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Hall W, Darke S, Farrell M. Do we need clinical trials of high dose stimulant agonist treatment for stimulant use disorders? Addiction 2024; 119:786-787. [PMID: 38178619 DOI: 10.1111/add.16416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/20/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Wayne Hall
- The National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Shane Darke
- The National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Farrell
- The National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, New South Wales, Australia
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Sharafi H, Jutras-Aswad D. Response to Hall et al.: Prescription psychostimulants for amphetamine-type stimulant use disorder - acknowledging challenges but not giving up on its potential cost-effectiveness. Addiction 2024; 119:788-789. [PMID: 38197173 DOI: 10.1111/add.16434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 01/11/2024]
Affiliation(s)
- Heidar Sharafi
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
| | - Didier Jutras-Aswad
- Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
- Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, Quebec, Canada
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Persson M, Vikingsson S, Kronstrand R, Green H. Characterization of neurotransmitter inhibition for seven cathinones by a proprietary fluorescent dye method. Drug Test Anal 2024; 16:339-347. [PMID: 37489044 DOI: 10.1002/dta.3547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/26/2023]
Abstract
Many new psychoactive substances (NPS) are stimulants, and information about their potency and abuse potential is often lacking. To start addressing this need, a method measuring the inhibition of the dopamine, serotonin, and norepinephrine transporters (DAT, SERT, and NET) by stimulant drugs was developed. The use of a proprietary fluorescent dye mixture and three cell lines (CHO-K1, HEK 293, and MDCK), each expressing a single transporter, allowed for a semiautomated, one-pot determination of inhibition in a 384-well format. The method was validated using well characterized stimulants, including cocaine, amphetamine, 3,4-methylenedioxymethamphetamine (MDMA), α-PVP, and fluoxetine and performed similarly to other methods. Seven synthetic cathinones all showed highest potency for DAT inhibition, followed by NET and SERT. The rank potency for DAT inhibition IC50 (nM) was MPHP (4.53) > 4Cl-α-PVP (8.05) > 3F-α-PVP (12.7) > α-PiHP (13.4) > N-ethylpentylone (16.9) > N-ethylhexedrone (44.5) > 4-methylpentedrone (261). All but 4-methylpentedrone were more potent than amphetamine (257) and cocaine (111). The DAT/SERT inhibition ratio for the cathinones was in the range from 5.02 for 4-methylpentedrone to >3730 for α-PiHP, compared to 1.64 for cocaine and >4030 for α-PVP. All seven substances had inhibition profiles similar to those of potent stimulants with high abuse potential.
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Affiliation(s)
- Mattias Persson
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
| | - Svante Vikingsson
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
- Center for Forensic Science Advancement and Application, RTI International, Research Triangle Park, North Carolina, USA
| | - Robert Kronstrand
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Henrik Green
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
- Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
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Kobidze G, Sprega G, Daziani G, Balloni A, Lo Faro AF, Farkas T, Peluso P, Basile G, Busardò FP, Chankvetadze B. Separation of undeuterated and partially deuterated enantioisotopologues of some amphetamine derivatives on achiral and polysaccharide-based chiral columns in high-performance liquid chromatography. J Chromatogr A 2024; 1718:464709. [PMID: 38350352 DOI: 10.1016/j.chroma.2024.464709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/15/2024]
Abstract
The different behavior of enantiomers of chiral compounds in non-isotropic environments (among them in living organism) is well known. On the other hand, the importance of a kinetic isotope effect in the biomedical field has become evident during past few decades. Thus, separation of both, enantiomers and isotopologues is now critical. Only very few published studies have attempted the simultaneous separation of enantioisotopologues. In this article we report baseline separation of partially deuterated isotopologues of a few amphetamine derivatives in high-performance liquid chromatography (HPLC) using achiral columns. In addition, the simultaneous separations of enantiomers and isotopologues (i.e. enantioisotopologues) were attempted on polysaccharide-based chiral columns. For several compounds the isotope effect was tunable and could be switched from a "normal" to "inverse" by making changes to the mobile-phase composition. A stronger isotope effect was observed in acetonitrile-containing mobile phases compared to methanol-containing ones with both chiral and achiral columns. In a separation system where both "normal" and "inverse" isotope effects were observed the "normal" isotope effect was favored in polar organic solvents while increasing content of the aqueous component in the reversed-phase (RP) mobile phase favored an "inverse" isotope effect. This observation indicates that polar, hydrogen bonding-type noncovalent interactions are involved in the "normal" isotope effect, while apolar hydrophobic-type interactions are mostly responsible for the "inverse" isotope effect.
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Affiliation(s)
- Giorgi Kobidze
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Giorgia Sprega
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Gloria Daziani
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Aurora Balloni
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Tivadar Farkas
- Phenomenex Inc., 411 Madrid Ave., Torrance, 90501 CA, USA
| | - Paola Peluso
- Istituto di Chimica Biomolecolare ICB-CNR, Sede secondaria di Sassari, Traversa La Crucca 3, Regione Baldinca, Li Punti, 07100 Sassari, Italy
| | - Giuseppe Basile
- Department of Trauma Surgery, IRCCS Galeazzi Orthopedic Institute, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Francesco Paolo Busardò
- Department of Excellence-Biomedical Sciences and Public Health, Università Politecnica delle Marche, 60121 Ancona, Italy.
| | - Bezhan Chankvetadze
- Institute of Physical and Analytical Chemistry, School of Exact and Natural Sciences, Tbilisi State University, 0179 Tbilisi, Georgia.
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Taipale H, Bergström J, Gèmes K, Tanskanen A, Ekselius L, Mittendorfer-Rutz E, Helgesson M. Attention-Deficit/Hyperactivity Disorder Medications and Work Disability and Mental Health Outcomes. JAMA Netw Open 2024; 7:e242859. [PMID: 38506810 PMCID: PMC10955386 DOI: 10.1001/jamanetworkopen.2024.2859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/24/2024] [Indexed: 03/21/2024] Open
Abstract
Importance Individuals with attention-deficit/hyperactivity disorder (ADHD) often have comorbid psychiatric conditions. Relatively little is known about how specific ADHD medications are associated with overall treatment outcomes among these patients. Objective To investigate the association of the use of specific ADHD medications with hospitalization outcomes and work disability among adolescents and adults with ADHD. Design, Setting, and Participants This nationwide register-based cohort study identified individuals (aged 16-65 years) with ADHD from Swedish nationwide registers of inpatient health care, specialized outpatient health care, sickness absence, and disability pension during the years 2006 to 2021. Data analysis was performed from November 2022 to August 2023. Exposure Use of specific ADHD medications. Main Outcomes and Measures The main outcome measure was psychiatric hospitalization, and secondary outcomes were suicide attempt and/or death by suicide, nonpsychiatric hospitalization, and work disability (ie, sickness absence or disability pension). The risk of outcomes between use vs nonuse periods of ADHD medications was compared in a within-individual design, where a person acts as their own control, and was analyzed with stratified Cox models. Results A total of 221 714 persons with ADHD were included in the study cohort (mean [SD] age, 25.0 [11.2] years; 120 968 male individuals [54.6%]). Methylphenidate was the most commonly used ADHD medication (151 837 individuals [68.5%]), followed by lisdexamphetamine (78 106 individuals [35.2%]) during the follow-up (mean [SD], 7.0 [4.7] years). The following medications were associated with a decreased risk of psychiatric hospitalization: amphetamine (adjusted hazard ratio [aHR], 0.74; 95% CI, 0.61-0.90), lisdexamphetamine (aHR, 0.80; 95% CI, 0.78-0.82), ADHD drug polytherapy (aHR, 0.85; 95% CI, 0.82-0.88), dexamphetamine (aHR, 0.88; 95% CI, 0.83-0.94), and methylphenidate (aHR, 0.93; 95% CI, 0.92-0.95). No associations were found for modafinil, atomoxetine, clonidine, and guanfacine. Decreased risk of suicidal behavior was associated with the use of dexamphetamine (aHR, 0.69; 95% CI, 0.53-0.89), lisdexamphetamine (aHR, 0.76; 95% CI, 0.68-0.84), and methylphenidate (aHR, 0.92; 95% CI, 0.86-0.98). None of the medications was associated with increased risk of nonpsychiatric hospitalization; instead, use of amphetamine, lisdexamphetamine, polytherapy, dexamphetamine, methylphenidate, and atomoxetine were associated with decreased risk of nonpsychiatric hospitalization. The results regarding work disability were significant only for the use of atomoxetine (aHR, 0.89; 95% CI, 0.82-0.97), especially among adolescents and young adults aged 16 to 29 years, (aHR, 0.82; 95% CI, 0.73-0.92). Conclusions and Relevance In this nationwide cohort study of adolescents and adults with ADHD, the use of ADHD medication was associated with fewer hospitalizations for both psychiatric and nonpsychiatric morbidity and lower suicidal behavior.
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Affiliation(s)
- Heidi Taipale
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Niuvanniemi Hospital, Kuopio, Finland
- School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Jakob Bergström
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Katalin Gèmes
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Antti Tanskanen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Niuvanniemi Hospital, Kuopio, Finland
| | - Lisa Ekselius
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Magnus Helgesson
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Health Equity and Working Life, Uppsala University, Uppsala, Sweden
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Bellot M, Soria F, López-Arnau R, Gómez-Canela C, Barata C. Daphnia magna an emerging environmental model of neuro and cardiotoxicity of illicit drugs. Environ Pollut 2024; 344:123355. [PMID: 38228265 DOI: 10.1016/j.envpol.2024.123355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/10/2023] [Accepted: 01/13/2024] [Indexed: 01/18/2024]
Abstract
Cocaine, methamphetamine, ectasy (3,4-methylenedioxy amphetamine (MDMA)) and ketamine are among the most consumed drugs worldwide causing cognitive, oxidative stress and cardiovascular problems in humans. Residue levels of these drugs and their transformation products may still enter the aquatic environment, where concentrations up to hundreds of ng/L have been measured. In the present work we tested the hypothesis that psychotropic effects and the mode of action of these drugs in D. magna cognitive, oxidative stress and cardiovascular responses are equivalent to those reported in humans and other vertebrate models. Accordingly we expose D. magna juveniles to pharmacological and environmental relevant concentrations. The study was complemented with the measurement of the main neurotransmitters involved in the known mechanisms of action of these drugs in mammals and physiological relevant amino acids. Behavioural cognitive patters clearly differentiate the 3 psychostimulant drugs (methamphetamine, cocaine, MDMA) from the dissociative one ketamine. Psychostimulant drugs at pharmacological doses (10-200 μM), increased basal locomotion activities and responses to light, and decreased habituation to it. Ketamine only increased habituation to light. The four drugs enhanced the production of reactive oxygen species in a concentration related manner, and at moderate concentrations (10-60 μM) increased heartbeats, diminishing them at high doses (200 μM). In chronic exposures to environmental low concentrations (10-1000 ng/L) the four drugs did not affect any of the behavioural responses measured but methamphetamine and cocaine inhibited reproduction at 10 ng/L. Observed effects on neurotransmitters and related metabolites were in concern with reported responses in mammalian and other vertebrate models: cocaine and MDMA enhanced dopamine and serotonin levels, respectively, methamphetamine and MDMA decreased dopamine and octopamine, and all but MDMA decreased 3 MT levels. Drug effects on the concentration of up to 10 amino acids evidence disruptive effects on neurotransmitter synthesis, the urea cycle, lipid metabolism and cardiac function.
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Affiliation(s)
- Marina Bellot
- Department of Analytical and Applied Chemistry, School of Engineering, Institut Químic de Sarrià-Universitat Ramon Llull, Barcelona, Spain
| | - Fernando Soria
- Department of Analytical and Applied Chemistry, School of Engineering, Institut Químic de Sarrià-Universitat Ramon Llull, Barcelona, Spain
| | - Raul López-Arnau
- Department of Pharmacology, Toxicology and Therapeutic Chemistry, Faculty of Pharmacy and Food Science, Institut de Biomedicina IBUB, University of Barcelona, Barcelona, Spain
| | - Cristian Gómez-Canela
- Department of Analytical and Applied Chemistry, School of Engineering, Institut Químic de Sarrià-Universitat Ramon Llull, Barcelona, Spain
| | - Carlos Barata
- Institute for Environmental Assessment and Water Research (IDAEA-CSIC), Jordi Girona 18, 08034 Barcelona, Spain.
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Leung J, Yimer TM, Chiu V, Hall WD, Connor JP, Chan GCK. Participation in Australian drug treatment programs for individuals engaging in high-risk substance use: Data from a nationally representative sample. Drug Alcohol Rev 2024; 43:688-693. [PMID: 38087847 DOI: 10.1111/dar.13792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 11/10/2023] [Accepted: 11/12/2023] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Substance use, including drugs, alcohol and smoking have a significant health, social and economic impact. We aim to assess the rate and factors associated with treatment access among individuals with high-risk substance use. METHOD This study is a cross-sectional analysis of the 2019 Australian National Drug Strategy Household Survey (N = 22,015). Participants were persons with high-risk substance use based on the Alcohol, Smoking and Substance Involvement Screening Test-Lite (ASSIST-Lite) and current smokers. We measured self-reports of past 12-month engagement in a tobacco, alcohol or other drugs treatment program. RESULTS Overall, 0.4% had high-risk drug use (0.3% cannabis, 0.1% meth/amphetamine or 0.1% opioids), 7.4% had high-risk alcohol use, and 14.0% currently smoked. Among high-risk users, past 12-month treatment access rates were 50.6% [22.3-78.9%] for opioids, 27.1% [8.1-46.1%] for meth/amphetamine, 14.5% [4.3-24.7%] for cannabis, 9.6% [8.1-11.0%] for alcohol and 11.7% [10.6-12.9%] for current smoking. The primary source of treatment support was information and education (12.7% drugs, 4.6% alcohol, 4.0% smoking), followed by counselling (6.7% drugs, 4.5% alcohol, 3.0% smoking). Online or internet support was accessed by 5.9% (drug) and 1.6% (alcohol) people with high-risk use. Psychological distress was associated with treatment access (drugs: odds ratio 3.03 [0.77-11.95], p = 0.111; alcohol: odds ratio 3.16 [2.20-4.56], p ≤ 0.001; smoking: odds ratio 1.95 [1.52-2.49], p ≤ 0.001). DISCUSSION AND CONCLUSIONS The proportion of people engaging in risky substance use who had used treatment programs remains low, especially for alcohol. Public health strategies to scale up treatment access are warranted.
