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Lodetti G, de Bitencourt RM, Rico EP. Classic psychedelics and the treatment for alcoholism. Prog Neuropsychopharmacol Biol Psychiatry 2024; 135:111129. [PMID: 39181308 DOI: 10.1016/j.pnpbp.2024.111129] [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: 11/23/2023] [Revised: 08/21/2024] [Accepted: 08/21/2024] [Indexed: 08/27/2024]
Abstract
Alcohol is a harmful drug, and reducing its consumption is a significant challenge for users. Furthermore, alcohol dependence is often treatment-resistant, and no completely effective treatment model is available for chemical dependence. Classic psychedelics, such as LSD, psilocybin, and ayahuasca have been used in different clinical and pre-clinical trials, demonstrating promising pharmacotherapeutic effects in the treatment of treatment-resistant psychopathological conditions, such as addiction, especially related to alcohol dependence. In this work, we conducted a narrative review of the emerging research regarding the potential of psychedelics for alcohol use disorder treatment. Psychedelic substances have demonstrated potential for treating drug addiction, especially AUD, mostly by modulating neuroplasticity in the brain. Given that serotonergic psychedelics do not produce physical dependence or withdrawal symptoms with repeated use, they may be considered promising treatment options for managing drug use disorders. However, certain limitations could be found. Although many participants achieve positive results with only one treatment dose in clinical studies, great inter-individual variability exists in the duration of these effects. Therefore, further studies using different doses and experimental protocols should be conducted to enhance evidence about psychedelic substances.
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Affiliation(s)
- Guilherme Lodetti
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil
| | - Rafael Mariano de Bitencourt
- Behavioral Neuroscience Laboratory, University of Southern Santa Catarina (UNISUL), Tubarão, Santa Catarina, Brazil
| | - Eduardo Pacheco Rico
- Laboratory of Translational Psychiatry, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil.
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Novin MH, Razaghi E, Farzadfar F, Tarokh MJ, Rouhifard M. Measuring The Harms Caused by Illicit Drugs. A New Methodology for Estimating Drug Harm Index. Subst Use Misuse 2024:1-9. [PMID: 39069745 DOI: 10.1080/10826084.2024.2383973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
BACKGROUND Substance use carries a wide range of negative consequences, impacting both the individual using the substances and others. In recent years, there have been multiple efforts to assess the harm caused by drugs and to rank them, with each taking a distinctive approach to the matter. Objectives: This study seeks to introduce a new model for assessing the harm index and ranking of drugs. Methods: This prospective study involved the evaluation of 277 male drug users, assessing substance use harm on four separate occasions throughout the span of 1 year. Various aspects of harm were quantified through the utilization of the Duke Health Profile (DUKE) and the Addiction Severity Index (ASI) questionnaire. The pharmaceutical properties of each drug were incorporated into the study. The relationship between the combined variables in a mixed statistical model was determined at a significance level of .05 using the Rsoftware. This procedure facilitated the establishment of models and the definition of harm index ranges for each substance. Result: The results indicated that heroin had the highest harm index at 71.2 (95% CI69.6-72.8), while pure methadone scored the lowest at 36.5 (95% CI31.7-41.7), along with methadone combined with methamphetamine, which scored 35 (95% CI33-37.1). Conclusion: The variables utilized in this study can help estimate the approximate harm index range for both traditional and novel substances. Furthermore, the harm model designed in this study has the capability to predict the extent of harm to a drug user.
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Affiliation(s)
- Mohammad Hassan Novin
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Emran Razaghi
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Jafar Tarokh
- Industrial Engineering Department, K.T. Toosi University of Technology, Tehran, Iran
| | - Mahtab Rouhifard
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Heal DJ, Gosden J, Smith SL. A critical assessment of the abuse, dependence and associated safety risks of naturally occurring and synthetic cannabinoids. Front Psychiatry 2024; 15:1322434. [PMID: 38915848 PMCID: PMC11194422 DOI: 10.3389/fpsyt.2024.1322434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 05/27/2024] [Indexed: 06/26/2024] Open
Abstract
Various countries and US States have legalized cannabis, and the use of the psychoactive1 and non-psychoactive cannabinoids is steadily increasing. In this review, we have collated evidence from published non-clinical and clinical sources to evaluate the abuse, dependence and associated safety risks of the individual cannabinoids present in cannabis. As context, we also evaluated various synthetic cannabinoids. The evidence shows that delta-9 tetrahydrocannabinol (Δ9-THC) and other psychoactive cannabinoids in cannabis have moderate reinforcing effects. Although they rapidly induce pharmacological tolerance, the withdrawal syndrome produced by the psychoactive cannabinoids in cannabis is of moderate severity and lasts from 2 to 6 days. The evidence overwhelmingly shows that non-psychoactive cannabinoids do not produce intoxicating, cognitive or rewarding properties in humans. There has been much speculation whether cannabidiol (CBD) influences the psychoactive and potentially harmful effects of Δ9-THC. Although most non-clinical and clinical investigations have shown that CBD does not attenuate the CNS effects of Δ9-THC or synthetic psychoactive cannabinoids, there is sufficient uncertainty to warrant further research. Based on the analysis, our assessment is cannabis has moderate levels of abuse and dependence risk. While the risks and harms are substantially lower than those posed by many illegal and legal substances of abuse, including tobacco and alcohol, they are far from negligible. In contrast, potent synthetic cannabinoid (CB1/CB2) receptor agonists are more reinforcing and highly intoxicating and pose a substantial risk for abuse and harm. 1 "Psychoactive" is defined as a substance that when taken or administered affects mental processes, e.g., perception, consciousness, cognition or mood and emotions.
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Affiliation(s)
- David J. Heal
- DevelRx Limited, Nottingham, United Kingdom
- Department of Life Sciences, University of Bath, Bath, United Kingdom
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Yuan Y, Kasson E, Taylor J, Cavazos-Rehg P, De Choudhury M, Aledavood T. Examining the Gateway Hypothesis and Mapping Substance Use Pathways on Social Media: Machine Learning Approach. JMIR Form Res 2024; 8:e54433. [PMID: 38713904 PMCID: PMC11109860 DOI: 10.2196/54433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/15/2024] [Accepted: 04/01/2024] [Indexed: 05/09/2024] Open
Abstract
BACKGROUND Substance misuse presents significant global public health challenges. Understanding transitions between substance types and the timing of shifts to polysubstance use is vital to developing effective prevention and recovery strategies. The gateway hypothesis suggests that high-risk substance use is preceded by lower-risk substance use. However, the source of this correlation is hotly contested. While some claim that low-risk substance use causes subsequent, riskier substance use, most people using low-risk substances also do not escalate to higher-risk substances. Social media data hold the potential to shed light on the factors contributing to substance use transitions. OBJECTIVE By leveraging social media data, our study aimed to gain a better understanding of substance use pathways. By identifying and analyzing the transitions of individuals between different risk levels of substance use, our goal was to find specific linguistic cues in individuals' social media posts that could indicate escalating or de-escalating patterns in substance use. METHODS We conducted a large-scale analysis using data from Reddit, collected between 2015 and 2019, consisting of over 2.29 million posts and approximately 29.37 million comments by around 1.4 million users from subreddits. These data, derived from substance use subreddits, facilitated the creation of a risk transition data set reflecting the substance use behaviors of over 1.4 million users. We deployed deep learning and machine learning techniques to predict the escalation or de-escalation transitions in risk levels, based on initial transition phases documented in posts and comments. We conducted a linguistic analysis to analyze the language patterns associated with transitions in substance use, emphasizing the role of n-gram features in predicting future risk trajectories. RESULTS Our results showed promise in predicting the escalation or de-escalation transition in risk levels, based on the historical data of Reddit users created on initial transition phases among drug-related subreddits, with an accuracy of 78.48% and an F1-score of 79.20%. We highlighted the vital predictive features, such as specific substance names and tools indicative of future risk escalations. Our linguistic analysis showed that terms linked with harm reduction strategies were instrumental in signaling de-escalation, whereas descriptors of frequent substance use were characteristic of escalating transitions. CONCLUSIONS This study sheds light on the complexities surrounding the gateway hypothesis of substance use through an examination of web-based behavior on Reddit. While certain findings validate the hypothesis, indicating a progression from lower-risk substances such as marijuana to higher-risk ones, a significant number of individuals did not show this transition. The research underscores the potential of using machine learning with social media analysis to predict substance use transitions. Our results point toward future directions for leveraging social media data in substance use research, underlining the importance of continued exploration before suggesting direct implications for interventions.
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Affiliation(s)
- Yunhao Yuan
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Erin Kasson
- School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
| | - Jordan Taylor
- Carnegie Mellon University, Pittsburgh, PA, United States
| | - Patricia Cavazos-Rehg
- School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
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Pengsomjit U, Alabdo F, Karuwan C, Kraiya C, Alahmad W, Ozkan SA. Innovative Graphene-Based Nanocomposites for Improvement of Electrochemical Sensors: Synthesis, Characterization, and Applications. Crit Rev Anal Chem 2024:1-19. [PMID: 38656227 DOI: 10.1080/10408347.2024.2343854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Graphene, renowned for its exceptional physicochemical attributes, has emerged as a favored substrate for integrating a wide array of inorganic and organic materials in scientific endeavors and innovations. Electrochemical graphene-based nanocomposite sensors have been developed by incorporating diverse nanoparticles into graphene, effectively immobilized onto electrodes through various techniques. These graphene-based nanocomposite sensors have effectively detected and quantified various electroactive species in samples. This review delves into using graphene nanocomposites to fabricate electrochemical sensors, leveraging the exceptional electrical, mechanical, and thermal properties inherent to graphene derivatives. These nanocomposites showcase electrocatalytic activity, substantial surface area, superior electrical conductivity, adsorption capabilities, and notable porosity, which are highly advantageous for sensing applications. A myriad of characterization techniques, including Raman spectroscopy, scanning electron microscopy (SEM), transmission electron microscopy (TEM), BET surface area analysis, and X-ray diffraction (XRD), have proven effective in exploring the properties of graphene nanocomposites and validating the adjustable formation of these nanomaterials with graphene. The applicability of these sensors across various matrices, encompassing environmental, food, and biological domains, has been evaluated through electrochemical measurements, such as cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and differential pulse voltammetry (DPV). This review provides a comprehensive overview of synthesis methods, characterization techniques, and sensor applications pertinent to graphene-based nanocomposites. Furthermore, it deliberates on the challenges and future prospects within this burgeoning field.
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Affiliation(s)
- Untika Pengsomjit
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
- Department of Chemistry, Faculty of Science, Electrochemistry and Optical Spectroscopy Center of Excellence, Chulalongkorn University, Bangkok, Thailand
| | - Fatima Alabdo
- Department of Chemistry and Physics, Faculty of Science, Idlib University, Idlib, Syria
| | - Chanpen Karuwan
- Graphene Research Team (GRP), National Nanotechnology Center (NANOTEC), National Science and Technology Development (NSTDA), Pathum Thani, Thailand
| | - Charoenkwan Kraiya
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
- Department of Chemistry, Faculty of Science, Electrochemistry and Optical Spectroscopy Center of Excellence, Chulalongkorn University, Bangkok, Thailand
| | - Waleed Alahmad
- Department of Chemistry, Faculty of Science, Chulalongkorn University, Bangkok, Thailand
| | - Sibel A Ozkan
- Department of Analytical Chemistry, Faculty of Pharmacy, Ankara University, Ankara, Turkiye
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Cunningham JA, Limaksorn J. Perceptions of the Seriousness of Different Addictive Behaviors in the United Kingdom. Subst Use Misuse 2024; 59:1067-1071. [PMID: 38419184 DOI: 10.1080/10826084.2024.2320375] [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] [Indexed: 03/02/2024]
Abstract
Background: Societal beliefs about the seriousness of different addictions were assessed in the United Kingdom (UK). Methods: An online panel, conducted in 2021 and sampled to be representative of the UK general population 18 years and over (N = 1499), was conducted and asked participants their views regarding the seriousness of different societal problems, including various addictive behaviors. Results: Cannabis was ranked as the least serious of the addictive behaviors. Other illicit drug use (cocaine, amphetamine, heroin) was rated as the most serious of addictive behaviors. None of the addictive behaviors were rated as being as serious a problem to society as environmental damage, violent crime, poverty, and the COVID-19 pandemic. Conclusions: Ratings of cannabis use were not as expected and stand in contrast to the current UK policy on cannabis use. In addition, the UK policy on alcohol consumption contrasts with societal concerns about alcohol use.
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Affiliation(s)
- John A Cunningham
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
- Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Jirapart Limaksorn
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
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Vanderijst L, Hever F, Buot A, Dauré C, Benoit J, Hanak C, Veeser J, Morgiève M, Campanella S, Kornreich C, Mallet L, Leys C, Noël X. Psilocybin-assisted therapy for severe alcohol use disorder: protocol for a double-blind, randomized, placebo-controlled, 7-month parallel-group phase II superiority trial. BMC Psychiatry 2024; 24:77. [PMID: 38279085 PMCID: PMC10821548 DOI: 10.1186/s12888-024-05502-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/06/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND A significant number of individuals with alcohol use disorder remain unresponsive to currently available treatments, which calls for the development of new alternatives. In parallel, psilocybin-assisted therapy for alcohol use disorder has recently yielded promising preliminary results. Building on extant findings, the proposed study is set to evaluate the feasibility and preliminary clinical efficacy of psilocybin-assisted therapy when incorporated as an auxiliary intervention during inpatient rehabilitation for severe alcohol use disorder. Moreover, it intends to pinpoint the modifications in the two core neurocognitive systems underscored by dual-process models of addiction. METHODS In this double-blind, randomized, placebo-controlled, 7-month parallel-group phase II superiority trial, 62 participants aged 21-64 years will be enrolled to undergo psilocybin-assisted therapy as part of a 4-week inpatient rehabilitation for severe alcohol use disorder. The experimental group will receive a high dose of psilocybin (30 mg), whereas the control group will receive an active placebo dose of psilocybin (5 mg), both within the context of a brief standardized psychotherapeutic intervention drawing from key elements of acceptance and commitment therapy. The primary clinical outcome is the between-group difference regarding the change in percentage of heavy drinking days from baseline to four weeks posthospital discharge, while safety and feasibility metrics will also be reported as primary outcomes. Key secondary assessments include between-group differences in terms of changes in (1) drinking behavior parameters up to six months posthospital discharge, (2) symptoms of depression, anxiety, trauma, and global functioning, (3) neuroplasticity and key neurocognitive mechanisms associated with addiction, and (4) psychological processes and alcohol-related parameters. DISCUSSION The discussion outlines issues that might arise from our design. TRIAL REGISTRATION EudraCT 2022-002369-14 and NCT06160232.
