1
|
Penttala J, Mustonen A, Koivukangas A, Halme J, Karjalainen K, Aalto M. Concurrent use of alcohol and sedatives in Finnish general population. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2084784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Juha Penttala
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Psychiatry, South Ostrobothnia Hospital District, Seinäjoki, Finland
| | - Antti Mustonen
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Psychiatry, South Ostrobothnia Hospital District, Seinäjoki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Antti Koivukangas
- Department of Psychiatry, South Ostrobothnia Hospital District, Seinäjoki, Finland
| | - Jukka Halme
- Harjavalta Hospital, Satakunta Hospital District, Pori, Finland
| | - Karoliina Karjalainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mauri Aalto
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Department of Psychiatry, South Ostrobothnia Hospital District, Seinäjoki, Finland
| |
Collapse
|
2
|
Akhigbe RE, Oladipo AA, Oyedokun PA, Hamed MA, Okeleji LO, Ajayi AF. Upregulation of Uric Acid Production and Caspase 3 Signalling Mediates Rohypnol-Induced Cardiorenal Damage. Cardiovasc Toxicol 2022; 22:419-435. [PMID: 35103933 DOI: 10.1007/s12012-022-09723-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 01/19/2022] [Indexed: 12/22/2022]
Abstract
The global prevalence of illicit drug use is on the increase with attendant complications like cardiorenal collapse. One such substance of abuse is rohypnol. Despite its ban in most countries, it remains a popular substance of abuse. Whether or not rohypnol induces cardiorenal injury and the associated mechanism is yet to be elucidated. Therefore, the present study investigated the effect of rohypnol on cardiorenal integrity and functions, and glucolipid metabolism. Forty-eight male Wistar rats randomized into six groups (n = 8/group) received (per os) vehicle, low-dose (2 mg/kg) and high-dose (4 mg/kg) rohypnol once daily for twenty eight days, with or without a cessation period. Data revealed that rohypnol exposure irreversibly caused insulin resistance, hyperglycaemia, and dyslipidaemia. This was accompanied by reduced cardiorenal mass and impaired cardiorenal cytoarchitecture and function. Furthermore, rohypnol treatment promoted oxidative stress, inflammation, genotoxicity, and decreased cardiorenal activities of Na+-K+-ATPase, Ca2+-ATPase, and Mg2+-ATPase. These alterations were associated with enhanced uric acid generation and caspase 3 activity in the cardiorenal complex. Thus, this study reveals that rohypnol exposure triggers cardiorenal toxicity with incident insulin resistance, glucolipid and cardiorenal proton pump dysregulation, altered redox state, and inflammation via enhancement of uric acid generation and caspase 3-dependent mechanism.
Collapse
Affiliation(s)
- R E Akhigbe
- Reproductive Physiology and Bioinformatics Research Unit, Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria.,Reproductive Biology and Toxicology Research Laboratories, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria.,Department of Chemical Sciences, Kings University, Odeomu, Osun, Nigeria
| | - A A Oladipo
- Reproductive Physiology and Bioinformatics Research Unit, Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - P A Oyedokun
- Reproductive Physiology and Bioinformatics Research Unit, Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
| | - M A Hamed
- Reproductive Biology and Toxicology Research Laboratories, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria.,Buntai Medical and Diagnostic Laboratories, Osogbo, Nigeria
| | - L O Okeleji
- Cardio-Thoracic Unit, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Osun State, Nigeria
| | - A F Ajayi
- Reproductive Physiology and Bioinformatics Research Unit, Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria. .,Department of Human Physiology, Faculty of Basic Medical Sciences, Baze University, Abuja, Nigeria.
| |
Collapse
|
3
|
Dåderman AM, Meurling AW, Hallman J. Different personality patterns in non‐socialized (juvenile delinquents) and socialized (air force pilot recruits) sensation seekers. EUROPEAN JOURNAL OF PERSONALITY 2020. [DOI: 10.1002/per.407] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Young delinquents are known to be sensation seekers. Not all sensation seekers become delinquents: many engage in socially accepted activities, such as mountaineering or parachute jumping. The present study compares 47 juvenile delinquents (mean age 17 years) with 18 Swedish air force pilot recruits (mean age 23 years) and 19 conscripts (mean age 18 years) as a control group. Sensation‐seeking behaviour, impulsiveness, and psychiatric/psychological vulnerability were measured by the Zuckerman Sensation‐Seeking Scales (SSS), the Karolinska Scales of Personality, and the Eysenck Personality Questionnaire. Two separate multivariate analyses of variance were performed, followed up by stepdown analyses to identify those personality scale scores that contributed uniquely. In order to clarify the relationships, the pooled within‐group correlations among scales were computed. Juvenile delinquents and pilot recruits were both high in sensation seeking, but on different subscales. Delinquents were high in impulsiveness, somatic anxiety, and extraversion–sociability, and low in socialization, suggesting psychiatric/psychological vulnerability. The findings may have implications for the treatment of juvenile delinquents. Copyright © 2001 John Wiley & Sons, Ltd.
Collapse
|
4
|
Abstract
After participating in this activity, learners should be better able to:• Assess the misuse potential of clonazepam• Characterize the nonmedical use of clonazepam• Identify the health problems associated with long-term use of clonazepam ABSTRACT: Clonazepam, a benzodiazepine, is commonly used in treating various conditions, including anxiety disorders and epileptic seizures. Due to its low price and easy availability, however, it has become a commonly misused medication, both in medical and recreational contexts. In this review, we aim to highlight the behavioral and pharmacological aspects of clonazepam and its history following its approval for human use. We examine the circumstances commonly associated with the nonmedical use of clonazepam and raise points of particular concern. Clonazepam, alone or in combination with other psychoactive substances, can lead to unwanted effects on health, such as motor and cognitive impairment, sleep disorders, and aggravation of mood and anxiety disorders. Prolonged use of clonazepam may lead to physical dependence and tolerance. There is therefore a need to find safer therapeutic alternatives for treating seizures and anxiety disorders. Greater awareness of its frequent nonmedical use is also needed to achieve safer overall use of this medication.
Collapse
|
5
|
Votaw VR, Geyer R, Rieselbach MM, McHugh RK. The epidemiology of benzodiazepine misuse: A systematic review. Drug Alcohol Depend 2019; 200:95-114. [PMID: 31121495 PMCID: PMC6639084 DOI: 10.1016/j.drugalcdep.2019.02.033] [Citation(s) in RCA: 222] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 02/22/2019] [Accepted: 02/27/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Benzodiazepine misuse is a growing public health problem, with increases in benzodiazepine-related overdose deaths and emergency room visits in recent years. However, relatively little attention has been paid to this emergent problem. We systematically reviewed epidemiological studies on benzodiazepine misuse to identify key findings, limitations, and future directions for research. METHODS PubMed and PsychINFO databases were searched through February 2019 for peer-reviewed publications on benzodiazepine misuse (e.g., use without a prescription; at a higher frequency or dose than prescribed). Eligibility criteria included human studies that focused on the prevalence, trends, correlates, motives, patterns, sources, and consequences of benzodiazepine misuse. RESULTS The search identified 1970 publications, and 351 articles were eligible for data extraction and inclusion. In 2017, benzodiazepines and other tranquilizers were the third most commonly misused illicit or prescription drug in the U.S. (approximately 2.2% of the population). Worldwide rates of misuse appear to be similar to those reported in the U.S. Factors associated with misuse include other substance use, receipt of a benzodiazepine prescription, and psychiatric symptoms and disorders. Benzodiazepine misuse encompasses heterogeneous presentations of motives, patterns, and sources. Moreover, misuse is associated with myriad poor outcomes, including mortality, HIV/HCV risk behaviors, poor self-reported quality of life, criminality, and continued substance use during treatment. CONCLUSIONS Benzodiazepine misuse is a worldwide public health concern that is associated with a number of concerning consequences. Findings from the present review have implications for identifying subgroups who could benefit from prevention and treatment efforts, critical points for intervention, and treatment targets.
