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Esteban L, Bellido I, Arcos-Romero AI. The "Chemsex" Phenomenon and Its Relationship with Psychological Variables in Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:3515-3525. [PMID: 38956002 DOI: 10.1007/s10508-024-02920-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 05/27/2024] [Accepted: 05/28/2024] [Indexed: 07/04/2024]
Abstract
Chemsex is described as the use of psychoactive substances during sexual activity to sustain, enhance, disinhibit, or facilitate the sexual experience. It preferentially concerns men who have sex with men. The main objective of this study was to examine the relationship between participation in chemsex and the psychological variables impulsivity, sexual assertiveness, and hypersexuality. The sample was composed of 137 Spanish men. A total of 104 participants reported that they had engaged in chemsex, with ages ranging from 19 to 42 years (M = 31.41, SD = 4.83). A total of 33 participants reported that they had never participated in chemsex sessions. The participants were contacted and recruited at social centers, LGBT associations, and key informants. Results showed that men who participated in chemsex reported higher impulsivity, higher hypersexuality, and lower sexual assertiveness than those who have never participated in it. The frequency of participation in chemsex, as well as the number of substances consumed, was positively and significantly correlated with dimensions of impulsivity and hypersexuality. This frequency and this consumption were negatively and significantly correlated with sexual assertiveness. Findings showed significant differences in the psychological variables based on the number of consumed substances (polydrug use/consumption of one substance) and the time of consumption (before, during or before and during sex). In conclusion, the study demonstrates the existence of a clear relationship between the experience of chemsex and psychological factors such as being an impulsive person, presenting hypersexual behavior, and/or having low sexual assertiveness.
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Affiliation(s)
- Laura Esteban
- Department of Psychology, Faculty of Psychology and Education, Universidad Loyola Andalucía, Avda. de las Universidades, 2, Dos Hermanas, PC: 41704, Seville, Spain.
| | - Iván Bellido
- Department of Psychology, Faculty of Psychology and Education, Universidad Loyola Andalucía, Avda. de las Universidades, 2, Dos Hermanas, PC: 41704, Seville, Spain
| | - Ana I Arcos-Romero
- Department of Psychology, Faculty of Psychology and Education, Universidad Loyola Andalucía, Avda. de las Universidades, 2, Dos Hermanas, PC: 41704, Seville, Spain
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Del Pozo-Herce P, Baca-García E, Martínez-Sabater A, Pérez-Elvira R, Gea-Caballero V, Chover-Sierra E, Satústegui-Dordá PJ, Tovar-Reinoso A, Rodríguez-Velasco FJ, Sánchez-Barba M, Pérez J, Juárez-Vela R. The Chem-Sex Inventory Scale (CSI): A Tool to Assess the Mental Health Risk of Chemsex Behaviors in Men Who Have Sex with Men. NURSING REPORTS 2024; 14:2226-2245. [PMID: 39311174 PMCID: PMC11417715 DOI: 10.3390/nursrep14030166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 08/29/2024] [Accepted: 08/30/2024] [Indexed: 09/26/2024] Open
Abstract
Background: Chemsex has been defined as the deliberate use of drugs for prolonged sexual intercourse between gay and bisexual men and other men who have sex with men (MSM). Drugs associated with chemsex can trigger mental health problems such as anxiety, depression, risk of psychosis and suicidal ideation, social isolation, stigmatization, and even loss of impulse control and lack of coping strategies. Currently, the increase in illicit drugs in a sexual context is considered an outbreak of a public health emergency. Objective: The aim of this study is the construction and validation of the Chem-Sex Inventory (CSI), a new scale to assess the mental health risk of chemsex behaviors. Methods: A cross-sectional design was conducted to study 563 participants. Data were collected through an online questionnaire between January and April 2023, and the construct validity of the CSI was assessed through exploratory and confirmatory factor analysis. Results: The sample was, on average, 36 years old (SD: ±9.2). The majority of gender identity was cisgender (97.7%). A factor structure was found that can be summarized in four dimensions: emotional instability, risk of psychosis, altered body perception, and risk of suicide. The confirmatory factor analysis (CFA) presents adequate reliability values, with a Cronbach's alpha above 0.87 for all dimensions and a McDonald's omega above 0.88 with a good fit of the 42 items. Conclusions: Our study has shown that the Chem-Sex Inventory (CSI) scale has factorial validity and could be used in clinical practice and research to measure the behavioral contribution of the chemsex phenomenon in MSM.
