Do Poisonous Plants in Pastures Communicate Their Toxicity? Meta-Study and Evaluation of Poisoning Cases in Central Europe

One of the possible roles of secondary plant metabolites, including toxins, is facilitating plant-animal communication. Lethal cases of pasture poisoning show that the message is not always successfully conveyed. As the focus of poisoning lies in the clinical aspects, the external circumstances of pasture poisoning are widely unknown. To document poisoning conditions in cattle, sheep, goats, and horses on pastures and to compile a checklist of plants involved in either poisoning or co-existence (zero poisoning), published case reports were evaluated as primary sources. The number of affected animal individuals was estimated within abundance classes from 0 to more than 100. The checklist of poisonous plants comprised 52 taxa. Of these, 13 taxa were deemed safe (no reference was found indicating poisoning), 11 taxa were associated with evidence-based zero poisoning (positive list), and 28 taxa were associated with poisoning (negative list). Nine plant taxa caused poisoning in more than 100 animal individuals. Zero poisoning accounted for 40% and poisoning accounted for 60% of a total of 85 cases. Poisoning was most often associated with a limited choice of feed (24.7%), followed by overgrazing (12.9%), seasonally scarce feed (10.6%), and co-ingestion of grass (4.7%). Hunger interferes with plant-animal co-existence, while zero poisoning improves it. In conclusion, poisonous plants in pastures may communicate their toxicity if the animals have enough alternative feed plants. An individual animal might utterly perceive the communication of toxicity by the plant species but be forced to ignore the message owing to a limited choice of feed options.

Prescription Drug Misuse with Alcohol Coingestion among US Adolescents: Youth Experiences, Health-related Factors, and Other Substance Use Behaviors

BACKGROUND

While alcohol use and prescription drug misuse (PDM) are common among adolescents, there is relatively little research on coingestion. This is disquieting as polysubstance use has become a major contributing factor in drug overdose deaths among young people in the United States.

METHODS

The current research uses multiple years of data from the National Survey on Drug Use and Health (2015-2019) to assess characteristics associated with coingestion among adolescents aged 12 to 17 years ( N = 57,352). Multinomial logistic regression analysis is used to identify characteristics associated with past 30-day PDM with and without alcohol coingestion. The primary objective is to determine how youth experiences with parents, involvement in conventional activities, religiosity, social support, and school status are associated with coingestion.

RESULTS

Among adolescents who report past 30-day PDM, 18.6% coingest with alcohol and 77.5% of adolescents who coingest report at least one substance use disorder. Several youth experiences were significantly associated with opioid coingestion including increased conflict with parents (relative risk ratio [RRR], 1.27; 95% confidence interval [CI], 1.07-1.48), lower levels of religiosity (RRR, 0.72; 95% CI, 0.52-0.98), less social support (RRR, 0.36; 95% CI, 0.18-0.69), and not being in school (RRR, 3.86; 95% CI, 1.33-11.17). In addition, emergency department visits, depression, and other substance use behaviors were also significantly associated with coingestion.

CONCLUSIONS

Findings demonstrate a strong connection between coingestion and substance use disorder among US adolescents. The findings from the current study can inform prevention and intervention efforts by identifying youth experiences and health-related factors that are associated with coingestion.

young adults: Prevalence and correlates

Simultaneous co-ingestion of prescription medication (e.g., opioid, tranquilizer/sedative, stimulant) and alcohol is associated with overdose and elevated substance use, but no studies have examined prescription drug misuse (PDM) and alcohol co-ingestion in U.S. young adults (18-25 years), despite the high rates of PDM in this age group. We used the 2015-19 National Survey on Drug Use and Health (young adult N = 69,916) to examine prevalence of past-month PDM-alcohol co-ingestion, PDM characteristics, and sociodemographic, physical health, mental health, and substance use correlates. Logistic regression examined correlates, comparing those without past-year PDM, those with past-year but not past-month PDM, those with past-month PDM without alcohol co-ingestion, and those with past-month PDM and alcohol co-ingestion. An estimated 585,000 young adults engaged in any past-month PDM-alcohol co-ingestion, or between 32.7% (opioids) and 44.6% (tranquilizer/sedatives) of those who were engaged in past-month PDM. Co-ingestion varied by educational status and was more common in males and white or multiracial young adults. All PDM-involved groups had elevated odds of suicidal ideation and other psychopathology, but substance use and substance use disorder (SUD) odds were significantly higher in young adults with co-ingestion, versus all other groups. To illustrate, 41.1% with opioid-alcohol co-ingestion had multiple past-year SUDs, versus 2.0% in those without past-year PDM. Young adults with co-ingestion are particularly likely to have problematic alcohol use and higher rates of SUD. Counseling about the risks of PDM-alcohol co-ingestion and screening for co-ingestion among those at risk are warranted to limit poor outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Patterns and motivations of polysubstance use: a rapid review of the qualitative evidence