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Affiliation(s)
- Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Tesfa Mekonen Yimer
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
- Psychiatry Department, Bahir Dar University, Bahir Dar, Ethiopia
| | - Vivian Chiu
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Wayne D Hall
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Jason P Connor
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Gary Chung Kai Chan
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
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Rackow AR, Knezevic CE. Solriamfetol and m-chlorophenylpiperazine cause false positive amphetamine results on urine drug screening. J Anal Toxicol 2024; 48:126-129. [PMID: 38048281 DOI: 10.1093/jat/bkad088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 12/06/2023] Open
Abstract
Urine drug screening by immunoassay is a common method to quickly identify drug exposures in the emergency setting and to detect unexpected drug exposures in a variety of patient care and occupational health settings. Although they provide rapid results, immunoassays are susceptible to cross-reactivity with other medications and metabolites. Herein we evaluate the performance of the Thermo Scientific DRI Amphetamines immunoassay for reactivity with trazodone, aripiprazole, atomoxetine, solriamfetol and relevant metabolites. Each of these compounds were spiked into drug-free urine across a range of concentrations and assessed for positivity on amphetamine screen. We demonstrate that the Thermo Scientific DRI assay is susceptible to interferences from m-chlorophenylpiperazine (mCPP), the main metabolite of trazodone, and solriamfetol. Characterization of assay-specific interferences in toxicology screening is instrumental for accurate interpretation of toxicology results, evaluation of patients in emergent settings and supporting patient care.
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Affiliation(s)
- Ashley R Rackow
- Department of Pathology, Johns Hopkins University, Baltimore, MD, United States
| | - Claire E Knezevic
- Department of Pathology, Johns Hopkins University, Baltimore, MD, United States
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Zhao LY, Qin M, Wu GP, Zhou YT, Zhu JX, Peng H. Quantitative determination of amphetamine-type stimulants in sewage and urine by hybrid monolithic column solid-phase microextraction coupled with UPLC-QTRAP MS/MS. Talanta 2024; 269:125437. [PMID: 38070282 DOI: 10.1016/j.talanta.2023.125437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/24/2023] [Accepted: 11/17/2023] [Indexed: 01/05/2024]
Abstract
A needle-solid-phase microextraction (SPME) method based on hybrid monolithic column (HMC) was proposed for simultaneous separation and extraction of seven amphetamine-type stimulants (ATSs) (amphetamine, methamphetamine, cathinone, methcathinone, 3,4-methylenedioxyamphetamine, 3,4-methylenedioxymethamphetamine, and 3,4-methylenedioxyethylamphetamine), combining with ultra-performance liquid chromatography-triple quadrupole/linear ion trap mass spectrometer (UPLC-QTRAP MS/MS). Thiol functionalized HMC (T-HMC) showed high extraction efficiency and excellent elution results towards target analytes, among three kinds of single/bi-functionalized HMCs. Various parameters of SPME operation and analytical performance were investigated systematically. The adsorption mechanism of T-HMC to ATSs was also discussed and explained as a mixed mode of electrostatic and hydrophobic interactions. Under the optimum experimental conditions, the proposed T-HMC needle-SPME-UPLC-QTRAP MS/MS method was rapid and convenient with good accuracy, low sample consumption, high sensitivity and strong anti-interference ability. This method was successfully applied to quantitative determination of seven trace ATSs in complex sewage and urine samples. In view of abundant types of HMCs, the needle-SPME based on functional HMC also had the potential to selectively separating and enriching other tract new psychoactive substances in complex matrices, and could provide a reliable tool for drug monitoring, especially in applications for forensic analysis and drug abuse.
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Affiliation(s)
- Ling-Yu Zhao
- Department of Criminal Science and Technology, Jiangsu Police Institute, Nanjing 210031, China; Jiangsu Provincial Engineering Laboratory for Technical and Criminal Inspection of Food, Drug and Environmental Cases, Nanjing 210031, China.
| | - Mian Qin
- Department of Criminal Science and Technology, Jiangsu Police Institute, Nanjing 210031, China; Jiangsu Provincial Engineering Laboratory for Technical and Criminal Inspection of Food, Drug and Environmental Cases, Nanjing 210031, China
| | - Guo-Ping Wu
- Department of Criminal Science and Technology, Jiangsu Police Institute, Nanjing 210031, China; Jiangsu Provincial Engineering Laboratory for Technical and Criminal Inspection of Food, Drug and Environmental Cases, Nanjing 210031, China
| | - Yi-Tong Zhou
- Department of Criminal Science and Technology, Jiangsu Police Institute, Nanjing 210031, China
| | - Jia-Xuan Zhu
- Department of Criminal Science and Technology, Jiangsu Police Institute, Nanjing 210031, China
| | - Hao Peng
- Department of Criminal Science and Technology, Jiangsu Police Institute, Nanjing 210031, China
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Recław R, Chmielowiec K, Suchanecka A, Boroń A, Chmielowiec J, Strońska-Pluta A, Kowalski MT, Masiak J, Trybek G, Grzywacz A. The Influence of Genetic Polymorphic Variability of the Catechol-O-methyltransferase Gene in a Group of Patients with a Diagnosis of Behavioural Addiction, including Personality Traits. Genes (Basel) 2024; 15:299. [PMID: 38540358 PMCID: PMC10969953 DOI: 10.3390/genes15030299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/24/2024] [Accepted: 02/24/2024] [Indexed: 04/02/2024] Open
Abstract
Gambling Disorder (GD) is characterised by a harmful, enduring, and recurrent involvement in betting-related behaviours. Therefore, GD shares similar biological mechanisms and symptoms to substance use disorders (SUD). Therefore, in this study, we chose the behavioural addictions group. During the examination and recruitment to the study, it turned out that all the people undergoing treatment for gambling addiction were also addicted to amphetamines, which is consistent with the biological mechanism related to cerebral neurotransmission. The aim of the study was to investigate the association of the COMT gene polymorphism with behavioral addiction. The study group consisted of 307 participants: 107 men with gambling disorder and amphetamine dependency (mean age = 27.51, SD = 5.25) and 200 non-addicted, nor dependent, free from neuro-psychiatric disorders control group men (mean age = 20.20, SD = 4.51). Both groups were subjected to psychometric evaluation using the State-Trait Anxiety Inventory and the NEO Five-Factor Personality Inventory. Genomic DNA was extracted from venous blood following standard protocols. Determination of the rs4680 polymorphism in the COMT gene was performed using the real-time PCR technique. Statistically significant differences in the frequency of rs4680 genotypes were found in the tested sample of subjects compared with the control group (p = 0.03543). Subjects with gambling disorder and amphetamine use disorder compared to the control group obtained higher scores in the assessment of the STAI trait scale (p = 0.0019), state scale (p < 0.0000), and NEO-FFI Neuroticism scale (p < 0.0000). Significantly lower results were obtained for the NEO-FFI Agreeability scale (p < 0.0000). Additionally, a significant statistical impact of gambling disorder and amphetamine use disorder, and the COMT rs4680 genotype was demonstrated for the score of the STAI trait (p = 0.0351) and state (p = 0.0343) and the NEO-FFI Conscientiousness scale (p = 0.0018). We conclude that COMT and its polymorphic variant influence the development of addiction. Still, considering its multifactorial and polygenic nature, it should be combined with other factors such as personality.
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Affiliation(s)
- Remigiusz Recław
- Foundation Strong in the Spirit, 60 Sienkiewicza St., 90-058 Łódź, Poland;
| | - Krzysztof Chmielowiec
- Department of Hygiene and Epidemiology, Collegium Medicum, University of Zielona Góra, 28 Zyty St., 65-046 Zielona Góra, Poland; (K.C.); (J.C.)
| | - Aleksandra Suchanecka
- Independent Laboratory of Health Promotion, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (A.S.); (A.S.-P.)
| | - Agnieszka Boroń
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University in Szczecin, Aleja Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland;
| | - Jolanta Chmielowiec
- Department of Hygiene and Epidemiology, Collegium Medicum, University of Zielona Góra, 28 Zyty St., 65-046 Zielona Góra, Poland; (K.C.); (J.C.)
| | - Aleksandra Strońska-Pluta
- Independent Laboratory of Health Promotion, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (A.S.); (A.S.-P.)
| | - Michał Tomasz Kowalski
- Clinical Department of Cardiology, Nowa Sól Multidisciplinary Hospital, 67-100 Nowa Sol, Poland;
| | - Jolanta Masiak
- II Department of Psychiatry and Psychiatric Rehabilitation, Medical University of Lublin, 1 Głuska St., 20-059 Lublin, Poland;
| | - Grzegorz Trybek
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
- Maxillofacial Surgery Clinic, 4th Military Clinical Hospital in Wroclaw, ul. Rudolfa Weigla 5, 50-981 Wrolaw, Poland
| | - Anna Grzywacz
- Independent Laboratory of Health Promotion, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich 72 St., 70-111 Szczecin, Poland; (A.S.); (A.S.-P.)
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Yu WG, He Q, Wang ZD, Tian CJ, Wang JK, Zheng Q, Ren F, Zhang C, Wang YM, Xu P, Wei ZW, Yun KM. Toxicokinetics of MDMA and Its Metabolite MDA in Rats. Fa Yi Xue Za Zhi 2024; 40:37-42. [PMID: 38500459 DOI: 10.12116/j.issn.1004-5619.2022.320201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
OBJECTIVES To investigate the toxicokinetic differences of 3,4-methylenedioxy-N-methylamphetamine (MDMA) and its metabolite 4,5-methylene dioxy amphetamine (MDA) in rats after single and continuous administration of MDMA, providing reference data for the forensic identification of MDMA. METHODS A total of 24 rats in the single administration group were randomly divided into 5, 10 and 20 mg/kg experimental groups and the control group, with 6 rats in each group. The experimental group was given intraperitoneal injection of MDMA, and the control group was given intraperitoneal injection of the same volume of normal saline as the experimental group. The amount of 0.5 mL blood was collected from the medial canthus 5 min, 30 min, 1 h, 1.5 h, 2 h, 4 h, 6 h, 8 h, 10 h, 12 h after administration. In the continuous administration group, 24 rats were randomly divided into the experimental group (18 rats) and the control group (6 rats). The experimental group was given MDMA 7 d by continuous intraperitoneal injection in increments of 5, 7, 9, 11, 13, 15, 17 mg/kg per day, respectively, while the control group was given the same volume of normal saline as the experimental group by intraperitoneal injection. On the eighth day, the experimental rats were randomly divided into 5, 10 and 20 mg/kg dose groups, with 6 rats in each group. MDMA was injected intraperitoneally, and the control group was injected intraperitoneally with the same volume of normal saline as the experimental group. On the eighth day, 0.5 mL of blood was taken from the medial canthus 5 min, 30 min, 1 h, 1.5 h, 2 h, 4 h, 6 h, 8 h, 10 h, 12 h after administration. Liquid chromatography-triple quadrupole tandem mass spectrometry was used to detect MDMA and MDA levels, and statistical software was employed for data analysis. RESULTS In the single-administration group, peak concentrations of MDMA and MDA were reached at 5 min and 1 h after administration, respectively, with the largest detection time limit of 12 h. In the continuous administration group, peak concentrations were reached at 30 min and 1.5 h after administration, respectively, with the largest detection time limit of 10 h. Nonlinear fitting equations for the concentration ratio of MDMA and MDA in plasma and administration time in the single-administration group and continuous administration group were as follows: T=10.362C-1.183, R2=0.974 6; T=7.397 3C-0.694, R2=0.961 5 (T: injection time; C: concentration ratio of MDMA to MDA in plasma). CONCLUSIONS The toxicokinetic data of MDMA and its metabolite MDA in rats, obtained through single and continuous administration, including peak concentration, peak time, detection time limit, and the relationship between concentration ratio and administration time, provide a theoretical and data foundation for relevant forensic identification.
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Affiliation(s)
- Wei-Guang Yu
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Qiang He
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Zheng-di Wang
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Cheng-Jun Tian
- Yuxian Public Security Bureau of Yangquan City, Yangquan 045000, Shanxi Province, China
| | - Jin-Kai Wang
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Qian Zheng
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Fei Ren
- Taiyuan Public Security Bureau, Taiyuan 030000, China
| | - Chao Zhang
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - You-Mei Wang
- National Drug Laboratory, Centre for Counter-Narcotics Information Technology, Ministry of Public Security, Beijing 100193, China
| | - Peng Xu
- National Drug Laboratory, Centre for Counter-Narcotics Information Technology, Ministry of Public Security, Beijing 100193, China
| | - Zhi-Wen Wei
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
| | - Ke-Ming Yun
- School of Forensic Medicine, Shanxi Medical University, Jinzhong 030600, Shanxi Province, China
- Key Laboratory of the Ministry of Public Security for Toxicological Analysis of the Tribunal, Jinzhong 030600, Shanxi Province, China
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Carpenter KM, Choi CJ, Basaraba C, Pavlicova M, Brooks DJ, Brezing CA, Bisaga A, Nunes EV, Mariani JJ, Levin FR. Mixed amphetamine salts-extended release (MAS-ER) as a behavioral treatment augmentation strategy for cocaine use disorder: A randomized clinical trial. Exp Clin Psychopharmacol 2024; 32:112-127. [PMID: 37732961 PMCID: PMC10872820 DOI: 10.1037/pha0000676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Psychosocial interventions remain the primary strategy for addressing cocaine use disorder (CUD), although many individuals do not benefit from these approaches. Amphetamine-based interventions have shown significant promise and may improve outcomes among individuals continuing to use cocaine in the context of behavioral interventions. One hundred forty-five adults (122 males) who used cocaine a minimum of 4 days in the prior month and met the criteria for a CUD enrolled in a two-stage intervention. All participants received a computer-delivered skills intervention and contingency management for reinforcing abstinence for a 1-month period. Participants demonstrating less than 3 weeks of abstinence in the first month were randomized to receive mixed amphetamine salts-extended release (MAS-ER) or placebo (80 mg/day) for 10 weeks under double-blind conditions. All participants continued with the behavioral intervention. The primary outcome was the proportion of individuals who achieved 3 consecutive weeks of abstinence as measured by urine toxicology confirmed self-report at the study end. The proportion of participants demonstrating 3 consecutive weeks of abstinence at study end did not differ between the medication groups: MAS-ER = 15.6% (7/45) and placebo = 12.2% (5/41). Participants who received MAS-ER reported greater reductions in the magnitude of wanting cocaine, although no group differences were noted in either the perceived improvement or the frequency of wanting cocaine. Retention rates were greater for both medication groups compared to behavioral responders. Overall, augmenting a behavioral intervention with MAS-ER did not significantly increase the abstinence rate among individuals continuing to use cocaine following a month of behavioral therapy alone. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | - Daniel J Brooks
- Division on Substance Use Disorders, New York State Psychiatric Institute
| | | | - Adam Bisaga
- Division on Substance Use Disorders, New York State Psychiatric Institute
| | - Edward V Nunes
- Division on Substance Use Disorders, New York State Psychiatric Institute
| | - John J Mariani
- Division on Substance Use Disorders, New York State Psychiatric Institute
| | - Frances R Levin
- Division on Substance Use Disorders, New York State Psychiatric Institute
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Janowitz HN, Linden DJ. Chronic Treatment with Serotonin Selective Reuptake Inhibitors Does Not Affect Regrowth of Serotonin Axons Following Amphetamine Injury in the Mouse Forebrain. eNeuro 2024; 11:ENEURO.0444-22.2023. [PMID: 38355299 PMCID: PMC10867722 DOI: 10.1523/eneuro.0444-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 08/01/2023] [Accepted: 08/12/2023] [Indexed: 02/16/2024] Open
Abstract
A current hypothesis to explain the limited recovery following brain and spinal cord trauma stems from the dogma that neurons in the mammalian central nervous system lack the ability to regenerate their axons after injury. Serotonin (5-HT) neurons in the adult brain are a notable exception in that they can slowly regrow their axons following chemical or mechanical lesions. This process of regrowth occurs without intervention over several months and results in anatomical recovery that approximates the preinjured state. During development, serotonin is a trophic factor, playing a role in both cell survival and axon growth. Additionally, some studies have shown that stroke patients treated after injury with serotonin selective reuptake inhibitors (SSRIs) appeared to have improved recovery. To test the hypothesis that serotonin can influence the regrowth of 5-HT axons, mice received a high dose of para-chloroamphetamine (PCA) to induce widespread retrograde degeneration of 5-HT axons. Then, after a short rest period to avoid any interaction with the acute injury phase, SSRIs were administered daily for 6 or 10 weeks. Using immunohistochemistry in 5-HT transporter-GFP BAC transgenic mice, we determined that while PCA led to a rapid initial decrease in total 5-HT axon length in the somatosensory cortex, visual cortex, or area CA1 of the hippocampus, treatment with either fluoxetine or sertraline (two different SSRIs) did not affect the recovery of axon length. These results suggest that chronic SSRI treatment does not affect the regrowth of 5-HT axons and argue against SSRIs as a potential therapy following brain injury.
