Showing papers in "Journal of Psychoactive Drugs in 2018"
TL;DR: The modern era of research regarding the use of psychedelic substances seems to fall quite naturally into two dichotomies as mentioned in this paper : the first dichotomy divides the results of such resea...
Abstract: The modern (last 65 or 70 years) era of research regarding the use of psychedelic substances seems to fall quite naturally into two dichotomies.The first dichotomy divides the results of such resea...
93 citations
TL;DR: Investigating heroin injectors’ perceptions and experiences of changes in the heroin supply in the East Coast city of Baltimore, Maryland, currently facing an epidemic in heroin- and fentanyl-related overdose deaths finds that Scramble heroin, while gaining market share, has become a highly unstable product.
Abstract: Since 2001, heroin-related overdose deaths in the United States have risen six-fold, a rise unaccounted for by the expanding user population. Has heroin become a more dangerous drug? Reports of fentanyl and its analogs, often concealed in or sold as heroin, have also increased sharply. This article investigates heroin injectors' perceptions and experiences of changes in the heroin supply in the East Coast city of Baltimore, Maryland, currently facing an epidemic in heroin- and fentanyl-related overdose deaths. Unusually, Baltimore's heroin market is divided between two types: "Raw," believed to be Colombian in origin and relatively pure, and the more adulterated "Scramble" (raw heroin traditionally blended with quinine and lactose). Users reported that Scramble heroin, while gaining market share, has become a highly unstable product, varying dramatically in appearance, intensity of onset, duration of action, and effect. Some considered that Scramble was no longer "heroin," but was heavily adulterated or even replaced, mentioning fentanyl, benzodiazepines, and crushed opioid pills as additives. There was intense awareness of overdose as a present danger in users' lives, which they linked to the recent adulteration of the heroin supply. Responses to this perceived adulteration varied, including information gathering, attraction, avoidance, taking precautions, and acceptance.
90 citations
TL;DR: Regular kratom users were recruited from the northern state of Penang (Malaysia) and the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) scales were used to assess the severity of the symptoms of anxiety and depression.
Abstract: Kratom leaves (Mitragyna speciosa Korth.) are traditionally used in Southeast Asia for their medicinal value. Self-report studies suggest that cessation from chronic kratom tea consumption (freshly...
46 citations
TL;DR: A conceptual model is proposed, which employs a sequential mediation model, identifying perceived coping self-efficacy, psychological distress, and self-medication as pathways to substance use after a disaster.
Abstract: This article applies constructs from the Self-Medication Hypothesis and Social Cognitive Theory to explain the development of substance use and psychological distress after a disaster. A conceptual model is proposed, which employs a sequential mediation model, identifying perceived coping self-efficacy, psychological distress, and self-medication as pathways to substance use after a disaster. Disaster exposure decreases perceived coping self-efficacy, which, in turn, increases psychological distress and subsequently increases perceptions of self-medication in vulnerable individuals. These mechanisms lead to an increase in postdisaster substance use. Last, recommendations are offered to encourage disaster researchers to test more complex models in studies on postdisaster psychological distress and substance use.
40 citations
TL;DR: The current article examines the evidence the DEA cited to support their decision to emergency schedule kratom and the degree and type of media coverage of kratom to determine if a media-driven drug panic occurred.
Abstract: Kratom is a traditional drug from Southeast Asia that has been an emerging new substance in the United States. On August 30, 2016, the DEA announced the intention to emergency schedule kratom into ...
39 citations
TL;DR: While larger numbers of individuals obtained naloxone after state law changed, PWUO—especially heroin users—were significantly more likely to reverse an overdose and return to PPP for a nalOXone refill.
