug market risks and navigational strategies of drug dealers in western societies. Less is known about this phenomenon in Africa. This study explores drug market risk environment and navigational strategies of street drug dealers in Nigeria.The study uses qualitative data from in-depth interviews with street-level dealers (n = 31) recruited through snowball sampling in Uyo, Nigeria. Thematic analysis of transcripts generated three major themes (‘policing,’ ‘rivalry’ and ‘indiscretion’) as risk factors for police harassment, arrest and violence.Accounts identified policing, rivalry between drug dealers and indiscretion (e.g., exchanging drugs for potentially stolen items) as risk factors for police harassments, arrest and violence. Drug dealers navigate risks in different ways, including through bribing police officers, using police proxies in partisan negotiation of drug market conflicts, and non-exchange of drugs for potentially stolen items.The findings underscore an ecological view of drug market risks where factors operating at different levels interact to shape risks, with policing featuring as an overarching macro-level risk factor. The failure of law enforcement to absolutely deter drug selling due to dealer’s navigational strategies such as informal privatization of police, indicates a need for alternative approaches to controlling street-level drug markets. [ABSTRACT FROM AUTHOR]

Jason Ruiz's book "Narcomedia: Latinidad, Popular Culture, and America's War on Drugs" explores the connection between drugs and Latinidad in popular culture since the 1980s. Ruiz critically analyzes various forms of media, such as movies, TV shows, and music, that perpetuate stereotypes about Latin Americans and the drug trade. He highlights the damaging effects of these portrayals, particularly in shaping public opinion and policy responses to the War on Drugs. Ruiz challenges these narratives and calls for a reevaluation of how Latinx individuals are depicted in media. [Extracted from the article]

Background: Addiction to smartphone is defined as the disability to cease using the device despite the physical, psychological, or social consequences. The diagnosis of this disorder is increasing exponentially among teenagers, even more so after Corona Virus Disease 2019 (COVID-19) pandemic. This study aims to analyze the risk of mobile phone addiction among teenagers in Italy and its relationship with other risk behaviors, such as drug consumption and emotional well-being, following the COVID-19 pandemic. Methods: A cross-sectional observational study was conducted in Catania, Sicily, during 2022. The study sample comprised 342 students from a secondary education center that answered to a validated Italian version of the Smartphone Addiction Scale Short Version (SAS-SV) accessing through computers and mobile devices. Subjective Wellbeing was measured with the Personal Wellbeing Index-School Children (PWI-SC). Also, they completed the NIAAA Brief Alcohol Use Screener. Results: Our results showed that 30.1% of students who participated in the survey were classified with a smartphone addiction. Besides, most of the participants used the Smartphone for social networks (86.0%). Regarding the other aspects measured, the mean self-perceived well-being score measured with the PWI-SC was 55.5, and 36.2% of participants were categorized as "high risk" for depression. Finally, four out of ten participants were at "moderate or high risk" of an alcohol use disorder. Conclusions: Our results suggest that the use of mobile phones is increasing in adolescents, an age group also exposed to social and health problems. [ABSTRACT FROM AUTHOR]