Collapse
Affiliation(s)
- Victoria R. Votaw
- Department of Psychology, University of New Mexico, MSC 03-2220, Albuquerque, NM, USA,Corresponding author: Victoria R. Votaw, Clinical Psychology Ph.D. Student Department of Psychology, University of New Mexico, Logan Hall, 1 University of New Mexico, Albuquerque, NM 87131,
| | - Rachel Geyer
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA, USA
| | - Maya M. Rieselbach
- Department of Psychiatry, McLean Hospital, 115 Mill Street, Belmont, MA, USA
| | - R. Kathryn McHugh
- Division of Alcohol and Drug Abuse, McLean Hospital, 115 Mill Street, Belmont, MA, USA,Department of Psychiatry, Harvard Medical School, 401 Park Drive, Boston, MA, USA
| |
Collapse
|
6
|
Pinyopornpanish K, Jiraporncharoen W, Thaikla K, Yoonut K, Angkurawaranon C. Sedative and Analgesic Drugs Online: A Content Analysis of the Supply and Demand Information Available in Thailand. Subst Use Misuse 2018; 53:641-647. [PMID: 28910188 DOI: 10.1080/10826084.2017.1355386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Evidence from other countries has suggested that many controlled drugs are also offered online, even though it is illegal to sell these drugs without a license. OBJECTIVES To evaluate the current contents related to the supply and demand of sedatives and analgesic drugs available online in Thailand, with a particular focus on Facebook. METHODS A team of reviewers manually searched for data by entering keywords related to analgesic drugs and sedatives. The contents of the website were screened for supply and demand-related information. FINDINGS A total of 5,352 websites were found publicly available. The number of websites and Facebook pages containing the information potentially related to the supply and demand of analgesic drugs and sedatives was limited. Nine websites sold sedatives, and six websites sold analgesics directly. Fourteen Facebook pages were found, including 7 sedative pages and 7 analgesic pages. Within one year, the three remaining active pages multiplied in the number of followers by three- to nine-fold. The most popular Facebook page had over 2,900 followers. CONCLUSIONS Both the internet and social media contain sites and pages where sedatives and analgesics are illegally advertised. These websites are searchable through common search engines. Although the number of websites is limited, the number of followers on these Facebook pages does suggest a growing number of people who are interested in such pages. Our study emphasized the importance of monitoring and developing potential plans relative to the online marketing of prescription drugs in Thailand.
Collapse
Affiliation(s)
- Kanokporn Pinyopornpanish
- a Department of Family Medicine, Faculty of Medicine , Chiang Mai University , Sriphum, Muang, Chiang Mai , Thailand
| | - Wichuda Jiraporncharoen
- a Department of Family Medicine, Faculty of Medicine , Chiang Mai University , Sriphum, Muang, Chiang Mai , Thailand
| | - Kanittha Thaikla
- b Drug Abuse Research Unit, Research Institute for Health Science , Chiang Mai University , Sriphum, Muang, Chiang Mai , Thailand
| | - Kulyapa Yoonut
- a Department of Family Medicine, Faculty of Medicine , Chiang Mai University , Sriphum, Muang, Chiang Mai , Thailand
| | - Chaisiri Angkurawaranon
- a Department of Family Medicine, Faculty of Medicine , Chiang Mai University , Sriphum, Muang, Chiang Mai , Thailand
| |
Collapse
|
7
|
Townsend EA, Platt DM, Rowlett JK, Roma PG, Freeman KB. Reinforcing effectiveness of midazolam, ethanol, and sucrose: behavioral economic comparison of a mixture relative to its component solutions. Behav Pharmacol 2017; 28:386-393. [PMID: 28537943 PMCID: PMC5648065 DOI: 10.1097/fbp.0000000000000308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Benzodiazepines (BZs) are relatively safe when administered alone. However, these drugs can produce severe side effects when coadministered with ethanol. Despite these adverse consequences, rates of concurrent BZ and ethanol misuse are increasing, and it is unclear whether this behavior is maintained by an enhanced reinforcing effect of the mixture. To address this issue, the current study compared the reinforcing effectiveness of sucrose solutions mixed with midazolam, ethanol, or both. Eight male rats were trained to orally self-administer solutions of either sucrose (S), sucrose+midazolam (SM), sucrose+ethanol (SE), or sucrose+midazolam+ethanol (SME). The response requirement was increased between sessions until the number of reinforcers earned was zero and the relationship between response requirement and reinforcers earned was analyzed using the exponential model of demand. Although baseline intake was similar across drug conditions, consumption of SM was least affected by increases in cost, indicating that it possessed the highest reinforcing effectiveness (i.e. least elastic). The reinforcing effectiveness of S, SE, and SME did not differ significantly. The finding that the reinforcing effectiveness of the SME was less than that of SM does not support the supposition that BZ and ethanol coadministration is maintained by a higher reinforcing effectiveness of the mixture.
Collapse
Affiliation(s)
- E. Andrew Townsend
- Division of Neurobiology and Behavior Research, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States
- Graduate Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS, United States
| | - Donna M. Platt
- Division of Neurobiology and Behavior Research, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States
| | - James K. Rowlett
- Division of Neurobiology and Behavior Research, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States
| | - Peter G. Roma
- Institutes for Behavior Resources, Baltimore, MD 21218, United States
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kevin B. Freeman
- Division of Neurobiology and Behavior Research, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, United States
| |
Collapse
|
8
|
Abstract
Aggression is a serious medical problem that can place both the patient and the health care provider at risk. Aggression can result from medical, neurologic, and/or psychiatric disorders. A comprehensive patient evaluation is needed. Treatment options include pharmacotherapy as well as nonpharmacologic interventions, both of which need to be individualized to the patient.
Collapse
Affiliation(s)
- Scott D Lane
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, 1941 East Road Houston, TX 77054, USA
| | | | | |
Collapse
|
9
|
Shbair MKS, Eljabour S, Lhermitte M. Drugs involved in drug-facilitated crimes: part I: alcohol, sedative-hypnotic drugs, gamma-hydroxybutyrate and ketamine. A review. ANNALES PHARMACEUTIQUES FRANÇAISES 2010; 68:275-85. [PMID: 20849998 DOI: 10.1016/j.pharma.2010.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 05/12/2010] [Accepted: 05/20/2010] [Indexed: 11/25/2022]
Abstract
SUMMARY In recent years, there has been a notable increase in the number of reports of drug-facilitated crimes (DFCs). Usually, individuals report that they were robbed or assaulted while incapacitated by drugs. Most often, these cases have involved drugs that have the ability to produce an effect that leaves the victim in a semiconscious or unconscious state. It is reasonable to assume that the purpose of drug-induced incapacitation is probably largely unchanged with time. This covers the full range of property offences (particularly theft) and crimes against the person. What have changed are the drugs themselves: the number; type; their accessibility; effects and detection. The purpose of this review is to explore the different aspects related to the involvement and use of ethanol, sedative-hypnotics drugs, gamma-hydroxybutyrate (GHB) and ketamine in DFCs or offences, which may help people working in this field to expand their knowledge for better understanding of the nature of these crimes or offences.