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Affiliation(s)
- Laetitia Vanderijst
- Laboratory of Medical Psychology and Addictology, Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium.
- Research Center for the Promotion of Health, Prosocial Behavior and Wellbeing, Faculty of Psychology, Université libre de Bruxelles, Brussels, Belgium.
| | - Felix Hever
- Laboratory of Medical Psychology and Addictology, Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium
- Psychiatric Institute, University Hospital Brugmann, Brussels, Belgium
| | - Anne Buot
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, Paris, France
| | - Charles Dauré
- Université de Paris, INSERM UMRS1144, 4 avenue de l'Observatoire, 75006, Paris, France
| | - Janaïna Benoit
- Psychiatric Institute, University Hospital Brugmann, Brussels, Belgium
| | - Catherine Hanak
- Psychiatric Institute, University Hospital Brugmann, Brussels, Belgium
| | - Johannes Veeser
- Psychiatric Institute, University Hospital Brugmann, Brussels, Belgium
| | - Margot Morgiève
- Université Paris Cité, CNRS, Inserm, Cermes3, F-75006, Paris, France
| | - Salvatore Campanella
- Laboratory of Medical Psychology and Addictology, Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium
| | - Charles Kornreich
- Laboratory of Medical Psychology and Addictology, Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium
- Psychiatric Institute, University Hospital Brugmann, Brussels, Belgium
| | - Luc Mallet
- Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, CNRS, Inserm, Paris, France
- Département Médical-Universitaire de Psychiatrie et d'Addictologie, Univ Paris-Est Créteil, DMU IMPACT, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Créteil, France
- Department of Mental Health and Psychiatry, Global Health Institute, University of Geneva, Geneva, Switzerland
| | - Christophe Leys
- Research Center for the Promotion of Health, Prosocial Behavior and Wellbeing, Faculty of Psychology, Université libre de Bruxelles, Brussels, Belgium
| | - Xavier Noël
- Laboratory of Medical Psychology and Addictology, Faculty of Medicine, Université libre de Bruxelles, Brussels, Belgium
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Yilin D, Bellerose M, Borbely C, Rowell-Cunsolo TL. Assessing the relationship between drug use initiation age and racial characteristics. J Ethn Subst Abuse 2023:1-15. [PMID: 37882363 DOI: 10.1080/15332640.2023.2271871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Initiating drug use in adolescence is associated with greater risk of drug misuse and dependence in adulthood and co-occurring mental health disorders. Initiating drug use in adulthood has been linked to higher-risk drug use networks and primary use of "harder drugs". The aim of our research is to examine racial/ethnic differences in age at drug use initiation and its relationship with adult outcomes. Based on data from the 2019 National Survey on Drug Use and Health (NSDUH), we used survey-weighted Poisson regression models with robust variance to identify associations between racial characteristics, age at drug use initiation, and three adult outcomes - past year polydrug use, substance use, and mental illness - adjusting for individual-level characteristics. Among 25,986 respondents who ever used drugs and reported their drug use initiation age, Asian-Americans reported the oldest drug use initiation age (19.5) on average, while Native Americans reported the youngest initiation age (16.6). While there were no significant differences in type of drug used during onset by race or ethnicity, generally, individuals start to use inhalants at the earliest age (17.4), while the misuse of sedatives is initiated at the oldest age (46.4). Initiation during late adolescence was associated with greater likelihood of a substance use disorder diagnosis, mental health diagnoses, and polydrug use in adulthood. Drug use prevention interventions should be tailored and accessible during adolescence to delay onset. Interventions that are culturally sensitive, screen for vulnerability to drug use, and offer age-appropriate services should be prioritized.
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Affiliation(s)
- Diandian Yilin
- School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Meghan Bellerose
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Carson Borbely
- School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
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9
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Yan Y, Yoshihama M, Hong JS, Jia F. Substance Use Among Asian American Adults in 2016-2020: A Difference-in-Difference Analysis of a National Survey on Drug Use and Health Data. Am J Public Health 2023; 113:671-679. [PMID: 36996372 DOI: 10.2105/ajph.2023.307256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
Objectives. To compare substance use among Asian American adults in 2020, when anti-Asian violence increased, with substance use among the same group during the previous 4 years and compare this with that of non-Hispanic Whites. Methods. Using data from the National Survey on Drug Use and Health, 2016 to 2020, we investigated changes in substance use among Asian Americans compared with non-Hispanic Whites before and during the COVID-19 pandemic. We performed difference-in-difference analyses to estimate adjusted changes in past-month substance use in the 2 groups. Results. The incidence rate ratio (IRR) among Asian Americans' past-month alcohol use, cocaine use, and tranquilizer misuse in 2020 versus in 2016 to 2019 was 1.3 times, 3.0 times, and 17.2 times, respectively, the same IRR among Whites. Conclusions. The significant increase in misuse of several substances among Asian Americans relative to Whites in 2020 calls for careful assessment, identification, and treatment of this understudied population group. Public Health Implications. Besides increasing Asian substance users' access to socioculturally responsive treatment programs, policy and resources should be focused on multilevel violence prevention efforts such as antiracial discrimination public education programs. (Am J Public Health. Published online ahead of print March 30, 2023:e1-e9. https://doi.org/10.2105/AJPH.2023.307256).
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Affiliation(s)
- Yueqi Yan
- Yueqi Yan is with the Health Science Research Institute, University of California, Merced. Mieko Yoshihama is with the School of Social Work, University of Michigan, Ann Arbor. Jun Sung Hong is with the School of Social Work, Wayne State University, Detroit, MI, and the Department of Social Welfare, Ewha Womans University, Seoul, South Korea. Fan Jia is with the Department of Psychological Sciences, University of California, Merced
| | - Mieko Yoshihama
- Yueqi Yan is with the Health Science Research Institute, University of California, Merced. Mieko Yoshihama is with the School of Social Work, University of Michigan, Ann Arbor. Jun Sung Hong is with the School of Social Work, Wayne State University, Detroit, MI, and the Department of Social Welfare, Ewha Womans University, Seoul, South Korea. Fan Jia is with the Department of Psychological Sciences, University of California, Merced
| | - Jun Sung Hong
- Yueqi Yan is with the Health Science Research Institute, University of California, Merced. Mieko Yoshihama is with the School of Social Work, University of Michigan, Ann Arbor. Jun Sung Hong is with the School of Social Work, Wayne State University, Detroit, MI, and the Department of Social Welfare, Ewha Womans University, Seoul, South Korea. Fan Jia is with the Department of Psychological Sciences, University of California, Merced
| | - Fan Jia
- Yueqi Yan is with the Health Science Research Institute, University of California, Merced. Mieko Yoshihama is with the School of Social Work, University of Michigan, Ann Arbor. Jun Sung Hong is with the School of Social Work, Wayne State University, Detroit, MI, and the Department of Social Welfare, Ewha Womans University, Seoul, South Korea. Fan Jia is with the Department of Psychological Sciences, University of California, Merced
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10
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Knottnerus JA, Blom T, van Eerden S, Mans JHH, Mheen DVD, de Neeling JND, Schelfhout DCL, Seidell JC, van Wijk AH, van Wingerde CGK, Brink WVD. Cannabis policy in The Netherlands: Rationale and design of an experiment with a controlled legal ('closed') cannabis supply chain. Health Policy 2023; 129:104699. [PMID: 36566153 DOI: 10.1016/j.healthpol.2022.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Since the Dutch tolerance policy, allowing the purchase of cannabis in 'coffeeshops', is associated with problems of public order and safety as well as health risks, there has been a long debate about legalisation of cannabis production and supply. It was therefore decided to conduct an experiment with a controlled legal ('closed') cannabis supply chain for recreational use. This is of international relevance in view of the current illegal cannabis exports from the Netherlands, the importance of sharing knowledge about the effectiveness of cannabis policies, and the accumulation of evidence needed to evaluate and update international treaties. Here we describe and discuss the background, general approach and design of the experiment. An independent expert committee elaborated how the closed chain will operate and be evaluated, based on the experience with the medicinal cannabis chain, and round table discussions with stakeholders (mayors, coffeeshop owners, cannabis consumers, growers, regulators, scientists, and addiction experts). Ten trusted cannabis growers are contracted to produce and supply cannabis to the coffeeshops in intervention municipalities, with product quality control, law enforcement against criminal interference, and preventive efforts to reduce health risks being implemented. No changes will be made in the cannabis supply to the coffeeshops in participating control municipalities. A process evaluation will assess whether the chain from production to sale in the intervention municipalities was really closed. In a quasi-experimental study comparing intervention and control municipalities, the chain's effects on public health, cannabis-related crime, safety and public nuisance will be estimated. The fieldwork period is expected to start early 2024 and will take four years, including reporting to the government and parliament. These will then decide whether and what further steps towards legalisation of the production and supply of cannabis will be taken.
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Affiliation(s)
- J André Knottnerus
- Epidemiologist, former Chair of the Scientific Council of Government Policy, The Hague, Em. Professor of General Practice, Maastricht University, The Netherlands.
| | - Tom Blom
- Professor of Criminal (Procedural) Law, University of Amsterdam, The Netherlands
| | - Sanne van Eerden
- Public sector consultant. Andersson Elffers Felix, Utrecht, The Netherlands
| | - Jan H H Mans
- Former Mayor of the municipalities of Meerssen, Kerkrade, Enschede, Venlo, Zaanstad, Maastricht, Moerdijk, and Gouda, The Netherlands
| | - Dike van de Mheen
- Professor of Transformations in Care, Tranzo Scientific Center for Care and Wellbeing, School of Social and Behavioral Sciences, Tilburg University, The Netherlands
| | - J Nico D de Neeling
- Senior scientific officer, Ministry of Health, Welfare and Sport, the Hague. The Netherlands
| | | | - Jaap C Seidell
- Professor of Nutrition and Health. Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, The Netherlands
| | - Albert H van Wijk
- Chairman of the Board of Directors of the IJsselland Hospital, Capelle aan den IJssel, former Attorney General, The Hague, The Netherlands
| | - C G Karin van Wingerde
- Professor of Corporate Crime and Governance, Erasmus School of Law, Erasmus University Rotterdam, The Netherlands
| | - Wim van den Brink
- Em. Professor of Psychiatry and Addiction, Amsterdam University Medical Centers, location Academic Medical Center, Amsterdam, The Netherlands
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Kanti AK, Specka M, Scherbaum N, Bonnet U. [Comparative Harm/Benefit Analysis of Various Psychotropic Substances from the Perspective of German Drug Users and Addiction Medicine Experts - A Contribution to Psychoeducation of Substance-Addicted Individuals and Restriction/Legalization Debates]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2022. [PMID: 36522164 DOI: 10.1055/a-1971-9558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND To date, we cannot find any current international comparative study on the assessment of a benefit/harm profile of various licit and illicit psychoactive substances conducted by adult drug users and addiction experts as well. Particularly, there is no study from the German-speaking area of Western Europe. METHODS In addition to the data already published by 101 German addiction medicine experts (published in this journal, [1]), we carried out interviews using a structured questionnaire with 100 German substance dependent users, residing in acute and rehabilitation clinical setting, to evaluate 34 psychoactive substances regarding their health and social harm potential for users and others as well as their potential benefit. RESULTS Both, users and experts estimated traditional illicit drugs, such as heroin, crack/cocaine and methamphetamine, to be particularly harmful. Synthetic cannabinoids, alcohol and benzodiazepines were in the upper midfield, cannabis and psychotropic mushrooms in the lower midfield, and gabapentinoids at the bottom of the harm rankings of both, users and experts. In comparison with the experts, the users estimated methadone and benzodiazepines to be significantly more harmful. In the benefit analysis, users rated traditional illicit drugs including cannabis and psychotropic mushrooms as well as nicotine as significantly more useful than the experts. In contrast to the experts (traditional illicit drugs), the users did not assess any substance as very harmful and very useless at the same time. Only a few users reported to have experiences with opioid analgesics which, however, did not differ between the users´ and experts´ harm/benefit-assessments. Neither users nor experts predicted cannabis-legalization to change the overall risk potential of cannabis. Specific cognitive valuation biases seemed to be prominent in both groups. CONCLUSION This study presents first harm/benefit assessments of psychotropic substances from the perspective of German addiction medicine experts and drug users. The results can be valuable to the psychoeducation of substance-addicted individuals and to current restriction or legalization debates.
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Affiliation(s)
- Ann-Kristin Kanti
- Klinik für Innere Medizin, Evangelisches Krankenhaus Castrop-Rauxel, (Akademisches Lehrkrankenhaus der Universität Duisburg-Essen), Castrop-Rauxel, Deutschland
| | - Michael Specka
- LVR-Klinikum Essen, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland
| | - Norbert Scherbaum
- LVR-Klinikum Essen, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland
| | - Udo Bonnet
- LVR-Klinikum Essen, Klinik für Psychiatrie und Psychotherapie, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Evangelisches Krankenhaus Castrop-Rauxel, (Akademisches Lehrkrankenhaus der Universität Duisburg-Essen), Castrop-Rauxel, Deutschland
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12
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Dleštíková T. (De)criminalisation of psychedelics in the Czech Republic-Where are we heading in drug policy and legislation? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 110:103900. [PMID: 36347160 DOI: 10.1016/j.drugpo.2022.103900] [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: 08/15/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/08/2022]
Abstract
The article deals with the issue of decriminalization of drugs, in all relevant contexts, both in terms of criminal policy and legislation, as well as law enforcement, with focus on the Czech Republic. The article proceeds deductively from the general to the specific. First, it discusses the role of law in society and its legitimacy, with focus on legitimate criminal sanctions, which are discussed in the context of the principle of subsidiarity of criminal repression and the principle of opportunity (discretionary prosecution). After these general considerations, the article turns to the issue of drugs and discusses both drug policy and legislation, arguing that the general considerations are in favor of decriminalization tendencies in this area. In the final part, the article focuses on psychedelics, emphasizing a fundamental discrepancy between their factual and legal status and then considering ways of changing the perspective. At this point, the article outlines the importance of decriminalization of psychedelics for therapeutic use, which basically consist of rescheduling of these drugs. The aim of such decriminalization is to make psychedelic-assisted therapy legally available. The article concludes that this is the direction that criminal policy and law in the Czech Republic should take.