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Affiliation(s)
- Pablo Del Pozo-Herce
- Doctorate Program in Psychology, Autonomous University of Madrid, 28049 Madrid, Spain;
- Department of Psychiatry, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain;
- Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, 28040 Madrid, Spain
- UNIE Universidad, 28040 Madrid, Spain;
| | - Enrique Baca-García
- Department of Psychiatry, Fundación Jiménez Díaz University Hospital, 28040 Madrid, Spain;
- Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Antonio Martínez-Sabater
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 Valencia, Spain;
- Care Research Group (INCLIVA), Hospital Clínico Universitario de Valencia, 46014 Valencia, Spain
| | - Rubén Pérez-Elvira
- Faculty of Psychology, Potificial University of Salamanca, 37007 Salamanca, Spain;
| | - Vicente Gea-Caballero
- Research Group Community Health and Care, Faculty of Health Sciences, International University of Valencia, 46014 Valencia, Spain;
| | - Elena Chover-Sierra
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Nursing Department, Universitat de Valencia, 46010 Valencia, Spain;
- Internal Medicine, Consorci Hospital General Universitari de Valencia, 46014 Valencia, Spain
| | - Pedro José Satústegui-Dordá
- SAPIENF (B53_23R) Research Group, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain;
| | | | - Francisco José Rodríguez-Velasco
- Biopsychosocial Research Group (GIBIPSO), Faculty of Medicine and Health Sciences, University of Extremadura, 10003 Caceres, Spain;
| | - Mercedes Sánchez-Barba
- Department of Statistics, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Jesús Pérez
- Prevention and Early Intervention in Mental Health (PRINT), Faculty of Medicine, Biomedical Institute of Salamanca, University of Salamanca, 37007 Salamanca, Spain; (J.P.); (R.J.-V.)
- Department of Medicine, Faculty of Medicine, University of Salamanca, 37007 Salamanca, Spain
| | - Raúl Juárez-Vela
- Prevention and Early Intervention in Mental Health (PRINT), Faculty of Medicine, Biomedical Institute of Salamanca, University of Salamanca, 37007 Salamanca, Spain; (J.P.); (R.J.-V.)
- Research Group in Care, Faculty of Health Sciences, University of La Rioja, 26004 Logroño, Spain
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Jennings TL, Gleason N, Pachankis JE, Bőthe B, Kraus SW. LGBQ-affirming clinical recommendations for compulsive sexual behavior disorder. J Behav Addict 2024; 13:413-428. [PMID: 38592797 PMCID: PMC11220820 DOI: 10.1556/2006.2024.00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 01/28/2024] [Accepted: 03/14/2024] [Indexed: 04/11/2024] Open
Abstract
Background and aims Since the inclusion of Compulsive Sexual Behavior Disorder (CSBD) in the International Classification of Diseases (11th ed.), there has been little effort placed into developing clinical recommendations for lesbian, gay, bisexual, and queer (LGBQ) clients with this condition. Thus, we develop preliminary clinical recommendations for mental health professionals working with LGBQ clients who may be struggling with CSBD. Methods The present paper synthesizes the CSBD literature with advances in LGBQ-affirming care to develop assessment and treatment recommendations. These recommendations are discussed within the context of minority stress theory, which provides an empirically supported explanation for how anti-LGBQ stigma may contribute to the development of mental health conditions in LGBQ populations. Results Assessment recommendations are designed to assist mental health professionals in distinguishing aspects of an LGBQ client's sociocultural context from CSBD symptomology, given recent concerns that these constructs may be wrongly conflated and result in misdiagnosis. The treatment recommendations consist of broadly applicable, evidence-based principles that can be leveraged by mental health professionals of various theoretical orientations to provide LGBQ-affirming treatment for CSBD. Discussion and Conclusions The present article provides theoretically and empirically supported recommendations for mental health professionals who want to provide LGBQ-affirming care for CSBD. Given the preliminary nature of these recommendations, future research is needed to investigate their clinical applicability and efficacy.
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Affiliation(s)
- Todd L. Jennings
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Neil Gleason
- Department of Psychology, University of Washington, Seattle, WA, USA
| | | | - Beáta Bőthe
- Department of Psychology, University of Montréal, Montréal, QC, CAN
| | - Shane W. Kraus
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
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del Pozo-Herce P, Baca-García E, Martínez-Sabater A, Chover-Sierra E, Gea-Caballero V, Curto-Ramos J, Czapla M, Karniej P, Martínez-Tofe J, Sánchez-Barba M, de Viñaspre RR, Juárez-Vela R. Descriptive study on substance uses and risk of sexually transmitted infections in the practice of Chemsex in Spain. Front Public Health 2024; 12:1391390. [PMID: 38799691 PMCID: PMC11121992 DOI: 10.3389/fpubh.2024.1391390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 04/16/2024] [Indexed: 05/29/2024] Open
Abstract
Background In recent years, there has been an increasing use of sex-related substances (known as "Chemsex") to facilitate, intensify, and prolong the sexual experience of men who have sex with men. This phenomenon poses a public health problem, increasing the risk of sexually transmitted infections (STIs) and mental disorders. Objective The primary aim of this study was to delve into the correlation between substance use and sexual health, specifically examining the association between different substances used and the risk of sexually transmitted infections (STIs) in the context of Chemsex in Spain. Methods An observational, descriptive, cross-sectional study was conducted among 563 Spanish participants between January and April 2023. Non-probabilistic purposive sampling was used by the investigators. The researchers administered a questionnaire to men who have sex with men who use substances, especially in the sexual sphere, in all the autonomous communities of Spain. Results 14.7% reported having practiced slamsex in the last year, and 17.94% were diagnosed with a Sexually Transmitted Infection in the previous 6 months. Of these, 21% were on PREP treatment, with the main STIs being gonorrhea (p < 0.001), chlamydia (p < 0.001), genital herpes (p = 0.020), and syphilis (p < 0.001). The 63.7% used methamphetamines as the main drug in the practice of chemsex. Discussion Chemsex in Spain is linked to a high prevalence of STIs, especially gonorrhea and chlamydia, even among those on PrEP treatment. The use of various drugs during chemsex, such as amyl nitrite, GHB, ecstasy, and others, correlates with higher rates of STIs, highlighting the need for interventions to reduce risk and harm. The drugs most associated with slamsex include ketamine, mephedrone, and methamphetamine, underscoring the importance of addressing the risk behaviors associated with this activity. Conclusion This study shows that chemsex appears to be associated with a high prevalence among men who have sex with men. Who use multiple substances in a sexual context, and are particularly exposed to sexually transmitted infections (STIs), indicating a particular need for STI prevention and care in this group.