INTRODUCTION

Polysubstance use-the use of substances at the same time or close in time-is a common practice among people who use drugs. The recent rise in mortality and overdose associated with polysubstance use makes understanding current motivations underlying this pattern critical. The objective of this review was to synthesize current knowledge of the reasons for combining substances in a single defined episode of drug use.

METHODS

We conducted a rapid review of the literature to identify empirical studies describing patterns and/or motivations for polysubstance use. Included studies were published between 2010 and 2021 and identified using MEDLINE, Embase, PsycINFO and Google Scholar.

RESULTS

We included 13 qualitative or mixed-method studies in our analysis. Substances were combined sequentially to alleviate withdrawal symptoms or prolong a state of euphoria ("high"). Simultaneous use was motivated by an intention to counteract or balance the effect(s) of a substance with those of another, enhance a high or reduce overall use, and to mimic the effect of another unavailable or more expensive substance. Self-medication for a pre-existing condition was also the intention behind sequential or simultaneous use.

CONCLUSION

Polysubstance use is often motivated by a desire to improve the experience based on expected effects of combinations. A better understanding of the reasons underlying substance combination are needed to mitigate the impact of the current overdose crisis.

Influence of Dairy Products on Bioavailability of Zinc from Other Food Products: A Review of Complementarity at a Meal Level

In this paper, we reviewed the role of dairy products in dietary zinc absorption. Dairy products can have a reasonable contribution for dietary zinc intake in Western diets, where dairy consumption is high. However, the co-ingestion of dairy products can also improve zinc absorption from other food products. Such improvements have been observed when dairy products (e.g., milk or yoghurt) were ingested together with food such as rice, tortillas or bread products, all of which are considered to be high-phytate foods with low inherent zinc absorption. For foods low in phytate, the co-ingestion of dairy products did not improve zinc absorption. Improved zinc absorption of zinc from high-phytate foods following co-ingestion with dairy products may be related to the beneficial effects of the citrate and phosphopeptides present in dairy products. Considering that the main dietary zinc sources in areas in the world where zinc deficiency is most prevalent are typically high in phytate, the inclusion of dairy products in meals may be a viable dietary strategy to improve zinc absorption.

A comparative analysis of kratom exposure cases in Thailand and the United States from 2010-2017

Background: Interest in the Southeast Asian natural remedy kratom has increased in Western countries recently, along with increasing concern over its potential toxic effects.Objective: To describe and compare demographics, common co-exposure substances, clinical effects, treatments, and medical outcomes of kratom "abuse" exposures in the United States (US) and Thailand.Methods: This is a retrospective analysis of kratom "abuse" exposures, defined as use when attempting to gain a psychotropic effect, reported to the National Poison Data System (NPDS) in the US and the Ramathibodi Poison Center (RPC) in Thailand from 2010 to 2017. Multivariate analysis identified risk factors for severe medical outcomes, defined as both ICU admissions and death.Results: Nine-hundred-twenty-eight cases were included (760 from NPDS and 168 from RPC). A greater proportion of cases involved co-exposures in Thailand (64.8% versus 37.4%; odds ratio [OR] = 3.10, 95% confidence interval [CI] = 2.15-4.47, p < .01). Both countries had a similar prevalence of opioid and benzodiazepine co-ingestions, but the US had more co-ingestions with other sedatives (4.6% versus 0%, OR = 0, 95% CI = 0-0.47, p < .01). Common clinical effects included tachycardia (30.4%), agitation/irritability (26.2%), and drowsiness/lethargy (21.1%). Six deaths occurred, including one single-substance exposure in the US, three multiple-substance exposures in the US, and two multiple-substance exposures in Thailand. Severe medical outcomes were reported more frequently in the US (OR = 18.82, 95% CI = 5.85-60.56, p < .01).Conclusions: Despite lower frequencies of co-ingestants overall, US kratom abuse exposures yielded greater clinical severity. This disparity may be attributable to differences in the products labeled "kratom," greater sedative co-exposures in the US, and/or differences in population genetics or use patterns.