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Bonnet U, Specka M, Kanti AK, Scherbaum N. Differences between users' and addiction medicine experts' harm and benefit assessments of licit and illicit psychoactive drugs: Input for psychoeducation and legalization/restriction debates. Front Psychiatry 2022; 13:1041762. [PMID: 36465301 PMCID: PMC9709475 DOI: 10.3389/fpsyt.2022.1041762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background There is a lack of benefit/harm assessments of illicit and licit psychoactive substances performed by substance-dependent users in comparison to addiction medicine experts. Methods We extended the analyses of substance harm/benefit assessments of German addiction medicine experts (N = 101), in parts reported recently in this journal [doi.org/10.3389/fpsyt.2020.59219], by the perspectives of substance-addicted persons. The same questionnaire as used for the abovementioned "experts-study" was handed out to inpatient detoxification or rehab treatment seeking German substance-dependent adults (N = 117) for a subsequent structured interview about harms and benefits of 33 new and traditional psychoactive substances comprising also prescription drugs. Results and discussion Both, users and experts, ranked the traditional illicit psychoactive substances heroin, cocaine and amphetamines within the top overall harm level group. Synthetic cannabinoids, alcohol and benzodiazepine were in a subordinate top-harm level position. Both cohorts also ranked methadone, nicotine and cannabis within the midrange and buprenorphine as well as psychotropic mushrooms within the lowest harm level positions. Experiences with prescription drugs (including opioidergic analgesics and gabapentinoids), cathinones, GHB, methamphetamine and methylphenidate was not prevalent in our user population. The same applied to barbiturates, propofol, kratom, ayahuasca with nearly zero assessments for each substance. The most user-experiences (>50% per assessed substance) were reported with nicotine, cannabis, alcohol, cocaine, heroin, amphetamine and methadone (core group). The user's overall harm ratings in terms of these psychoactive substances were similar to those of the experts with the exception of the methadone assessment which was rated by the experts to be significantly less harmful if compared with the users' estimation (supposed "treatment bias" of experts). The users' benefit ratings for the traditional illicit psychoactive substances, cannabis as well as for nicotine were significantly more positive in comparison to those of the experts (supposed "attraction bias" of users). Both, experts and users, ranked the harms arising from the use of alcohol or benzodiazepines (usually unregulated substances) higher than the harms caused by the use of methadone, cannabis or psychotropic mushrooms (regulated by most Western narcotic acts). Users attributed the most benefits to buprenorphine, methadone and cannabis. This might reflect a main limitation of the study as the data are from an user population comprising over 50% patients who sought detoxification-treatment of opiates where methadone and buprenorphine are usual transient medications (supposed "selection bias"). Conclusion This study addressed current trends of psychoactive substance abuse (e.g., synthetic cannabinoids, prescription drugs) and provides from both perspectives (that of the user and that of the addiction medicine experts) robust harm/benefit evaluations at least of a core group of psychoactive substances (traditional illicit psychoactive substances, cannabis, methadone, alcohol and nicotine). The results of this study can be valuable to the psychoeducation of substance-addicted individuals and to current restriction/legalization debates, especially in the Western-EU.
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Affiliation(s)
- Udo Bonnet
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Castrop-Rauxel, Germany - Academic Teaching Hospital of the University of Duisburg-Essen, Essen, Germany
- Department of Psychiatry and Psychotherapy, LVR-Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Michael Specka
- Department of Psychiatry and Psychotherapy, LVR-Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Ann-Kristin Kanti
- Department of Internal Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Castrop-Rauxel, Germany - Academic Teaching Hospital of the University of Duisburg-Essen, Essen, Germany
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, LVR-Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
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Ter Laak TL, Emke E, Benschop A, Nabben T, Béen F. Triangulating Amsterdam's illicit stimulant use trends by wastewater analysis and recreational drug use monitoring. Forensic Sci Int 2022; 340:111449. [PMID: 36150279 DOI: 10.1016/j.forsciint.2022.111449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/18/2022] [Accepted: 09/05/2022] [Indexed: 11/26/2022]
Abstract
Drug consumption estimates are of relevance because of public health effects as well as associated criminal activities. Wastewater analysis of drug residues enables the estimation of drug consumption and drug markets. Short-term and long-term trends of cocaine, MDMA (ecstasy), amphetamine (speed) and methamphetamine (crystal meth), were studied for the city of Amsterdam. MDMA (+41%) and cocaine (+26%) showed significantly higher weekend vs. week consumption, while no differences were observed for the other drugs. The consumption of MDMA, cocaine, amphetamine and methamphetamine significantly increased between 2011 and 2019. Weekly trends emerging from wastewater analyses were supported by qualitative and quantitative data from a recreational drug use monitoring scheme. However, information collected in panel interviews within nightlife networks and surveys among visitors of pubs, clubs and festivals only partially reflected the long term increase in consumption as registered from wastewater analysis. Furthermore, methamphetamine use was not well presented in survey data, panel studies and test service samples, but could be monitored trough wastewater analysis. This illustrates that wastewater analysis can function as an early warning if use and user groups are small or difficult to reach trough other forms of research. All in all, this study illustrates that wastewater-based epidemiology is complementary to research among user groups, and vice versa. These different types of information enable to connect observed trends in total drug consumption to behaviour of users and the social context in which the use takes place as well as validate qualitative signals about (increased) consumption of psychoactive substances. Such a multi angular approach to map the illicit drug situation on local or regional scale can provide valuable information for public health.
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Affiliation(s)
- Thomas L Ter Laak
- KWR Water Research Institute, P.O. Box 1072, 3430 BB Nieuwegein, the Netherlands; Department of Freshwater and Marine Ecology (FAME), Institute for Biodiversity and Ecosystem Dynamics (IBED), University of Amsterdam (UvA), Science Park 904, Amsterdam 1098XH, the Netherlands.
| | - Erik Emke
- KWR Water Research Institute, P.O. Box 1072, 3430 BB Nieuwegein, the Netherlands
| | - Annemieke Benschop
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, P.O. Box 2557, 1000 CN Amsterdam, the Netherlands
| | - Ton Nabben
- Centre of Expertise Urban Governance & Social Innovation, Faculty of Society and Law, Amsterdam University of Applied Sciences, P.O. Box 1025, 1000 BA Amsterdam, the Netherlands
| | - Frederic Béen
- KWR Water Research Institute, P.O. Box 1072, 3430 BB Nieuwegein, the Netherlands
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15
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Kurtz JS, Patel NA, Gendreau JL, Yang C, Brown N, Bui N, Picton B, Harris M, Hatter M, Beyer R, Sahyouni R, Diaz-Aguilar LD, Castellano J, Schuster N, Abraham ME. The Use of Psychedelics in the Treatment of Medical Conditions: An Analysis of Currently Registered Psychedelics Studies in the American Drug Trial Registry. Cureus 2022; 14:e29167. [PMID: 36259015 PMCID: PMC9567237 DOI: 10.7759/cureus.29167] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2022] [Indexed: 12/03/2022] Open
Abstract
Although early therapeutic research on psychedelics dates back to the 1940s, this field of investigation was met with many cultural and legal challenges in the 1970s. Over the past two decades, clinical trials using psychedelics have resumed. Therefore, the goal of this study was to (1) better characterize the recent uptrend in psychedelics in clinical trials and (2) identify areas where potentially new clinical trials could be initiated to help in the treatment of widely prevalent medical disorders. A systematic search was conducted on the clinicaltrials.gov database for all registered clinical trials examining the use of psychedelic drugs and was both qualitatively and quantitatively assessed. Analysis of recent studies registered in clinicaltrials.gov was performed using Pearson’s correlation coefficient testing. Statistical analysis and visualization were performed using R software. In totality, 105 clinical trials met this study’s inclusion criteria. The recent uptrend in registered clinical trials studying psychedelics (p = 0.002) was similar to the uptrend in total registered clinical trials in the registry (p < 0.001). All trials took place from 2007 to 2020, with 77.1% of studies starting in 2017 or later. A majority of clinical trials were in phase 1 (53.3%) or phase 2 (25.7%). Common disorders treated include substance addiction, post-traumatic stress disorder, and major depressive disorder. Potential research gaps include studying psychedelics as a potential option for symptomatic treatment during opioid tapering. There appears to be a recent uptrend in registered clinical trials studying psychedelics, which is similar to the recent increase in overall trials registered. Potentially, more studies could be performed to evaluate the potential of psychedelics for symptomatic treatment during opioid tapering and depression refractory to selective serotonin reuptake inhibitors.
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16
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Staal YCM, Bos PMJ, Talhout R. Methodological Approaches for Risk Assessment of Tobacco and Related Products. TOXICS 2022; 10:491. [PMID: 36136456 PMCID: PMC9505557 DOI: 10.3390/toxics10090491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 06/16/2023]
Abstract
Health risk assessment of tobacco and related products (TRPs) is highly challenging due to the variety in products, even within the product class, the complex mixture of components in the emission and the variety of user behaviour. In this paper, we summarize methods that can be used to assess the health risks associated with the use of TRPs. The choice of methods to be used and the data needed are dependent on the aim. Risk assessment can be used to identify the emission components of highest health concern. Alternatively, risk assessment methods can be used to determine the absolute risk of a TRP, which is the health risk of a product, not related to other products, or to determine the relative risk of a TRP, which is the health risk of a TRP compared to, for example, a cigarette. Generally, health risk assessment can be based on the effects of the complete mixture (whole smoke) or based on the (added) effects of individual components. Data requirements are dependent on the method used, but most methods require substantial data on identity and quantity of components in emissions and on the hazards of these components. Especially for hazards, only limited data are available. Currently, due to a lack of suitable data, quantitative risk assessment methods cannot be used to inform regulation.
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17
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Kopra EI, Ferris JA, Winstock AR, Young AH, Rucker JJ. Adverse experiences resulting in emergency medical treatment seeking following the use of magic mushrooms. J Psychopharmacol 2022; 36:965-973. [PMID: 35388724 PMCID: PMC9353971 DOI: 10.1177/02698811221084063] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Psilocybin-containing mushrooms are used for recreational, spiritual, self-development and therapeutic purposes. However, physiologically relatively nontoxic, adverse reactions are occasionally reported. AIMS This study investigated the 12-month prevalence and nature of magic mushroom-related adverse reactions resulting in emergency medical treatment seeking in a global sample of people reporting magic mushroom use. METHODS We use data from the 2017 Global Drug Survey - a large anonymous online survey on patterns of drug use conducted between November 2016 and January 2017. RESULTS Out of 9233 past year magic mushroom users, 19 (0.2%) reported having sought emergency medical treatment, with a per-event risk estimate of 0.06%. Young age was the only predictor associated with higher risk of emergency medical presentations. The most common symptoms were psychological, namely anxiety/panic and paranoia/suspiciousness. Poor 'mindset', poor 'setting' and mixing substances were most reported reasons for incidents. All but one respondent returned back to normality within 24 h. CONCLUSIONS The results confirm psilocybin mushrooms are a relatively safe drug, with serious incidents rare and short lasting. Providing harm-reduction information likely plays a key role in preventing adverse effects. More research is needed to examine the detailed circumstances and predictors of adverse reactions including rarer physiological reactions.
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Affiliation(s)
- Emma I Kopra
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology & Neuroscience, King’s College London,
London, UK
| | - Jason A Ferris
- Centre for Health Services Research,
Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Adam R Winstock
- Institute of Epidemiology and Health
Care, University College London, London, UK
- Global Drug Survey, London, UK
| | - Allan H Young
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology & Neuroscience, King’s College London,
London, UK
- South London and Maudsley NHS
Foundation Trust, London, UK
| | - James J Rucker
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology & Neuroscience, King’s College London,
London, UK
- South London and Maudsley NHS
Foundation Trust, London, UK
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18
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Dolan SB, Spindle TR, Vandrey R, Johnson MW. Behavioral economic interactions between cannabis and alcohol purchasing: Associations with disordered use. Exp Clin Psychopharmacol 2022; 30:159-171. [PMID: 33001691 PMCID: PMC8209692 DOI: 10.1037/pha0000397] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
As cannabis policy changes, there is an urgent need to understand interactions between cannabis and alcohol couse. An online sample of 711 adult past-month cannabis and alcohol users completed both single-item hypothetical purchasing tasks for cannabis and alcohol and cross-commodity purchasing tasks assessing adjusting-price cannabis with concurrently available, fixed-price alcohol, and vice versa. Participants provided information about cannabis and alcohol use patterns, and completed the Alcohol and Cannabis Use Disorder Identification Tests (AUDIT and CUDIT, respectively). Group data showed that cannabis and alcohol served as complements (as the price of the adjusting-price commodity increased, consumption of both commodities decreased). However, individual data showed substantial variability with nontrivial proportions showing patterns of complementarity, substitution, and independence. More negative slopes (greater complementarity) for fixed-price cannabis and alcohol were both associated with greater self-reported drug consumption and CUDIT and AUDIT scores. The negative relation between cross-price slope and CUDIT/AUDIT score indicates that individuals who treat cannabis and alcohol more as complements are more likely to experience disordered use. Based on these cross-commodity purchasing data, when both cannabis and alcohol are concurrently available at low prices, both may be used at high levels, whereas limiting consumption of one commodity (e.g., through increased price) may reduce consumption of the other. These data show the importance of examining individual participant analyses of behavioral economic drug interactions and suggest that manipulation of cost (e.g., through taxes) or cosale restrictions are potential public health regulatory mechanisms for reducing alcohol and cannabis use and couse behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Sean B Dolan
- Department of Psychiatry and Behavioral Sciences
| | | | - Ryan Vandrey
- Department of Psychiatry and Behavioral Sciences
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19
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Mangot-Sala L, Tran KA, Smidt N, Liefbroer AC. The impact of the COVID lockdown on alcohol consumption in the Netherlands. The role of living arrangements and social isolation. Drug Alcohol Depend 2022; 233:109349. [PMID: 35168117 PMCID: PMC8830152 DOI: 10.1016/j.drugalcdep.2022.109349] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 02/04/2022] [Accepted: 02/04/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The COVID-19 pandemic and the subsequent lockdown have a strong impact on health and health behaviours, such as alcohol consumption. Although there is some evidence of an overall decline in alcohol consumption during the lockdown, studies also show an increase in risky drinking patterns, e.g. solitary drinking, and differences between subgroups of individuals, e.g. depending on their living arrangement. Yet most studies rely on cross-sectional designs with retrospective questions, and small samples. METHODS A longitudinal study was conducted using 13 waves of the COVID-Questionnaire within the Lifelines cohort from the northern Netherlands (n = 63,194). The outcome was alcohol consumption (glasses per week) between April 2020 and July 2021. Linear fixed-effects models were fitted to analyse trends in alcohol consumption, and these were compared with pre-COVID drinking levels. Moreover, the role of living arrangement and feelings of social isolation as potential moderators was tested. RESULTS Alcohol consumption during the pandemic was lower than in previous years, and the seasonal pattern differed from the pre-COVID one, with levels being lower when lockdown measures were stricter. Moreover, the seasonal pattern differed by living arrangement: those living alone saw a relative increase in drinking throughout tight lockdown periods, whereas those living with children showed the strongest increase during the summer. Social isolation showed a weaker moderation effect. CONCLUSIONS Overall alcohol levels were down in the pandemic, and in particular during strict lockdowns. Those living on their own and those who felt more isolated reacted more strongly to the lockdown, the longer it lasted.