Collapse
Affiliation(s)
- M K S Shbair
- UDSL, université Lille-Nord-de-France, rue Laguesse, 59000 Lille, France
| | | | | |
Collapse
|
10
|
Pépin G. Aspects analytique, toxicologique, judiciaire de la soumission chimique : dix ans d’expérience. ANNALES PHARMACEUTIQUES FRANÇAISES 2010; 68:61-75. [DOI: 10.1016/j.pharma.2010.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2009] [Revised: 01/06/2010] [Accepted: 01/06/2010] [Indexed: 11/28/2022]
|
11
|
Abstract
Reports of drug-facilitated crimes have significantly increased since the mid-1990s. When individuals report that they were robbed or assaulted while incapacitated by a drug, toxicologic testing may be needed to help substantiate the alleged victim's claims. Most often, these cases have involved strong central nervous system depressant drugs, which have the capability of preventing individuals from consenting to the action of the perpetrator or fighting off their attackers. For all intents and purposes, the drug acts as the offender's weapon, so many jurisdictions require analytical proof of its presence for criminal charges of the drug-facilitated crime to be filed. This article provides information on the manner in which drug-facilitated crimes occur, the drugs that are used to commit these crimes, and recommendations to improve the detection of these drugs through toxicologic analyses.
Collapse
|
12
|
Modulation of human risky decision making by flunitrazepam. Psychopharmacology (Berl) 2008; 196:177-88. [PMID: 17917718 DOI: 10.1007/s00213-007-0951-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2007] [Accepted: 09/13/2007] [Indexed: 10/22/2022]
Abstract
RATIONALE GABA-modulating drugs produce disinhibitory effects that increase the probability of risk-taking behavior. Previous reports suggest that the misuse of the benzodiazepine flunitrazepam is associated with several forms of harmful risky behavior, including theft, violence, and intoxication-related auto accidents. OBJECTIVES The present study examined the dose-response relationships between acute flunitrazepam administration and human decision making under conditions of risk. The analyses also examined flunitrazepam-mediated changes in decision-making processes using a computational modeling approach, the expectancy valence model (EVM). MATERIALS AND METHODS Using a laboratory measure of risky decision making designed to address acute drug effects, 12 adults were administered placebo, 0.5, 1.0, and 2.0 mg/70 kg flunitrazepam in a within-subject, repeated measures counterbalanced design. Flunitrazepam was compounded and doses were administered in an 8-oz liquid solution. Primary data analyses examined subjective effects, response rates, distribution of choices between the risky and nonrisky option, and personality correlates related to peak drug effects. Individual-subject data were submitted to a computational modeling analysis (EVM) that provided parameter estimates corresponding to components of valence; updating expectancies about alternatives (learning/memory); and consistency between choices and expected outcomes (sensitivity to learned outcomes). RESULTS Flunitrazepam produced dose-related changes in subjective effects and response rates, and increased selection of the risky response option. High doses significantly changed decision-making processes related to the learning/memory and consistency parameters. CONCLUSIONS At sufficiently high doses, flunitrazepam can engender increases in risky decision making. Globally, these changes appear similar to previous effects we have observed after acute administration of alcohol and alprazolam. As suggested by the EVM outcomes, the mechanisms underlying the changes in risky decision making are more similar to alprazolam than alcohol.
Collapse
|
13
|
Winger G, Galuska CM, Hursh SR. Modification of ethanol's reinforcing effectiveness in rhesus monkeys by cocaine, flunitrazepam, or gamma-hydroxybutyrate. Psychopharmacology (Berl) 2007; 193:587-98. [PMID: 17510760 DOI: 10.1007/s00213-007-0809-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2006] [Accepted: 04/18/2007] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although ethanol is frequently used in combination with other psychoactive drugs, the behavioral and pharmacological reasons for this form of polydrug abuse have not been well described. MATERIALS AND METHODS Rhesus monkeys with indwelling intravenous catheters produced intravenous injections of ethanol (50, 100, or 200 mg/kg/inj), flunitrazepam (0.001-0.03 mg/kg/inj), cocaine (0.01 or 0.03 mg/kg/inj), or combinations of ethanol and these drugs or gammahydroxybutyrate (GHB) (1.0 or 3.2 mg/kg/inj) by lever pressing according to a fixed-ratio schedule. The response requirement for each drug or drug combination was increased across sessions (10, 32, 100, 320, or 1,000). The dependent variables were rates of responding maintained by the drug or drug combination and the elasticity of drug demand when consumption was expressed as a function of price. RESULTS Elasticity (P (max)) values for each drug varied among the monkeys but retained the same rank order for the monkeys, suggesting a fundamental difference in the animals' apparent sensitivities to the reinforcing effects of the drugs. Combining ethanol with the other drugs did not increase their reinforcing effectiveness. GHB (ineffective in previous studies) did not modify ethanol's reinforcing effects; demand functions for the combination of ethanol and flunitrazepam were slightly less elastic than for ethanol alone, but no different from that for flunitrazepam alone; adding ethanol to cocaine detracted from the reinforcing effectiveness of cocaine. CONCLUSIONS The hypothesis that use of ethanol in combination with sedative and stimulant drugs is due to an ability of ethanol to enhance the reinforcing effects of these drugs is not supported.
Collapse
Affiliation(s)
- Gail Winger
- Department of Pharmacology, University of Michigan, 1301 MSRB III, Ann Arbor, MI 48109-0632, USA.
| | | | | |
Collapse
|
14
|
Yacoubian GS, Peters RJ. An exploration of recent club drug use among rave attendees. JOURNAL OF DRUG EDUCATION 2007; 37:145-161. [PMID: 17977238 DOI: 10.2190/4vk6-0571-n771-863t] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Raves are characterized by large numbers of youth dancing for long periods of time and by the use of "club drugs," such as 3, 4-methylenedioxymethamphetamine (MDMA or "ecstasy"). While a small body of research has explored the use of ecstasy and other club drugs (EOCD) among club rave attendees in the United States, we are aware of no studies that have investigated the relationship between EOCD use and high-risk sexual behaviors among members of this population. We explored the association between EOCD use and high-risk sexual behaviors among a sample of 283 club rave attendees interviewed during the spring and summer of 2005. Data were collected at 13 rave events in two different clubs along the Baltimore-Washington corridor between March 17 and September 3, 2005. Potential respondents were conveniently sampled and approached between 12 a.m. and 5 a.m. as they exited the clubs. Only 12% reported using ecstasy within the two days preceding the interview, findings considerably lower than our earlier studies of club rave attendees. Moreover, no significant relationship was discerned between recent MDMA use and high-risk sexual behavior. These findings suggest that the use of EOCD among rave attendees has diminished and that the allocation of significant resources to combat their proliferation, among this and other populations at risk for EOCD use, may be premature.