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Affiliation(s)
- Haley N Janowitz
- Cellular and Molecular Medicine Graduate Program, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
| | - David J Linden
- Cellular and Molecular Medicine Graduate Program, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205
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Ioannou KA, Ioannou GD, Christou A, Schmid MG, Stavrou IJ, Kapnissi-Christodoulou CP. Novel supramolecular deep eutectic solvent (SUPRADES) as a sole chiral selector in capillary electrophoresis for the enantiomeric separation of fluorine-substituted amphetamine analogs. J Chromatogr A 2024; 1715:464628. [PMID: 38183783 DOI: 10.1016/j.chroma.2024.464628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/20/2023] [Accepted: 01/02/2024] [Indexed: 01/08/2024]
Abstract
In this study, a novel supramolecular deep eutectic solvent consisting of sulfated-β-CD and citric acid (S-β-CD-CA) is reported for the first time. This innovative system was evaluated as a sole chiral selector in capillary electrophoresis for the enantioseparation of six fluorine-substituted amphetamine analogs, yielding remarkable outcomes. Baseline separations of all amphetamine analogs under study were achieved in less than 21.00 min using the S-β-CD-CA as the chiral selector. It was observed that the addition of 0.050 % v/v S-β-CD-CA into the background electrolyte resulted in the baseline separation of five out of the six fluorine-substituted amphetamine analogs, while in the case of the para-substituted amphetamine analog, 4-fluoramphetamine (4-FA), a higher percentage (0.15 % v/v) was required to achieve baseline enantioseparation. These findings emphasized the potential of this new supramolecular system in providing a class of solvents with promising chiral recognition properties.
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Affiliation(s)
| | | | | | - Martin G Schmid
- Department of Pharmaceutical Chemistry, Institute of Pharmaceutical Sciences, University of Graz, Graz 8010, Austria
| | - Ioannis J Stavrou
- Department of Life Sciences, European University Cyprus, Nicosia 2404, Cyprus.
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Wazaify M, Al-Khateeb YM, Musleh B, Al-Smadi H, Steenkamp C. Qualitative Exploration of the Experiences of People Who Use Captagon and Therapists in Jordan. Subst Use Misuse 2024; 59:816-824. [PMID: 38263603 DOI: 10.1080/10826084.2024.2304012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
Background: Captagon (Fenethylline) is an amphetamine type stimulant (ATS) and one of the most popular substances of use in the Middle East. This study aims to describe and analyze the trajectory of captagon use, severity of addiction and withdrawal symptoms and its effect on quality of life from the perspectives of people who use captagon, who receive treatment as well as therapists. Methods: This study took a qualitative approach, using semi-structured, audio-recorded interviews, which were transcribed verbatim, translated to English and coded using Nvivo software for thematic analysis. Results: Data saturation was achieved after interviewing a total of 27 participants (7 therapists and 20 patients using captagon either alone or among other illicit drugs), most of which were male (n = 22). Their ages ranged between 18-48 years (median= 27). Four main themes were identified during the interviews: (1) Definition and sought effects of captagon; (2) the downside of captagon use and withdrawal symptoms associated with captagon use; (3) motivations for captagon use and to treatment; and (4) the impact of Covid-19 on captagon's use and on treatment. Conclusion: This qualitative study has illustrated for the first time the several challenges and complicating factors that people who use captagon and therapists face in Jordan. Findings call attention to implementing effective interventions to raise public's awareness of the negative impact of such use, with focus on high-risk groups, address the needs of different users and encourage the use of international treatment guidelines.
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Affiliation(s)
- Mayyada Wazaify
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
| | - Yara M Al-Khateeb
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
| | | | - Hamza Al-Smadi
- National Centre for Mental Health, Ministry of Health, Amman, Jordan
| | - Christina Steenkamp
- School of Social Sciences, Faculty of Humanities and Social Sciences, Oxford Brookes University, Oxford, UK
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Rizk N, Crawford D, Karanas Y, Barnes C, Pham TN, Sheckter CC. Amphetamine Positivity Prior to Burn Surgery Does not Adversely Affect Intraoperative Outcomes. J Burn Care Res 2024; 45:17-24. [PMID: 37875155 PMCID: PMC11023316 DOI: 10.1093/jbcr/irad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Indexed: 10/26/2023]
Abstract
The treatment of burn patients using amphetamines is challenging due hemodynamic liabilty and altered physiology. Wide variation exists in the operative timing for this patient population. We hypothesize that burn excision in patients admitted with amphetamine positivity is safe regardless of timing. Data from two verified burn centers between 2017 and 2022 with differing practice patterns in operative timing for amphetamine-positive patients. Center A obtains toxicology only on admission and proceeds with surgery based on hemodynamic status and operative urgency, whereas Center B sends daily toxicology until a negative test results. The primary outcome was the use of vasoactive agents during the index operation, modeled using logistic regression adjusting for burn severity and hospital days to index operation. Secondary outcomes included death and inpatient complications. A total of 270 patients were included, and there were no significant differences in demographics or burn characteristics between centers. Center A screened once and Center B obtained a median of four screens prior to the surgery. The adjusted OR of requiring vasoactive support intraoperatively was not associated with negative toxicology result (P = .821). Having a body surface area burned >20% conferred a significantly higher risk of vasoactive support (adj. OR 13.42 [3.90-46.23], P < .001). Mortality, number of operations, stroke, and hospital length of stay were similar between cohorts. Comparison between two verified burn centers indicates that waiting until a negative amphetamine toxicology result does not impact intraoperative management or subsequent burn outcomes. Serial toxicology tests are unnecessary to guide operative timing of burn patients with amphetamine use.
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Affiliation(s)
- Nada Rizk
- Department of Surgery, Stanford University School of Medicine, 770 Welch Road suite 400, Palo Alto, CA 94304, USA
| | - David Crawford
- UW Burn Center at Harborview Medical Center, University of Washington, 325 9th Ave Seattle, WA 98104, USA
- Department of Surgery, University of Washington, 325 9th Ave Seattle WA 98104, USA
| | - Yvonne Karanas
- Regional Burn Center, Santa Clara Valley Medical Center, 751 S Bascom Ave San Jose, CA 95128, USA
| | - Christopher Barnes
- UW Burn Center at Harborview Medical Center, University of Washington, 325 9th Ave Seattle, WA 98104, USA
- Department of Anesthesia, University of Washington, 325 9th Ave Seattle WA 98104, USA
| | - Tam N Pham
- UW Burn Center at Harborview Medical Center, University of Washington, 325 9th Ave Seattle, WA 98104, USA
- Department of Surgery, University of Washington, 325 9th Ave Seattle WA 98104, USA
| | - Clifford C Sheckter
- Department of Surgery, Stanford University School of Medicine, 770 Welch Road suite 400, Palo Alto, CA 94304, USA
- Regional Burn Center, Santa Clara Valley Medical Center, 751 S Bascom Ave San Jose, CA 95128, USA
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Li F. A retrospective study of traffic offenses associated with driving under the influence of drugs in China. Traffic Inj Prev 2024; 25:103-109. [PMID: 38054845 DOI: 10.1080/15389588.2023.2285714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 11/15/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVE This study aimed to investigate the prevalence and pattern of traffic offenses associated with driving under the influence of drugs (DUID) in 31 provinces of mainland China. METHODS Traffic offenses were extracted from the nationally representative court file disclosure website. Drivers convicted of traffic offenses associated with DUID were included. The monthly percentage change (MPC) in rates was estimated by fitting negative binomial regression models to assess the time trends. Moran's I was used to determine the correlations of DUID-related rates among surrounding provinces. RESULTS In total, 896 individuals convicted of DUID offenses were identified (April 2007 to March 2022). Of these, 769 individuals were involved in traffic crashes, and they killed 629 people. Regarding the types of drugs, 638 used amphetamine-type stimulants (ATS; methamphetamine, 3,4-methylenedioxymethamphetamine, amphetamine, and tenamfetamine), 104 used ketamine, 104 used opioids (heroin, morphine, methadone, codeine, and tramadol), 20 used caffeine, 4 used tetrahydrocannabinol, and 1 used gamma-hydroxybutyric acid. The offense trends among overall drug users (MPC, -1.1; p < .001) declined from 2014 to 2020. The trends also decreased for DUID-related traffic crashes (-1.5; p < .001) and deaths (-1.7; p < .001) during the same period. Except in three provinces, ATS-related offense rates were higher than opioid-related offense rates. Ketamine-related offense rates showed a significant positive correlation among the surrounding provinces (Moran's I, 0.22; p < .01), and South China had the highest ketamine-related offense rates. CONCLUSIONS In the sample, the case fatality rate was 70.7%, which was a strong indicator of underreporting, and most minor DUID-related offenses could not be captured by Chinese court files. The frequency of drug screening tests for people should be increased. The traffic police in Qinghai, Tibet, and Xinjiang should always be equipped with fast screening test kits for drugs, which could increase the possibility of identifying DUID offenders.
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Affiliation(s)
- Feng Li
- School of Humanities, Southeast University, Nanjing, China
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18
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Munetomo-Aoki S, Kaizaki-Mitsumoto A, Nakano R, Numazawa S. Paternal meth amphetamine exposure differentially affects first and second generations in mice. J Toxicol Sci 2024; 49:9-26. [PMID: 38191192 DOI: 10.2131/jts.49.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Amphetamine-type stimulants are abused worldwide, and methamphetamine (METH) accounts for a large majority of seized abused drug cases. Recently, the paternal origin of health and disease theory has been proposed as a concept wherein paternal factors influence descendants. Although METH abuse is more common among males, its effects on their descendants were not examined. Therefore, we investigated the effects of paternal METH exposure on F1 and F2 levels in a mouse model. Sires were administered METH for 21 days and mated with female mice to obtain F1 mice. Growth evaluations (number of births, survival rate, body weight, righting reflex, cliff avoidance tests, and wire-hanging maneuver) were performed on F1 mice. Upon reaching six weeks of age, the mice were subjected to spontaneous locomotion, elevated plus-maze, acute METH treatment, and passive avoidance tests. Additionally, RNA-seq was performed on the striatum of male mice. Male F1 mice were mated with female mice to obtain F2 mice. They were subjected to the same tests as the F1 mice. Paternal METH exposure resulted in delayed growth and decreased memory function in F1 mice, overweight in F2 mice, decreased METH sensitivity, and reduced anxiety-related behaviors in female F2 mice. Enrichment analysis revealed significant enrichment of terms related to behavior in F1 and protein folding in F2. These results indicated that the effects of paternal METH exposure vary across generations. The effects of paternal factors need to be examined not only in F1, but also in F2 and beyond.
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Affiliation(s)
| | | | - Ryota Nakano
- Department of Physiology, Showa University Graduate School of Pharmacy
| | - Satoshi Numazawa
- Department of Toxicology, Showa University Graduate School of Pharmacy
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Pelletier R, Le Daré B, Le Bouëdec D, Bourdais A, Ferron PJ, Morel I, Porée FH, Gicquel T. Identification, synthesis and quantification of eutylone consumption markers in a chemsex context. Arch Toxicol 2024; 98:151-158. [PMID: 37833490 DOI: 10.1007/s00204-023-03615-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023]
Abstract
Eutylone is a cathinone-derived synthetic amphetamine scheduled by the World Health Organization and European Monitoring Centre for Drugs and Drug Addiction since 2022 due to its growing consumption. We report here an eutylone intoxication involving a 38-year-old man and a 29-year-old woman in a chemsex context. A bag containing a white crystalline powder labelled as a research product was found in their vehicle. Nuclear magnetic resonance and liquid chromatography-high-resolution mass spectrometry (LC-HRMS) analyses identified the powder as eutylone and confirmed purity superior to 99%. LC-HRMS data analysis using molecular networking allowed to propose new eutylone metabolites in blood samples in a graphical manner. We described 16 phase I (e.g. hydroxylated or demethylated) and phase II metabolites (glucuroconjugates and sulfoconjugates). The same metabolites were found both in male and female blood samples. Toxicological analyses measured eutylone concentration in blood samples at 1374 ng/mL and 1536 ng/mL for the man and the woman, respectively. A keto-reduced metabolite (m/z 238.144) was synthesized to permit its quantification at 67 ng/mL and 54 ng/mL in male and female blood samples, respectively. Overall, the identification of these metabolites will increase the knowledge of potential drug consumption markers and allow to implement mass spectrometry databases to better monitor future drug abuse or consumption.
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Affiliation(s)
- Romain Pelletier
- INSERM, Univ Rennes, INRAE, Institut NUMECAN (Nutrition, Metabolisms and Cancer) UMR_A 1341, UMR_S 1317, 35000, Rennes, France.