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Affiliation(s)
- Lluís Mangot-Sala
- Netherlands Interdisciplinary Demographic Institute, The Netherlands; Department of Epidemiology, University Medical Center Groningen, University of Groningen, The Netherlands.
| | - Khoa A Tran
- Netherlands Interdisciplinary Demographic Institute, The Netherlands; University College Utrecht, Utrecht University, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Aart C Liefbroer
- Netherlands Interdisciplinary Demographic Institute, The Netherlands; Department of Epidemiology, University Medical Center Groningen, University of Groningen, The Netherlands; Department of Sociology, Vrije Universiteit Amsterdam, The Netherlands
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20
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Deligianni ML, Studer J, Gmel G, Khazaal Y, Bertholet N. Consciousness alterations in a cohort of young Swiss men: Associations with substance use and personality traits. Front Psychiatry 2022; 13:1056159. [PMID: 36683973 PMCID: PMC9846235 DOI: 10.3389/fpsyt.2022.1056159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/02/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Substance-induced consciousness alterations (CA) have mainly been studied among users of psychedelics but not among people using street drugs. AIMS Explore occurrences of three different types of substance-induced CA [ego dissolution (ED), visual pseudo-hallucinations (VPH), anxiety/paranoia (A/P)] and their perceived influences on life, together with their associations with substance use and personality correlates in a general population sample of 25-year-old men. METHODS 2,796 young Swiss men lifetime substance users completed a self-report questionnaire including history of use (never, former, and current) of different substances categories (psychedelics, cocaine, psychostimulants, ecstasy, MDMA, and other drugs), substance-induced ego dissolution (ED), visual pseudo-hallucinations (VPH) and anxiety/paranoia (A/P), the influence of these CA experiences on life, and personality traits (sensation seeking, sociability, anxiety-neuroticism, and aggression-hostility). RESULTS 32.2% reported at least one CA (i.e., ED, VPH or A/P), with 20.5% reporting ED, 16.7% VPH, and 14.6% A/P. Former and current use of psychedelics and ketamine was significantly associated with occurrences of all three types of CAs and with a positive influence of CA on life. Associations between the former and current use of other substances and the different types of CA were less consistent, and perceived influences on life were not statistically significant. Sociability was negatively associated with occurrences of all three types of CA. Positive associations were found between anxiety-neuroticism and ED and A/P, between aggression-hostility and A/P, and between sensation seeking and ED and VPH. CONCLUSION This study supports the potential for psychedelics to induce CAs perceived as beneficial to life among people using street drugs, possibly reflecting the mechanism underlying the therapeutic potential of psychedelics.
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Affiliation(s)
- Marianthi Lousiana Deligianni
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Joseph Studer
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.,Service of Adult Psychiatry North-West, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gerhard Gmel
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.,Research Department, Addiction Switzerland, Lausanne, Switzerland.,Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada.,Faculty of Health and Social Science, University of the West of England, Bristol, United Kingdom
| | - Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.,Research Centre, Montreal University Institute of Mental Health, Montreal, QC, Canada
| | - Nicolas Bertholet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
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21
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Mangot-Sala L, Smidt N, Liefbroer AC. The association between unemployment trajectories and alcohol consumption patterns. Evidence from a large prospective cohort in The Netherlands. ADVANCES IN LIFE COURSE RESEARCH 2021; 50:100434. [PMID: 36661293 DOI: 10.1016/j.alcr.2021.100434] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 06/17/2023]
Abstract
Unemployment is expected to influence alcohol consumption, but studies show mixed results, partly because most studies concentrate on current employment status. However, unemployment could be particularly consequential if it is part of a trajectory of employment precariousness. Moreover, the association between unemployment and alcohol consumption may not be homogeneous across the population, but differ by subgroups (e.g. socioeconomic status). This study longitudinally analyses the association between different employment trajectories and alcohol consumption, and examines if the association is moderated by socioeconomic status (SES), partner status, age and gender. Four waves of data of the Lifelines Cohort study are used. Sample consists of individuals from 18-50 years old, active in the labor market (n = 104,766) from the northern provinces of the Netherlands. Employment trajectories are defined by employment status in each wave, duration of unemployment, and number of exposures to unemployment. Drinking patterns are divided into "abstainers", "moderate drinking" (<1.5 drinks/day), "heavy drinking" (≥1.5 drinks/day) and "binge drinking" (≥5 drinks/occasion; 4 for women). The associations are estimated with multinomial logistic regression models. Results show that recent, long-term unemployment (≥ 6 months) is associated with higher rates of heavy drinking (RRR = 1.26 [95 % CI 1.03-1.54]), whereas short-term unemployment does not show any association with the outcome. Being continuously unemployed throughout the observation period shows a strong association with binge drinking (RRR = 1.43 [95 % CI 1.06-1.93]), as well as reporting 2 or more long unemployment spells (RRR = 1.49 [95 % CI 1.21-1.83]). The group of abstainers (77.95 % women) have significantly lower SES, and poorer health than their peers. For some individuals, recent unemployment increases the likelihood for abstinence (RRR = 1.23 [95 % CI 1.00-1.51]). Evidence suggests that length of unemployment is key in order to grasp its effects in terms of changing drinking patterns.
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Affiliation(s)
- Lluís Mangot-Sala
- Netherlands Interdisciplinary Demographic Institute (NIDI) - Royal Netherlands Academy of Sciences (KNAW), the Netherlands; University Medical Center Groningen (UMCG) - Faculty of Medical Sciences, Department of Epidemiology, University of Groningen (RUG), the Netherlands.
| | - Nynke Smidt
- University Medical Center Groningen (UMCG) - Faculty of Medical Sciences, Department of Epidemiology, University of Groningen (RUG), the Netherlands
| | - Aart C Liefbroer
- Netherlands Interdisciplinary Demographic Institute (NIDI) - Royal Netherlands Academy of Sciences (KNAW), the Netherlands; University Medical Center Groningen (UMCG) - Faculty of Medical Sciences, Department of Epidemiology, University of Groningen (RUG), the Netherlands; Department of Sociology, Vrije University of Amsterdam (VU), the Netherlands
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Dubljevic V, List G, Milojevich J, Ajmeri N, Bauer WA, Singh MP, Bardaka E, Birkland TA, Edwards CHW, Mayer RC, Muntean I, Powers TM, Rakha HA, Ricks VA, Samandar MS. Toward a rational and ethical sociotechnical system of autonomous vehicles: A novel application of multi-criteria decision analysis. PLoS One 2021; 16:e0256224. [PMID: 34388216 PMCID: PMC8363020 DOI: 10.1371/journal.pone.0256224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/03/2021] [Indexed: 11/19/2022] Open
Abstract
The impacts of autonomous vehicles (AV) are widely anticipated to be socially, economically, and ethically significant. A reliable assessment of the harms and benefits of their large-scale deployment requires a multi-disciplinary approach. To that end, we employed Multi-Criteria Decision Analysis to make such an assessment. We obtained opinions from 19 disciplinary experts to assess the significance of 13 potential harms and eight potential benefits that might arise under four deployments schemes. Specifically, we considered: (1) the status quo, i.e., no AVs are deployed; (2) unfettered assimilation, i.e., no regulatory control would be exercised and commercial entities would "push" the development and deployment; (3) regulated introduction, i.e., regulatory control would be applied and either private individuals or commercial fleet operators could own the AVs; and (4) fleets only, i.e., regulatory control would be applied and only commercial fleet operators could own the AVs. Our results suggest that two of these scenarios, (3) and (4), namely regulated privately-owned introduction or fleet ownership or autonomous vehicles would be less likely to cause harm than either the status quo or the unfettered options.
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Affiliation(s)
- Veljko Dubljevic
- North Carolina State University, Raleigh, NC, United States of America
| | - George List
- North Carolina State University, Raleigh, NC, United States of America
| | - Jovan Milojevich
- Oklahoma State University, Stillwater, Oklahoma, United States of America
| | - Nirav Ajmeri
- North Carolina State University, Raleigh, NC, United States of America
| | - William A. Bauer
- North Carolina State University, Raleigh, NC, United States of America
| | - Munindar P. Singh
- North Carolina State University, Raleigh, NC, United States of America
| | - Eleni Bardaka
- North Carolina State University, Raleigh, NC, United States of America
| | | | | | - Roger C. Mayer
- North Carolina State University, Raleigh, NC, United States of America
| | - Ioan Muntean
- University of North Carolina, Asheville, NC, United States of America
| | - Thomas M. Powers
- University of Delaware, Newark, Delaware, United States of America
| | - Hesham A. Rakha
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia, United States of America
| | - Vance A. Ricks
- Guilford College, Greensboro, NC, United States of America
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23
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Sohoni T, Snell J, Harden E. “He was Drugged up on Something...” Portrayals of Drugs and Violence on Crime Scene Investigation (CSI) as System Justification. JOURNAL OF DRUG ISSUES 2021. [DOI: 10.1177/00220426211034404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We conducted a content analysis of the first two and last two seasons of the popular crime drama Crime Scene Investigation ( CSI), to determine the extent to which depictions of the intersection of substance use and violence were consistent with research. Using the lens of system justification theory, we find that CSI focuses on aspects of crime that preserve the status quo, specifically it overemphasizes the negative impact of illicit substances as opposed to legal substances (such as alcohol), and it emphasizes the psychopharmacological role of drugs in violent crime compared to systemic violence related to the illegality of drug markets, even though research demonstrates that systemic violence makes up a large proportion of substance-related homicides. Despite significant changes in drug policy that occurred during the time that CSI was on the air, we find these portrayals are largely unchanged between episodes that were broadcast between 2000–2002 versus those that aired 2014–2015.
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Affiliation(s)
- Tracy Sohoni
- Department of Sociology and Criminal Justice, Old Dominion University, Norfolk, VA, USA
| | - Julie Snell
- Department of Sociology and Criminal Justice, Old Dominion University, Norfolk, VA, USA
| | - Elizabeth Harden
- Department of Sociology and Criminal Justice, Old Dominion University, Norfolk, VA, USA
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24
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Gabrhelík R, Handal M, Mravčík V, Nechanská B, Tjagvad C, Thylstrup B, Hesse M, Minařík J, Jarkovský J, Bukten A, Clausen T, Skurtveit S. Opioid maintenance treatment in the Czech Republic, Norway and Denmark: a study protocol of a comparative registry linkage study. BMJ Open 2021; 11:e047028. [PMID: 33972343 PMCID: PMC8112418 DOI: 10.1136/bmjopen-2020-047028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/05/2021] [Accepted: 04/16/2021] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Opioid maintenance treatment (OMT) varies across settings and between countries. We plan to use data from several nationwide health and population registers to further improve the knowledge base established from earlier studies. Our aim is to study OMT adherence trajectories and to identify factors associated with improved outcomes for OMT patients across the Czech Republic, Norway and Denmark, in order to further improve OMT and our understanding of the key elements of treatment success. METHODS AND ANALYSIS The registry-based cohort approach across the three countries allows us to link data from a range of registers on the individual level, by using personal identifiers in nationwide cohorts of OMT and non-OMT patients and the general non-using populations. A total of ~21 500 OMT patients over the last two decades in all three countries will be included in the study. The following outcome variables (based on the International Classification of Diseases, 10th Revision codes) will be obtained from relevant registers: treatment adherence to OMT, comorbidity (somatic and mental health), and all-cause and cause-specific mortality. Outcomes of the country-specific analyses will be pooled. ETHICS AND DISSEMINATION The national OMT cohorts have been approved by the ethics committees in the respective countries. Data will be stored according to national and local guidelines and treated confidentially, and all data will be analysed separately for each country and compared across countries. Findings will be disseminated in peer-reviewed scientific journals, national and international conferences, and in briefings to inform clinical decision-making.
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Affiliation(s)
- Roman Gabrhelík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Marte Handal
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Norwegian Institute of Public Health, Oslo, Norway
| | - Viktor Mravčík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Blanka Nechanská
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Christian Tjagvad
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Birgitte Thylstrup
- Centre For Alcohol And Drug Research, Aarhus University, Aarhus, Denmark
| | - Morten Hesse
- Centre For Alcohol And Drug Research, Aarhus University, Aarhus, Denmark
| | - Jakub Minařík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiří Jarkovský
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Anne Bukten
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Thomas Clausen
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
| | - Svetlana Skurtveit
- Norwegian Institute of Public Health, Oslo, Norway
- Norwegian Centre for Addiction Research, University of Oslo, Oslo, Norway
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25
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van Amsterdam J, Peters GJY, Pennings E, Blickman T, Hollemans K, Breeksema JJJ, Ramaekers JG, Maris C, van Bakkum F, Nabben T, Scholten W, Reitsma T, Noijen J, Koning R, van den Brink W. Developing a new national MDMA policy: Results of a multi-decision multi-criterion decision analysis. J Psychopharmacol 2021; 35:537-546. [PMID: 33530825 PMCID: PMC8155737 DOI: 10.1177/0269881120981380] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ecstasy (3,4-methylenedioxymethamphetamine (MDMA)) has a relatively low harm and low dependence liability but is scheduled on List I of the Dutch Opium Act ('hard drugs'). Concerns surrounding increasing MDMA-related criminality coupled with the possibly inappropriate scheduling of MDMA initiated a debate to revise the current Dutch ecstasy policy. METHODS An interdisciplinary group of 18 experts on health, social harms and drug criminality and law enforcement reformulated the science-based Dutch MDMA policy using multi-decision multi-criterion decision analysis (MD-MCDA). The experts collectively formulated policy instruments and rated their effects on 25 outcome criteria, including health, criminality, law enforcement and financial issues, thematically grouped in six clusters. RESULTS The experts scored the effect of 22 policy instruments, each with between two and seven different mutually exclusive options, on 25 outcome criteria. The optimal policy model was defined by the set of 22 policy instrument options which gave the highest overall score on the 25 outcome criteria. Implementation of the optimal policy model, including regulated MDMA sales, decreases health harms, MDMA-related organised crime and environmental damage, as well as increases state revenues and quality of MDMA products and user information. This model was slightly modified to increase its political feasibility. Sensitivity analyses showed that the outcomes of the current MD-MCDA are robust and independent of variability in weight values. CONCLUSION The present results provide a feasible and realistic set of policy instrument options to revise the legislation towards a rational MDMA policy that is likely to reduce both adverse (public) health risks and MDMA-related criminal burden.