Abstract: Distribution of the opioid overdose reversal drug naloxone has been central to efforts to combat the ongoing opioid epidemic in the United States. This report presents data from Prevention Point Pittsburgh (PPP), a public health advocacy and direct service organization that has operated an overdose prevention program (OPP) with naloxone distribution since 2005. The program initially provided naloxone training and distribution only to people who use opioids (PWUO). In 2015, a change to state law enabled PPP to provide naloxone to anyone in a position to respond to an opioid-related overdose. This report examines the characteristics and naloxone-related experiences of 1330 PWUO trained in overdose prevention and naloxone administration by PPP between January 1, 2006, and December 31, 2015, and compares rates of return for a naloxone refill by PWUO and the 619 non-users trained between January 1, 2015, and December 31, 2015. While larger numbers of individuals obtained naloxone after state law change...
32 citations
TL;DR: Drug prevention programs should consider targeting certain settings, including workplaces and sports clubs, for preventative interventions in response to the methamphetamine use epidemic in Iran.
Abstract: Background: Iran has experienced an emerging epidemic of methamphetamine use during recent years which has added to existing non-injecting and injecting opioid use in the country. This study explor...
30 citations
TL;DR: Being the victim of cyberbullying and both types of bullying was significantly associated with binge drinking and marijuana use, and important gender differences were found.
Abstract: The current research examines the association between bullying victimization, binge drinking, and marijuana use among adolescents We seek to determine if this association varies based on the type of bullying experienced, traditional or cyberbullying We used data from the 2013 Youth Risk Behavior Survey, a nationally representative sample of high school students in the United States The dependent variables were binge drinking and marijuana use Our key independent variable, bullying victimization, included both traditional and cyberbullying We estimated logistic regression models, by gender, to examine the association between bullying victimization and substance use About 25% of the sample reported bullying victimization, including 1039% for only traditional, 547% for only cyber, and 926% for both Traditional bullying was not significantly associated with binge drinking, but was negatively related to marijuana use Being the victim of cyberbullying and both types of bullying was significantly associated with binge drinking and marijuana use We also found important gender differences The current research adds to a growing list of studies that suggests that cyberbullying is associated with more adverse outcomes than traditional bullying Bullying prevention and intervention efforts should focus on reducing cyberbullying and providing adolescents with the skills needed to effectively deal with cyberbullying
28 citations
TL;DR: Ibogaine appears to facilitate opioid detoxification by reducing opioid withdrawal and craving in participants with OUD, and warrant further research using rigorous controlled trials.
Abstract: Opioid use disorder (OUD) is currently an epidemic in the United States (US) and ibogaine is reported to have the ability to interrupt opioid addiction by simultaneously mitigating withdrawal and c...
27 citations
TL;DR: Mental health disorder prevalence and substance use disorder severity were both elevated, and both methamphetamine and alcohol use Disorder severity were associated with increased likelihood of comorbid mental health disorder.
Abstract: Men who have sex with men (MSM) exhibit elevated rates of mental health and substance use disorder relative to their non-MSM male counterparts. Methamphetamine use in particular has been associated with both neuronal damage and mental health disorders among MSM, and this study reports on the prevalence and comorbidity of DSM-5 mental health and substance use disorders in a sample of methamphetamine-using MSM. From March 2014 through January 2015, 286 methamphetamine-using MSM enrolled in a study to reduce methamphetamine use and sexual risk behaviors. At baseline, participants demonstrated high rates of current major depressive episode (35.8%), antisocial personality disorder (23.9%), suicide risk (23.2%), obsessive-compulsive disorder (23.2%), and social phobia (20.4%), as well as methamphetamine use disorder (89.1%), marijuana use disorder (41.0%), alcohol use disorder (39.6%), cocaine use disorder (30.9%), and inhalants use disorder (15.4%). Analyses revealed significant (p < 0.05) associations between methamphetamine use disorder severity and all listed mental health disorders, as well as between alcohol use disorder and all listed mental health disorders. Mental health disorder prevalence and substance use disorder severity were both elevated, and both methamphetamine and alcohol use disorder severity were associated with increased likelihood of comorbid mental health disorder.