- Rennes University Hospital, Clinical and Forensic Toxicology Laboratory, CHU Pontchaillou, 2 Rue Henri Le Guilloux, 35000, Rennes, France.
| | - Brendan Le Daré
- INSERM, Univ Rennes, INRAE, Institut NUMECAN (Nutrition, Metabolisms and Cancer) UMR_A 1341, UMR_S 1317, 35000, Rennes, France
- Rennes University Hospital, Pharmacy Departement, CHU Rennes, 35000, Rennes, France
| | - Diane Le Bouëdec
- Rennes University Hospital, Clinical and Forensic Toxicology Laboratory, CHU Pontchaillou, 2 Rue Henri Le Guilloux, 35000, Rennes, France
| | - Alexis Bourdais
- INSERM, Univ Rennes, INRAE, Institut NUMECAN (Nutrition, Metabolisms and Cancer) UMR_A 1341, UMR_S 1317, 35000, Rennes, France
| | - Pierre-Jean Ferron
- INSERM, Univ Rennes, INRAE, Institut NUMECAN (Nutrition, Metabolisms and Cancer) UMR_A 1341, UMR_S 1317, 35000, Rennes, France
| | - Isabelle Morel
- INSERM, Univ Rennes, INRAE, Institut NUMECAN (Nutrition, Metabolisms and Cancer) UMR_A 1341, UMR_S 1317, 35000, Rennes, France
- Rennes University Hospital, Clinical and Forensic Toxicology Laboratory, CHU Pontchaillou, 2 Rue Henri Le Guilloux, 35000, Rennes, France
| | - François-Hugues Porée
- ISCR UMR CNRS 6226, Faculty of Pharmacy, Rennes University, 2 Avenue du Pr Léon Bernard, 35000, Rennes, France
| | - Thomas Gicquel
- INSERM, Univ Rennes, INRAE, Institut NUMECAN (Nutrition, Metabolisms and Cancer) UMR_A 1341, UMR_S 1317, 35000, Rennes, France
- Rennes University Hospital, Clinical and Forensic Toxicology Laboratory, CHU Pontchaillou, 2 Rue Henri Le Guilloux, 35000, Rennes, France
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Gqamana PP, Victoria Zhang Y. Quantitative LC-MS/MS Analysis of Amphetamines and Cocaine in Human Urine. Methods Mol Biol 2024; 2737:15-23. [PMID: 38036806 DOI: 10.1007/978-1-0716-3541-4_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
We hereby present a fast and high-throughput LC-MS/MS assay for the simultaneous analysis of amphetamines and cocaine in human urine. The assay is used for confirmations following immunoassay urine drug screens as well as a quantitative assay to report actual urine concentrations in the range 30-10,000 ng/mL for each of the seven analytes, namely, amphetamine; methamphetamine; phentermine; methylenedioxyamphetamine; 3,4-methylenedioxymethamphetamine; methylenedioxy-ethyl-amphetamine; and a cocaine metabolite, benzoylecgonine. The assay derives its efficacy from minimal sample preparation via dilute and shoot. The platform is based on reversed-phase liquid chromatography coupled to the TSQ Endura triple-quadrupole (QqQ) MS instrument for detection via electrospray ionization multiple-reaction monitoring MS. The quantitative analysis is based on the linear calibration whereby the instrument response for each analyte at a given concentration is normalized against stable isotope-labeled internal standard. In addition, the assay can be multiplexed across more than one LC channel to obtain high-sample throughput.
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Affiliation(s)
- Putuma P Gqamana
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Y Victoria Zhang
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA.
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Looby A, Piccorelli AV, Zimmerman L, Falco C, Livingston NR, Akin C, Benton S, Juliano LM. Expectancy for Adderall influences subjective mood and drug effects regardless of concurrent caffeine ingestion: A randomized controlled trial. Psychopharmacology (Berl) 2024; 241:109-118. [PMID: 37740001 DOI: 10.1007/s00213-023-06467-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/07/2023] [Indexed: 09/24/2023]
Abstract
RATIONALE Nonmedical prescription stimulant use (NPS; use without a prescription or in ways other than prescribed) is common among college students. Despite the potential for negative consequences, students continue engaging in NPS for cognitive enhancement purposes, which may be maintained by expectancy and placebo effects. OBJECTIVES This study examined if a placebo administered under the guise of Adderall influenced subjective mood/drug effects and cognitive performance. Furthermore, this study examined if concurrent caffeine ingestion incrementally enhanced Adderall-related placebo effects. METHODS Undergraduate students with features that put them at elevated risk for NPS (N = 121) completed measures of mood and drug effects and cognitive assessments on two separate laboratory visits in this parallel randomized controlled trial. Visit 1 was a baseline control visit, on which no drug was expected or received. On visit 2, subjects were randomized to: (1) expect/receive no drug (control); (2) expect Adderall/receive placebo; or (3) expect Adderall/receive 200 mg caffeine. RESULTS There were several significant condition × visit interactions for subjective effects, including amphetamine effects, energy and efficiency effects, and feeling high. In most cases, participants who expected Adderall reported greater positive subjective effects on visit 2 compared to controls; however, there were generally not incremental enhancements for those ingesting caffeine compared to placebo. There were no significant effects for any cognitive tests. CONCLUSIONS Expectation for prescription stimulant effects influenced subjective outcomes in a sample of high-risk college students. These findings may inform expectancy challenge interventions to reduce NPS. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03648684.
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Affiliation(s)
- Alison Looby
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA.
| | - Annalisa V Piccorelli
- Kaiser Permanente Washington Health Research Institute, Biostatistics Division, 1730 Minor Avenue, Ste 1600, Seattle, WA, 98101, USA
| | - Lauren Zimmerman
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA
| | - Caitlin Falco
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA
| | - Nicholas R Livingston
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA
| | - Cody Akin
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA
| | - Samuel Benton
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Department 3415, Laramie, WY, 82071, USA
| | - Laura M Juliano
- Department of Psychology, American University, 4400 Massachusetts Avenue NW, Washington, DC, 20016, USA
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Yuen AWH, Sang JM, Wang L, Barath J, Lachowsky NJ, Lal A, Elefante J, Hart TA, Skakoon-Sparling S, Grey C, Grace D, Cox J, Lambert G, Noor SW, Apelian H, Parlette A, Card KG, Hull MW, Jollimore J, Moore DM. Attitudes of Gay, Bisexual, and Other Men Who Have Sex with Men (GBM) toward Their Use of Amphetamine-Type Stimulants and Relation to Reducing Use in Three Canadian Cities. Subst Use Misuse 2023; 59:278-290. [PMID: 37867395 DOI: 10.1080/10826084.2023.2269577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
BACKGROUND We explored attitudes of gay, bisexual, and other men who have sex with men (GBM) toward their amphetamine-use and associations with reduced use over time. METHODS We recruited sexually-active GBM aged 16+ years in Montreal, Toronto, and Vancouver, Canada, from 02-2017 to 08-2019, with follow-up visits every 6-12 months until November 2020. Among participants who reported past-six-month (P6M) amphetamine-use at enrollment, we used logistic regression to identify demographic, psychological, social, mental health, other substance-use, and behavioral factors associated with reporting needing help reducing their substance-use. We used mixed-effects logistic regression to model reduced P6M amphetamine-use with perceived problematic-use as our primary explanatory variable. RESULTS We enrolled 2,449 GBM across sites. 15.5-24.7% reported P6M amphetamine-use at enrollment and 82.6 - 85.7% reported needing no help or only a little help in reducing their substance use. Reporting needing a lot/of help or completely needing help in reducing substance-use was associated with group sex participation (AOR = 2.35, 95%CI:1.25-4.44), greater anxiety symptomatology (AOR = 2.11, 95%CI:1.16-3.83), greater financial strain (AOR = 1.35, 95%CI:1.21-1.50), and greater Escape Motive scores (AOR = 1.07, 95%CI:1.03-1.10). Reductions in P6M amphetamine-use were less likely among GBM who perceived their amphetamine-use as problematic (AOR = 0.17 95% CI 0.10 - 0.29). CONCLUSIONS Most amphetamine-using GBM did not feel they needed help reducing their substance use, and many reported reduced amphetamine-use at subsequent visits. Those who perceived their use as problematic were less likely to reduce their use. Further interventions to assist GBM in reducing their use are needed to assist those who perceive their use as problematic.
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Affiliation(s)
| | - Jordan M Sang
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
| | - Lu Wang
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Justin Barath
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | - Nathan J Lachowsky
- University of Victoria, Victoria, BC, Canada
- Community-Based Research Centre, Vancouver, BC, Canada
| | - Allan Lal
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | | | - Trevor A Hart
- Toronto Metropolitan University, Toronto, ON, Canada
- University of Toronto, ON, Canada
| | | | | | | | - Joseph Cox
- McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | - Gilles Lambert
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
- Institut national de santé publique du Québec, Montréal, QC, Canada
| | - Syed W Noor
- Toronto Metropolitan University, Toronto, ON, Canada
- Louisiana State University Shreveport, Shreveport, Louisiana, USA
| | - Herak Apelian
- McGill University, Montreal, QC, Canada
- Research Institute of the McGill University Health Centre, Montréal, QC, Canada
| | | | - Kiffer G Card
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
- University of Victoria, Victoria, BC, Canada
- Simon Fraser University, Burnaby, BC, Canada
| | - Mark W Hull
- University of British Columbia, Vancouver, BC, Canada
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada
| | | | - David M Moore
- University of British Columbia, Vancouver, BC, Canada
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23
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Angoa-Perez M, Kuhn DM. The pharmacology and neurotoxicology of synthetic cathinones. Adv Pharmacol 2023; 99:61-82. [PMID: 38467489 DOI: 10.1016/bs.apha.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
The synthetic cathinones are man-made compounds derived from the naturally occurring drug cathinone, which is found in the khat plant. The drugs in this pharmacological class that will be the focus of this chapter include mephedrone, MDPV, methcathinone and methylone. These drugs are colloquially known as "bath salts". This misnomer suggests that these drugs are used for health improvement or that they have legitimate medical uses. The synthetic cathinones are dangerous drugs with powerful pharmacological effects that include high abuse potential, hyperthermia and hyperlocomotion. These drugs also share many of the pharmacological effects of the amphetamine class of drugs including methamphetamine, amphetamine and MDMA and therefore have high potential to cause damage to the central nervous system. The synthetic cathinones are frequently taken in combination with other psychoactive drugs such as alcohol, marijuana and the amphetamine-like stimulants, creating a situation where heightened pharmacological and neurotoxicological effects are likely to occur. Despite the structural features shared by the synthetic cathinones and amphetamine-like stimulants, including their actions at monoamine transporters and receptors, the effects of the synthetic cathinones do not always match those of the amphetamines. In particular, the synthetic cathinones are far less neurotoxic than their amphetamine counterparts, they produce a weaker hyperthermia, and they cause less glial activation. This chapter will briefly review the pharmacology and neurotoxicology of selected synthetic cathinones with the aim of delineating key areas of agreement and disagreement in the literature particularly as it relates to neurotoxicological outcomes.
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Affiliation(s)
- Mariana Angoa-Perez
- Research and Development Service, John D. Dingell VA Medical Center, Detroit, MI, United States; Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Donald M Kuhn
- Research and Development Service, John D. Dingell VA Medical Center, Detroit, MI, United States; Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States.
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Vojtechova I, Tuckova K, Juza R, Stuchlik A, Kelemen E, Korabecny J, Soukup O, Petrasek T. Dopaminergic and glutamatergic models of psychosis show differential sensitivity to aripiprazole and a novel experimental compound modulating D 2/5-HT receptor activity. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110819. [PMID: 37379895 DOI: 10.1016/j.pnpbp.2023.110819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 06/30/2023]
Abstract
Dopamine type 2 receptors (D2Rs) constitute the main molecular target in the pharmacotherapy of schizophrenia. However, the second and third generation of antipsychotics comprises multi-target ligands, also binding serotonin type 3 receptors (5-HT3Rs) and other receptor classes as well. Here, we examined two experimental compounds (marked compound K1697 and K1700) from the group of 1,4-di-substituted aromatic piperazines, previously described in the study of Juza et al., 2021, and compared them with the chosen reference antipsychotic, aripiprazole. Their efficacy against schizophrenia-like behavior was tested in two different models of psychosis in the rat, induced by acute administration of either amphetamine (1.5 mg/kg) or dizocilpine (0.1 mg/kg), reflecting the dopaminergic and glutamatergic hypotheses of schizophrenia. The two models exhibited broadly similar behavioral manifestations: hyperlocomotion, disrupted social behavior and impaired prepulse inhibition of the startle response. However, they differed in their treatment responses as hyperlocomotion and prepulse inhibition deficit in the dizocilpine model were resistant to antipsychotic treatment, unlike the amphetamine model. One of the experimental compounds, K1700, ameliorated all the observed schizophrenia-like behaviors in the amphetamine model with an efficacy comparable to or greater than aripiprazole. Whereas social impairments caused by dizocilpine were strongly suppressed by aripiprazole, K1700 was less efficient. Taken together, K1700 showed antipsychotic properties comparable to those of aripiprazole, although the efficacy of the two drugs differed in specific domains of behavior and was also model-dependent. Our present results highlight the differences in these two schizophrenia models and their responsiveness to pharmacotherapy, and confirm compound K1700 as a promising drug candidate.
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Affiliation(s)
- Iveta Vojtechova
- National Institute of Mental Health, Topolova 748, 250 67 Klecany, Czech Republic; Institute of Physiology, Czech Academy of Sciences, Videnska 1083, 142 20 Prague, Czech Republic
| | - Klara Tuckova
- National Institute of Mental Health, Topolova 748, 250 67 Klecany, Czech Republic
| | - Radomir Juza
- National Institute of Mental Health, Topolova 748, 250 67 Klecany, Czech Republic
| | - Ales Stuchlik
- National Institute of Mental Health, Topolova 748, 250 67 Klecany, Czech Republic; Institute of Physiology, Czech Academy of Sciences, Videnska 1083, 142 20 Prague, Czech Republic
| | - Eduard Kelemen
- National Institute of Mental Health, Topolova 748, 250 67 Klecany, Czech Republic
| | - Jan Korabecny
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic
| | - Ondrej Soukup
- Biomedical Research Centre, University Hospital Hradec Kralove, Sokolska 581, 500 05 Hradec Kralove, Czech Republic.
| | - Tomas Petrasek
- National Institute of Mental Health, Topolova 748, 250 67 Klecany, Czech Republic; Institute of Physiology, Czech Academy of Sciences, Videnska 1083, 142 20 Prague, Czech Republic.