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Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Amsterdam
University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Ed Pennings
- The Maastricht Forensic Institute,
Maastricht, The Netherlands
| | | | | | - Joost J Jacobus Breeksema
- Department of Psychiatry, Leiden
University Medical Center, Leiden, The Netherlands; University Centre of Psychiatry,
University Medical Centre Groningen, Groningen, The Netherlands
| | - Johannes G Ramaekers
- Department of Neuropsychology and
Psychopharmacology, Faculty of Neuroscience and Psychology, Maastricht University,
Maastricht, The Netherlands
| | - Cees Maris
- Faculty of Law, University of Amsterdam,
Amsterdam, The Netherlands
| | | | - Ton Nabben
- Department of Urban Management,
Faculty Society and Law, Amsterdam University of Applied Sciences, Amsterdam, The
Netherlands
| | | | | | | | | | - Wim van den Brink
- Department of Psychiatry, Amsterdam
University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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26
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Abstract
BACKGROUND In recent years, there has been significant research on the mental health effects of classic psychedelic use, but there is very little evidence on how classic psychedelics might influence physical health. AIMS The purpose of the present study was to investigate the associations between lifetime classic psychedelic use and markers of physical health. METHODS Using data from the National Survey on Drug Use and Health (2015-2018) with 171,766 (unweighted) adults aged 18 or above in the United States, the current study examined the associations between lifetime classic psychedelic use and three markers of physical health (self-reported overall health, body mass index, and heart condition and/or cancer in the past 12 months) while controlling for a range of covariates. RESULTS Respondents who reported having tried a classic psychedelic at least once in their lifetime had significantly higher odds of greater self-reported overall health and significantly lower odds of being overweight or obese versus having a normal weight. The association between lifetime classic psychedelic use and having a heart condition and/or cancer in the past 12 months approached conventional levels of significance, with lower odds of having a heart condition and/or cancer in the past 12 months for respondents who had tried a classic psychedelic at least once. CONCLUSION The results of the present study suggest that classic psychedelics may be beneficial to physical health. Future research should investigate the causal effects of classic psychedelics on physical health and evaluate possible mechanisms.
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Affiliation(s)
- Otto Simonsson
- Department of Sociology, University of Oxford, Oxford, UK
| | - James D Sexton
- Department of Brain Sciences, Imperial College London, London, UK
| | - Peter S Hendricks
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, USA
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27
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Hahlbeck SM, Vito AG. Adolescent Marijuana Dependence: The Role of Social Bonds and Social Learning Theory. J Psychoactive Drugs 2021; 54:43-53. [PMID: 33775242 DOI: 10.1080/02791072.2021.1903122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Using the 2017 National Survey of Drug Use and Health (NSDUH) data, this research examines the extent to which social bonds and social learning theory predict adolescent marijuana dependence. Full information maximum likelihood (FIML) for logistic regression analyses were conducted in four models to test the competing theories. The results revealed partial support for both theories, such that adolescents with stronger parental bonds and negative definitions of substance use were less likely to be dependent on marijuana, while adolescents who associated with substance using peers were more likely to be dependent on marijuana. The multi-theoretical model suggested that only the social learning theory concepts of differential association and negative definitions were significant theoretical predictors of adolescent marijuana dependence. Additional analyses revealed that first using marijuana at 14 or 15 years old was also significantly related to adolescent marijuana dependence. Implications for future research and risk prevention programs are discussed.
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Affiliation(s)
- Sydney M Hahlbeck
- Department of Psychological Science, Ball State University, Muncie, IN, USA
| | - Anthony G Vito
- Department of Criminal Justice & Criminology, Ball State University, Muncie, IN, USA
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28
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Genrich G, Zeller C, Znoj HJ. Interactions of protective behavioral strategies and cannabis use motives: An online survey among past-month users. PLoS One 2021; 16:e0247387. [PMID: 33647024 PMCID: PMC7920385 DOI: 10.1371/journal.pone.0247387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 02/05/2021] [Indexed: 11/19/2022] Open
Abstract
Given the constant high prevalence of cannabis use and cannabis dependence, it is important to determine protective behaviors on the individual level, which buffer the effects of risk factors. Protective Behavioral Strategies for Marijuana (PBSM) have been identified to play an important role for harm reduction in adolescent and young adult users. In the present study, we analyzed if PBSM moderate the effects of use motives (captured by the Marijuana Motives Measure, MMM) on the severity of dependence beyond the effects of age, gender, education and cannabis use frequency. We used confirmatory factor analysis (CFA) to validate the German versions of PBSM and MMM. Data was gathered in an online survey distributed to randomly chosen households in the city of Bern in the German speaking part of Switzerland. The final sample comprised 362 past-month users. Results showed negative correlations between PBSM and cannabis use frequency and severity of dependence. The only motives being correlated with severity of dependence were coping and routine, beyond frequency of use. PBSM significantly moderated the effect only of routine motives on the severity of dependence. However, only a few cases who used PBSM extensively were affected. PBSM appear to be an important factor to reduce harm among past-month users but not among those with dependent use patterns, e.g. coping and routine users. Clinical implications are discussed. The routine factor adds significantly to the MMM and should be implemented and improved in future studies. PBSM as well as the MMM can be used in future studies in German speaking populations.
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Affiliation(s)
- Gregor Genrich
- Department of Health Psychology and Behavioral Medicine, University of Bern, Bern, Switzerland
| | - Céline Zeller
- Department of Health Psychology and Behavioral Medicine, University of Bern, Bern, Switzerland
| | - Hans Jörg Znoj
- Department of Health Psychology and Behavioral Medicine, University of Bern, Bern, Switzerland
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29
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Bonnet U, Specka M, Soyka M, Alberti T, Bender S, Hilger J, Hillemacher T, Kuhlmann T, Kuhn J, Lüdecke C, Reimer J, Schneider U, Schroeder W, Stuppe M, Wiesbeck G, Wodarz N, Scherbaum N. [Weighing the benefits and harms of psychotropic and analgesic substances - A perspective of German addiction medicine experts]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2021; 90:19-29. [PMID: 33634461 DOI: 10.1055/a-1363-0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND In Europe, there have been several addiction-expert rankings of harms related to the use of psychotropic substances in the last 15 years. Among them, only one expert ranking took into account the potential benefits of these drugs. Non-Opioidergic Analgesics (NOAs), such as gabapentinoids and NSAIDs, which have been increasingly the subject of abuse / misuse reports, have not been considered in such expert rankings. Likewise, there is currently no multi-substance comparison as to whether the valuation rank of the harmfulness of an illegal drug may change along with an imagined change in legal status in Germany. OBJECTIVES AND METHODS Using a questionnaire, 101 experienced addiction physicians (first cohort) evaluated 33 psychoactive substances including analgesics with regard to their health and social harms as well as potential usefulness for the consumer and their environment / society ('others'). In addition, this cohort investigated whether the harmfulness assessment of an illegal substance changes if it would be legalized. In order to obtain the average overall harmfulness (overall risk) of a substance, the percentage contribution of each dimension to the overall harmfulness was determined in a second survey (second cohort, 36 experienced addiction medicine experts). Finally, the average benefit and overall risk ratings of each substance were related to each other. RESULTS Prescription psychoactive substances such as analgesics, NOAs (including gabapentinoids) and opioidergic maintenance medications to treat opiate dependence were judged to have a favorable benefit-harm profile. Cannabis and ketamine were placed in the midfield of both, the harm and benefit rankings. Together with most illicit narcotic drugs, alcohol and nicotine, have been ranked among the most harmful and least useful substances, whereby alcohol was judged on average to be more harmful but also more useful than nicotine. In the event of potential legalization, the overall harm of the traditional illegal drugs methamphetamine, heroin, cocaine and cannabis was estimated to be reduced. This was mainly due to a more favorable valuation of the harm to others under these virtual conditions. CONCLUSION Prescription substances including opioidergic and non-opioidergic analgesics as well as opioid maintenance therapy medications (methadone and buprenorphine) were assigned a favorable benefit-harm profile. Alcohol, nicotine and traditional illicit drugs (with the exception of cannabis and ketamine) were determined to have an unfavorable profile. The overall harm of traditional illicit drugs was assessed to decrease along with legalization, mainly by decreasing the harm to others in this virtual event.
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Affiliation(s)
- Udo Bonnet
- Evangelisches Krankenhaus Castrop-Rauxel, Klinik für Psychiatrie, Psychotherapie und Psychosomatik.,LVR-Klinik Essen, Klinik für Psychiatrie und Psychotherapie & Klinik für Abhängiges Verhalten und Suchtmedizin, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland
| | - Michael Specka
- LVR-Klinik Essen, Klinik für Psychiatrie und Psychotherapie & Klinik für Abhängiges Verhalten und Suchtmedizin, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland
| | - Michael Soyka
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinik, LMU München, München, Deutschland
| | - Thomas Alberti
- Johanniter Krankenhaus Oberhausen, Evangelischer Klinikverbund Niederrhein gGmbH
| | - Stefan Bender
- LWL-Kliniken Marsberg, Klinik für Psychiatrie und Psychotherapie, Marsberg, Deutschland
| | - Jörg Hilger
- Evangelische Stiftung Tannenhof, Fachkrankenhaus für Psychiatrie, Psychotherapie, Psychosomatik und Neurologie, Remscheid, Deutschland
| | - Thomas Hillemacher
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinik der Paracelsus Medizinischen Privatuniversität Nürnberg.,Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover
| | - Thomas Kuhlmann
- Psychosomatische Klinik Bergisch Gladbach, Bergisch Gladbach, Deutschland
| | - Jens Kuhn
- Johanniter Krankenhaus Oberhausen, Evangelischer Klinikverbund Niederrhein gGmbH.,Klinik für Psychiatrie und Psychotherapie, Universitätsklinik Köln
| | - Christel Lüdecke
- Fachbereich für Abhängigkeitserkrankungen, Asklepios Fachklinikum Göttingen, Deutschland
| | - Jens Reimer
- Zentrum für Interdisziplinäre Suchtforschung, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf.,Zentrum für Psychosoziale Medizin, Gesundheit Nord, Klinikverbund Bremen, Bremen, Deutschland
| | - Udo Schneider
- Universitätsklinik für Psychiatrie und Psychotherapie der Ruhr-Universität Bochum, Campus Ost-Westfalen-Lippe, Lübbecke, Deutschland
| | | | - Markus Stuppe
- Carl-Friedrich-Flemming-Klinik, Helios Kliniken Schwerin, Klinik für Abhängigkeitserkrankungen, Schwerin, Deutschland
| | - Gerhard Wiesbeck
- Universitäre Psychiatrische Kliniken Basel, Zentrum für Abhängigkeitserkrankungen
| | - Norbert Wodarz
- Klinik und Poliklinik für Psychiatrie und Psychotherapie der Universität Regensburg am Bezirksklinikum, Zentrum für Suchtmedizin
| | - Norbert Scherbaum
- LVR-Klinik Essen, Klinik für Psychiatrie und Psychotherapie & Klinik für Abhängiges Verhalten und Suchtmedizin, Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland
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30
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Andersson HW, Lilleeng SE, Ose SO. Comparison of social and sociodemographic characteristics and treatment goals of persons with alcohol versus drug use disorders: Result from a national census of inpatients in specialized treatment for substance use. Addict Behav Rep 2021; 13:100340. [PMID: 33614886 PMCID: PMC7878974 DOI: 10.1016/j.abrep.2021.100340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/29/2021] [Accepted: 01/30/2021] [Indexed: 01/19/2023] Open
Abstract
A national census of patients in residential substance use treatment. We compared inpatients with primary alcohol use disorders vs. drug use disorders. Patients with drug use disorders were more likely sociodemographic disadvantaged. Patients with drug use disorders more likely had poor friend relationships. Treatment goal differences disappeared when adjusted for sociodemographic variables.
Introduction We examined differences in social and sociodemographic characteristics and treatment goals between people with primary alcohol use disorder (AUD) versus those with a primary drug use disorder receiving inpatient treatment for a substance use disorder (SUD). Methods A national census utilizing a cross sectional design included 56 of 60 specialized inpatient SUD treatment clinics in Norway and all patients receiving treatment on a specific date (responserate = 70%). Data on substance use, social and sociodemographic characteristics, and patient-reported treatment goals were collected. Patients were classified as having primary AUD or a drug use disorder based on the main SUD diagnosis relevant to the treatment episode. Results The analytic sample included 1093 patients. Patients with primary AUD (n = 362) were more often older, had a higher educational level and income from work, and lived in permanent housing compared with patients with a drug use disorder (n = 731). Patients with AUD were more likely to have good relationships with friends. The higher frequency of reported reduced substance use (versus quitting substance use) as the treatment goal among AUD patients disappeared when controlled for sociodemographic factors. Conclusions Knowledge about the different characteristics of inpatients with AUD versus a drug use disorder is relevant when conducting research involving the SUD treatment population and for facilitating treatment. The lower frequency of perceived support from friends among patients with a drug use disorder suggests a need for targeted efforts in (re)building supportive social relationships for inpatients being treated for SUD.