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Affiliation(s)
- Pablo del Pozo-Herce
- Department of Psychiatry, Fundación Jimenez Diaz University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, Madrid, Spain
| | - Enrique Baca-García
- Department of Psychiatry, Fundación Jimenez Diaz University Hospital, Madrid, Spain
- Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz, Madrid, Spain
| | - Antonio Martínez-Sabater
- Nursing Department, Nursing Care and Education Research Group (GRIECE), Universitat de Valencia, Valencia, Spain
- Care Research Group (INCLIVA), Hospital Clinico Universitario de Valencia, Valencia, Spain
| | - Elena Chover-Sierra
- Nursing Department, Nursing Care and Education Research Group (GRIECE), Universitat de Valencia, Valencia, Spain
- Internal Medicine, Consorci Hospital University of Valencia, Valencia, Spain
| | - Vicente Gea-Caballero
- Faculty of Health Sciences, Research Group Community Health and Care, International University of Valencia, Valencia, Spain
| | - Javier Curto-Ramos
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Michal Czapla
- Department of Emergency Medical Service, Faculty of Health Sciences, Wroclaw Medical University, Wrocław, Poland
- Department of Nursing, Faculty of Health Sciences, Research Group in Care, University of La Rioja, Logroño, Spain
| | - Piotr Karniej
- Faculty of Finance and Management, WSB University in Wroclaw, Wroclaw, Poland
| | - Jesús Martínez-Tofe
- Department of Nursing, Faculty of Health Sciences, Research Group in Care, University of La Rioja, Logroño, Spain
| | - Mercedes Sánchez-Barba
- Department of Statistics, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Regina Ruiz de Viñaspre
- Department of Nursing, Faculty of Health Sciences, Research Group in Care, University of La Rioja, Logroño, Spain
| | - Raúl Juárez-Vela
- Department of Nursing, Faculty of Health Sciences, Research Group in Care, University of La Rioja, Logroño, Spain
- Faculty of Medicine, Biomedical Institute of Salamanca, Prevention and Early Intervention in Mental Health, University of Salamanca, Salamanca, Spain
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González-Baeza A, Barrio-Fernández P, Curto-Ramos J, Ibarguchi L, Dolengevich-Segal H, Cano-Smith J, Rúa-Cebrián G, García-Carrillo de Albornoz A, Kessel D. Understanding Attachment, Emotional Regulation, and Childhood Adversity and Their Link to Chemsex. Subst Use Misuse 2023; 58:94-102. [PMID: 36422467 DOI: 10.1080/10826084.2022.2148482] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Although evidence shows that engaging in chemsex can be associated with poor mental health, little is known about the relationship between psychological factors and this type of drug use. We aim to explore associations between engagement in chemsex and several psychological variables (adverse life events, attachment styles, emotional regulation skills, self-care patterns) in a sample of gay, bisexual, and other men who have sex with men (GBMSM) with drug-related problems. Methods: A group of GBMSM engaged in chemsex (n = 41) and a control group of GBMSM (n = 39) completed an online survey to assess drug-related problems and the abovementioned psychological variables, in which both groups were compared. All analyses were adjusted for covariates showing significant differences between groups. Results: Compared to the control group, participants engaged in chemsex showed significantly higher frequencies of an avoidant-insecure attachment style and early adverse life events, regardless of all covariates (HIV status, job situation, and place of birth). Poorer emotional regulation and self-care patterns and a higher frequency of sexual abuse were also found in participants engaged in chemsex, though we cannot rule out the influence of HIV status on this second group of variables. Conclusions: Some people with drug-related problems engaged in chemsex might have suffered early adverse events and might have an avoidant-insecure attachment style. Moreover, those who have been diagnosed with HIV might show higher emotional dysregulation and poorer self-care patterns. These variables should be routinely evaluated in this population.