Effects on Anthocyanin Stability, Bioaccessibility and Uptake

Although the fate of anthocyanins along digestion has been a matter of research over the last decade, their bioaccessibility so far has been mainly assessed for single administered fruits or vegetables, which is far from the real scenario where they are co-ingested in a meal. Accordingly, the aim of this study was to evaluate the effect of simultaneous intake of fruit and vegetable on in vitro stability, bioaccessibility and uptake of anthocyanins. Black carrot and strawberry were used as food sources of anthocyanins. Anthocyanin identification and quantification were performed using HPLC-Qtof/HPLC-UV. Single matrices and mixtures thereof, were submitted to a standardized in vitro digestion procedure. Anthocyanin uptake was evaluated through an intestinal Caco-2 cell model. Our results showed an increased intestinal stability for specific anthocyanins as a consequence of co-digestion. The presence of the strawberry food matrix positively affected the bioaccessibility of the carrot associated cyanidin-based anthocyanins, whereas no reciprocal effect was observed for pelargonidin-based derivatives in the presence of the black carrot food matrix. Anthocyanin transport was maintained after co-administration. Overall, co-ingestion of black carrot and strawberry did not negatively affect the stability, bioaccessibility or uptake of cyanidin-based anthocyanins, although the effect on pelargonidin-based anthocyanins depended on the type of pelargonidin derivative.

Muscle Carnosine Concentration with the Co-Ingestion of Carbohydrate with β-alanine in Male Rats

Muscle carnosine is an intracellular buffer. The intake of β-alanine, combined with carbohydrate and protein, enhanced carnosine loading in human muscle. The aim of the present study was to examine if muscle carnosine loading was enhanced by β-alanine intake and co-ingestion of glucose in male rats. Thirty-six male rats were divided into three groups and supplemented for four weeks: β-alanine (βA group, 1.8% β-alanine in drinking water), β-alanine and glucose (βAGL group, 1.8% β-alanine and 5% glucose in drinking water), and control (C group, drinking water). During the supplementation period, rats were exercised (20 m·min^-1, 10 min·day^-1, 4 days·week^-1 for 4 weeks). Muscle carnosine concentration was quantified in soleus (n = 12) and rectus femoris (n = 6) muscles using high-performance liquid chromatography. In soleus muscle, carnosine concentration was 2.24 ± 1.10, 6.12 ± 1.08, and 6.93 ± 2.56 mmol/kg dw for control, βA, and βAGL, respectively. In rectus femoris, carnosine concentration was 2.26 ± 1.31, 7.90 ± 1.66, and 8.59 ± 2.33 mmol/kg dw for control, βA, and βAGL respectively. In each muscle, βA and βAGL resulted in similar carnosine increases compared to the control. In conclusion, β-alanine intake for four weeks, either alone or with glucose co-ingestion, equally increased muscle carnosine content. It appears that the potential insulin response to fluid glucose intake does not affect muscle carnosine loading in male rats.

Simultaneous co-ingestion of prescription stimulants, alcohol and other drugs: a multi-cohort national study of US adolescents

OBJECTIVE

To determine the past-year prevalence rates and correlates of simultaneous co-ingestion of prescription stimulants and other substances among US high school seniors.

METHODS

Nationally representative probability samples of US high school seniors were surveyed as a part of the Monitoring the Future study. The sample consisted of five cohorts including a total of 12,431 high school seniors (modal age: 18 years) and represented a population that was 53% female.

RESULTS

Among past-year nonmedical users of prescription stimulants (n = 835), the estimated prevalence of any past-year simultaneous co-ingestion of prescription stimulants and other substances was 64.4%. The substances most commonly co-ingested with prescription stimulants included marijuana (51.1%) and alcohol (48.4%). Nonmedical users who co-ingested prescription stimulants with other substances were more likely to report non-oral routes of administration, recreational motives and greater subjective high when using prescription stimulants than nonmedical users who did not co-ingest prescription stimulants with other substances.

CONCLUSIONS

The majority of past-year nonmedical users of prescription stimulants reported simultaneous co-ingestion of prescription stimulants and other substances. The findings indicate that co-ingestion of prescription stimulants and other substances is a pervasive behavior among US adolescents who engage in nonmedical use of prescription stimulants and should be carefully considered in future clinical practice and research.