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Affiliation(s)
- Helle Wessel Andersson
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, PB 3250 Sluppen, 7006 Trondheim, Norway
| | - Solfrid E Lilleeng
- The Norwegian Directorate of Health, Department of Analysis and Performance Assessment, Holtermanns vei 70, Trondheim 7031, Norway
| | - Solveig Osborg Ose
- SINTEF Technology and Society, Department of Health, Klæbuveien 153, Trondheim 7049, Norway
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31
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Abstract
In order to curb alcohol's harm to others, it is important to identify the contexts where people experience such harm. Objectives: To examine whether frequency of drinking in four different locations was associated with increased likelihood of experiencing harm from others' drinking. Methods: Data stem from surveys conducted in the five Nordic countries in 2015 (N = 7065, aged 18-64 years) as part of the European Union's Joint Action on Reducing Alcohol Related Harm (RARHA). Three types of harm from others' drinking in the past 12 months were measured: verbally abused by, harmed physically by, and experienced a serious argument with someone who had been drinking. Respondents also reported frequency of drinking in their own home, in others' homes, in a pub/bar/club/restaurant, and outdoors the past 12 months. Results: Country-pooled adjusted analyses showed that higher frequency of drinking in pubs/bars/clubs/restaurants, outdoors and in someone else's home was associated with increased likelihood of experiencing all three harms. Frequent drinking in one's own home was weakly associated with experience of harm. Women, young individuals, respondents without tertiary level of education and individuals who reported drinking almost daily were at increased risk of experiencing harm from others' drinking. Conclusions: Frequent drinking on licensed premises and outdoors was most clearly associated with experiencing harm from others' drinking, suggesting that these are important arenas for preventive efforts. Women, young individuals, those with low educational level and the most frequent drinkers are important target groups for preventive efforts.
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Affiliation(s)
- Inger Synnøve Moan
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Scott Brunborg
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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32
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Teymourian H, Parrilla M, Sempionatto JR, Montiel NF, Barfidokht A, Van Echelpoel R, De Wael K, Wang J. Wearable Electrochemical Sensors for the Monitoring and Screening of Drugs. ACS Sens 2020; 5:2679-2700. [PMID: 32822166 DOI: 10.1021/acssensors.0c01318] [Citation(s) in RCA: 147] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Wearable electrochemical sensors capable of noninvasive monitoring of chemical markers represent a rapidly emerging digital-health technology. Recent advances toward wearable continuous glucose monitoring (CGM) systems have ignited tremendous interest in expanding such sensor technology to other important fields. This article reviews for the first time wearable electrochemical sensors for monitoring therapeutic drugs and drugs of abuse. This rapidly emerging class of drug-sensing wearable devices addresses the growing demand for personalized medicine, toward improved therapeutic outcomes while minimizing the side effects of drugs and the related medical expenses. Continuous, noninvasive monitoring of therapeutic drugs within bodily fluids empowers clinicians and patients to correlate the pharmacokinetic properties with optimal outcomes by realizing patient-specific dose regulation and tracking dynamic changes in pharmacokinetics behavior while assuring the medication adherence of patients. Furthermore, wearable electrochemical drug monitoring devices can also serve as powerful screening tools in the hands of law enforcement agents to combat drug trafficking and support on-site forensic investigations. The review covers various wearable form factors developed for noninvasive monitoring of therapeutic drugs in different body fluids and toward on-site screening of drugs of abuse. The future prospects of such wearable drug monitoring devices are presented with the ultimate goals of introducing accurate real-time drug monitoring protocols and autonomous closed-loop platforms toward precise dose regulation and optimal therapeutic outcomes. Finally, current unmet challenges and existing gaps are discussed for motivating future technological innovations regarding personalized therapy. The current pace of developments and the tremendous market opportunities for such wearable drug monitoring platforms are expected to drive intense future research and commercialization efforts.
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Affiliation(s)
- Hazhir Teymourian
- Department of Nanoengineering, University of California San Diego, La Jolla, California 92093, United States
| | - Marc Parrilla
- AXES Research Group, Bioscience Engineering Department, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Juliane R. Sempionatto
- Department of Nanoengineering, University of California San Diego, La Jolla, California 92093, United States
| | - Noelia Felipe Montiel
- AXES Research Group, Bioscience Engineering Department, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Abbas Barfidokht
- Department of Nanoengineering, University of California San Diego, La Jolla, California 92093, United States
| | - Robin Van Echelpoel
- AXES Research Group, Bioscience Engineering Department, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Karolien De Wael
- AXES Research Group, Bioscience Engineering Department, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Joseph Wang
- Department of Nanoengineering, University of California San Diego, La Jolla, California 92093, United States
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Risso C, Boniface S, Subbaraman MS, Englund A. Does cannabis complement or substitute alcohol consumption? A systematic review of human and animal studies. J Psychopharmacol 2020; 34:938-954. [PMID: 32648806 DOI: 10.1177/0269881120919970] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Whether alcohol and cannabis complement or substitute each other has been studied for over two decades. In the changing cannabis policy landscape, debates are moving rapidly and spill-over effects on other substances are of interest. AIMS update and extend a previous systematic review, by: (a) identifying new human behavioural studies reporting on substitution and/or complementarity of alcohol and cannabis, and (b) additionally including animal studies. METHODS We replicated the search strategy of an earlier systematic review, supplemented with a new search for animal studies. Search results were crossed checked against the earlier review and reference lists were hand searched. Findings were synthesised using a narrative synthesis. RESULTS Sixty-five articles were included (64 in humans, one in animals). We synthesised findings into categories: patterns of use, substitution practices, economic relationship, substance use disorders, policy evaluation, others and animal studies. Overall, 30 studies found evidence for substitution, 17 for complementarity, 14 did not find evidence for either, and four found evidence for both. CONCLUSIONS Overall, the evidence regarding complementarity and substitution of cannabis and alcohol is mixed. We identified stronger support for substitution than complementarity, though evidence indicates different effects in different populations and to some extent across different study designs. The quality of studies varied and few were designed specifically to address this question. Dedicated high-quality research is warranted.
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Affiliation(s)
- Constanza Risso
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Clinica las Condes, Santiago, Chile
| | - Sadie Boniface
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Amir Englund
- Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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van Amsterdam J, Pennings E, van den Brink W. Fatal and non-fatal health incidents related to recreational ecstasy use. J Psychopharmacol 2020; 34:591-599. [PMID: 31909673 PMCID: PMC7249611 DOI: 10.1177/0269881119897559] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The recreational drug ecstasy (3,4-methylenedioxymethamphetamine) is currently used world-wide. Severe (including fatal) health incidents related to ecstasy have been reported but a risk assessment of acute non-fatal and fatal ecstasy-related health incidents has never been performed. METHODS In the current risk assessment review, national data of non-fatal health incidents collected in the Netherlands were combined with the nationwide exposure to ecstasy, that is, last-year prevalence of ecstasy use. In addition, the annual number of ecstasy-related deaths in Great Britain (Scotland, Wales and England) was used to assess the risk of fatal ecstasy-related cases. RESULTS In the Netherlands, the estimated risk of a moderate to severe acute health incident following the use of ecstasy is one in 900 pills (0.11%), whereas for cocaine it is one in 1600 doses (0.06%) and for gamma-hydroxybutyrate one in 95 doses (1.05%). With respect to ecstasy-related deaths in Great Britain, the estimated risk of ecstasy alone per user is 0.01-0.06%, which is close to the range of the fatality risk in chronic alcohol users (0.01-0.02%), amphetamine users (0.005%) and cocaine users (0.05%), but much lower than that of opiate use (heroin and morphine: 0.35%). CONCLUSION The current review shows that almost no data are available on the health risks of ecstasy use. The few data that are available show that ecstasy is not a safe substance. However, compared to opiates (heroin, morphine), the risk of acute ecstasy-related adverse health incidents per ecstasy user and per ecstasy use session is relatively low.
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Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Amsterdam
University Medical Center, Amsterdam, the Netherlands,Jan van Amsterdam, Department of Psychiatry,
Academic Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, 1070AW, the
Netherlands. Emails: ;
| | - Ed Pennings
- The Maastricht Forensic Institute,
Maastricht, the Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam
University Medical Center, Amsterdam, the Netherlands
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Zachová K, Petruželka B, Barták M, Rogalewicz V. Media portrayal of alcohol does not match its real harm effects in the Czech Republic. Cent Eur J Public Health 2020; 27 Suppl:S66-S73. [PMID: 31901194 DOI: 10.21101/cejph.a5826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 12/11/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The Czech Republic ranks among countries with the highest alcohol consumption per capita. Several older studies discuss Czech media portrayal of health effects of alcohol, but we found no recent analysis of media portrayal of harms caused by alcohol consumption. Our analysis aims to fill this gap in. METHODS The dataset of texts (n = 903) consisting of articles from press, radio, television and the internet published within a 30-day interval in 2017 (Newton Media computerized database) was coded and analyzed using mixed quantitative and qualitative approach to content analysis. The frequency of references to acute and long-term alcohol harms of various types were counted, and the results were compared to the classification of (alcohol) harms by the Independent Scientific Committee of Drugs (ISCD). RESULTS The short-term intoxication effects in the areas of crime and road safety, in particular reports on traffic accidents, are over-represented, while topics describing the impact of alcohol use on health, family and society, as well as economic costs or environmental issues seem to be marginal. That corresponds to the fact that police and courts were the information source in more than half of the articles, while information sourced from physicians, sociologists and drug field professionals was rather scarce. CONCLUSIONS Media portrayal of the harms caused by alcohol use does not match up to real harm effects on the society. In terms of public health, it is imperative to strengthen media presentation of the impact of alcohol use on health and social issues.
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Affiliation(s)
- Kateřina Zachová
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Benjamin Petruželka
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Miroslav Barták
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vladimír Rogalewicz
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Bonnet U, Specka M, Soyka M, Alberti T, Bender S, Grigoleit T, Hermle L, Hilger J, Hillemacher T, Kuhlmann T, Kuhn J, Luckhaus C, Lüdecke C, Reimer J, Schneider U, Schroeder W, Stuppe M, Wiesbeck GA, Wodarz N, McAnally H, Scherbaum N. Ranking the Harm of Psychoactive Drugs Including Prescription Analgesics to Users and Others-A Perspective of German Addiction Medicine Experts. Front Psychiatry 2020; 11:592199. [PMID: 33192740 PMCID: PMC7649209 DOI: 10.3389/fpsyt.2020.592199] [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: 08/06/2020] [Accepted: 09/22/2020] [Indexed: 11/22/2022] Open
Abstract
Background: Over the past 15 years, comparative assessments of psychoactive substance harms to both users and others have been compiled by addiction experts. None of these rankings however have included synthetic cannabinoids or non-opioid prescription analgesics (NOAs, e.g., gabapentinoids) despite evidence of increasing recreational use. We present here an updated assessment by German addiction medicine experts, considering changing Western consumption trends-including those of NOAs. Methods: In an initial survey, 101 German addiction medicine physicians evaluated both physical and psychosocial harms (in 5 dimensions) of 33 psychoactive substances including opioids and NOAs, to both users and others. In a second survey, 36 addiction medicine physicians estimated the relative weight of each health and social harm dimension to determine the overall harm rank of an individual substance. We compared our ranking with the most recent European assessment from 2014. Results: Illicit drugs such as methamphetamine, heroin, cocaine and also alcohol were judged particularly harmful, and new psychoactive drugs (cathinones, synthetic cannabinoids) were ranked among the most harmful substances. Cannabis was ranked in the midrange, on par with benzodiazepines and ketamine-somewhat more favorable compared to the last European survey. Prescribed drugs including opioids (in contrast to the USA, Canada, and Australia) were judged less harmful. NOAs were at the bottom end of the ranking. Conclusion: In Germany, alcohol and illicit drugs (including new psychoactive substances) continue to rank among the most harmful addictive substances in contrast to prescribed agents including opioid analgesics and NOAs. Current laws are incongruent with these harm rankings. This study is the first of its kind to include comparative harm rankings of several novel abused substances, both licit/prescribed and illicit.
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Affiliation(s)
- Udo Bonnet
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital of the University of Duisburg/Essen, Castrop-Rauxel, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine, Landschaftsverband Rheinland-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Michael Specka
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Landschaftsverband Rheinland-Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Michael Soyka
- Department of Psychiatry and Psychotherapy University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Thomas Alberti
- Department of Psychiatry, Psychotherapy and Psychosomatic, Johanniter Hospital Oberhausen, Oberhausen, Germany
| | - Stefan Bender
- Psychiatry, Psychotherapy and Psychosomatics, Landschaftsverband Westfalen-Lippe-Hospital Marsberg, Marsberg, Germany
| | - Torsten Grigoleit
- Psychiatry and Psychotherapy, Landschaftsverband Rheinland-Hospital Langenfeld, Langenfeld, Germany
| | - Leopold Hermle
- Clinic for Psychiatry and Psychotherapy, Christophsbad, Göppingen, Germany
| | - Jörg Hilger
- Clinic for Psychiatry, Psychotherapy, Psychosomatics and Neurology, Evangelische Stiftung Tannenhof, Remscheid, Germany
| | - Thomas Hillemacher
- Department of Psychiatry, Socialpsychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany.,Department of Psychiatry and Psychotherapy, Paracelsus Medical University, Nuremberg, Germany
| | - Thomas Kuhlmann
- Clinic for Psychosomatics Bergisch-Gladbach, Bergisch Gladbach, Germany
| | - Jens Kuhn
- Department of Psychiatry, Psychotherapy and Psychosomatic, Johanniter Hospital Oberhausen, Oberhausen, Germany.,Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christian Luckhaus
- Division of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, Department of Psychiatry, Landschaftsverband Westfalen-Lippe University Hospital Bochum, Ruhr University Bochum, Bochum, Germany
| | - Christel Lüdecke
- Lower Saxonian Psychiatric Hospital, Asklepios Hospital, Göttingen, Germany
| | - Jens Reimer
- Center for Interdisciplinary Addiction Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Health North Hospital Group Bemen, Bremen, Germany
| | - Udo Schneider
- Department of Psychiatry and Psychotherapy, Ruhr-University Bochum, Campus Ostwestfalen-Lippe, Luebbecke, Germany
| | | | - Markus Stuppe
- Department of Addiction Medicine, Helios Medical Center Schwerin, Carl-Friedrich-Flemming-Clinic, Schwerin, Germany
| | | | - Norbert Wodarz
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Heath McAnally
- Northern Anesthesia & Pain Medicine, Limited Liability Company, Eagle River, AK, United States.,Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Norbert Scherbaum
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Landschaftsverband Rheinland-Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Achterbergh RCA, de Vries HJC, Boyd A, Davidovich U, Drückler S, Hoornenborg E, Prins M, Matser A. Identification and characterization of latent classes based on drug use among men who have sex with men at risk of sexually transmitted infections in Amsterdam, the Netherlands. Addiction 2020; 115:121-133. [PMID: 31400174 DOI: 10.1111/add.14774] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/06/2019] [Accepted: 08/05/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Men who have sex with men (MSM) are at high risk for both drug use and sexually transmitted infections (STI). We aimed to (1) identify subgroups of drug use during sex among MSM in Amsterdam and after classifying participants and (2) compare sexual behaviour and STI across groups. DESIGN Cross-sectional study. Latent class analysis was used to identify subgroups with similar drug use patterns, between which sexual behaviour and STI prevalence were compared. SETTING Four different studies conducted at the STI out-patient clinic in Amsterdam, the Netherlands, between January 2014 and June 2016. PARTICIPANTS A total of 1130 self-declared MSM, aged ≥ 18 years. MEASUREMENTS Self-reported drug use, laboratory-confirmed STI, socio-demographics, sexual behaviour (including number of partners), condom use. FINDINGS Median age was 40 years [interquartile range (IQR) = 32-47]. We identified five latent classes of users, which we labelled: 'no substance' (n = 162), 'alcohol' (n = 159), 'nitrites and erectile dysfunction drugs (EDD)' (n = 286), 'polydrug' (n = 257) and 'chems' (n = 266). Median number of sex partners significantly differed across classes (P < 0.001), ranging from two (IQR = 1-6) in the 'no substance' class to 20 (IQR = 10-45) in the 'chems' class. The proportion of MSM reporting condomless anal sex also differed across classes (P < 0.001), ranging from 45.6% in the 'no substance' class to 86.5% in the 'chems' class. Compared with the 'no substance' class, the odds of STI were 3.9-fold [95% confidence interval (CI) = 1.1-14.4] higher in the 'alcohol' class, 8.9-fold (95% CI = 2.7-29.2) higher in the 'nitrites and EDD' class, 12.8-fold (95% CI = 3.9-41.9) higher in the 'polydrug' class and 15.0-fold (95% CI = 4.6-48.8) higher in the 'chems' class. CONCLUSION There are five distinct classes of drug use in a sexual context among men who have sex with men in Amsterdam, the Netherlands. Classes with higher levels of drug use appear to coincide with higher levels of sexual risk behaviour and sexually transmitted infections.