26 citations
TL;DR: The role of hitting bottom is explored as a motivation to initiate a recovery process and desistance from crime and substance use disorders, and in building recovery capital (RC) in the process of long-term recovery.
Abstract: The aim of this article is to explore the role of "hitting bottom" as a motivation to initiate a recovery process and desistance from crime and substance use disorders (SUDs), and in building recovery capital (RC). Researchers and practitioners have long been interested in why and how offenders desist from crime. Desistance and recovery from crime and SUDs have also been linked to negative turning points, such as hitting bottom, which represents multidimensional suffering with physiological, familial, social, and criminal implications. The deleterious outcomes of SUDs cause individuals to lose their social and personal resources and hit bottom. According to the conservation of resources model, in the context of actual or potential loss of resources, individuals strive to maintain, protect, and build them. Thus, hitting bottom not only provides the initial motivation for change, but also drives individuals to build personal resources. The prospects for successful recovery are dependent upon the individual's personal and social resources, or RC. This article represents a first step in examining the role of hitting bottom in building RC in the process of long-term recovery. The conclusions may have theoretical as well as practical implications.
TL;DR: Caution should be taken when considering the prescription of tianeptine to patients with prior history of substance abuse, and close monitoring for drug misuse is needed during the treatment period.
Abstract: Tianeptine is an atypical antidepressant approved in 25 countries for the treatment of depressive syndromes. Tianeptine abuse among psychiatric patients in the community and at inpatient wards has been increasingly reported in recent years. The purpose of this article is to alert clinicians to tianeptine abuse potential and identify any patterns in the literature. We searched the Academic Search Complete, Google Scholar, MEDLINE, Science Citation Index, Scopus, and the Social Sciences Citation Index for articles published between 1960–2017 in any language containing the keywords: “tianeptine abuse,” “tianeptine misuse,” “tianeptine dependence.” The search retrieved 18 cases. Higher frequency of tianeptine abuse/dependence was observed in women and 30- to 45-year-olds. Most cases (n = 13) reported a previous history of substance abuse. The therapeutic dose of tianeptine was exceeded 110-fold (i.e., up to 4125 mg/day) with a mean of about 1469 mg/day. The most prominent phenomena associated with tia...
TL;DR: Examination of attitudes, beliefs, and practices of palliative care providers regarding the use of cannabis for terminally ill patients demonstrated that palliatives care providers endorse cannabis for a wide range of palledative care symptoms, end-of-life care generally, and as an adjuvant medication.
Abstract: Medical cannabis research has become quite extensive, with indications ranging from glaucoma to chemotherapy-induced nausea. Despite increased interest in cannabis’ potential medical uses, research...
TL;DR: Cessation from regular kratom tea/juice consumption is not associated with prolonged pain and sleep problems, as compared to those reported for opioid analgesics.
Abstract: Kratom (Mitragyna speciosa Korth.) is traditionally used in Southeast Asia for its medicinal value and psychoactive properties. Nonetheless, cessation from regular kratom use is reported to cause u...
TL;DR: Age and substance use other than marijuana were consistent correlates of current and lifetime blunt use across all racial/ethnic groups, but other illicit drug use and alcohol use were differentially associated with lifetime and past-30-day blunt use by race/ethnicity.
Abstract: Blunt use is pervasive among adolescents. The study uses cross-sectional data from the 2014 National Survey on Drug Use and Health to examine sociodemographic, health, and other substance u...
TL;DR: Methamphetamine may increase the likelihood of PWID transmitting HIV to non-injecting primary sexual partners, as it can reduce ART adherence and can lead to weakening of the immune system and increased HIV viral loads.
Abstract: Methamphetamine use has increased significantly in Southeast Asia in the last 5–10 years, but there is little research on risk behaviors associated with the increase in this region We evaluate inj
TL;DR: California's initial cannabis manufacturing regulations should incorporate large and proportionately sized informational labels, a prominent universal cannabis symbol, rotating and pictorial health warnings, mandatory plain packaging, a comprehensive ban on characterizing flavors and addictive additives, and strict limits on the potency of inhalable products and those easily confused with non-cannabis products.