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Affiliation(s)
- Alicia González-Baeza
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Javier Curto-Ramos
- Apoyo Positivo, Psychological Department, Apoyo Positivo, Madrid, Spain.,Psychiatry Service, Hospital Universitario La Paz, Madrid, Spain
| | - Lorena Ibarguchi
- Apoyo Positivo, Psychological Department, Apoyo Positivo, Madrid, Spain
| | | | - Joanna Cano-Smith
- HIV Unit, Internal Medicine Service, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Dominique Kessel
- Biological and Health Psychology Department, Universidad Autónoma de Madrid, Madrid, Spain
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Chemsex and Psychosis: A Systematic Review. Behav Sci (Basel) 2022; 12:bs12120516. [PMID: 36546999 PMCID: PMC9774634 DOI: 10.3390/bs12120516] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
Chemsex is presented as a major challenge in public health, with numerous physical and mental consequences. The general objective of this review was to analyze the relationship between the practice of chemsex and the development of psychosis. A mixed systematic review model was chosen. PubMed, PsycINFO, and Web of Science databases were searched following a predetermined search strategy. The studies were selected, and their information was extracted following a systematic method. A total of 10 articles were included. Psychotic symptoms ranged from 6.7% to 37.2%, being one of the most frequent psychiatric diagnoses. Slamsex, polydrug use and smoked methamphetamine posed up to a 3-fold increased risk of psychosis within this practice. The risk factors found were foreign or ethnic minority status, location in large cities, stress and anxiety, trauma, loneliness, sexually transmitted infections (STIs), hepatitis, and previous psychotic history. In conclusion, chemsex is associated with psychosis development; we found numerous converging risk factors and a clear mediating role of drugs. It is important, in approaching the prevention and treatment of this addiction, to take into account motivations and psychosocial circumstances.
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Garcia-Fuentes D, Fernández-Fernández EP, Planet Nielsen N, Batlle De Santiago E, Giné-Servén E, Cañete Crespillo J. Attempted suicide with intravenous methamphetamine and chemsex. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:76-80. [PMID: 35210209 DOI: 10.1016/j.rcpeng.2020.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/03/2020] [Indexed: 06/14/2023]
Abstract
BACKGROUND Undiagnosed attention deficit and hyperactivity disorder (ADHD) is frequent in the substance abuse disorder population, and has an intense repercussion in the daily life of the patients. That condition increases the risk of substance abuse disorders and risk conducts derived from impulsivity. There are not yet studies linking ADHD and the new emergent phenomenon of chemsex, that is, the action of use the intravenous injection of substances in sex parties, with the objective of maximising the practising time and sexual experience. In these sessions, different types of drug are used, for example, synthetic cathinone or mephedrone, and may lead to diverse medical and psychiatric complications like psychosis, aggressiveness and suicide ideation. CASE We report the case of a 44-year-old man admitted into a psychiatric unit, presenting with 2nd time suicidal high risk attempt using intravenous methamphetamine and a dissolvent acid in the context of a depressive episode, after practising chemsex sessions almost every weekend with psychoactive substances taken orally, intravenously and intrarectally. The patient also presented psychotic symptoms from the use of these drugs. When we interviewed the patient during his hospital stay, we observed that there were symptoms of a possible attention and hyperactivity deficit, which was confirmed by study with ASRS-V1.1 and WURS scales. After three weeks, the patient improved substantially as his depressive symptoms and autolytic ideation disappeared. DISCUSSION Look for "hidden" symptoms in substance abuse disorder patients. It is important not to delay important diagnostic tests and to prevent complications. Psychiatric and medical conditions related to chemsex have been reported in several European cities, and recently in Spain where it is an emergent phenomenon and a problem concerning medical and political institutions. The suicide attempt with metamphetamine and acid taken intravenously in the case we report, depressive and psychotic symptoms, addiction, suicide attempts and medical complications are described.
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Affiliation(s)
- Daniel Garcia-Fuentes
- Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, Spain; Unitat d'Aguts de Psiquiatria, Hospital de Mataró, Mataró, Barcelona, Spain.