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Affiliation(s)
- Roel C A Achterbergh
- STI Outpatient Clinic, Department Of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Henry J C de Vries
- STI Outpatient Clinic, Department Of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands.,Department of Dermatology, Amsterdam Institute for Infection and Immunity (AI and II), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Anders Boyd
- Research and Prevention, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands.,Institut Pierre Louis d'Épidémiologie et de Santé Publique, INSERM, Sorbonne Université, Paris, France
| | - Udi Davidovich
- Research and Prevention, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Susanne Drückler
- STI Outpatient Clinic, Department Of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Elske Hoornenborg
- Research and Prevention, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
| | - Maria Prins
- Research and Prevention, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands.,Department of Infectious Diseases, Amsterdam Institute for Infection and Immunity (AI and II), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Amy Matser
- Research and Prevention, Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands
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Abstract
Drinking alcohol with coworkers is a common practice in many occupational cultures. This practice may produce negative consequences for some employees. Objectives: We estimate the prevalence of a set of negative consequences of work-related alcohol use and identify risk factors associated with experience of harm from coworkers' drinking. Methods: In an online survey, Norwegian employees (n = 3596) aged 20-69 reported whether they had experienced the following due to coworkers' drinking the past 12 months: (a) felt excluded, (b) experienced unwanted sexual attention, (c) been physically harmed, and (d) been verbally abused. Each outcome was regressed on socio-demographics (age, gender, education, and income), job characteristics (flexibility and autonomy), respondents' alcohol use, and perceived intoxication frequency in work contexts for a typical coworker (perceived coworker intoxication frequency). Results: The 12-month prevalence of experiencing any of the negative consequences was 18%. Having felt excluded (10.7%) and experienced unwanted sexual attention (7.0%) were more common than being verbally abused (4.8%) or physically harmed (1.9%). Perceived coworker intoxication frequency was strongly associated with all outcomes. Respondents' own drinking frequency predicted being verbally abused, being physically harmed, and experiencing unwanted sexual attention. Women experienced less physical harm and more unwanted sexual attention than men. Prevalence also varied by age, education, income, and job characteristics. Conclusions: Each year, approximately one-sixth of Norwegian employees experience harm from their coworkers' drinking. The frequency of intoxication in work contexts is strongly associated with harm to others.
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Affiliation(s)
- Inger Synnøve Moan
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
| | - Torleif Halkjelsvik
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, Oslo, Norway
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Flexon JL, Stolzenberg L, D'Alessio SJ. The effect of cannabis laws on opioid use. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 74:152-159. [PMID: 31590091 DOI: 10.1016/j.drugpo.2019.09.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 09/22/2019] [Accepted: 09/23/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Many Americans rely on opioids at varying dosages to help ameliorate their suffering. However, empirical evidence is mounting that opioids are ineffective at controlling non-cancer related chronic pain, and many argue the strategies meant to relieve patient suffering are contributing to the growing opioid epidemic. Concurrently, several states now allow the use of medical cannabis to treat a variety of medical conditions, including chronic pain. Needing more exploration is the impact of cannabis laws on general opioid reliance and whether chronic pain sufferers are opting to use cannabis medicinally instead of opioids. METHODS This study investigates the effect of Medical Marijuana Laws (MML)s on opioid use and misuse controlling for a number of relevant factors using data from several years of the National Survey on Drug Use and Health and multivariate logistic regression and longitudinal analysis strategies. RESULTS Results provide evidence that MMLs may be effective at reducing opioid reliance as survey respondents living in states with medical cannabis legislation are much less apt to report using opioid analgesics than people living in states without such laws, net other factors. Results further indicate that the presence of medicinal cannabis legislation appears to have no influence over opioid misuse. CONCLUSION MMLs may ultimately serve to attenuate the consequences of opioid overreliance.
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Affiliation(s)
- Jamie L Flexon
- Department of Criminology and Criminal Justice, Green School of International and Public Affairs, Florida International University, Modesto A. Maidique Campus, 11200 SW 8th Street, PCA-366A, Miami, FL 33199, USA.
| | - Lisa Stolzenberg
- Department of Criminology and Criminal Justice, Green School of International and Public Affairs, Florida International University, Modesto A. Maidique Campus, 11200 SW 8th Street, PCA-253A, Miami, FL 33199, USA.
| | - Stewart J D'Alessio
- Department of Criminology and Criminal Justice, Green School of International and Public Affairs. Florida International University, Modesto A. Maidique Campus, 11200 SW 8th Street, PCA-263B, Miami, FL 33199, USA.
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40
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Moan IS, Bye EK, Storvoll EE, Lund IO. Self-reported harm from others' alcohol, cigarette and illegal drug use in Norway. NORDIC STUDIES ON ALCOHOL AND DRUGS 2019; 36:413-429. [PMID: 32934576 PMCID: PMC7434141 DOI: 10.1177/1455072519836372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 02/14/2019] [Indexed: 11/25/2022] Open
Abstract
AIMS While it is documented that substance use harms others than the user, less is known about which substances people experience most harm from, and who the victims and perpetrators are. The aims were: (i) to estimate the prevalence of and overlap in self-reported harm from others' alcohol, cigarette, and illegal drug use; (ii) to examine potential differences in the prevalence of harm from close relations' and strangers' use; and (iii) to examine how the prevalence of harm varies according to demographics and the respondents' substance use. METHODS Population surveys conducted among 16-64-year-old Norwegians in 2012 and 2016 (N = 3407) assessed self-reported harm from others' alcohol, cigarette and illegal drug use with identical measures, demographic variables and the respondents' substance use. RESULTS Experience of harm from others' alcohol use was most common, followed by others' smoking. For all three substances, a higher proportion experienced harm from close relations' use. Nearly half had experienced harm from others' use of at least one substance. Women and younger participants were more likely to report harm from others' alcohol and cigarette use. While alcohol and illegal drug users were more often harmed by others' use of these substances, smokers reported being less often harmed by others' smoking. CONCLUSIONS Self-reported harm from others' alcohol, cigarette and illegal drug use corresponds with the prevalence of use of these substances in Norway. For all three substances, close relations' use accounted for more harm than strangers' use. Own substance use was an important correlate of experienced harm.
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Affiliation(s)
- Inger Synnøve Moan
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Norway
| | - Elin K Bye
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Norway
| | - Elisabet E Storvoll
- Norwegian Institute of Public Health, Division of Mental and Physical Health, Norway
| | - Ingunn Olea Lund
- Norwegian Institute of Public Health, Department of Mental Disorders, Norway
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James E, Robertshaw TL, Pascoe MJ, Chapman FM, Westwell AD, Smith AP. Using the pharmacy retail model to examine perceptions and biases of a UK population sample towards regulation of specific psychoactive drugs. ACTA ACUST UNITED AC 2019. [DOI: 10.1177/2050324519876123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background:Contemporary research indicates that the legal classifications of cannabis (Schedule 2, Class B), 3,4-methylenedioxymethamphetamine (MDMA) (Schedule 1, Class A) and psilocybin (Schedule 1, Class A) in the United Kingdom are not entirely based on considerations of harm and therapeutic utility. The legal classifications of the substances discussed are typically determined by legislators such as Parliament and, therefore, may be a reflection of the views or perceived views of the general public.Objective:The aim of the study was to provide an indication of the underlying psychology regarding the legislated sale of alcohol, tobacco, cannabis, MDMA and psilocybin in pharmacies according to a UK general population sample.Methods:A sample of 105 UK nationals was selected for the survey. Participants were asked questions on perceived relative harm of the five substances. After viewing contemporary information on reported relative harm and therapeutic applications, the participants were asked questions related to using the pharmacy retail model for the sale of the substances discussed. Participants who opposed the substances being sold primarily in pharmacies were asked to explain their rationale according to a predetermined list of options for each of the five drugs. Participants were also asked whether they consider it a human right to be legally permitted to consume the substances.Results:The participants' perceptions of relative harm (tobacco > MDMA > psilocybin > alcohol > cannabis) were not in agreement with the relative harm reported in the literature (alcohol > tobacco > cannabis > MDMA > psilocybin). Principal objections to the currently illicit substances being legally available in pharmacies include it sending the wrong message; it feels wrong; it is too dangerous; disliking the smell of cannabis; disapproval of the people; and not liking the idea of people using psychoactive drugs for entertainment or to have mystical/religious experiences. Overall, the participants determined that being legally permitted to consume the substances discussed is an issue of relevance to human rights. A majority of the male participants concluded that being legally permitted to consume alcohol, tobacco, cannabis and Psilocybe mushrooms is a human right in contrast to the majority of female participants who solely considered alcohol consumption to be a human right.Conclusions:The data suggest that the legal classifications may not simply be based on considerations of harm. Misperceptions of the dangers, biases and non-health-related aversions likely contribute to the continuation of policies that do not reflect the state of scientific research.
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Affiliation(s)
- Edward James
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, UK
| | | | - Michael J Pascoe
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, UK
| | - Fiona M Chapman
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, UK
| | - Andrew D Westwell
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, UK
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Bonomo Y, Norman A, Biondo S, Bruno R, Daglish M, Dawe S, Egerton-Warburton D, Karro J, Kim C, Lenton S, Lubman DI, Pastor A, Rundle J, Ryan J, Gordon P, Sharry P, Nutt D, Castle D. The Australian drug harms ranking study. J Psychopharmacol 2019; 33:759-768. [PMID: 31081439 DOI: 10.1177/0269881119841569] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND/AIM The aim of the current study was to review drug harms as they occur in Australia using the Multi-criteria Decision Analysis (MCDA) methodology adopted in earlier studies in other jurisdictions. METHOD A facilitated workshop with 25 experts from across Australia, was held to score 22 drugs on 16 criteria: 9 related to harms that a drug produces in the individual and 7 to harms to others. Participants were guided by facilitators through the methodology and principles of MCDA. In open discussion, each drug was scored on each criterion. The criteria were then weighted using a process of swing weighting. Scoring was captured in MCDA software tool. RESULTS MCDA modelling showed the most harmful substances to users were fentanyls (part score 50), heroin (part score 45) and crystal methamphetamine (part score 42). The most harmful substances to others were alcohol (part score 41), crystal methamphetamine (part score 24) and cigarettes/tobacco (part score 14). Overall, alcohol was the most harmful drug when harm to users and harm to others was combined. A supplementary analysis took into consideration the prevalence of each substance in Australia. Alcohol was again ranked the most harmful substance overall, followed by cigarettes, crystal methamphetamine, cannabis, heroin and pharmaceutical opioids. CONCLUSIONS The results of this study make an important contribution to the emerging international picture of drug harms. They highlight the persistent and pervasive harms caused by alcohol. Policy implications and recommendations are discussed. Policies to reduce harm from alcohol and methamphetamine should be a priority.