Abstract: State legalization and regulation of cannabis, despite continued federal illegality, is a massive shift in regulatory approach. Manufactured cannabis, including concentrates, extracts, edibles, tinctures, topicals and other products, has received less attention than more commonly used dried flower, but represents emerging regulatory challenges due to additives, potency, consumption methods, and abuse and misuse potential. In November 2017, the California Department of Public Health (CDPH) released initial cannabis manufacturing regulations as part of a new state regulatory structure. As the largest U.S. medical cannabis market (and largest legal adult use market in the world beginning in 2018), California’s regulatory approach will potentially influence national and global policy. Comparing CDPH’s initial regulations to tobacco control best practices reveals that, while the regulations recognize the need to protect public health, prioritizing public health over business interests requires stronger...
TL;DR: Findings indicate that ayahuasca, in a religious context, may have therapeutic value for crack cocaine dependence treatment.
Abstract: The low efficacy of crack cocaine addiction treatment available in Brazil has led Brazilian users to find alternatives to reduce drug consumption or even to reach abstinence. One of them is the use of entheogenic substances, like ayahuasca, an infusion obtained from two native plant species from the Amazon. The present report aimed to understand how crack cocaine users recover from drug addiction by consuming ayahuasca tea in a religious context. This is a qualitative study with a purposeful sample of 40 crack cocaine users, based on in-depth, semi-structured interviews. Participants reported that ayahuasca allowed them to access a consciousness dimension which enabled them to solve problems and traumas and reduce crack cocaine consumption. The religious ceremony increased the user’s spirituality and the reception from the community gave them a sense of self-esteem, strengthening them in an emotional and social way. That positive experience has been incorporated into the daily routine of most part...
TL;DR: Qualitative analyses revealed that treatment responders reported a heightened sense of spiritual awareness and greater connection to their intra-/interpersonal relationships after ibogaine detoxification.
Abstract: We examined persisting effects, self-perceived challenges, and potential benefits associated with positive outcomes following ibogaine detoxification using data collected as part of a larger online...
TL;DR: Among persons with co-occurring cannabis and tobacco use, varenicline is well-tolerated and may reduce cannabis craving, cannabis use, and Tobacco use.
Abstract: Few studies have evaluated treatment for co-occurring cannabis and tobacco use. The objective of this pilot study was to evaluate the feasibility and preliminary effectiveness of varenicline for co-occurring cannabis and tobacco use. Participants who reported cannabis use on ≥5 days per week were recruited from an urban, outpatient opioid treatment program (OTP). Participants were randomized to either four weeks of standard OTP clinical care (SCC; medication-assisted treatment for opioid use disorder and individual behavioral counseling), followed by four weeks of SCC plus varenicline (SCC+VT), or to four weeks of SCC+VT followed by four weeks of SCC. All participants contributed feasibility and outcome data during both study phases. Of 193 persons screened, seven were enrolled. Retention at eight weeks was 100%. No adverse effects prompted varenicline discontinuation. Participants reported lower cannabis craving during the SCC+VT phase compared to baseline, and lower frequencies and quantities of...
TL;DR: Most treatment-seeking crack-dependent individuals in Brazil are living in extremely poor social conditions and are struggling with the severe, chronic, and comorbid features of this disorder.
Abstract: Crack cocaine (crack) dependence is a severe disorder associated with considerable morbidity and mortality, constituting a major public health problem in Brazil. The aim of this study was to improv...
TL;DR: PIO failed to alter the reinforcing or positive subjective effects of heroin, but it did reduce heroin craving and overall anxiety, providing an indication of drug effects that deserves further exploration.