Collapse
|
15
|
Dorandeu AH, Pagès CA, Sordino MC, Pépin G, Baccino E, Kintz P. A case in south-eastern France: A review of drug facilitated sexual assault in European and English-speaking countries. ACTA ACUST UNITED AC 2006; 13:253-61. [PMID: 16530452 DOI: 10.1016/j.jcfm.2005.11.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2005] [Revised: 11/24/2005] [Accepted: 11/29/2005] [Indexed: 10/24/2022]
Abstract
Drug facilitated sexual assaults (DFSA) have been increasingly reported in the medical literature since the 1980s but their legal recognition is more recent, at least in Europe. From a case treated in south-eastern France, whose judicial consequences were known, it seemed of interest to carry out an international study of jurisprudence concerning this type of rape. While from the medical viewpoint the drugs used are well-known and their presence can be clinically verified, the legal consequences of their use in subsequent criminal prosecution is less clear-cut. Some European countries have no jurisprudence in this area, while others consider the use of drugs as an aggravating circumstance. In France, it was only in 2003 that the first case of DFSA was truly punished by the judicial system, with considerable media attention. By contrast, in English-speaking countries, particularly the United States, the use of drugs to facilitate sexual assault has frequently been recognized in legislation and in criminal prosecutions. Prevention is fundamental and is recognised as demonstrated by campaigns in various countries.
Collapse
Affiliation(s)
- Anne H Dorandeu
- Department of Forensic Sciences, Hôpital Lapeyronie, 371, avenue du Doyen Gaston Giraud, 34295 Montpellier, France.
| | | | | | | | | | | |
Collapse
|
16
|
Violle N, Messaoudi M, Lefranc-Millot C, Desor D, Nejdi A, Demagny B, Schroeder H. Ethological comparison of the effects of a bovine αs1-casein tryptic hydrolysate and diazepam on the behaviour of rats in two models of anxiety. Pharmacol Biochem Behav 2006; 84:517-23. [PMID: 16899284 DOI: 10.1016/j.pbb.2006.06.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Revised: 06/26/2006] [Accepted: 06/28/2006] [Indexed: 11/26/2022]
Abstract
A bovine alpha s1-casein tryptic hydrolysate was previously demonstrated to display an anxiolytic-like activity in the conditioned defensive burying and in the elevated plus-maze models when i.p. injected. The present study assessed the anxiolytic-like effects of this tryptic hydrolysate after an oral administration in rats faced to the same behavioural situations using diazepam as a reference. In a first experiment, the behavioural effects of the hydrolysate in the conditioned defensive burying test were investigated at doses ranging 5-50 mg/kg. The results showed that the minimal dose required to elicit an anxiolytic-like activity is 15 mg/kg. In a second experiment, the alpha s1-casein tryptic hydrolysate (15 mg/kg, p.o.) was demonstrated to display an anxiolytic-like activity similar to diazepam (3 mg/kg, p.o.) in the conditioned defensive burying test and the elevated plus-maze. However, the ethological analysis of behaviour indicated that this hydrolysate has a different activity compared to diazepam. While diazepam induced a disinhibition state in rats, possibly related to the risk-taking behaviour observed after a benzodiazepine ingestion in humans, the tryptic hydrolysate did not display such a side effect. These results suggest that the mechanism of action of the bovine alpha s1-casein tryptic hydrolysate may differ from that of diazepam.
Collapse
Affiliation(s)
- Nicolas Violle
- Neurosciences Comportementales, URAFPA, INRA UC12340, INPL-UHP, 54500 Vandoeuvre-lès-Nancy, France
| | | | | | | | | | | | | |
Collapse
|
17
|
Lane SD, Tcheremissine OV, Lieving LM, Nouvion S, Cherek DR. Acute effects of alprazolam on risky decision making in humans. Psychopharmacology (Berl) 2005; 181:364-73. [PMID: 15830221 DOI: 10.1007/s00213-005-2265-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2004] [Accepted: 03/06/2005] [Indexed: 10/25/2022]
Abstract
RATIONALE GABA-A receptor ligands, including benzodiapines, may induce disinhibitory effects that increase the probability of risky decision making. To date, few laboratory studies have examined the acute, dose-related effects of benzodiazepines on human risk-taking behavior. Recent data indicate that in the United States alprazolam is the benzodiazepine most frequently misused for recreational purposes. OBJECTIVES The present study was designed to demonstrate a dose-response relationship between acute alprazolam administration and human risk taking. Furthermore, this investigation sought to examine: (1) the behavioral mechanisms that may be involved in changes in the probability of risky decision making related to alprazolam administration and (2) risk seeking-related personality variables that may predict drug effects on risk taking. METHODS Using a laboratory measure of risk taking designed to address acute drug effects, 16 adults were administered placebo, 0.5, 1.0, and 2.0 mg alprazolam in a within-subject repeated-measures design. The risk-taking task presented subjects with a choice between two response options operationally defined as risky and nonrisky. Data analyses examined subjective effects, response rates, distribution of choices between the risky and nonrisky option, trial-by-trial response probabilities, and personality correlates related to drug effects at the 2.0-mg dose. RESULTS Alprazolam administration produced dose-related changes in subjective effects, response rates, and, most importantly, dose-dependently increased selection of the risky response option. The 2.0-mg dose increased the probability of making consecutive risky responses following a gain on the risky response option. Increases at 2.0 mg were related to a combination of personality scales that included high venturesomeness and novelty seeking and low harm avoidance. CONCLUSIONS Alprazolam administration produced increases in human risk taking under laboratory conditions. In union with previous studies, the observed shift in trial-by-trial response probabilities suggests that sensitivity to consequences (e.g., oversensitivity to recent rewards) may be an important mechanism in the psychopharmacology of risky decision making. Additionally, risk-seeking personality traits may be predictive of acute drug effects on risk-taking behavior.
Collapse
Affiliation(s)
- Scott D Lane
- Department of Psychiatry and Behavioral Sciences, UTHSC-Houston, TX 77030, USA.
| | | | | | | | | |
Collapse
|
18
|
Scott-Ham M, Burton FC. Toxicological findings in cases of alleged drug-facilitated sexual assault in the United Kingdom over a 3-year period. ACTA ACUST UNITED AC 2005; 12:175-86. [PMID: 16054005 DOI: 10.1016/j.jcfm.2005.03.009] [Citation(s) in RCA: 142] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This paper outlines the toxicology results from 1014 cases of claimed drug-facilitated sexual assault (DFSA) analysed at the Forensic Science Service, London Laboratory between January 2000 and December 2002. Where appropriate, either a whole blood sample and/or a urine sample was analysed for alcohol, common drugs of abuse and potentially stupefying drugs. The results were interpreted with respect to the number of drugs detected and an attempt was made to distinguish between voluntary and involuntary ingestion from information supplied. Alcohol (either alone or with an illicit and/or medicinal drug) was detected in 470 of all cases (46%). Illicit drugs were detected in 344 cases (34%), with cannabis being the most commonly detected (26% of cases), followed by cocaine (11%). In 21 cases (2%), a sedative or disinhibiting drug was detected which had not been admitted and could therefore be an instance of deliberate spiking. This included three cases in which complainants were allegedly given Ecstasy (MDMA) without their knowledge. Other drugs detected included gammahydroxybutyrate (GHB) and the benzodiazepine drugs diazepam and temazepam. Another nine cases (1%) involved the complainant being either given or forced to ingest pharmaceutical tablets or an illicit drug.