| | | | - Núria Planet Nielsen
- Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, Spain
| | - Enric Batlle De Santiago
- Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, Spain
| | - Eloi Giné-Servén
- Unitat d'Aguts de Psiquiatria, Hospital de Mataró, Mataró, Barcelona, Spain
| | - Jose Cañete Crespillo
- Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, Spain; Unitat d'Aguts de Psiquiatria, Hospital de Mataró, Mataró, Barcelona, Spain; Consultas externas, Departament de Psiquiatria, Hospital de Mataró, Mataró, Barcelona, Spain
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Íncera-Fernández D, Gámez-Guadix M, Moreno-Guillén S. Mental Health Symptoms Associated with Sexualized Drug Use (Chemsex) among Men Who Have Sex with Men: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413299. [PMID: 34948907 PMCID: PMC8701799 DOI: 10.3390/ijerph182413299] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 01/21/2023]
Abstract
Background: Sexualized drug use (SDU), also known as chemsex, refers to the use of psychoactive substances for sexual purposes among men who have sex with men (MSM), which has been associated with mental health symptoms. The objective of this review is to systematically review the available evidence on mental health outcomes in MSM who use sexualized drugs. Methods: To prepare this systematic review, search strategies were developed and applied to the Web of Science, Science Direct, PubMed, and Scopus databases. A total of 117 articles were found, of which 12 were selected for the final review. Results: Those MSM who practiced SDU were more likely to experience from depression, anxiety, or a substance dependence, although these results were not found in all the studies analyzed. Among those who practiced the administration of intravenous drugs (referred to as slamsex), the mental health symptoms were more severe. Conclusions: This systematic review contributes to a fuller understanding of the mental health symptoms present in MSM who consume drugs for sexual purposes. Greater uniformity in data collection instruments is required, as well as the need to conduct a more in-depth assessment of the psychosocial adjustment of people who practice chemsex.
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Affiliation(s)
- Daniel Íncera-Fernández
- Department of Personality, Assessment and Psychological Treatment, Autonomous University of Madrid, 28049 Madrid, Spain;
- Correspondence: ; Tel.: +34-686-454-251
| | - Manuel Gámez-Guadix
- Department of Personality, Assessment and Psychological Treatment, Autonomous University of Madrid, 28049 Madrid, Spain;
| | - Santiago Moreno-Guillén
- Department of Medicine and Medical Specialties, Alcalá University, 28871 Alcala de Henares, Spain;
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Scheibein F, Wells J, Henriques S, Van Hout MC. "Slam Sex" - Sexualized Injecting Drug Use ("SIDU") Amongst Men Who Have Sex with Men (MSM)-A Scoping Review. JOURNAL OF HOMOSEXUALITY 2021; 68:2344-2358. [PMID: 32875954 DOI: 10.1080/00918369.2020.1804258] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sexualized injecting drug use ("SIDU") is a phenomenon associated with a wide array of high-risk injecting and sex-related practices. This scoping review establishes what is known about MSM and SIDU to assess implications for health care and policy. Characteristics of MSM for "SIDU" may include being on anti-retroviral treatment and urban residency with drivers being challenging social taboos; a search for intimacy; convenience of administration; relationship breakdown and increased restrictions in clubs and saunas. Attraction for use appears to be enhancement or prolongation of sexual experiences/pleasure; intimacy and the facilitation of a range of potentially "unsafe" sexual activity. Traditional services are ill-equipped to address "SIDU" because of a lack of knowledge of practices, lack of associated vocabulary, and a failure to integrate sexual health with drug services. For effective responses, these issues need to be addressed.
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Affiliation(s)
- Florian Scheibein
- School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - John Wells
- School of Health Science, Waterford Institute of Technology, Waterford, Ireland
| | - Susana Henriques
- Centre for Research and Studies in Sociology, University Institute of Lisbon (Iscte-iul)/centro de Investigação e Estudos de Sociologia (CIES-IUL) and Universidade Aberta, Lisbon, Portugal
| | - Marie Claire Van Hout
- Public Health Institute, Liverpool John Moores, Liverpool John Moores, Liverpool, UK
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[Chemsex : A new challenge in addiction medicine and infectious diseases]. DER NERVENARZT 2021; 93:263-278. [PMID: 33852029 DOI: 10.1007/s00115-021-01116-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Recently there has been an increase in reports of the phenomenon called chemsex, a subform of sexualized substance use. Chemsex is a neologism consisting of the two terms "chemicals" and "sex". It describes the use of methamphetamine, γ‑hydroxybutyrate/γ-butyrolactone (GHB/GBL), mephedrone and sometimes other substances in a sexual context, especially by men who have sex with men (MSM). Chemsex has been described as a significant risk factor for mental and physical diseases. OBJECTIVE Due to the increasing importance of the phenomenon and the significantly increased number of publications on the subject, this article provides an overview of the current and relevant literature. The aim is to raise awareness on this topic among practitioners and researchers and thus to facilitate access to the help system for those affected. METHOD A literature search was conducted in PubMed/Medline, Cochrane and Embase for the terms "chemsex", "sexualized drug use" and "slamming. A total of 22 articles were identified as being relevant. RESULTS In the published literature on chemsex the current focus lies on somatic comorbidities. There is a significantly increased risk of sexually transmitted diseases. Mental illnesses such as depression, substance-induced psychosis and addiction also appear to be a significant consequence of chemsex. An individualized and specialized treatment approach is not yet established. DISCUSSION The complexity of chemsex with its psychiatric and somatic aspects does not yet appear to be sufficiently reflected by the current data situation; however, due to the mutual influence of these different comorbidities, this patient clientele appears to be particularly at risk in the absence of a specialized treatment option, which is why further research on this topic is needed.