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Rodríguez-Campello A, Figueras-Aguirre G, Puchades V, Ois-Santiago A, Cuadrado-Godia E, Giralt-Steinhauer E, Jiménez-Conde J, Bertran-Recasens B, Fernández-Pérez I, Soriano-Tárraga C, Mateus JA, Roquer J. [Clinical profile and non-recreational meth amphetamine abuse (shabu) among stroke patients in the Philippine population]. Rev Neurol 2023; 77:293-298. [PMID: 38095053 PMCID: PMC10831742 DOI: 10.33588/rn.7712.2023238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Chronic non-recreational use of methamphetamine (shabu) is increasing among the Filipino population in Barcelona. The Asian population presents a different stroke pattern, with a higher incidence of haemorrhage, and different vascular risk factors and health behaviours. The objective of this study is to describe the stroke profile and incidence of methamphetamine use in patients of Filipino origin admitted to our centre. PATIENTS AND METHODS Demographic data, vascular risk factors, clinical data and prognosis were recorded. Methamphetamine exposure was analysed in plasma samples collected on admission, which were then analysed by liquid chromatography-mass spectrometry. RESULTS Of a total of 6,418 stroke patients, 73 (1.1%) were identified as being of Filipino origin. The mean age was 54.4 ± 12.1 years, 54% were male and the stroke was ischaemic in 64.4% of cases. Arterial hypertension was the main risk factor. Ten (13.7%) patients tested positive for methamphetamine and amphetamine. These results confirm recent substance use prior to the stroke, mostly in men (80%). In patients who were consumers, 60% had a haemorrhagic stroke, with a poor functional prognosis at three months in 55.6% of patients. CONCLUSIONS In our setting, patients of Filipino ethnicity admitted for stroke related to the consumption of shabu belonged a younger age bracket, with a lower prevalence of vascular risk factors and a predominance of the haemorrhagic subtype. Methamphetamine testing in Filipino stroke patients is recommended due to the high prevalence of methamphetamine use in our country.
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Affiliation(s)
| | | | - V Puchades
- Universitat Autònoma de Barcelona, Bellaterra, España
- Universitat Pompeu Fabra, Barcelona, España
| | - A Ois-Santiago
- Universitat Pompeu Fabra, Barcelona, España
- Hospital del Mar, Barcelona, España
| | - E Cuadrado-Godia
- Hospital del Mar, Barcelona, España
- Universitat Pompeu Fabra, Barcelona, España
| | | | | | | | | | | | | | - J Roquer
- Hospital del Mar, Barcelona, España
- Universitat Pompeu Fabra, Barcelona, España
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26
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Cruz SL, Bencomo-Cruz M, Medina-Mora ME, Vázquez-Quiroz F, Fleiz-Bautista C. First drug-checking study at an electronic festival and fentanyl detection in the central region of Mexico. Harm Reduct J 2023; 20:174. [PMID: 38053148 DOI: 10.1186/s12954-023-00905-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 11/17/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Perception of drug adulteration has increased in Mexico, but there is little research on adulterants and toxicity. The aim of this study was to identify drug composition in an electronic music outdoor festival nearby Mexico City. METHODS The participants completed a questionnaire with demographic data, harm reduction strategies, drug-use patterns, history, and the drug they expected to find. We took a small sample of each substance and prepared it for drug checking. A two-section drug testing station was placed within the grounds of the festival. Interaction with participants occurred at the front part. Drug checking was conducted at the rear part. The service was free of charge, voluntary and confidential. Forty persons aged 22 to 48 years participated (mode = 28), of which 92.5% were male, most (82.5%) were single. Through the Substance Analysis Program of "ReverdeSer Collective," we conducted the testing with the attendants that provided 51 drug samples, following ethical and biosafety protocols. We used colorimetry, Fourier Transform Infrared Spectroscopy, and fentanyl immunoassay strips for sample analysis. RESULTS Substances of choice among attendants were psychostimulants (MDMA and other amphetamine-like drugs) and hallucinogens. Most samples contained what the users expected plus adulterants. Main adulterants were methylene-dioxy-ethyl-amphetamine, methylene-dioxy-propyl-amphetamine, hydroxyamphetamine, and the selective serotonin reuptake inhibitor venlafaxine. Fentanyl was present in 2 out of 4 cocaine samples and in 14 of the 22 confirmed MDMA samples. CONCLUSIONS Some of the adulterants found pose serious health risks, especially fentanyl, amphetamine-like substances, and venlafaxine. Therefore, it is urgent to monitor these adulterants at electronic music festivals and to implement prevention, treatment, and harm reduction public policies. Naloxone distribution and drug-assisted therapies should be part of government programs in Mexico.
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Affiliation(s)
- Silvia L Cruz
- Department of Pharmacobiology, Center for Research and Advanced Studies (Cinvestav), Mexico City, Mexico
- Opioids Working Group. Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Miguel Bencomo-Cruz
- Substance Analysis Program-Deliberar A. C. and ReverdeSer Collective A. C., Mexico City, Mexico
| | - María E Medina-Mora
- Opioids Working Group. Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
- Faculty of Psychology Director, National Autonomous University of Mexico, Mexico City, Mexico
- National Institute of Psychiatry Ramon de la Fuente Muñiz (INPRFM), Calzada México-Xochimilco 101 Col. San Lorenzo Huipulco, 14370, Mexico City, Mexico
| | - Fabiola Vázquez-Quiroz
- National Institute of Psychiatry Ramon de la Fuente Muñiz (INPRFM), Calzada México-Xochimilco 101 Col. San Lorenzo Huipulco, 14370, Mexico City, Mexico
| | - Clara Fleiz-Bautista
- Opioids Working Group. Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
- National Institute of Psychiatry Ramon de la Fuente Muñiz (INPRFM), Calzada México-Xochimilco 101 Col. San Lorenzo Huipulco, 14370, Mexico City, Mexico.
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27
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Martínez Pina V, Gil del Castillo ML, Cebreiros López I, Cerón Moreno AM, Sánchez Carretero PJ, Noguera Velasco JA. Amphetamine-positive urine screen in a patient treated with metoclopramide. Emergencias 2023; 35:476. [PMID: 38116976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Affiliation(s)
- Verónica Martínez Pina
- Servicio de Análisis Clínicos, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | | | - Iria Cebreiros López
- Servicio de Análisis Clínicos, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Ana María Cerón Moreno
- Servicio de Análisis Clínicos, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
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H Z R, H J S, R C S B, Kr R, R RD, M E B. Physical Exercise Promotes Beneficial Changes on Neurotrophic Factors in Mesolimbic Brain Areas After AMPH Relapse: Involvement of the Endogenous Opioid System. Neurotox Res 2023; 41:741-751. [PMID: 37904065 DOI: 10.1007/s12640-023-00675-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 11/01/2023]
Abstract
Addiction is a serious public health problem, and the current pharmacotherapy is unable to prevent drug use reinstatement. Studies have focused on physical exercise as a promising coadjuvant treatment. Our research group recently showed beneficial neuroadaptations in the dopaminergic system related to amphetamine-relapse prevention involving physical exercise-induced endogenous opioid system activation (EXE-OS activation). In this context, additional mechanisms were explored to understand the exercise benefits on drug addiction. Male rats previously exposed to amphetamine (AMPH, 4.0 mg/kg) for 8 days were submitted to physical exercise for 5 weeks. EXE-OS activation was blocked by naloxone administration (0.3 mg/kg) 5 min before each physical exercise session. After the exercise protocol, the rats were re-exposed to AMPH for 3 days, and in sequence, euthanasia was performed and the VTA and NAc were dissected. In the VTA, our findings showed increased immunocontent of proBDNF, BDNF, and GDNF and decreased levels of AMPH-induced TrkB; therefore, EXE-OS activation increased all these markers and naloxone administration prevented this exercise-induced effect. In the NAc, the same molecular markers were also increased by AMPH and decreased by EXE-OS activation. In this study, we propose a close relation between EXE-OS activation beneficial influence and a consequent neuroadaptation on neurotrophins and dopaminergic system levels in the mesolimbic brain area, preventing the observed AMPH-relapse behavior. Our outcomes bring additional knowledge concerning addiction neurobiology understanding and show that EXE-OS activation may be a potential adjuvant tool in drug addiction therapy.
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Affiliation(s)
- Rosa H Z
- Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
| | - Segat H J
- Departamento de Patologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Barcelos R C S
- Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Roversi Kr
- Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Rossato D R
- Departamento de Fisiologia e Farmacologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Burger M E
- Programa de Pós-Graduação em Farmacologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
- Departamento de Patologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
- Departamento de Fisiologia e Farmacologia, Universidade Federal de Santa Maria (UFSM), Santa Maria, RS, Brazil.
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29
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Gwachha K, Wisner AS, Chau TQ, Hall FS, Schiefer IT, Williams FE. Development of Liquid Chromatography-Tandem Mass Spectrometry Analytical Methods for the Study of Whole-Body, Head, and Trunk Uptake and Elimination of Meth amphetamine in 5-Day Postfertilization Zebrafish Larvae Using the Quick, Easy, Cheap, Effective, Rugged, and Safe Technique. Zebrafish 2023; 20:236-242. [PMID: 38117220 DOI: 10.1089/zeb.2023.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
Synthetic cathinones are drugs of abuse substituted for amphetamine-like stimulant drugs such as methamphetamine. In this study, methamphetamine was studied as a prototypical amphetamine-like drug as a first step toward establishing methods to study this entire drug class. The internal concentration of methamphetamine in zebrafish larvae was determined using matrix-matched calibration along with extraction and purification of samples using the quick, easy, cheap, effective, rugged, and safe technique in liquid chromatography-tandem mass spectrometry. Whole-body and head/trunk uptake and elimination in 5-day postfertilization zebrafish larvae were determined. A gradient method was developed using 5 mM ammonium formate with 0.1% formic acid and methanol with 0.1% formic acid as mobile phases, 10 min of total run time, and a 0.3 mL/min flow rate. The limit of quantification was 60 ng/mL, linearity with r2 = 0.9991, and recovery values from 92% to 120%. The internal concentration of methamphetamine was quantifiable in whole-body homogenates within 15 min of uptake analysis. The internal concentration increased with time, whereas a biphasic elimination pattern was shown. With increasing length of exposure, a higher accumulation of drugs was found in the head than in the trunk.
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Affiliation(s)
- Kabita Gwachha
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, Ohio, USA
| | - Alexander S Wisner
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, Ohio, USA
- Department of Medicinal and Biological Chemistry, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, Ohio, USA
| | - Tue Quynh Chau
- Department of Medicinal and Biological Chemistry, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, Ohio, USA
| | - Frank Scott Hall
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, Ohio, USA
| | - Isaac T Schiefer
- Department of Medicinal and Biological Chemistry, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, Ohio, USA
| | - Frederick E Williams
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy and Pharmaceutical Sciences, University of Toledo, Toledo, Ohio, USA
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Herbst C, O'Connell M, Melton BL, Moeller KE. Initiation of Antipsychotic Treatment for Amphetamine Induced Psychosis and Its Impact on Length of Stay. J Pharm Pract 2023; 36:1324-1329. [PMID: 35730758 DOI: 10.1177/08971900221110453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: A risk of amphetamine use is amphetamine-induced psychosis (AIP). Symptoms of AIP include hallucinations, delusions, and agitation. While AIP may resolve with abstinence from amphetamines, antipsychotics are commonly used despite not being FDA approved. The primary objective of this study was to compare length of stay (LOS) for patients with AIP treated with antipsychotics vs untreated. Secondary aims were to determine antipsychotic prescribed, proportion of patients utilizing as needed doses, time to initiation, and readmissions. Methods: A retrospective chart review conducted at an academic medical center identified adult participants who were diagnosed with AIP, admitted to inpatient psychiatry service, and had a urine drug screen (UDS) positive for amphetamines. Patients were excluded if they were already taking an antipsychotic, had active prescriptions for amphetamine salts, or were in the emergency department for more than 48 hours. Demographics were assessed with descriptive statistics. Length of stay was compared between treatment groups using Kruskal-Wallis. Secondary aims were assessed using chi-square, Mann-Whitney U, and Kruskal-Wallis. Results: Sixty-nine patients were included. Median LOS for patients treated with antipsychotics (n = 35) was longer than untreated patients (n = 34), (5 days vs 2.5 days, P = .001). Type of antipsychotic used and time to initiation of antipsychotic were not found to affect LOS. There was no difference in readmissions rates and positive UDS on readmission between groups. Conclusion: This study found patients with scheduled antipsychotics for AIP had a longer LOS than patients who did not receive scheduled antipsychotics. Future studies are needed to evaluate antipsychotic use in AIP.
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Affiliation(s)
- Claire Herbst
- The University of Kansas Health System, Strawberry Hill Campus, Kansas City, MO, USA
| | - Megan O'Connell
- University of Maryland School of Pharmacy, Baltimore, MD, USA
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Kim J, Yum H, Kang S, Lee N, Song J, Park Y, Choe S, Park M. Comprehensive evaluation of drug cases in Seoul and its metropolitan areas - 2022. Forensic Sci Int 2023; 353:111877. [PMID: 37989071 DOI: 10.1016/j.forsciint.2023.111877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 11/23/2023]
Abstract
In order to prepare a response strategy for future drug analyses, the number and results of drug cases handled by the Seoul Institute of National Forensic Service were comprehensively evaluated, with a focus on Seoul and its metropolitan areas. In 2022, the Seoul Institute received approximately 12,150 requests for drug testing related to drug abuse and possession, and the urine samples were tested for approximately 16,000 drug species. The most frequently requested test was for cannabis (Δ-9-THC and Δ-8-THC), followed by methamphetamine, MDMA, ketamine, and synthetic cannabinoids. ADB-5'Br-BUTINACA and propyl butylone were newly emerging substances in 2022. These results were consistent with the main drug detection findings of the confiscated materials. During this period, 24 cases of drug-related deaths were reported, of which 6 were suspected to be the result of acute overdose poisoning caused by methamphetamine, MDMA, fentanyl, and heroin. In addition to the controlled substances regulated by the Narcotics Control Act, new psychoactive substances are being found to be circulating, and various measures are required to address this issue. This study is expected to improve future drug analyses methods and assist in establishing drug policies, and responding to future investigations.