Abstract: Possibly through its effects on glia, the peroxisome proliferator-activated gamma receptor (PPARγ) agonist pioglitazone (PIO) has been shown to alter the effects of heroin in preclinical models. Until now, these results have not been assessed in humans. Heroin-dependent participants were randomized to either active (45 mg, n = 14) or placebo (0 mg, n = 16) PIO maintenance for the duration of the three-week study. After stabilization on buprenorphine (8 mg), participants began a two-week testing period. On the first to fourth test days, participants could self-administer drug or money by making verbal choices for either option. On the fifth day, active heroin and money were administered and participants could work to receive heroin or money using a progressive ratio choice procedure. Test days 6-10 were identical to test days 1-5 with the exception that, during one of the test weeks, placebo was available on the first four days, and during the other week heroin was available. PIO failed to alter the reinforcing or positive subjective effects of heroin, but it did reduce heroin craving and overall anxiety. Although we were unable to replicate the robust effects found in preclinical models, these data provide an indication of drug effects that deserves further exploration.
TL;DR: Strain preferences were highly state/dispensary specific with one-fifth of MC patients in Maine preferring Mother of Berries and many respondents mentioned that they had developed a time-dependent pattern with sativa use during the day and an indica for nighttime use and for improving sleep.
Abstract: Medical marijuana patients often believe that specific strains are more efficacious at treating their conditions. The goals of this investigation were to determine: (1) how many strains of cannabis are there; (2) which strains are used by medical cannabis (MC) patients; and (3) are there any differences in the strains used by patient condition? Study I involved quantifying the number of strains listed in the online database leafly.com and categorizing these by whether the strain name included a gustatory component. MC patients (N = 455) from New England completed an anonymous online survey about their medical history and strain preferences in Study II. There were 1,987 strains listed. Hybrids were significantly more likely than Cannabis indica strains to have a gustatory title. Strain preferences were highly state/dispensary specific with one-fifth of MC patients in Maine preferring Mother of Berries (M.O.B., 21.5%). Many respondents mentioned that they had developed a time-dependent pattern with sativa use during the day and an indica for nighttime use and for improving sleep. There is some general consistency across dispensaries in that hybrid strains and C. indica were most common. Further longitudinal and controlled investigations are necessary to identify the strains that are most efficacious for specific conditions.
TL;DR: The results suggest that the intensity of effects produced by ayahuasca is not directly proportional to its therapeutic effect, and this therapeutic potential could be based on memory recall.
Abstract: This article focuses on the therapeutic potential ascribed to ayahuasca by users in the Czech Republic. Following an online survey, the fieldwork among users of ayahuasca was carried out from November 2015 to December 2016. The research sample consisted of 46 persons (23 women and 23 men), who took part at least once in some type of ayahuasca ritual and/or were the facilitators of the ayahuasca sessions. We held semi-structured interviews with participants in order to discover the therapeutic potential of ayahuasca. Transcribed recordings were analyzed using the Grounded Theory Method. The results suggest that the intensity of effects produced by ayahuasca is not directly proportional to its therapeutic effect. According to the informants, ayahuasca is applicable in the treatment of drug addiction. They consider it to have a broad spectrum of therapeutic potential. This therapeutic potential could be based on memory recall.
TL;DR: Examination of the acquired preparedness model revealed that positive urgency’s link to marijuana use was fully mediated by expectancies, and suggest that stimulant expectancies predict heavier, more frequent marijuana use than sedative expectancies and that marijuana expectancies vary based on the limb of marijuana intoxication.
Abstract: Impulsivity and substance use covary Smith and Anderson’s acquired preparedness model proposes that impulsivity predicts substance use through a mediational model such that substance use e
TL;DR: Lead-adulterated psychoactive drugs are among the new sources of exposure to lead, while illicit drugs’ contamination with different drugs may present a health hazard for drug-abusing patients.