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Vulnerability factors for mephedrone-induced conditioned place preference in rats-the impact of sex differences, social-conditioning and stress. Psychopharmacology (Berl) 2021; 238:2947-2961. [PMID: 34268586 PMCID: PMC8455394 DOI: 10.1007/s00213-021-05910-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/25/2021] [Indexed: 11/19/2022]
Abstract
RATIONALE Mephedrone is a frequently overused drug of abuse that belongs to the group of novel psychoactive substances. Although its mechanism of action, as well as toxic and psychoactive effects, has been widely studied, the role of different factors that could contribute to the increased vulnerability to mephedrone abuse is still poorly understood. OBJECTIVES The aim of the presented study was to assess the impact of several factors (sex differences, social-conditioning, and chronic mild unpredictable stress - CMUS) on the liability to mephedrone-induced reward in Wistar rats. METHODS The rewarding effects of mephedrone in male and female rats were assessed using the conditioned place preference (CPP) procedure. Furthermore, the impact of social factor and stress was evaluated in male rats using social-CPP and CMUS-dependent CPP, respectively. RESULTS Mephedrone induced classic-CPP in female (10 mg/kg), as well as in male (10 and 20 mg/kg) rats. However, the impact of mephedrone treatment during social-CPP was highly dose-dependent as the rewarding effects of low dose of mephedrone (5 mg/kg; non-active in classic-CPP) were potentiated when administered during social-conditioning. Interestingly, social-conditioning with a higher dose of 20 mg/kg (that induced classic-CPP) was able to reverse these effects. Finally, CMUS potentiated rewarding effects of a low dose of mephedrone (5 mg/kg) and increased the level of corticosterone in rats' prefrontal cortex and hippocampus. CONCLUSIONS Altogether, the presented results give new insight into possible factors underlying the vulnerability to mephedrone abuse and can serve as a basis for further studies assessing mechanisms underlying observed effects.
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Garcia-Fuentes D, Fernández-Fernández EP, Planet Nielsen N, Batlle De Santiago E, Giné-Servén E, Cañete Crespillo J. Attempted Suicide with Intravenous Methamphetamine and Chemsex. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 51:S0034-7450(20)30082-2. [PMID: 33734991 DOI: 10.1016/j.rcp.2020.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 09/03/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Undiagnosed attention deficit and hyperactivity disorder (ADHD) is frequent in the substance abuse disorder population, and has an intense repercussion in the daily life of the patients. That condition increases the risk of substance abuse disorders and risk conducts derived from impulsivity. There are not yet studies linking ADHD and the new emergent phenomenon of chemsex, that is, the action of use the intravenous injection of substances in sex parties, with the objective of maximising the practising time and sexual experience. In these sessions, different types of drug are used, for example, synthetic cathinone or mephedrone, and may lead to diverse medical and psychiatric complications like psychosis, aggressiveness and suicide ideation. CASE We report the case of a 44-year-old man admitted into a psychiatric unit, presenting with 2nd time suicidal high risk attempt using intravenous methamphetamine and a dissolvent acid in the context of a depressive episode, after practising chemsex sessions almost every weekend with psychoactive substances taken orally, intravenously and intrarectally. The patient also presented psychotic symptoms from the use of these drugs. When we interviewed the patient during his hospital stay, we observed that there were symptoms of a possible attention and hyperactivity deficit, which was confirmed by study with ASRS-V1.1 and WURS scales. After three weeks, the patient improved substantially as his depressive symptoms and autolytic ideation disappeared. DISCUSSION Look for "hidden" symptoms in substance abuse disorder patients. It is important not to delay important diagnostic tests and to prevent complications. Psychiatric and medical conditions related to chemsex have been reported in several European cities, and recently in Spain where it is an emergent phenomenon and a problem concerning medical and political institutions. The suicide attempt with metamphetamine and acid taken intravenously in the case we report, depressive and psychotic symptoms, addiction, suicide attempts and medical complications are described.