Collapse
Affiliation(s)
- Michael Scott-Ham
- The Forensic Science Service, London Laboratory, 109 Lambeth Road, London, SE1 7LP, UK.
| | | |
Collapse
|
19
|
Abstract
This preliminary descriptive study was designed to assess the reasons, primary contexts, and consequences (physical, psychological, lifestyle) of club drug use in a sample of young adults in a mid-size U.S. city. Fifty young adults (18 to 30 years old) reported on their use of club drugs (Ecstasy, GHB, ketamine, Rohypnol, methamphetamine, LSD) in face-to-face interviews that included quantitative and qualitative measures. Ecstasy was the most frequently used club drug followed by ketamine, LSD and methamphetamine. All of the participants reported using club drugs to "experiment" and most reported using these drugs to feel good and enhance social activities. Club drugs were frequently used at raves, in bars or clubs, and at home with friends. An average of 16 negative physical, psychological, and lifestyle consequences were reported for club drug use. Despite substantial negative consequences, participants perceived several positive consequences of regular recreational club drug use. These findings corroborate descriptions of club drug use in other countries (e.g., Australia, United Kingdom) and provide additional information on perceived positive consequences that users experience with club drug use. Further exploration of the reasons and positive consequences that are associated with use of each of the club drugs may provide important information on the growing trend in use of these drugs.
Collapse
Affiliation(s)
- Kathleen A Parks
- Research Institute on Addictions, 1021 Main Street, Buffalo, New York 14203, USA.
| | | |
Collapse
|
20
|
Abstract
Four different "club drugs" are reviewed: MDMA (methylenedioxymethamphetamine, "Ecstasy"), GHB (gamma-hydroxybutyrate), ketamine, and Rohypnol (flunitrazepam). The neurobiology, clinical pharmacology, and treatment issues for each are discussed.
Collapse
Affiliation(s)
- Gena Covell Britt
- Division of Addiction Psychiatry, Virginia Commonwealth University, Richmond, Virginia 23219, USA.
| | | |
Collapse
|
21
|
Yacoubian GS, Miller S, Pianim S, Kunz M, Orrick E, Link T, Palacios WR, Peters RJ. Toward an ecstasy and other club drug (EOCD) prevention intervention for rave attendees. JOURNAL OF DRUG EDUCATION 2004; 34:41-59. [PMID: 15468747 DOI: 10.2190/qqct-61h5-cl3f-fvq3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
A growing body of recent research has identified that "rave" attendees are at high risk for the use of "club drugs," such as 3,4-methylenedioxymethamphetamine (MDMA or "ecstasy"). Rave attendees, however, comprise only one of several club-going populations. In the current study, we explore the prevalence of ecstasy and other club drug (EOCD) use among a sample of club attendees in Washington, DC. Data were collected from adult, primarily homosexual, club attendees during the summer of 2003. Data collection was scheduled between 11 p.m. and 3 a.m. Participation rates were high. Of the 211 club attendees approached, 88% (n = 186) completed the interview. Drug use prevalence rates were low. With the exception of alcohol and marijuana, 2-day self-reports were less than 1% for each drug. These findings, amalgamated with results from other EOCD-related studies involving several distinct populations, offer considerable insight into the state of ecstasy in American society. Based on a meta-analysis of this literature, we offer a community-level prevention intervention for the population at highest risk for EOCD use-rave attendees.
Collapse
Affiliation(s)
- George S Yacoubian
- Pacific Institute for Research Evaluation (PIRE), Calverton, MD 20705-3102, USA.
| | | | | | | | | | | | | | | |
Collapse
|
22
|
Dåderman AM, Strindlund H, Wiklund N, Fredriksen SO, Lidberg L. The importance of a urine sample in persons intoxicated with flunitrazepam-legal issues in a forensic psychiatric case study of a serial murderer. Forensic Sci Int 2003; 137:21-7. [PMID: 14550609 DOI: 10.1016/s0379-0738(03)00273-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The sedative-hypnotic benzodiazepine flunitrazepam (FZ) is abused worldwide. The purpose of our study was to investigate violence and anterograde amnesia following intoxication with FZ, and how this was legally evaluated in forensic psychiatric investigations with the objective of drawing some conclusions about the importance of urine sample in a case of a suspected intoxication with FZ. The case was a 23-year-old male university student who, intoxicated with FZ (and possibly with other substances such as diazepam, amphetamines or cannabis), first stabbed an acquaintance and, 2 years later, two friends to death. The police investigation files, including video-typed interviews, the forensic psychiatric files, and also results from the forensic autopsy of the victims, were compared with the information obtained from the case. Only partial recovery from anterograde amnesia was shown during a period of several months. Some important new information is contained in this case report: a forensic analysis of blood sample instead of a urine sample, might lead to confusion during police investigation and forensic psychiatric assessment (FPA) of an FZ abuser, and in consequence wrong legal decisions. FZ, alone or combined with other substances, induces severe violence and is followed by anterograde amnesia. All cases of bizarre, unexpected aggression followed by anterograde amnesia should be assessed for abuse of FZ. A urine sample is needed in case of suspected FZ intoxication. The police need to be more aware of these issues, and they must recognise that they play a crucial role in an assessment procedure. Declaring FZ an illegal drug is strongly recommended.
Collapse
Affiliation(s)
- Anna Maria Dåderman
- Department of Psychology, Division of Biological Psychology, Stockholm University, SE-106 91 Stockholm, Sweden.
| | | | | | | | | |
Collapse
|
23
|
Yacoubian GS. Correlates of benzodiazepine use among a sample of arrestees surveyed through the Arrestee Drug Abuse Monitoring (ADAM) Program. Subst Use Misuse 2003; 38:127-39. [PMID: 12602810 DOI: 10.1081/ja-120016569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
While marijuana and cocaine are the two most prevalent drugs used among arrestee populations, benzodiazepine use has surpassed that of opiates in several jurisdictions across the United States. Despite this proliferation, few scholarly works have focused on benzodiazepine use among individuals under criminal justice supervision. In the present study, chi-square statistics and logistic regression are utilized to identify significant associations between recent benzodiazepine use (as measured by urinalysis), demographic characteristics, and alcohol and other drug (AOD) use among a sample of 862 adult Philadelphia arrestees interviewed in 1997 through the Arrestee Drug Abuse Monitoring (ADAM) Program. Compared to nonusers, benzodiazepine-positive respondents were more likely to be White, to have used alcohol and barbiturates in the three days preceding the interview, and to have tested positive by urinalysis for marijuana, cocaine, opiates, and phencyclidine (PCP). Moreover, logistic regression identified that if an arrestee reported three-day barbiturate use, the odds ratio (OR) of recent benzodiazepine use was more than nine times higher than an arrestee who reported no three-day barbiturate use. Implications for drug surveillance are assessed in light of the current findings.
Collapse
|
24
|
Yacoubian GS, Urbach BJ, Larsen KL, Johnson RJ, Peters RJ. Exploring benzodiazepine use among Houston arrestees. J Psychoactive Drugs 2002; 34:393-9. [PMID: 12562107 DOI: 10.1080/02791072.2002.10399980] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
While marijuana and cocaine are the two most prevalent drugs among arrestees, benzodiazepine use has surpassed that of opiates in several jurisdictions across the United States. Despite this proliferation, few scholarly works have focused on benzodiazepine use among individuals under criminal justice supervision. In the present study, the authors used Chi-square statistics and logistic regression to identify significant associations between recent benzodiazepine use (as measured by urinalysis), demographic characteristics, and alcohol and other drug (AOD) use among a sample of 1,572 adult Houston arrestees surveyed through the Arrestee Drug Abuse Monitoring (ADAM) Program in 1999. Compared to nonusers, benzodiazepine-positive arrestees were more likely to be Black, less likely to have a high school diploma, and more likely to be arrested for a drug- or alcohol-related offense. Moreover, analyses indicated that recent barbiturate, heroin, PCP, and marijuana use, as measured by urinalysis, were the strongest predictors of recent benzodiazepine use. Policy implications are assessed in light of the current findings.