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Affiliation(s)
- Yvonne Bonomo
- 1 Department of Addiction Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia
| | - Amanda Norman
- 1 Department of Addiction Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia
| | - Sam Biondo
- 2 Victorian Alcohol and Drug Association (VAADA), Melbourne, VIC, Australia
| | - Raimondo Bruno
- 3 School of Medicine (Psychology), University of Tasmania, Hobart, TAS, Australia
| | - Mark Daglish
- 4 Alcohol and Drug Service, Metro North Hospital and Health Service, The University of Queensland, St Lucia, Brisbane, QLD, Australia
| | - Sharon Dawe
- 5 School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Diana Egerton-Warburton
- 6 Department of Medicine, School of Clinical Sciences at Monash Health, Melbourne, VIC, Australia
| | - Jonathan Karro
- 7 Emergency Department, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Charles Kim
- 8 Department of Anaesthesia and Pain Management, The Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Simon Lenton
- 9 National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Dan I Lubman
- 10 Turning Point, Eastern Health and Monash University, Melbourne, VIC, Australia
| | - Adam Pastor
- 1 Department of Addiction Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia
| | - Jill Rundle
- 11 Western Australian Network of Alcohol and Drug Agencies, Perth, WA, Australia
| | - John Ryan
- 12 Penington Institute, Melbourne, VIC, Australia
| | | | - Patrick Sharry
- 14 Australian Graduate School of Management, University of New South Wales, Sydney, NSW, Australia
| | | | - David Castle
- 16 Mental Health, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia
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Steroid Madness- has the dark side of anabolic-androgenic steroids (AAS) been over-stated? ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.peh.2019.03.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Nolan ML, Shamasunder S, Colon-Berezin C, Kunins HV, Paone D. Increased Presence of Fentanyl in Cocaine-Involved Fatal Overdoses: Implications for Prevention. J Urban Health 2019; 96:49-54. [PMID: 30635841 PMCID: PMC6391300 DOI: 10.1007/s11524-018-00343-z] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
After remaining stable from 2010 to 2014, the rate of cocaine-involved overdose death increased sharply from 2015 to 2016. This study aims to determine the contribution of opioids, and fentanyl in particular, to the increase in cocaine-involved overdose death from 2015 to 2016. Using New York City death certificate data linked to medical examiner toxicology data, we identified all overdose deaths where post-mortem toxicology results were positive for cocaine from 2010 to 2016. We analyzed cocaine-involved overdose deaths by co-occurring substances. Age-adjusted rates per 100,000 residents were calculated for 6-month intervals from 2010 to 2016. Data suggest that increased deaths involving opioids, specifically fentanyl, accounted for most of the increase in cocaine-involved deaths from 2015 to 2016.
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Affiliation(s)
- Michelle L Nolan
- Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, 42-09 28th St, 19th Floor, Queens, New York, NY, 11101, USA.
| | - Sindhu Shamasunder
- Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, 42-09 28th St, 19th Floor, Queens, New York, NY, 11101, USA
| | - Cody Colon-Berezin
- Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, 42-09 28th St, 19th Floor, Queens, New York, NY, 11101, USA
| | - Hillary V Kunins
- Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, 42-09 28th St, 19th Floor, Queens, New York, NY, 11101, USA
| | - Denise Paone
- Bureau of Alcohol and Drug Use Prevention, Care, and Treatment, New York City Department of Health and Mental Hygiene, 42-09 28th St, 19th Floor, Queens, New York, NY, 11101, USA
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Colasante E, Fabi F, Rossi C, Tomba GS, Molinaro S. Updated Indicators to Evaluate Harmful Drug Use, in Particular, Poly-Drug Use. Curr Drug Res Rev 2019; 11:51-57. [PMID: 30246647 DOI: 10.2174/1874473711666180924155231] [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: 06/22/2018] [Revised: 08/22/2018] [Accepted: 09/16/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Drug use indicators that are capable of measuring the individual levels of harm following drug use, and in particular, poly-drug use, have previously been proposed, based on individual drug and frequency of use data and expert rankings of harms related to various substances. These indicators allow the estimation of risk profiles for selected groups of individuals and comparisons, both over time and between populations. Recent advances regarding the ranking of drug use harms allow a refinement of these indicators, separating the effects on self and others. OBJECTIVE To define updated indicators and compare their performance to previous ones on datasets related to the Italian ESPAD longitudinal data. METHODS Two new scores, based respectively on the Harm to self and Harm to others substance scores, are defined. These scores follow the same logic as the previous poly-drug score (PDS), but now using the new Harm to self and Harm to others scores as weights, both in the individual calculations and in the calculation of the two normalizing factors. RESULTS The new harm-to-self drug use indicator is shown to correlate strongly with the previous poly-drug use indicator; and the Harm to others indicator, is introduced and commented upon. Using further ESPAD survey information related to personal behaviour, it is shown that high values of poly-drug use indicators are linked to specific behaviours related to interest in school, relationship with parents and use of leisure time. These results are consistent with previous analyses based on surveys among high school students in Italy.
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Affiliation(s)
| | | | - Carla Rossi
- Centro Studi Statistici e Sociali (Ce3S), Rome, Italy
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Matua L, Muharremi G, Petrela E, Koçibelli M, Vyshka G, Xhemali B. The Use of Psychoactive Substances and Illegal Drugs in the Albanian Society. Curr Drug Res Rev 2019; 11:73-79. [PMID: 30070180 DOI: 10.2174/1874473711666180719141731] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/30/2018] [Accepted: 07/02/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND To create a representative picture of the prevalence and the total number of drug users in Albania from 2012 to 2016, and compare those numbers to previous years with other available data. METHODS The required data for the conductance of this study was collected from three different fronts, namely The Institute of Forensic Medicine (IFM), Clinical Toxicology and Addictions Service, University Hospital "Mother Theresa" Tirana (CTS) and Methadone Maintenance Treatment Centers. The study targets all individuals who have consumed at least once abusive drugs and psychotropic substances during the period 2012-2016 in the Republic of Albania. A total of 7050 reported cases over the given period were reviewed. RESULTS Overall, Cannabis Sativa was the highest consumed drug, present in 62.58% of the cases. Other substances with a noticeable prevalence of use were heroin (15.02%) and cocaine (5.1%). It was found out that there were 36 drug-related deaths from 2012 to 2016. During this period of time, only 9 individuals resulted positive for Sexually Transmitted Infections (STI), of which, one positive for Hepatitis C and the remaining 8 positives for HIV. About 25% of drug users in Albania belong to the young subgroup of the population (13-32 years old). CONCLUSION Overall, taking into consideration all three databases, the number of drug users has significantly increased. There are more officially reported drug users today compared to 2012, however, different trends are observed during different periods. Youngsters are more eager and tempted to use and experiment more with safer and less harmful drugs like cannabis, meanwhile, as age increases, there is a tendency to shift towards more potent and dangerous drugs. Prevention and reducing the prevalence of use of psychoactive drugs is one of the main goals of public health.
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Affiliation(s)
- Linda Matua
- Faculty of Medicine, University of Medicine, Tirana, Albania
- Institute of Forensic Medicine, Tirana, Albania
| | - Guido Muharremi
- Faculty of Medicine, University of Medicine, Tirana, Albania
| | - Elizana Petrela
- Faculty of Medicine, University of Medicine, Tirana, Albania
- Service of Statistics, University Hospital Center "Mother Theresa", Tirana, Albania
| | | | - Gentian Vyshka
- Faculty of Medicine, University of Medicine, Tirana, Albania
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Cheeta S, Halil A, Kenny M, Sheehan E, Zamyadi R, Williams AL, Webb L. Does perception of drug-related harm change with age? A cross-sectional online survey of young and older people. BMJ Open 2018; 8:e021109. [PMID: 30401725 PMCID: PMC6231571 DOI: 10.1136/bmjopen-2017-021109] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To investigate how young and older people perceive the harms associated with legal and illegal drugs. DESIGN Cross-sectional study: adults aged 18-24 years versus 45+ completed an online survey ranking the perceived harms associated with 11 drugs on 16 drug-related harm criteria. SETTING Online survey. PARTICIPANTS 184 participants aged 18-24 years (113 female: mean age 21: SD 1.3) and 91 participants aged 45+ (51 female: mean age 60: SD 8.5). MAIN OUTCOME MEASURES 'Perception of drug-related harms': This was measured using a rating scale ranging from 1 (no risk of harm) to 4 (high risk of harm). Participants were also asked about sources which informed their perception on drug-related harms as well as their own personal self-reported drug experiences. RESULTS Of the illegal drugs, heroin, methamphetamine and cocaine were rated as the most harmful and cannabis was rated as the least harmful. Alcohol and tobacco were also rated as less harmful. The results showed that perceptions of drug-related harms were inconsistent with current knowledge from research on drugs. Furthermore, perceptions on drug harms were more conservative in the 45+ group for a number of illegal drugs and tobacco. However, the 45+ age group did not perceive alcohol as any more harmful than the younger group. CONCLUSIONS This survey demonstrates that the greatest misperception was in relation to alcohol-related harms which did not change with age. In order to minimise harms, this misperception needs to be addressed through education and policies that legislate drug use.
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Affiliation(s)
- Survjit Cheeta
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Adem Halil
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Matthew Kenny
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Erin Sheehan
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Roxanne Zamyadi
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Adrian Lloyd Williams
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Lucy Webb
- Substance Use and Addictive Behaviour (SUAB) Research Group, Manchester Metropolitan University, Manchester, UK
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Johnson MW, Griffiths RR, Hendricks PS, Henningfield JE. The abuse potential of medical psilocybin according to the 8 factors of the Controlled Substances Act. Neuropharmacology 2018; 142:143-166. [PMID: 29753748 PMCID: PMC6791528 DOI: 10.1016/j.neuropharm.2018.05.012] [Citation(s) in RCA: 157] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/22/2018] [Accepted: 05/09/2018] [Indexed: 01/09/2023]
Abstract
This review assesses the abuse potential of medically-administered psilocybin, following the structure of the 8 factors of the US Controlled Substances Act (CSA). Research suggests the potential safety and efficacy of psilocybin in treating cancer-related psychiatric distress and substance use disorders, setting the occasion for this review. A more extensive assessment of abuse potential according to an 8-factor analysis would eventually be required to guide appropriate schedule placement. Psilocybin, like other 5-HT2A agonist classic psychedelics, has limited reinforcing effects, supporting marginal, transient non-human self-administration. Nonetheless, mushrooms with variable psilocybin content are used illicitly, with a few lifetime use occasions being normative among users. Potential harms include dangerous behavior in unprepared, unsupervised users, and exacerbation of mental illness in those with or predisposed to psychotic disorders. However, scope of use and associated harms are low compared to prototypical abused drugs, and the medical model addresses these concerns with dose control, patient screening, preparation and follow-up, and session supervision in a medical facility. CONCLUSIONS: (1) psilocybin has an abuse potential appropriate for CSA scheduling if approved as medicine; (2) psilocybin can provide therapeutic benefits that may support the development of an approvable New Drug Application (NDA) but further studies are required which this review describes; (3) adverse effects of medical psilocybin are manageable when administered according to risk management approaches; and (4) although further study is required, this review suggests that placement in Schedule IV may be appropriate if a psilocybin-containing medicine is approved. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.
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Affiliation(s)
- Matthew W Johnson
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Roland R Griffiths
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Neuroscience, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Peter S Hendricks
- Department of Health Behavior, School of Public Health, University of Alabama, Birmingham, AL, USA.
| | - Jack E Henningfield
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; Pinney Associates, Bethesda, MD 20814, USA.
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Dubljević V. Toward an Improved Multi-Criteria Drug Harm Assessment Process and Evidence-Based Drug Policies. Front Pharmacol 2018; 9:898. [PMID: 30177880 PMCID: PMC6109763 DOI: 10.3389/fphar.2018.00898] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/23/2018] [Indexed: 11/13/2022] Open
Abstract
Drug scheduling within the international system of drug control and national legislation has been recently criticized as having insufficient footing in scientific evidence. The legal harms related to non-medical uses of certain drugs (e.g., cannabis) have arguably exceeded their physiological and social harmfulness compared to legally available substances (e.g., tobacco), which prompted some states to explore alternative regulation policies, similar to the drug regime in the Netherlands. Other legally prescribed drugs (e.g., stimulants) created a surge of interest for "better than well" uses, while yet others (e.g., opioids) caused an epidemic of dramatic proportions in North America. The evidence-based multi-criteria drug harm scale (MCDHS) has been proposed as a way of grounding policy in the actual degree of harmfulness of drugs. Indeed, the scale has had great ramifications in several areas of policy, and it has been used extensively in distinct lines of interdisciplinary research. However, some aspects of MCDHS remain disputed. For example, the way the data has been generated has been criticized as suffering from "expert bias." This article reviews strengths and weaknesses of evidence provided with the use of MCDHS. Furthermore, the author argues that the shortcomings of MCDHS can be resolved by offering methodological improvements. These include (1) dissociating the harms of use from harms of abuse, (2) adding the perspectives of people who use drugs, pharmacists, and general medical practitioners along with the expert assessments, and (3) focusing on subsets of drugs to allow for comparison without mixing different social contexts of drug use. The paper concludes with outlines of substance subset-specific extensions of the MCDHS and related policy proposals in the four areas identified as generating the most controversy: non-medical use of opioids, "study aid" uses of stimulants, shifting trends in nicotine containing products, and regulation of medical and recreational uses of cannabis.
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Affiliation(s)
- Veljko Dubljević
- Department of Philosophy and Religious Studies, North Carolina State University, Raleigh, NC, United States.,Science, Technology and Society Program, Interdisciplinary Studies Unit, North Carolina State University, Raleigh, NC, United States
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Buvik K, Moan IS, Halkjelsvik T. Alcohol-related absence and presenteeism: Beyond productivity loss. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 58:71-77. [PMID: 29864644 DOI: 10.1016/j.drugpo.2018.05.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcohol use by employees is associated with negative consequences for the workplace in terms of absence and poor work performance. The aims of this study were to map the prevalence of alcohol-related absence and inefficiency using survey data from a broad sample of employees, and to explore how alcohol-related absence and presenteeism are experienced and handled using data from qualitative interviews. METHODS The prevalence data stems from a web survey completed by 1940 Norwegian employees aged 20-74 years. The qualitative data consists of analyses of 24 interviews with managers, co-workers of heavy drinking employees, and heavy drinking employees, from various lines of businesses. RESULTS 1-2% reported alcohol-related full day absence in the last 12 months, and 2% reported partial day absence; 11% reported inefficiency due to drinking the previous day. Analyses of interview data revealed that alcohol-related absence and presenteeism may cause a range of economic and practical problems. Managers reported spending a lot of resources and effort on single cases. In addition, the results showed how the presence of a heavy drinking employee may have a negative impact on the broader psychosocial environment, and cause concern for workplace safety. Due to consideration of the drinker's well-being and fear of negative reactions, problem cases can last for years. CONCLUSIONS Despite the relatively low prevalence of alcohol-related absence and inefficiency, the study suggest that the alcohol-related problems of a few, or only one, employee may still have substantial and far-reaching negative consequences for the workplace.
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Affiliation(s)
- Kristin Buvik
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Postbox 4404, Nydalen, 0403 Oslo, Norway.
| | - Inger Synnøve Moan
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Postbox 4404, Nydalen, 0403 Oslo, Norway.
| | - Torleif Halkjelsvik
- Norwegian Institute of Public Health, Department of Alcohol, Tobacco and Drugs, Postbox 4404, Nydalen, 0403 Oslo, Norway.
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