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Affiliation(s)
- Jihyun Kim
- Seoul Institute, National Forensic Service, the Republic of Korea.
| | - Hyesun Yum
- Seoul Institute, National Forensic Service, the Republic of Korea
| | - Seojin Kang
- Seoul Institute, National Forensic Service, the Republic of Korea
| | - Nahyun Lee
- Seoul Institute, National Forensic Service, the Republic of Korea
| | - June Song
- Seoul Institute, National Forensic Service, the Republic of Korea
| | - Yuran Park
- Seoul Institute, National Forensic Service, the Republic of Korea
| | - Sanggil Choe
- Seoul Institute, National Forensic Service, the Republic of Korea
| | - Meejung Park
- Seoul Institute, National Forensic Service, the Republic of Korea
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Savchenko A, Belozertseva I, Leo D, Sukhanov I. Hyperdopaminergia in rats is associated with reverse effort-cost dependent performance. J Psychopharmacol 2023; 37:1238-1248. [PMID: 37962090 DOI: 10.1177/02698811231211225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
BACKGROUND Dopamine is implicated in the effort-based control of motivational processes; however, whether tonic dopamine regulates the effort-cost impact on motivation, is still debated. AIMS The rats lacking the dopamine transporter (DAT), which have dramatically increased levels of the synaptic dopamine, were used in the present study to elucidate the role of the synaptic dopamine in motivational processes. METHODS To study the reward-related processes, the progressive ratio 3 (PR3) operant schedule of food reinforcement (the ratio increases by 3 after each earned reinforcer) was performed in adult male rats (DAT knockouts (DAT-KO), heterozygotes (DAT-HT) and wild-types (DAT-WT)). RESULTS During the PR3 session, the response rate of DAT-KO rats was gradually increased following the augmented required number of responses. In contrast, the local response rate of DAT-WT and DAT-HT decreased. d-Amphetamine sulfate salt (3 mg/kg, i.p.) altered the local response rate dynamics in DAT-WT, which became similar to that of DAT-KO. Interestingly, the reduction in response rate at low effort demands was associated with decreased rate of entries into the magazine tray in DAT-WT rats treated with amphetamine (3 mg/kg) but not in DAT-KO rats. CONCLUSIONS Our results suggest that the elevated tonic synaptic dopamine can strongly affect motivation/effort-cost relation in rodents.
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Affiliation(s)
- Artem Savchenko
- Programme for Proteomics, Paracelsus Medical University, Salzburg, Austria
- Department of Psychopharmacology, Valdman Institute of Pharmacology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Irina Belozertseva
- Department of Psychopharmacology, Valdman Institute of Pharmacology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Damiana Leo
- Department of Neurosciences, University of Mons, Mons, Belgium
| | - Ilya Sukhanov
- Department of Psychopharmacology, Valdman Institute of Pharmacology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
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de Groot ADE, Borra LCP, van der Hulst R, Etsouli O, Kloos DP, Rijken DJ, Elsinga PH, Boersma HH, Bosman IJ, Touw DJ. Postmortem redistribution of amphetamines and benzodiazepines in humans: Important variables that might be influencing the central blood / peripheral blood ratio. Forensic Sci Int 2023; 353:111876. [PMID: 37931468 DOI: 10.1016/j.forsciint.2023.111876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/17/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION The primary objective of postmortem forensic toxicology is to determine if toxicological substances detected in bodily material of victims have contributed to the death of the victim. Interpretation of postmortem drug concentrations is hindered by the fact that time and site dependent variations in postmortem drug concentrations occur, as a result of postmortem redistribution (PMR). An often-used marker for the occurrence of PMR, is the cardiac blood concentration/peripheral blood concentration ratio (C/P ratio) of a drug. In this study, we investigated the relationship between 13 variables and the C/P ratios of amphetamines and benzodiazepines. METHOD Toxicological results of all postmortem cases that were positive for amphetamines (amphetamine, MDMA, MDA) and/or benzodiazepines (diazepam, desmethyldiazepam, temazepam, oxazepam, midazolam, α-hydroxymidazolam) investigated by the Netherlands Forensic Institute between January 1 2010 and July 31 2020 were reviewed. A total of 112 amphetamine positive cases (224 paired specimen) and 179 benzodiazepine positive cases (358 paired specimen) were selected. The C/P ratios were determined for all selected cases. Ratios were compared between subgroups by performing either a Mann-Whitney U test or a Kruskal-Wallis test followed by post-hoc Mann-Whitney U test. RESULTS After dividing cases in quartiles based on their amphetamine concentration in femoral blood, the amphetamine C/P ratio was significantly lower in cases with a high amphetamine concentration (quartile 4) compared to cases with a low amphetamine concentration (quartiles 1 and 2) with median C/P ratios of 1.6, 2.4 and 2.2, respectively (p-value<0.001 and p-value=0.001, respectively). The MDA C/P ratio was significantly higher in cases where trauma was the cause of death compared to cases where intoxication was the cause of death with median C/P ratios of 3.3 and 1.6, respectively (p-value<0.001). The MDA C/P ratio was also significantly lower in cases where resuscitation was attempted compared to cases where no resuscitation was attempted with median C/P ratios of 1.6 and 2.4, respectively (p-value=0.003). However, a significant dependency between the variables cause of death and attempted resuscitation was observed. No significant differences in benzodiazepine C/P ratios were observed between subgroups of any of the investigated variables. However, the low p-value of BMI suggests a potential difference in midazolam C/P ratio between BMI subgroups (p-value=0.027). CONCLUSION When interpreting postmortem toxicological results, it might prove useful to take the above-mentioned variables into account.
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Affiliation(s)
- Alida Daniëlle Elisabeth de Groot
- University of Groningen, Faculty of Science and Engineering, Department of Pharmacy, Nijenborgh 4, 9747AG Groningen, the Netherlands
| | | | - Rogier van der Hulst
- Netherlands Forensic Institute, Laan van Ypenburg 6, 2497GB The Hague, the Netherlands
| | - Oumaima Etsouli
- Franciscus Gasthuis en Vlietland, Department of Clinical Pharmacy, Kleiweg 500, 3045 PM Rotterdam, the Netherlands
| | - Dick-Paul Kloos
- Netherlands Forensic Institute, Laan van Ypenburg 6, 2497GB The Hague, the Netherlands
| | | | - Philip Hein Elsinga
- Uiversity Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Hendrikus Hessel Boersma
- University of Groningen, Faculty of Medical Sciences, Antonius Deusinglaan 1, 973AV Groningen, the Netherlands; University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Hanzeplein 1, 9713GZ Groningen, the Netherlands
| | - Ingrid Jolanda Bosman
- Netherlands Forensic Institute, Laan van Ypenburg 6, 2497GB The Hague, the Netherlands
| | - Daniel Johannes Touw
- University of Groningen, Faculty of Medical Sciences, Antonius Deusinglaan 1, 973AV Groningen, the Netherlands; University Medical Center Groningen, Department of Clinical Pharmacy and Pharmacology, Hanzeplein 1, 9713GZ Groningen, the Netherlands; University of Groningen, Faculty of Science and Engineering, Pharmaceutical Analysis - Groningen Research Institute of Pharmacy, Antonius Deusinglaan 1, 9713AV Groningen, the Netherlands
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Hicks S, Miller BD. Emergency department management of meth amphetamine toxicity. Emerg Med Pract 2023; 25:1-20. [PMID: 37877728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Management of patients who are acutely intoxicated with methamphetamine (a member of the substituted amphetamine class of drugs) can be resource-intensive for most emergency departments. Clinical presentations of the methamphetamine sympathomimetic toxidrome range from mild agitation to rhabdomyolysis, acute kidney injury, seizures, and intracranial hemorrhage. High-quality evidence on how to best manage these patients is lacking, and most research focuses on symptomatic interventions to control patients' agitation and hemodynamics. This review analyzes the best available evidence on the diagnosis and management of emergency department patients with substituted amphetamine toxicity and offers best-practice recommendations on treatment and disposition.
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Affiliation(s)
- Sherell Hicks
- Assistant Professor, Assistant Residency Program Director, Department of Emergency Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL
| | - Briana D Miller
- Fellow and Clinical Instructor, Department of Emergency Medicine, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, AL
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Crispo JA, Liu L, Bach P, Ansell DR, Sivapathasundaram B, Nguyen F, Kurdyak P, Seitz DP, Conlon M, Cragg JJ. Amphetamine-Related Emergency Department Visits in Ontario, Canada, 2003-2020. Can J Psychiatry 2023; 68:838-849. [PMID: 36891572 PMCID: PMC10590093 DOI: 10.1177/07067437231158933] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
OBJECTIVES Despite unregulated amphetamine use increasing, there are limited data on related emergency department (ED) visits in Canada. Our primary objective was to examine trends in amphetamine-related ED visits over time in Ontario, including by age and sex. Secondary objectives were to examine whether patient characteristics were associated with ED revisit within 6 months. METHODS Using administrative claims and census data, we calculated annual patient- and encounter-based rates of amphetamine-related ED visits from 2003 to 2020 among individuals 18+ years of age. We also performed a retrospective cohort study of individuals with amphetamine-related ED visits between 2019 and 2020 to determine whether select factors were associated with ED revisit within 6 months. Multivariable logistic regression modelling was used to measure associations. RESULTS The population-based rate of amphetamine-related ED visits increased nearly 15-fold between 2003 (1.9/100,000 Ontarians) and 2020 (27.9/100,000 Ontarians). Seventy-five percent of individuals returned to the ED for any reason within 6 months. Psychosis and use of other substances were both independently associated with ED revisit for any reason within 6 months (psychosis: AOR = 1.54, 95% CI = 1.30-1.83; other substances: AOR = 1.84, 95% CI = 1.57-2.15), whereas having a primary care physician was negatively associated with ED revisit (AOR = 0.77, 95% CI = 0.60-0.98). CONCLUSIONS Increasing rates of amphetamine-related ED visits in Ontario are cause for concern. Diagnoses of psychosis and the use of other substances may serve to identify individuals who are most likely to benefit from both primary and substance-specific care.
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Affiliation(s)
- James A.G. Crispo
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- Human Sciences Division, NOSM University, Sudbury, Ontario, Canada
- ICES North, Sudbury, Ontario, Canada
| | - Lisa Liu
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Paxton Bach
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Centre on Substance Use, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - Dominique R. Ansell
- Emergency Department, Health Sciences North, Sudbury, Ontario, Canada
- Clinical Sciences Division, NOSM University, Sudbury, Ontario, Canada
| | | | | | - Paul Kurdyak
- ICES, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Dallas P. Seitz
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michael Conlon
- Health Sciences North Research Institute, Sudbury, Ontario, Canada
- ICES, Toronto and North, Ontario, Canada
| | - Jacquelyn J. Cragg
- Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
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Chang SH, Pai PY, Hsu CH, Marthandam Asokan S, Tsai BCK, Weng WT, Kuo WW, Shih TC, Kao HC, Chen WST, Huang CY. Estimating the impact of drug addiction causes heart damage. Drug Chem Toxicol 2023; 46:1044-1050. [PMID: 36216784 DOI: 10.1080/01480545.2022.2122984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/26/2022] [Accepted: 09/01/2022] [Indexed: 11/03/2022]
Abstract
To date, few studies have investigated the toxicological effects of the combined use of amphetamine and heroin in the heart. Hence, the aim of this study was to identify indicators for clinical evaluation and prevention of cardiac injury induced by the combined use of amphetamine and heroin. Four different groups were analyzed: (1) normal group (n=25;average age=35 ± 6.8); (2) heart disease group (n=25;average age=58 ± 17.2); (3) drug abusers (n = 27; average age = 37 ± 7.7); (4) drug abstainers (previous amphetamine-heroin users who had been drug-free for more than two weeks; n = 22; average age = 35 ± 5.6). The activity of MMPs, and levels of TNF-α, IL-6, GH, IGF-I, and several serum biomarkers were examined to evaluate the impact of drug abuse on the heart. The selected plasma biomarkers and classic cardiac biomarkers were significantly increased compared to the normal group. The zymography data showed the changes in cardiac-remodeling enzymes MMP-9 and MMP-2 among combined users of amphetamine and heroin. The levels of TNF-α and IL-6 only increased in the heart disease group. Growth hormone was increased; however, IGF-I level decreased with drug abuse and the level was not restored by abstinence. We speculated that the amphetamine-heroin users might pose risk to initiate heart disease even though the users abstained for more than two weeks. The activity change of MMP-9 and MMP-2 can be a direct reason affecting heart function. The indirect reason may be related to liver damage by drug abuse reduce IGF-1 production to protect heart function.
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Affiliation(s)
- Sheng-Huang Chang
- Department of Health, Executive Yuan, Tsao-Tun Psychiatric Center, Nantou, Taiwan
| | - Pei-Ying Pai
- Division of Cardiology, China Medical University Hospital, Taichung, Taiwan
| | - Chiung-Hung Hsu
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Shibu Marthandam Asokan
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Biotechnology, Bharathiar University, Coimbatore, Tamil Nadu, India
| | - Bruce Chi-Kang Tsai
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Wen-Tsan Weng
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Wei-Wen Kuo
- Department of Biological Science and Technology, China Medical University, Taichung, Taiwan
- Ph.D. Program for Biotechnology Industry, China Medical University, Taichung, Taiwan
| | - Tzu-Ching Shih
- Department of Biomedical Imaging and Radiological Science College of Medicine, China Medical University, Taichung, Taiwan
| | - Hui-Chuan Kao
- Department of Public Health, Tzu Chi University, Hualien, Taiwan
| | - William Shao-Tsu Chen
- Department of Psychiatry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Human Development and Psychology, Tzu Chi University, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chih-Yang Huang
- Cardiovascular and Mitochondrial Related Disease Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung, Taiwan
- Center of General Education, Tzu Chi University of Science and Technology, Hualien, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
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Jarlais DCD, McKnight C, Weng CA, Feelemyer J, Tross S, Raag M, Org G, Talu A, Uuskula A. Field Testing the "Avoid the Needle" Intervention for Persons at Risk for Transitioning to Injecting Drug Use in Tallinn, Estonia and New York City, USA. AIDS Behav 2023; 27:3767-3779. [PMID: 37249805 PMCID: PMC10227783 DOI: 10.1007/s10461-023-04094-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2023] [Indexed: 05/31/2023]
Abstract
This study aimed to field tested the "Avoid the Needle" (AtN) intervention to reduce transitions from non-injecting to injecting drug use in two different epidemiological settings. Respondent driven sampling was used to recruit current non-injecting drug users (NIDUs) in Tallinn, Estonia in 2018-19 and in New York City (NYC) in 2019-20. Both persons who had never injected and persons who had previously injected but not in the last 6 months were eligible; a structured interview was administered, a blood sample collected, and the intervention administered by trained interventionists. We recruited 19 non-injectors from Tallinn and 140 from NYC. Participants in Tallinn were younger and had begun using drugs at earlier ages than participants in NYC. The primary drugs used in Tallinn were amphetamine, fentanyl, and opioid analgesics, while in NYC they were heroin, cocaine, speedball, and fentanyl. Six-month follow-up data were obtained from 95% of participants in Tallinn. The study was interrupted by COVID-19 lockdown in NYC, but follow-up data were obtained from 59% of participants. There were minimal transitions to injecting: 1/18 in Tallinn and 0/83 in NYC. There were significant declines in the frequencies of using readily injectable drugs (fentanyl, amphetamine, heroin, cocaine) from baseline to follow-up in both sites (Cochran-Armitage tests for trend, χ2 = 21.3, p < 0.001 for New York City; and χ2 = 3.9, p = 0.048 for Tallinn). Reducing transitions into injecting is a potentially very important method for reducing HIV transmission and other harms of drug use. Further investigation and implementation of AtN type interventions is warranted.