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Affiliation(s)
- Daniel Garcia-Fuentes
- Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, España; Unitat d'Aguts de Psiquiatria, Hospital de Mataró, Mataró, Barcelona, España.
| | | | - Núria Planet Nielsen
- Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, España
| | - Enric Batlle De Santiago
- Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, España
| | - Eloi Giné-Servén
- Unitat d'Aguts de Psiquiatria, Hospital de Mataró, Mataró, Barcelona, España
| | - Jose Cañete Crespillo
- Centre d'Atenció i Seguiment a les Drogodependències (CASD), Hospital de Mataró, Mataró, Barcelona, España; Unitat d'Aguts de Psiquiatria, Hospital de Mataró, Mataró, Barcelona, España; Consultas externas, Departament de Psiquiatria, Hospital de Mataró, Mataró, Barcelona, España
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Obarska K, Szymczak K, Lewczuk K, Gola M. Threats to Mental Health Facilitated by Dating Applications Use Among Men Having Sex With Men. Front Psychiatry 2020; 11:584548. [PMID: 33281645 PMCID: PMC7691247 DOI: 10.3389/fpsyt.2020.584548] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 09/30/2020] [Indexed: 11/19/2022] Open
Abstract
In the last years, dating applications (DAs) have had a significant impact on the way in which people seek sexual and romantic relationships. Social groups, such as men having sex with men (MSM), who can experience discrimination and social isolation, find DAs especially engaging and helpful in finding sexual partners. Previous studies have provided evidence showing vulnerability to mental health problems among the MSM population-these problems can be potentially facilitated by DAs use. Excessive use of DAs is associated with lower well-being and life satisfaction, depression, higher substance use, and lower sleep quality. Therefore, there is a need for a better understanding of psychological functioning and risk factors associated with the use of DAs among MSM, which we focus on in this review. We also discuss two relatively new research areas: compulsive sexual behavior disorder and chemsex, and their relation to geosocial-networking mobile technologies. Finally, we point out the limitations of available studies on the mental health of MSM using DAs and propose further research directions.
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Affiliation(s)
| | - Karol Szymczak
- Institute of Psychology, The Maria Grzegorzewska University, Warsaw, Poland
| | - Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszyński University, Warsaw, Poland
| | - Mateusz Gola
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
- Swartz Center for Computational Neurosciences, Institute for Neural Computation, University of California, San Diego, San Diego, CA, United States
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Descente fatale après consommation de 3-méthylmethcathinone (3-MMC) : à propos d’un cas. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2020. [DOI: 10.1016/j.toxac.2020.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Benschop A, Urbán R, Kapitány-Fövény M, Van Hout MC, Dąbrowska K, Felvinczi K, Hearne E, Henriques S, Kaló Z, Kamphausen G, Silva JP, Wieczorek Ł, Werse B, Bujalski M, Korf D, Demetrovics Z. Why do people use new psychoactive substances? Development of a new measurement tool in six European countries. J Psychopharmacol 2020; 34:600-611. [PMID: 32043399 DOI: 10.1177/0269881120904951] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION New psychoactive substances (NPS) pose a public health threat. Many studies have tried to identify the reasons of NPS use; however, none of them have so far used any standardised measures. The aim of this study was (i) to develop and cross-culturally validate the New Psychoactive Substance Use Motives Measure (NPSMM) and (ii) to compare motives of NPS use across countries and user types. METHODS Three subgroups (socially marginalised users, nightlife attendees and members of online communities) of NPS users (N = 3023) were recruited from six EU member countries. Demographics, motives and types of NPS used were assessed. NPS use motives were measured by adapting the extended six-factor version of the Marijuana Motives Measure. RESULTS Exploratory and confirmatory factor analysis resulted in a similar five-factor solution across most of the countries: coping, enhancement, social, conformity and expansion motives. Marginalised users scored higher on coping and conformity motives, nightlife groups showed higher endorsement of social motive, whereas online community users showed higher scores on expansion motives. Various types of NPS were also associated with different motives. CONCLUSION NPS use motives might be associated with both the groups of users and the specific types of NPS being consumed. Expansion (psychedelics) and enhancement (stimulants) motives seemed to be linked to the chosen NPS product type, while coping, social and conformity motives were rather associated with user groups. NPSMM was found to be a valid instrument to measure NPS motives.