Co-ingestion of prescription opioids and other drugs among high school seniors: results from a national study

BACKGROUND

The objective of this study was to determine the past-year prevalence rates and behavioral correlates of co-ingestion of prescription opioids and other drugs among high school seniors in the United States.

METHODS

Nationally representative probability samples of high school seniors in the United States were surveyed as a part of the Monitoring the Future (MTF) study. Data were collected in schools via self-administered paper-and-pencil questionnaires during the spring of each cohort's senior year. The sample consisted of five cohorts (senior years of 2002-2006) made up of 12,441 high school seniors (modal age 18), of which 53% were women.

RESULTS

The estimated prevalence of any past-year co-ingestion of prescription opioids and other drugs for these cohorts was 4.4%, and 69.8% among nonmedical users of prescription opioids. The substances most commonly co-ingested with prescription opioids included marijuana (58.5%), alcohol (52.1%), cocaine (10.6%), tranquilizers (10.3%), and amphetamines (9.5%). Nonmedical users who co-ingested prescription opioids with other drugs were more likely to report intranasal administration, recreational motives, oxycodone use, and greater subjective high when using prescription opioids than nonmedical users who did not co-ingest prescription opioids and other drugs.

CONCLUSIONS

Nearly 7 out of every 10 nonmedical users of prescription opioids reported co-ingestion of prescription opioids and other drugs in the past year. The findings indicate that the co-ingestion of prescription opioids and other drugs by high school seniors in the United States serves as a marker for substance abuse and represents a significant public health concern.

Motivational subtypes of nonmedical use of prescription medications: results from a national study

PURPOSE

Very little research has examined the heterogeneity associated with the nonmedical use of prescription medications (NUPM) in nationally representative samples of adolescents. The main objectives of this study were to (1) identify motivational subtypes of past-year NUPM among high school seniors in the United States using a person-centered approach, and (2) examine the associations among motivational subtypes and characteristics of substance abuse (i.e., route of administration, co-ingestion, and subjective high).

METHODS

Self-administered questionnaires as part of the Monitoring the Future study were completed by nationally representative samples of high school seniors (modal age, 18 years). The sample consisted of five cohorts (senior years of 2002-2006) made up of 12,431 high school seniors in total, of which 53% were women.

RESULTS

Approximately 75% of past-year nonmedical users of prescription opioids, stimulants, and tranquilizers endorsed more than one motive. Latent class analysis indicated five motivational subtypes associated with nonmedical use of prescription opioids (experiment, relax, get high, pain relief, and affect regulation), four subtypes of prescription stimulants (weight loss/enhance energy, enhance energy/awake/high, experiment, and affect regulation), and five subtypes of prescription tranquilizers (experiment, get high, relax/sleep, relax, affect regulation). Recreational subtypes were positively associated with characteristics of substance abuse, whereas self-treatment subtypes were associated with medical use before nonmedical use.

CONCLUSIONS

Because multiple motives underlie NUPM, identifying subgroups of individuals who endorse combinations of motives, versus a single motive, will better inform intervention efforts to reduce nonmedical prescription medication use.

Subtypes of nonmedical prescription drug misuse

This study used three characteristics (i.e., motive, route of administration, and co-ingestion with alcohol) of nonmedical prescription drug misuse across four separate classes (i.e., pain, sedative/anxiety, sleeping, and stimulant medications) to examine subtypes and drug related problems. A Web survey was self-administered by a randomly selected sample of 3639 undergraduate students attending a large midwestern 4-year U.S. university. Self-treatment subtypes were characterized by motives consistent with the prescription drug's pharmaceutical main indication, oral only routes of administration, and no co-ingestion with alcohol. Recreational subtypes were characterized by recreational motives, oral or non-oral routes, and co-ingestion. Mixed subtypes consisted of other combinations of motives, routes, and co-ingestion. Among those who reported nonmedical prescription drug misuse, approximately 13% were classified into the recreational subtype, while 39% were in the self-treatment subtype, and 48% were in the mixed subtype. There were significant differences in the subtypes in terms of gender, race and prescription drug class. Approximately 50% of those in subtypes other than self-treatment screened positive for drug abuse. The odds of substance use and abuse were generally lower among self-treatment subtypes than other subtypes. The findings indicate subtypes should be considered when examining nonmedical prescription drug misuse, especially for pain medication.