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Affiliation(s)
- Don C Des Jarlais
- New York University School of Global Public Health, New York, NY, USA.
| | - Courtney McKnight
- New York University School of Global Public Health, New York, NY, USA
| | | | | | - Susan Tross
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Mait Raag
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | | | - Ave Talu
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Anneli Uuskula
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
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Fogarty MF, Krotulski AJ, Papsun DM, Walton SE, Lamb M, Truver MT, Chronister CW, Goldberger BA, Logan BK. N,N-Dimethylpentylone (dipentylone)-A new synthetic cathinone identified in a postmortem forensic toxicology case series. J Anal Toxicol 2023; 47:753-761. [PMID: 37329303 DOI: 10.1093/jat/bkad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/17/2023] [Accepted: 06/15/2023] [Indexed: 06/19/2023] Open
Abstract
Synthetic cathinones emerged on the novel psychoactive substance (NPS) drug market as alternatives to controlled stimulants and entactogens such as methamphetamine and 3,4-methylenedioxymethamphetamine. The majority of synthetic cathinones can be subclassified into two groups: beta-keto amphetamines (i.e., NPS with the suffix "drone") and beta-keto methylenedioxyamphetamines (i.e., NPS with the suffix "lone"). Although a significant number of beta-keto amphetamines have been identified, beta-keto methylenedioxyamphetamines have dominated the NPS market, including notable drugs like methylone, butylone, N-ethyl pentylone (ephylone), eutylone and now N,N-dimethylpentylone. N,N-Dimethylpentylone, also known as dipentylone or beta-keto-dimethylbenzodioxolylpentanamine, emerged into the illicit drug supply <2 months of the international control of eutylone (September 2021). A novel standard addition method was developed and validated for N,N-dimethylpentylone, pentylone and eutylone, and 18 postmortem cases were quantitated using the method described in this manuscript. The resulting blood concentration range for N,N-dimethylpentylone in this case series was 3.3 to 970 ng/mL (median: 145 ng/mL, mean: 277 ± 283 ng/mL). Pentylone, a metabolite of N,N-dimethylpentylone, was detected in all cases (range: 1.3-420 ng/mL, median: 31 ng/mL and mean: 88 ± 127 ng/mL). Due to the rise in identifications of N,N-dimethylpentylone in postmortem investigations as well as the potential misidentification of N,N-dimethylpentylone as N-ethyl pentylone, samples testing positive for pentylone should be additionally confirmed for the presence of N,N-dimethylpentylone. Based on prior trends of new synthetic cathinones, it can be theorized that N,N-dimethylpentylone may predominate the US synthetic stimulant market for the next 1-2 years; however, given the emergence of additional closely related isomeric compounds, it is important to utilize methodology capable of differentiating N,N-dimethylpentylone from its isomers (N-isopropylbutylone, N-ethyl pentylone, N-ethyl N-methyl butylone, hexylone, N-propylbutylone, diethylone and tertylone).
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Affiliation(s)
- Melissa F Fogarty
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, 2300 Stratford Avenue, Willow Grove, PA 19090, USA
| | - Alex J Krotulski
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, 2300 Stratford Avenue, Willow Grove, PA 19090, USA
| | | | - Sara E Walton
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, 2300 Stratford Avenue, Willow Grove, PA 19090, USA
| | - Michael Lamb
- NMS Labs, 200 Welsh Road, Horsham, PA 19044, USA
| | - Michael T Truver
- Forensic Toxicology Laboratory, Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, 4800 SW 35th Drive, Gainesville, FL 32608, USA
| | - Chris W Chronister
- Forensic Toxicology Laboratory, Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, 4800 SW 35th Drive, Gainesville, FL 32608, USA
| | - Bruce A Goldberger
- Forensic Toxicology Laboratory, Department of Pathology, Immunology, and Laboratory Medicine, University of Florida College of Medicine, 4800 SW 35th Drive, Gainesville, FL 32608, USA
| | - Barry K Logan
- Center for Forensic Science Research and Education, Fredric Rieders Family Foundation, 2300 Stratford Avenue, Willow Grove, PA 19090, USA
- NMS Labs, 200 Welsh Road, Horsham, PA 19044, USA
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Black C, Russell M, Mayo E, Aitcheson C. Rapid analysis of amphetamine-type substances using Agilent's QuickProbe gas chromatograph/mass spectrometer technology. J Mass Spectrom 2023; 58:e4976. [PMID: 37903530 DOI: 10.1002/jms.4976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 11/01/2023]
Abstract
The Agilent QuickProbe gas chromatograph/mass spectrometer (QP-GCMS) is a rapid analytical instrument requiring minimal sample preparation. The instrument was considered for the screening of samples for potential implementation at New Zealand's border screening laboratory. One of the project's primary aims was to validate the method for the analysis of border seizures, including drug concealments, novel psychoactive substances (NPS), low-dose drugs and unknown substances. For the application to be useful beyond the capabilities of current handheld point-of-contact (POC) devices, the initial evaluation has included the analysis of a large variety of compounds in a large variety of matrices. These data will be reported separately. However, during the evaluation, several chromatographical challenges were encountered during the analysis of amphetamine-type substances (ATS). As such, the QP-GCMS required some troubleshooting and method development to improve resolution for this class of compounds.
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Affiliation(s)
- Chrissy Black
- The Institute of Environmental Science and Research (ESR), Auckland, New Zealand
| | - Matthew Russell
- The Institute of Environmental Science and Research (ESR), Auckland, New Zealand
| | - Erina Mayo
- The Institute of Environmental Science and Research (ESR), Auckland, New Zealand
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40
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Carrica LK, Gulley JM. The role of sex and drug use during adolescence in determining the risk for adverse consequences of amphetamines. Adv Pharmacol 2023; 99:125-144. [PMID: 38467479 DOI: 10.1016/bs.apha.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
Use of amphetamines during adolescence, a critical period of brain development and reorganization, may lead to particularly adverse outcomes that are long-lasting. Similarly, female users may be uniquely vulnerable to certain aspects of drug use. A recognition of the role of use during adolescence and sex on outcomes of amphetamine and methamphetamine exposure are of critical importance in understanding and treating substance use disorders. This chapter highlights what human research, which has been largely epidemiological, suggests about sex and age differences in drug use patterns and outcomes. We also discuss work in laboratory animals that has typically utilized rats or mice exposed to drugs in a non-contingent manner (i.e., involuntarily) or through volitional self-administration. Lastly, we draw attention to the fact that advancing our understanding of the effects of amphetamine and methamphetamine use, the development of problematic drug taking, and the mechanisms that contribute to relapse will require an emphasis on inclusion of age and sex as moderating factors in future studies.
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Affiliation(s)
- Lauren K Carrica
- Department of Psychology, University of Illinois, Urbana-Champaign, IL, United States
| | - Joshua M Gulley
- Department of Psychology, University of Illinois, Urbana-Champaign, IL, United States; Neuroscience Program, University of Illinois, Urbana-Champaign, IL, United States; Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana-Champaign, IL, United States.
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41
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Lawrence TI, Sims N, Kasprzyk-Hordern B, Jonnalagadda SB, Martincigh BS. Wastewater profiling of illicit drugs, an estimation of community consumption: A case study of eThekwini Metropolitan Municipality, South Africa. Environ Pollut 2023; 335:122270. [PMID: 37516292 DOI: 10.1016/j.envpol.2023.122270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 07/31/2023]
Abstract
Estimation of community-wide consumption of illicit drugs through wastewater analysis is a new concept in Africa although widely applied in developed nations as wastewater-based epidemiology (WBE). It is an important tool that can be used in understanding supply and demand patterns of illicit drug use on a local, national, and international scale. Information on illicit drug use is currently limited in Africa, because of a lack of monitoring structures by governments and financial constraints. This study hopes to bridge that gap by contributing to Africa's baseline information on illicit drug use. This study provides the first application of wastewater analysis to quantitatively evaluate daily illicit drug use in the eThekwini Metropolitan Municipality of KwaZulu-Natal Province of South Africa by quantifying the major urinary excreted metabolites, called drug target residues (DTRs), in raw wastewater from four major wastewater treatment plants (WWTPs) sampled for a week. The results showed that cocaine was the dominant illicit drug consumed in the catchment followed by amphetamine, methamphetamine, 3,4-methylenedioxymethamphetamine and 3,4-methylenedioxyamphetamine, with a per capita use of 360-3000 mg day-1 1000 inh-1, 47-800 mg day-1 1000 inh-1, 19-120 mg day -1 1000 inh-1, not detected (ND) to 4.9 mg day-1 1000 inh-1, and ND to 410 g day-1 1000 inh-1 respectively. The weekly usage patterns between the four WWTPs differed probably due to the lifestyle of the populace serving the different WWTPs. These results provide useful data on illicit drug use in eThekwini that can be utilised by public health agencies to implement suitable response strategies.
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Affiliation(s)
- Tolulope I Lawrence
- School of Chemistry and Physics, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa.
| | - Natalie Sims
- Department of Chemistry, University of Bath, Bath, BA2 7AY, United Kingdom
| | | | - Sreekantha B Jonnalagadda
- School of Chemistry and Physics, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa
| | - Bice S Martincigh
- School of Chemistry and Physics, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa.
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Tan D, Liang Y, Guo T, Wang Y, Li Y, Sun X, Wang D. Dummy molecularly imprinted polymers-agarose gel mixed matrix membrane for extraction of amphetamine-type stimulants in wastewater and urine. J Chromatogr A 2023; 1708:464368. [PMID: 37708673 DOI: 10.1016/j.chroma.2023.464368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/17/2023] [Accepted: 09/06/2023] [Indexed: 09/16/2023]
Abstract
Dummy molecularly imprinted polymers (DMIPs) with high selectivity for amphetamine-type stimulants (ATSs) were synthesized using synephrine molecule as a dummy template. The polymers were irregularly massive with a specific surface area of 330 m2g-1. Adsorption experiments found that the imprinting factors for five ATSs (amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine, 3,4-methylenedioxymethamphetamine, and 3,4-methylenedioxy-N-ethylamphetamine) were 2.3∼3.7. The DMIPs-agarose gel mixed matrix membranes (MMMs) were further prepared by incorporating DMIPs in the agarose matrix. MMMs were used to extract five ATSs from wastewater and urine samples. Extraction conditions such as membrane matrix, sample pH, dissolved organic matter content, extraction time, and elution reagent were optimized. Under optimal conditions, the developed MMMs-HPLC-MS/MS method exhibited low limits of detection (0.1∼3.0ng L-1), satisfactory recoveries (91.7∼100%), and good repeatability (RSD<7%, n=3). It was then successfully applied to ATSs analysis in wastewater and urine samples. Recoveries of ATSs in spiked wastewater and urine were 82.0∼98.4% and 82.3∼95.7%, respectively. Moreover, compared with other methods, the present method possessed the advantages of high quantitative ability, suitable for typical environmental conditions, and low application cost. The above results suggested that the developed MMMs-HPLC-MS/MS method could be used as a feasible strategy to extract and determine trace ATSs in wastewater and urine samples.
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Affiliation(s)
- Dongqin Tan
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, China.
| | - Yi Liang
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, China
| | - Ting Guo
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, China
| | - Yue Wang
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, China
| | - Yanying Li
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, China
| | - Xiaoli Sun
- Department of Chemistry, Lishui University, Lishui 32300, China
| | - Degao Wang
- College of Environmental Science and Engineering, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, China.
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Gao CX, Filia KM, Bedi G, Menssink JM, Brown E, Rickwood DJ, Parker AG, Hetrick SE, Herrman H, Hickie I, Telford N, McGorry PD, Cotton SM. Understanding the complexity, patterns, and correlates of alcohol and other substance use among young people seeking help for mental ill-health. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1457-1467. [PMID: 36914881 PMCID: PMC10460308 DOI: 10.1007/s00127-023-02444-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/27/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE Use of alcohol and other substances is a multifaceted issue impacting young people across multiple life domains. This paper aims to elucidate patterns of substance use and associated demographic and clinical factors among young people seeking treatment for their mental health. METHODS Young people (12-25 years old) were recruited from five youth-specific primary mental health ("headspace") services in Australia. Self-reported substance use and harms in the past 3 months were measured using WHO-ASSIST. Network analyses were conducted to evaluate interrelationships between use and harms associated with different substances. Subgroups were then identified based on whether participants reported using high centrality substances, and associated demographic and clinical factors were assessed with multinomial logistic regression. RESULTS 1107 youth participated. 70% reported use of at least one substance in the past 3 months, with around 30% of those reporting related health, social, legal or financial problems. Network analysis highlighted substantial interconnections between use and harm indicators for all substances, with amphetamine-type stimulants (ATS) and cannabis being high central substances. Higher levels of substance use and harms were reported in subgroups with ATS or cannabis use and different risk factors were associated with these subgroups. CONCLUSIONS Findings highlight the importance of screening for substance use in youth primary mental healthcare settings, offering a key opportunity for early intervention. Clinicians should be aware of the inner connections of use and harms of different drugs and the role of cannabis and amphetamine use as a marker for more substance use profiles.
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Affiliation(s)
- Caroline X Gao
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
- Orygen, 35 Poplar Road, Parkville, VIC, Australia.
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Kate M Filia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - Gillinder Bedi
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - Jana M Menssink
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - Ellie Brown
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - Debra J Rickwood
- Headspace, National Youth Mental Health Foundation, Melbourne, VIC, Australia
- Faculty of Health, University of Canberra, ACT, Canberra, Australia
| | - Alexandra G Parker
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Sarah E Hetrick
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Helen Herrman
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - Ian Hickie
- Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Nic Telford
- Headspace, National Youth Mental Health Foundation, Melbourne, VIC, Australia
| | - Patrick D McGorry
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
| | - Sue M Cotton
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, 35 Poplar Road, Parkville, VIC, Australia
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44
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Lopera SD, O'Kane VM, Goldhirsh JL, Piper BJ. Regional Disparities in Prescription Meth amphetamine and Amphetamine Distribution Across the United States. J Atten Disord 2023; 27:1322-1331. [PMID: 37288726 DOI: 10.1177/10870547231177467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The objectives of this report were to characterize the regional and state differences in prescription methamphetamine and amphetamine distribution in the US. METHODS Prescription methamphetamine and amphetamine distribution was obtained from the Drug Enforcement Administration for 2019. RESULTS Total per capita drug weight distribution of amphetamine was 4,000 times higher than methamphetamine. Regionally, total per capita drug weight for methamphetamine was highest in the West (32.2% of total distribution) and lowest in the Northeast (17.4%). The total per capita drug weight for amphetamine was highest in the South (37.0% of total distribution) and lowest in the Northeast (19.4%). Distribution of methamphetamine was 16.1% while amphetamine was 54.0% of its production quota. CONCLUSION Overall, prescription amphetamine distribution was common while prescription methamphetamine distribution was rare. The patterns observed in distribution are likely the result of stigmatization, differences in accessibility, and the efforts of initiatives such as the Montana Meth Project.