Collapse
|
25
|
Shen WW, Chang C, Hsieh WC, Yeh CJ, Chiu FY, Chuang YC. The flunitrazepam abuse prevention program at a general hospital in Taiwan: a descriptive study. Psychiatry Clin Neurosci 2002; 56:425-30. [PMID: 12109961 DOI: 10.1046/j.1440-1819.2002.01032.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The Bureau of Controlled Drugs at Ministry of Health, Executive Yuan in Taiwan announced, on 1 April 2000, the schedules of controlled drugs with abuse potential and implemented a policy on 1 October 2000 to control them. Flunitrazepam (FM2), along with other two benzodiazepines (triazolam and brotizolam), is placed on Schedule III. The aim of the present study was to analyze the pattern of flunitrazepam prescriptions across all medical subspecialty departments at Taipei Medical University-Wan Fang Hospital (TMU-WFH), Taiwan. We analyzed 1170 prescriptions over 12 month period from 1 July 2000 to 31 May 2001. All prescription data were divided into three 4 month periods: period I was when the flunitrazepam prescription was not controlled, period II represented the time when flunitrazepam was placed on Schedule III and when physicians were required to use a special duplicated prescription form and period III was when the TMU-WFH started to set a stricter control for the prescription of flunitrazepam. The results indicated that the number of flunitrazepam prescriptions during period III had decreased significantly compared with period I (P < or = 0.05). Eventually, 45.7% of flunitrazepam-medicated patients were followed up monthly with a restriction of their flunitrazepam supply to no more than 14 days, 22.9% of patients were followed up fortnightly at clinics with a 14 day supply of flunitrazepam, 15.7% were followed up fortnightly with a 14 day restriction of flunitrazepam plus a non-flunitrazepan benzodiazepine supplement, 10.7% were referred to clinics within the Department of Psychiatry and 5% were switched from flunitrazepam to other drugs.
Collapse
Affiliation(s)
- Winston W Shen
- Department of Psychiatry, Taipei Medical University-Wan Fang, Hospital, Taiwan.
| | | | | | | | | | | |
Collapse
|
26
|
Thirion X, Lapierre V, Micallef J, Ronflé E, Masut A, Pradel V, Coudert C, Mabriez JC, Sanmarco JL. Buprenorphine prescription by general practitioners in a French region. Drug Alcohol Depend 2002; 65:197-204. [PMID: 11772481 DOI: 10.1016/s0376-8716(01)00161-2] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Since 1996 French general practitioners (GPs) may prescribe sublingual buprenorphine tablets as maintenance treatment for opiate dependence. The computerised data management of the main French health reimbursement system now allows surveillance of the use of this drug, and how it is prescribed. The purpose of this study is to determine the profile of maintained patients, prescribed doses, associated psychotropic treatments and how practitioners prescribe these treatments. This study analyses the 11186 buprenorphine prescriptions electronically transmitted for reimbursement between September and December 1999 in a specific French region. It was found that the 2078 treated patients consumed a mean of 11.5 mg of buprenorphine per day and 12% of them procured prescriptions from more than two prescribers. 43% of maintained patients had an associated benzodiazepine prescription, mainly flunitrazepam, often on the same prescription form. 61% of patients had regular follow-up, others had occasional consultations (21%) and another 18% had deviant maintenance treatment (more than two prescribers or more than 20 mg per day of daily buprenorphine dose). Benzodiazepine consumption was much higher in the 'deviant group' (71.4%). 85% of buprenorphine prescriptions were made by GPs. 21% of GPs prescribed buprenorphine and 61% of those had only one or two maintained patients. Buprenorphine prescription by French GPs is a procedure with no particular requirements, allowing many patients to easily access maintenance treatments. However, a high risk of abuse exists, which demands extensive investigation and evaluation of these practices.
Collapse
Affiliation(s)
- X Thirion
- Centre for Evaluation and Information on Pharmacodependence, Public Health Department, School of Medicine, 27 Boulevard Jean Moulin, 13005 Marseilles, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Hindmarch I, ElSohly M, Gambles J, Salamone S. Forensic urinalysis of drug use in cases of alleged sexual assault. ACTA ACUST UNITED AC 2001; 8:197-205. [PMID: 16083685 DOI: 10.1054/jcfm.2001.0513] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The results of 3303 analyses of urine samples, collected in an independent testing programme from individuals who claimed to have been sexually assaulted and believed that drugs were involved, were examined in detail. Of the samples provided, 2026 (61.3%) proved positive for one or more substances. Alcohol, either alone or in combination with other drugs, was by far the commonest substance found, being present in 1358 samples (67.0% of positives). Cannabis was the second most prevalent drug, present in 613 samples, (30.3% of positives). Detailed examination of the testing results does not support the contention that any single drug, apart from alcohol, can be particularly identified as a 'date rape' drug. Rather, the alleged sexual assaults may often take place against a background of licit or recreational alcohol or drug use, where alcohol and other drugs are frequently taken together. The extensive forensic database examined here does not support the concept of a commonly occurring 'date rape' scenario, in which the victim's drink is covertly 'spiked' with a tablet, capsule or powder containing a sedative-hypnotic. This research highlights the need for the early collection of forensic samples in cases of alleged sexual assault. Law enforcement agencies and health professionals should establish guidelines and procedures to ensure that appropriate forensic samples (blood and urine) are collected in a timely manner following allegations of possible drug mediated sexual assault.
Collapse
Affiliation(s)
- I Hindmarch
- HPRU Medical Research Centre, University of Surrey, Guildford, UK
| | | | | | | |
Collapse
|
28
|
Deposition of 7-Aminoflunitrazepam and Flunitrazepam in Hair After a Single Dose of Rohypnol®. J Forensic Sci 2001. [DOI: 10.1520/jfs15113j] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
29
|
Abstract
Sixty male non-psychotic forensic psychiatric patients (aged 16-35 years) were studied after they completed their ordinary forensic psychiatric assessment (FPA). The prevalence of flunitrazepam (FZ) abuse was investigated by using both structured and in-depth interviews with the objective of studying the relationship between the abuse and personality traits. The patient's characteristics, DSM-IV disorders, and actual sentences were obtained by studying their files. In order to obtain measures on their personality traits, self-report inventories were administered to the patients. Eighteen out of 60 patients were FZ abusers, but only 4 of them received a diagnosis related to the FZ abuse during the ordinary FPA. In almost all cases, however, indications of the FZ abuse were found in the files. No differences in personality traits were found between the groups. The frequency of previous admissions to an FPA and actual sentences of robbery, weapons offenses, narcotic-related offenses, and other crimes (such as theft) among the FZ abusers deviated significantly from forensic non-FZ abusers. Therefore, the FZ abuse per se might be more responsible for their tendency to commit crimes characterized by danger and thrill-seeking (such as robbery, weapons offences, and theft) than personality. The most important conclusion is that assessment of FZ abuse is needed in forensic psychiatry.