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Affiliation(s)
| | - Róbert Urbán
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Máté Kapitány-Fövény
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary.,Nyírő Gyula National Institute of Psychiatry and Addictions, Budapest, Hungary
| | | | | | - Katalin Felvinczi
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Evelyn Hearne
- Public Health Institute, Liverpool John Moores University, Liverpool, UK
| | - Susana Henriques
- Centre for Research and Studies in Sociology, ISCTE Lisbon University Institute, Lisbon, Portugal.,Universidade Aberta de Portugal, Aberta, Portugal
| | - Zsuzsa Kaló
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | | | | | | | | | | | - Dirk Korf
- Bonger Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
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Riley AL, Nelson KH, To P, López-Arnau R, Xu P, Wang D, Wang Y, Shen HW, Kuhn DM, Angoa-Perez M, Anneken JH, Muskiewicz D, Hall FS. Abuse potential and toxicity of the synthetic cathinones (i.e., “Bath salts”). Neurosci Biobehav Rev 2020; 110:150-173. [DOI: 10.1016/j.neubiorev.2018.07.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 06/14/2018] [Accepted: 07/24/2018] [Indexed: 01/22/2023]
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Drug-related and psychopathological symptoms in HIV-positive men who have sex with men who inject drugs during sex (slamsex): Data from the U-SEX GESIDA 9416 Study. PLoS One 2019; 14:e0220272. [PMID: 31800575 PMCID: PMC6892548 DOI: 10.1371/journal.pone.0220272] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 11/05/2019] [Indexed: 12/02/2022] Open
Abstract
Objectives Sexualized intravenous drug use, also known as slamsex, seems to be increasing among HIV-positive men who have sex with men (MSM). Physical and psychopathological symptoms have previously been reported in this population, although research on the subject of slamsex is scarce. The objectives of our study were to describe the psychopathological background of a sample of HIV-positive MSM who engaged in slamsex during the previous year and to compare physical, psychopathological, and drug-related symptoms between these participants and those who engaged in non-injecting sexualized drug use. Design and methods Participants (HIV-positive MSM) were recruited from the U-Sex study in 22 HIV clinics in Madrid during 2016–17. All participants completed an anonymous cross-sectional online survey on sexual behavior and recreational drug use. When participants met the inclusion criteria, physicians offered them the opportunity to participate and gave them a card with a unique code and a link to access the online survey. The present analysis is based on HIV-positive MSM who had engaged in slamsex and non-injecting sexualized drug use. Results The survey sample comprised 742 participants. Of all the participants who completed the survey, 216 (29.1%) had engaged in chemsex, and of these, 34 (15.7%) had engaged in slamsex. Participants who engaged in slamsex were more likely to have current psychopathology (depression, anxiety, and drug-related disorders) than participants who engaged in non-injecting sexualized drug use. In addition, participants who engaged in slamsex more frequently reported high-risk sexual behaviors and polydrug use and were more often diagnosed with sexually transmitted infections (STIs) and hepatitis C than those who did not inject drugs. Compared with participants who did not inject drugs, participants who engaged in slamsex experienced more severe drug-related symptoms (withdrawal and dependence), symptoms of severe intoxication (loss of consciousness), and severe psychopathological symptoms during or after slamsex (eg, paranoid thoughts and suicidal behaviors). Conclusion Slamsex is closely associated with current psychiatric disorders and severe drug-related and psychiatric symptoms.
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Orsolini L, Chiappini S, Papanti D, De Berardis D, Corkery JM, Schifano F. The Bridge Between Classical and "Synthetic"/Chemical Psychoses: Towards a Clinical, Psychopathological, and Therapeutic Perspective. Front Psychiatry 2019; 10:851. [PMID: 31849723 PMCID: PMC6896660 DOI: 10.3389/fpsyt.2019.00851] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/30/2019] [Indexed: 12/12/2022] Open
Abstract
The critical spread and dissemination of novel psychoactive substances (NPS), particularly among the most vulnerable youngsters, may pose a further concern about the psychotic trajectories related to the intake of new synthetic drugs. The psychopathological pattern of the "new psychoses" appears to be extremely different from the classical presentation. Therefore, clinicians need more data on these new synthetic psychoses and recommendations on how to manage them. The present mini-review aims at deepening both the clinical, psychopathological features of synthetic/chemical NPS-induced psychoses and their therapeutic strategies, according to the different NPS classes implicated, by underlining the main differences with the "classical" psychoses. A comprehensive review was conducted using the PubMed/Medline database by combining the search strategy of free-text terms and exploding a range of MESH headings relating to the topics of novel psychoactive substances and synthetic/chemical psychoses as follows: {(Novel Psychoactive Substances[Title/Abstract]) AND Psychosis[Title/Abstract])} and for each NPS categories as well, focusing on synthetic cannabinoids and cathinones, without time and/or language restrictions. Finally, an overview of the main clinical and psychopathological features between classical versus NPS-induced chemical/synthetic psychoses is provided for clinicians working with dual disorders and addiction psychiatry. Further insight is given here on therapeutic strategies and practical guidelines for managing patients affected with synthetic/chemical NPS-induced psychoses.
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Affiliation(s)
- Laura Orsolini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Neomesia Mental Health, Villa Jolanda Hospital, Jesi, Italy
- Polyedra, Teramo, Italy
| | - Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Duccio Papanti
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Domenico De Berardis
- Polyedra, Teramo, Italy
- NHS, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", Teramo, Italy
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D’Annunzio", Chieti, Italy
| | - John M. Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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Simmons SJ, Kim E, Gentile TA, Murad A, Muschamp JW, Rawls SM. Behavioral Profiles and Underlying Transmitters/Circuits of Cathinone-Derived Psychostimulant Drugs of Abuse. CURRENT TOPICS IN NEUROTOXICITY 2018. [DOI: 10.1007/978-3-319-78707-7_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Ralphs R, Gray P. New psychoactive substances: new service provider challenges. DRUGS-EDUCATION PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2017.1417352] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Rob Ralphs
- Department of Sociology, Manchester Metropolitan University, Manchester, UK
| | - Paul Gray
- Department of Sociology, Manchester Metropolitan University, Manchester, UK
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