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Affiliation(s)
- Sarah D Lopera
- Geisinger Commonwealth School of Medicine, Scranton, PA, USA
| | | | | | - Brian J Piper
- Geisinger Commonwealth School of Medicine, Scranton, PA, USA
- Center for Pharmacy Innovation and Outcomes, Scranton, PA, USA
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45
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Weant KA, Hall GA. Possible Delay in Symptomatology of a Methadone Overdose in a Patient Ingesting an Energy Drink and Dextro amphetamine/Amphetamine. J Pharm Pract 2023; 36:1249-1252. [PMID: 35514326 DOI: 10.1177/08971900221100812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Methadone is a mu-opioid agonist with a delayed time to peak concentration that requires an extended period of monitoring following an overdose. Available data suggests that the combination of psychostimulants with methadone may augment antinociception and tolerance to opioids. Case Report: A 26-year-old male (83.9 kg) presented to the ED approximately 1 hour after unintentionally ingesting 200-250 mg of liquid methadone and an energy drink, along with 20 mg of dextroamphetamine/amphetamine prior to the event. Vital signs were: blood pressure (BP), 143/91 mmHg; heart rate (HR), 74; respirations (RR), 16; oxygen saturation 95% on room air. His urine drug screen was positive for amphetamines and methadone. Patient was monitored for 4 hours with no change in status and was discharged home. Approximately 26 hours later patient was found cyanotic and apneic. Patient was given 2 mg of naloxone and awoke with normal mental status. On presentation the patient's vital signs were: BP, 114/70 mmHg; HR, 114; RR 16; oxygen saturation 94% on 3 liters nasal cannula. During his ED stay, he required 2 doses of naloxone secondary to oxygen desaturation and was admitted to the hospital. His repeat urine drug screen was positive for amphetamines and methadone. The patient was discharged the following day. Discussion: This case illustrates an unintentional methadone overdose combined with the intentional ingestion of an energy drink and dextroamphetamine/amphetamine that possibly masked the toxicity for over 24 hrs. Monitoring parameters for methadone overdoses may need re-evaluation in the setting of the co-ingestion of a stimulant.
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Affiliation(s)
- Kyle A Weant
- College of Pharmacy, University of South Carolina, Columbia, SC, USA
| | - Gregory A Hall
- Department of Emergency Medicine, Medical University of South Carolina, Charleston, SC, USA
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46
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Kumar G, Auckley D, Merrick T, Breckenridge M, Carter JC, Ali M. False positive urine amphetamine immunoassay due to solriamfetol. Sleep Med 2023; 110:297-299. [PMID: 37708619 DOI: 10.1016/j.sleep.2023.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023]
Abstract
Solriamfetol is a schedule IV-controlled substance used to treat excessive daytime sleepiness resulting from narcolepsy or obstructive sleep apnea. We present a patient prescribed solriamfetol who tested positive for amphetamines on a routine urinary toxicology screen despite patient denial of illicit drug use, raising the possibility of a false positive amphetamine screen. Spiking studies were performed on negative urine, and different concentrations of solriamfetol drug on 2 different amphetamine assays: the commonly used Beckman Emit® II Plus Amphetamines Assay, and the Citrine™ Triple Quad™ MS/MS Systems. The Beckman yielded positive results for amphetamines at solriamfetol concentrations of 200 μg/mL and 2000 μg/mL and negative results at 0.2 μg/mL and 2 μg/mL. However, the Citrine™ Triple Quad™ MS/MS Systems was negative at all concentrations. The Beckman Emit® II Plus Amphetamine Assay gave false positive results for amphetamines due to solriamfetol drug usage, a finding of relevance to prescribers of solriamfetol.
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Affiliation(s)
- Gopal Kumar
- Department of Pathology, MetroHealth System, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Dennis Auckley
- Case Western Reserve University School of Medicine, Cleveland, OH, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, MetroHealth System Cleveland, OH, USA.
| | - Troy Merrick
- Department of Pathology, MetroHealth System, Cleveland, OH, USA
| | | | - John C Carter
- Case Western Reserve University School of Medicine, Cleveland, OH, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, MetroHealth System Cleveland, OH, USA
| | - Mahesheema Ali
- Department of Pathology, MetroHealth System, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Brousseau NM, Kalichman SC, Watson RJ, Eaton LA. Amphetamine use and its associations with antiretroviral adherence and viral load among sexual minority men and transgender women living with HIV. AIDS Care 2023; 35:1472-1479. [PMID: 37139536 PMCID: PMC10524564 DOI: 10.1080/09540121.2023.2206096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 04/17/2023] [Indexed: 05/05/2023]
Abstract
Substance use has complex associations to HIV disease progression. The current study tested the associations between several substances and HIV viral load while accounting for confounders relevant to HIV disease progression and substance use. Young sexual minority men and transgender women living with HIV (LWH) in Georgia (N = 385) completed measures and biological tests for HIV viral load and substance use. Multivariable regression models tested the role of specific drugs (i.e., alcohol, cannabis/THC, cocaine, and combined amphetamine and methamphetamine) directly on viral load and indirectly through antiretroviral (ART) adherence. ART adherence and HIV care self-efficacy were consistently associated with greater HIV suppression. Alcohol and cocaine were not associated with ART adherence or viral load. Cannabis was negatively associated with ART adherence (B = -.053, p = .037) but not viral load. Amphetamine/methamphetamine demonstrated significant direct effects on higher viral load (B = .708, p = .010) while indirectly influencing viral load through a negative association with ART adherence. Our findings support previous research demonstrating amphetamine/methamphetamine use impacts viral load both directly and indirectly through ART adherence. Interventions addressing amphetamine/methamphetamine use by young sexual minority men and transgender women LWH are urgently needed, and future research should focus on determining the mechanisms by which formulations of amphetamine impact HIV replication.Trial registration: ClinicalTrials.gov identifier: NCT03665532.
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Affiliation(s)
- Natalie M Brousseau
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Seth C Kalichman
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Ryan J Watson
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
| | - Lisa A Eaton
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, USA
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48
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Mostafa T, Alghobary M. Substance abuse and male sexual dysfunction: what lies beneath? Sex Med Rev 2023; 11:395-411. [PMID: 37085960 DOI: 10.1093/sxmrev/qead011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Substance abuse has become a worldwide health problem, leading to numerous consequences such as social problems among family members, abnormal behavior, adverse health effects, and psychological problems as well as economic consequences. OBJECTIVES We sought to assess the relationship between substance abuse and male sexual health. METHODS A search was carried out in the following databases: PubMed, MeSH (Medical Subject Headings), Science Direct, Scopus, Cochrane Library, EMBASE, CINAHL, Academic Search Complete, and the Egyptian Knowledge Bank. The following keywords were used to assess the outcomes for relevant associations: illicit drugs, addiction, substance abuse, sexual health, erectile dysfunction, ejaculatory disorders, impotence, orgasm disorders, and sexual performance. RESULTS The initial literature search identified a total of 148 articles in all searched databases. After removal of duplicate studies and application of inclusion/exclusion criteria, 75 reported studies were retained for review, including 38 case-control studies and 37 cross-sectional studies. These articles were classified into the following categories according to the type of abused substance addressed: cannabis/marihuana, 16 articles; opioids, 13 articles; heroin, 11 articles; cocaine, 5 articles; tramadol, 6 articles; ketamine, 2 articles; ecstasy, 4 articles; amphetamine, 2 articles; khat, 7 articles; androgen anabolic steroids, 2 articles; and polydrugs, 7 articles. Most of these recruited articles demonstrated a negative impact of the addressed substance on male sexual health, with variable levels. CONCLUSION Substance abuse has negative impacts on male sexual health that should be addressed. More studies conducted with proper methodological and statistical approaches, including logistic regression analysis, are needed to predict the effects of specific substances, considering the rapidly growing effects of non-substance-use disorders on male sexual health.
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Affiliation(s)
- Taymour Mostafa
- Department of Andrology, Sexology, & STIs, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
| | - Moheiddin Alghobary
- Department of Dermatology, Andrology & STIs, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
- Department of Clinical Science, Fakeeh College of Medical Sciences, Jeddah, KSA
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49
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Rockhill KM, Olson R, Dart RC, Iwanicki JL, Black JC. Differing Behaviors Around Adult Nonmedical Use of Prescription Stimulants and Opioids: Latent Class Analysis. J Med Internet Res 2023; 25:e46742. [PMID: 37728974 PMCID: PMC10551786 DOI: 10.2196/46742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/03/2023] [Accepted: 08/18/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND The availability of central nervous system stimulants has risen in recent years, along with increased dispensing of stimulants for treatment of, for example, parent-reported attention-deficit/hyperactivity disorder in children and new diagnoses during adulthood. Typologies of drug use, as has been done with opioids, fail to include a sufficient range of behavioral factors to contextualize person-centric circumstances surrounding drug use. Understanding these patterns across drug classes would bring public health and regulatory practices toward precision public health. OBJECTIVE The objective of this study was to quantitatively delineate the unique behavioral profiles of adults who currently nonmedically use stimulants and opioids using a latent class analysis and to contrast the differences in findings by class. We further evaluated whether the subgroups identified were associated with an increased Drug Abuse Screening Test-10 (DAST-10) score, which is an indicator of average problematic drug use. METHODS This study used a national cross-sectional web-based survey, using 3 survey launches from 2019 to 2020 (before the COVID-19 pandemic). Data from adults who reported nonmedical use of prescription stimulants (n=2083) or prescription opioids (n=6127) in the last 12 months were analyzed. A weighted latent class analysis was used to identify the patterns of use. Drug types, motivations, and behaviors were factors in the model, which characterized unique classes of behavior. RESULTS Five stimulant nonmedical use classes were identified: amphetamine self-medication, network-sourced stimulant for alertness, nonamphetamine performance use, recreational use, and nondiscriminatory behaviors. The drug used nonmedically, acquisition through a friend or family member, and use to get high were strong differentiators among the stimulant classes. The latter 4 classes had significantly higher DAST-10 scores than amphetamine self-medication (P<.001). In addition, 4 opioid nonmedical use classes were identified: moderate pain with low mental health burden, high pain with higher mental health burden, risky behaviors with diverse motivations, and nondiscriminatory behaviors. There was a progressive and significant increase in DAST-10 scores across classes (P<.001). The potency of the opioid, pain history, the routes of administration, and psychoactive effect behaviors were strong differentiators among the opioid classes. CONCLUSIONS A more precise understanding of how behaviors tend to co-occur would improve efficacy and efficiency in developing interventions and supporting the overall health of those who use drugs, and it would improve communication with, and connection to, those at risk for severe drug outcomes.
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Affiliation(s)
- Karilynn M Rockhill
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
| | - Richard Olson
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
| | - Richard C Dart
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
| | - Janetta L Iwanicki
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
| | - Joshua C Black
- Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, United States
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50
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Black E, Bruno R, Mammen K, Mills L, Siefried KJ, Deacon RM, Shakeshaft A, Dunlop AJ, Ezard N, Montebello M, Childs S, Reid D, Holmes J, Lintzeris N. Substance use, socio-demographic characteristics, and self-rated health of people seeking alcohol and other drug treatment in New South Wales: baseline findings from a cohort study. Med J Aust 2023; 219:218-226. [PMID: 37449648 DOI: 10.5694/mja2.52039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To investigate the demographic characteristics, substance use, and self-rated health of people entering treatment in New South Wales public health services for alcohol, amphetamine-type stimulants, cannabis, cocaine, or opioids use, by principal drug of concern. DESIGN Baseline findings of a cohort study; analysis of data in patient electronic medical records and NSW minimum data set for drug and alcohol treatment services. SETTING, PARTICIPANTS People completing initial Australian Treatment Outcomes Profile (ATOP) assessments on entry to publicly funded alcohol and other drug treatment services in six NSW local health districts/networks, 1 July 2016 - 30 June 2019. MAIN OUTCOME MEASURES Socio-demographic characteristics, and substance use and self-rated health (psychological, physical, quality of life) during preceding 28 days, by principal drug of concern. RESULTS Of 14 087 people included in our analysis, the principal drug of concern was alcohol for 6051 people (43%), opioids for 3158 (22%), amphetamine-type stimulants for 2534 (18%), cannabis for 2098 (15%), and cocaine for 246 (2%). Most people commencing treatment were male (9373, 66.5%), aged 20-39 years (7846, 50.4%), and were born in Australia (10 934, 86.7%). Polysubstance use was frequently reported, particularly by people for whom opioids or amphetamine-type stimulants were the principal drugs of concern. Large proportions used tobacco daily (53-82%, by principal drug of concern group) and reported poor psychological health (47-59%), poor physical health (32-44%), or poor quality of life (43-52%). CONCLUSIONS The prevalence of social disadvantage and poor health is high among people seeking assistance with alcohol, amphetamine-type stimulants, cannabis, cocaine, or opioids use problems. Given the differences in these characteristics by principal drug of concern, health services should collect comprehensive patient information during assessment to facilitate more holistic, tailored, and person-centred care.
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Affiliation(s)
- Emma Black
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- The University of Tasmania, Hobart, TAS
| | - Kristie Mammen
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Llewellyn Mills
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Krista J Siefried
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, NSW
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, NSW
| | - Rachel M Deacon
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- The Poche Centre for Indigenous Health, the University of Queensland, Brisbane, QLD
| | - Adrian J Dunlop
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, NSW
- The University of Newcastle, Newcastle, NSW
- Hunter Medical Research Institute, Newcastle, NSW
| | - Nadine Ezard
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- National Centre for Clinical Research on Emerging Drugs, University of New South Wales, Sydney, NSW
- Alcohol and Drug Service, St Vincent's Hospital Sydney, Sydney, NSW
| | - Mark Montebello
- Central Clinical School, the University of Sydney, Sydney, NSW
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Services, North Sydney Local Health District, Sydney, NSW
| | - Steven Childs
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Services, Central Coast Local Health District, Gosford, NSW
| | - David Reid
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
- Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, NSW
| | - Jennifer Holmes
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
| | - Nicholas Lintzeris
- Drug and Alcohol Services, South Eastern Sydney Local Health District, Sydney, NSW
- Central Clinical School, the University of Sydney, Sydney, NSW
- NSW Drug and Alcohol Clinical Research and Improvement Network (DACRIN), NSW Ministry of Health, Sydney, NSW
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