Collapse
Affiliation(s)
- A M Dåderman
- Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Division of Forensic Psychiatry, Karolinska Institute, Huddinge, Sweden.
| | | |
Collapse
|
30
|
Elimination of 7-Aminoflunitrazepam and Flunitrazepam in Urine After a Single Dose of Rohypnol®. J Forensic Sci 2000. [DOI: 10.1520/jfs14827j] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
31
|
Abstract
STUDY OBJECTIVE To evaluate the independent relationship between depressive symptoms. self-esteem. and drug resistance self-efficacy, and future intentions to use flunitrazepam. DESIGN Cross-sectional survey. SETTING Community-based family planning clinics. PARTICIPANTS 865 sexually active women who self-identified as Caucasian. African-American. or Mexican American. denied using flunitrazepam in the last 12 months and reported intentions to use or not use this substance in the next 12 months. INTERVENTIONS None. MAIN OUTCOME MEASURE An anonymous self-report measure assessed the patient's intentions to use flunitrazepam in the next 12 months: other lifetime drug use: and standardized measures of depression. self-esteem, and drug resistance self-efficacy. We hypothesized that future potential users of flunitrazepam would exhibit an increased number of depressive symptoms, lowered self-esteem, and limited drug resistance self-efficacy. RESULTS Of the 865 subjects. 16 (1.8%) reported using flunitrazepam in their lifetime but not in the last 12 months. and 46 (5.3%) were identified as potential users. Logistic regression analyses controlling for confounding factors found that potential to use flunitrazepam was significantly associated with limited drug resistance self-efficacy (adjusted odds ratio [AOR] = 9.3) and the presence of both severe depressive symptoms and lowered self-esteem (AOR = 3.2). CONCLUSIONS These data suggest that young women with severe depressive symptoms and diminished self-esteem are at high risk for future flunitrazepam use and may use this drug to self-medicate psychological distress.
Collapse
Affiliation(s)
- V I Rickert
- Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA.
| | | | | |
Collapse
|
32
|
Abstract
The benzodiazepines are still extensively used in psychiatry, neurology and medicine in general. Anxiety disorder and severe insomnia are important syndromal indications, but these drugs are widely prescribed at the symptomatic level, resulting in potential overuse. The official data sheets recommend short durations of usage and conservative dosage. Although short-term efficacy is established, long-term efficacy remains controversial, as relevant data are scanty and relapse, rebound and dependence on withdrawal not clearly distinguished. The risks of the benzodiazepines are well-documented and comprise psychological and physical effects. Among the former are subjective sedation, paradoxical release of anxiety and/or hostility, psychomotor impairment, memory disruption, and risks of accidents. Physical effects include vertigo, dysarthria, ataxia with falls, especially in the elderly. Dependence can supervene on long-term use, occasionally with dose escalation. The benzodiazepines are now recognised as major drugs of abuse and addiction. Other drug and non-drug therapies are available and have a superior risk benefit ratio in long-term use. It is concluded that benzodiazepines should be reserved for short-term use--up to 4 weeks--and in conservative dosage.
Collapse
Affiliation(s)
- M H Lader
- Institute of Psychiatry, University of London, UK.
| |
Collapse
|
33
|
Affiliation(s)
- M E Mullins
- Oregon Poison Center, Department of Emergency Medicine, Oregon Health Sciences University, Portland, USA
| |
Collapse
|
34
|
Assaf M, Abdel-Rahman M. Hepatotoxicity of Flunitrazepam and Alcohol In Vitro. Toxicol In Vitro 1999; 13:393-401. [DOI: 10.1016/s0887-2333(99)00004-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/1998] [Indexed: 11/16/2022]
|
35
|
Abstract
Detection of low levels of flunitrazepam and its metabolites was developed using solid-phase extraction to isolate the drugs from whole liquid blood and dried bloodstains, with subsequent derivatization with pentafluoropropionic anhydride (PFPA) followed by N-(tert-butyldimethyl-silyl)-N-methyl-trifluoroacetamide (MTBSTFA) with 1% TBDMSCI. Analysis was confirmed by gas chromatography/mass spectroscopy using select ion monitoring (sim) in electron impact mode. The limit of detection of this procedure using 1 ml of blood was determined to be 0.1 microgram/dl.
Collapse
Affiliation(s)
- A A Elian
- Commonwealth of Massachusetts, Forensic Toxicology Laboratory, Sudbury 01776, USA
| |
Collapse
|
36
|
Abstract
OBJECTIVE To determine prevalence, patterns, and correlates of voluntary flunitrazepam use in a sample of sexually active adolescent and young adult women 14 to 26 years of age. DESIGN Cross-sectional survey. SETTING University-based ambulatory reproductive health clinics. PATIENTS OR OTHER PARTICIPANTS There were 904 women self-identified as white, African-American, or Mexican-American. INTERVENTIONS None. MAIN OUTCOME MEASURE Lifetime, frequency, patterns, and physical effects of flunitrazepam use. RESULTS Lifetime use was reported by 5.9% (n = 53) of subjects, with frequency of use ranging from 1 to 40 times. Flunitrazepam was taken most often with alcohol (74%), and 49% took this substance with other illicit drugs. Logistic regression analyses controlling for age and race/ethnicity found that users were significantly more likely than were nonusers to report lifetime use of marijuana (odds ratio [OR] = 3.6) or LSD (OR = 5.2), having a peer or partner who used flunitrazepam (OR = 21.7), pressure to use flunitrazepam when out with friends (OR = 2.7), and a mother who had at least a high school education (OR = 2.6). Finally, 10% of voluntary users reported experiencing subsequent physical or sexual victimization. CONCLUSIONS Voluntary use of flunitrazepam is becoming a health concern to sexually active young women who reside in the southwestern United States. Young women who have used LSD or marijuana in the past or who have a peer or partner who used this drug appear to be at the greatest risk.
Collapse
Affiliation(s)
- V I Rickert
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX 77555-0587, USA
| | | | | |
Collapse
|
37
|
BARRETT AM, WALSHE K, KAVANAGH PV, McNAMARA SM, MORAN C, BURDETT J, SHATTOCK AG. A comparison of five commercial immunoassays for the detection of flunitrazepam and other benzodiazepines in urine. Addict Biol 1999; 4:81-7. [PMID: 20575774 DOI: 10.1080/13556219971885] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Five commercially available immunoassay test kits (SYVA EMIT(R) d.a.u(TM), SYVA EMIT(R) II assay, Abbott FPIA, Cozart Auto-Lyte(R) and Roche Abuscreen(R) Online(TM), all used for the benzodiazepine group of drugs) were evaluated for their ability to detect flunitrazepam, its major urinary metabolite, 7-aminoflunitrazepam, and several other benzodiazepines at serial dilutions (final concentration 25-1000 ng/ml) in drug-free urine and in urines following oral administration of flunitrazepam (1-3 mg). For comparison, gas chromatography/mass spectrometry was used to measure urinary levels of 7-aminoflunitrazepam. Levels of drug detected in the study were compared with the cross-reactivities presented by the manufacturers for each individual kit. One to three mg doses of flunitrazepam were taken by volunteers and levels excreted in urine analysed over several hours. A positive response was obtained in several samples from volunteers who had taken 2 mg or 3 mg doses, but not a 1 mg dose. Thirty-five clinical samples from the individuals suspected of benzodiazepine abuse were also examined. The results were not consistent among the kits evaluated.We conclude that the test kits evaluated in this study do not detect flunitrazepam reliably, due primarily to their poor sensitivities.
Collapse
|
38
|
Valdez A, Cepeda A, Kaplan CD, Yin Z. The legal importation of prescription drugs into the United States from Mexico: a study of Customs declaration forms. Subst Use Misuse 1998; 33:2485-97. [PMID: 9781826 DOI: 10.3109/10826089809059336] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The nature and magnitude of the problem of the diversion of prescription drugs from legal to illegal markets have been identified as a high priority by the federal government. This study was based on a random sample (2,005) of declaration forms of persons declaring Mexican prescription drugs at the US Customs office in Laredo, Texas. Of the 75 different types of drugs, the most frequently declared drugs were Valium (71%), Rohypnol (46%), and Tafil (25%), drugs highly associated with nonmedicinal use among United States teenagers and young adults. These data reinforce a documented need for more transnational cooperative efforts between the United States and Mexico.
Collapse
Affiliation(s)
- A Valdez
- Hispanic Research Center, The University of Texas at San Antonio, 78249-0601, USA
| | | | | | | |
Collapse
|
39
|
Cupp MJ. Author's Reply. Ann Pharmacother 1998. [DOI: 10.1177/106002809803200901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Melanie Johns Cupp
- Clinical Assistant Professor School of Pharmacy Drug Information Center West Virginia University 1124 HSN PO Box 9550 Morgantown, West Virginia 26505 FAX 304/293-5483
| |
Collapse
|
40
|
Bogusz MJ, Maier RD, Krüger KD, Früchtnicht W. Determination of flunitrazepam and its metabolites in blood by high-performance liquid chromatography-atmospheric pressure chemical ionization mass spectrometry. JOURNAL OF CHROMATOGRAPHY. B, BIOMEDICAL SCIENCES AND APPLICATIONS 1998; 713:361-9. [PMID: 9746251 DOI: 10.1016/s0378-4347(98)00207-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A selective assay of flunitrazepam (F) and its metabolites 7-aminoflunitrazepam (7-AF), N-desmethylflunitrazepam (N-DF) and 3-hydroxyflunitrazepam (3-OHF) with liquid chromatography-atmospheric pressure chemical ionization mass spectrometry (LC-APCI-MS, positive ions) is described. The drugs were isolated from serum, blood or urine using a solid-phase extraction procedure previously applied to various drugs of abuse. F-d3 and 7-AF-d3 were used as internal standards. The drugs were separated on ODS column in acetonitrile-50 mM ammonium formate buffer, pH 3.0 (45:55, v/v). After analysis of mass spectra taken in full scan mode, a selected-ion monitoring detection was applied with following ions: m/z 284 (7-AF and F), 287 (7-AF-d3 and F-d3), 314 (F), 300 (N-DF and 3-OHF), 317 (F-d3), 330 (3-OHF). The limits of detection were: 0.2 microg/l for F and 7-AF, 1 microg/l for N-DF and 3-OHF. The method was linear in the range 1-500 microg/l, the recoveries ranged from 92 to 99%. The method was applied for determination of F and metabolites in clinical and forensic samples. LC-APCI-MS seems to be a method of choice for these compounds.
Collapse
Affiliation(s)
- M J Bogusz
- Institute of Forensic Medicine, Aachen University of Technology, Germany
| | | | | | | |
Collapse
|
41
|
Bismuth C, Dally S, Borron SW. Chemical submission: GHB, benzodiazepines, and other knock out drops. JOURNAL OF TOXICOLOGY. CLINICAL TOXICOLOGY 1997; 35:595-8. [PMID: 9365425 DOI: 10.3109/15563659709001238] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- C Bismuth
- Hôpital Fernand Widal Paris University, France
| | | | | |
Collapse
|
42
|
Valdez A, Sifaneck SJ. Drug Tourists and Drug Policy on the U.S.-Mexican Border: An Ethnographic Investigation of the Acquisition of Prescription Drugs. JOURNAL OF DRUG ISSUES 1997. [DOI: 10.1177/002204269702700413] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recent increases in the prevalence of non-medical prescription drug use across the United States have prompted national concern about the sources of these drugs. The focus of this study is the process by which prescription drugs enter the United States from Mexico through “drug tourism.” Drug tourism refers to the phenomenon by which persons become attracted to a particular location because of the accessibility of licit or illicit drugs and related services. A loophole in U.S. Customs laws enables Americans to legally bring pharmaceutical drugs into the United States when accompanied by a Mexican prescription. Using ethnographic field methods, this study (1) describes the acquisition process, (2) develops a typology of consumers, and (3) explores the interaction between the actors in this process. This study provides a better understanding of the social dynamics of a “gray market” in prescription drugs, and identifies a hidden population of drug users.
Collapse
|
43
|
Abstract
Flunitrazepam is among the most frequently prescribed hypnotics in many countries. Although it was never marketed in the United States, flunitrazepam, in recent years, has been smuggled into the country, and reports of abuse--including alleged use of the drug to facilitate "date rape"--have attracted a great deal of scrutiny. It has been suggested that flunitrazepam may have greater liability for abuse than other benzodiazepines; such suggestions are supported by surveys of opioid abusers, many of whom report a distinct preference for flunitrazepam over other benzodiazepines. Experimental studies of animals and normal human subjects indicate that, although flunitrazepam has high efficacy and is very potent, it is pharmacologically similar to most other benzodiazepines. Although the studies are limited in number and scope, the data show no apparent differences between flunitrazepam and other benzodiazepines in ability to produce drug-taking or drug-seeking behavior, in capacity to produce physiologic dependence, nor in the characteristics of withdrawal after administration of an antagonist or discontinuation of treatment. Similar to other benzodiazepines, flunitrazepam produces dose-dependent effects on psychomotor performance and recall. Flunitrazepam does not seem to be involved in medical emergencies more often than other benzodiazepines, and there is no indication that flunitrazepam is more toxic than other benzodiazepines when taken in overdose by drug abusers or other individuals. Survey research among typical patient populations suggests that flunitrazepam is characteristic of benzodiazepines in that it is used appropriately and conservatively, with low liability for abuse. Thus the reported preference for flunitrazepam among opioid abusers seems to be the only way in which flunitrazepam is distinguished from other benzodiazepines; it is unclear what characteristics of the drug may be responsible for this reported preference. The evidence considered in this review indicates that abuse of flunitrazepam in this special population is not associated with any distinctive threats to the health of the general public.
Collapse
Affiliation(s)
- J H Woods
- Department of Pharmacology, University of Michigan Medical School, Ann Arbor 48109-0632, USA
| | | |
Collapse
|
44
|
Abstract
An estimated 1 in 4 women in the United States will be raped in their lifetimes. Approximately 75% of all rapes are date or acquaintance rapes. Recently the illegal use of flunitrazepam (Rohypnol), a benzodiazepine, as a prelude to the assault has been reported. Flunitrazepam readily dissolves, and once in solution, is colorless, odorless, and tasteless. The predominant clinical manifestations are drowsiness, impaired motor skills, and anterograde amnesia. Due to the amnestic effects of flunitrazepam, historical clues of the rape event are difficult to obtain. Patients with a complaint of sexual assault who appear intoxicated or have anterograde amnesia should be suspected of unknowingly ingesting flunitrazepam. In addition to adhering to standard rape protocols, a urine specimen should be analyzed for flunitrazepam metabolites using gas chromatography/mass spectrometry. If the hospital, local, or forensic laboratory is unable to analyze for flunitrazepam, Hoffmann-La Roche Inc., the manufacturer of Rohypnol, should be contacted. Hoffmann-La Roche has a mechanism for definitive testing for flunitrazepam, at no cost, for health care providers, rape treatment centers, and law enforcement agencies. A network of organizations is attempting to reduce the abuse of flunitrazepam in association with date rape.
Collapse
Affiliation(s)
- D Anglin
- Department of Emergency Medicine, USC Medical Center, Los Angeles 90033, USA.
| | | | | |
Collapse
|