Abstract: Psychoactive illicit drugs are widely used all over the world. Due to the high demand for illicit drugs, adulteration of substances with poisonous and active pharmaceutical ingredients is a common phenomenon in some countries. Lead and other active pharmaceutical ingredients are among adulterants added to illicit drugs intentionally. In the present study, we analyzed four major abused street drugs in Iran's drug black market (opium, Iranian crack, ecstasy tablets, and crystal methamphetamine) to assess active pharmaceutical ingredients and determine a quantitative assay of lead. A total of 40 psychoactive drugs were analyzed using high-performance liquid chromatography, gas chromatography/mass spectrometry, and flame atomic absorption spectroscopy. The results demonstrated that psychoactive drugs were adulterated with different drug categories, such as tramadol, ketamine, methadone, acetaminophen, and caffeine. Lead was found in all analyzed samples, ranging from 9-90 ppm. The smallest lead level was detected in methamphetamine samples. Iranian crack samples contained the highest amount of lead. Psychoactive illicit drugs were adulterated with different drug classes and also lead. Lead-adulterated psychoactive drugs are among the new sources of exposure to lead, while illicit drugs' contamination with different drugs may present a health hazard for drug-abusing patients.
TL;DR: Social interaction anxiety was positively related to problematic drinking and coping motives for drinking, and Alexithymia mediated the relationship of social interaction anxiety with coping motives, consistent with a developmental hypothesis of the links between social anxiety, alexithyma, and drinking motives.
Abstract: In young adults at university, social interaction anxiety has been linked to elevated risk of alcohol-related problems, as has alexithymia. The present study sought to assess whether social interac...
TL;DR: Multivariate analysis confirms the decreasing trend in the risk of death and shows a higher mortality risk for participants in the under-25 age group and among cocaine users, special attention should be paid to the prevention of suicide deaths.
Abstract: A total of 852 participants attending 11 centers for addiction treatment in north Italy following problems due to cocaine abuse between 1989 and 2013 were recruited. Two typologies were created: cocaine users (never heroin) (CU) and heroin and cocaine users (HCU). During the 38-year follow-up period, 4.8% of the whole cohort died. Over the whole period, tumors were the main causes of death; starting in 2010, suicide deaths became the first cause of death. Among CUs, most deaths were due to road accidents and suicide; among HCUs, most of the deaths were from opiate overdose and from cardio-circulatory system diseases. The excess mortality observed for all causes in either sex was 6.24; higher in females (15.03) as compared in males (6.23), higher in HCUs (9.06) as compared in CUs (5.21). The directly age-sex standardized mortality rates were 5.31 per 100, higher for females, declining after 2009 for all patients and after 2004 for HCUs. Multivariate analysis confirms the decreasing trend in the ris...
TL;DR: The majority reported great or urgent need for treatment and these PWID had greater odds of transitioning to a higher-risk status at follow-up, emphasizing the need for evidence-based drug treatment options for PWID.
Abstract: People who inject drugs (PWID) in Tijuana, Mexico, use heroin and/or methamphetamine. While polydrug use is associated with HIV risk behavior, less is known about the stability of polydrug use patterns over time and how polydrug use is related to perceived treatment need. Within a cohort of PWID in Tijuana (N = 735) we sought to (1) characterize subgroups of polydrug and polyroute use from baseline to six months; (2) determine the probabilities of transitioning between subgroups; and (3) examine whether self-reported need for help for drug use modified these transition probabilities. Latent transition analysis (LTA) identified four latent statuses: heroin-only injection (38% at both baseline and follow-up); co-injection of heroin with methamphetamine (3% baseline, 15% follow-up); injection of heroin and methamphetamine (37% baseline, 32% follow-up); and polydrug and polyroute users who injected heroin and both smoked and injected methamphetamine (22% baseline, 14% follow-up). Heroin-only injectors had the highest probability of remaining in the same latent status at follow-up. The majority reported great or urgent need for treatment (51%) and these PWID had greater odds of transitioning to a higher-risk status at follow-up, emphasizing the need for evidence-based drug treatment options for PWID.
TL;DR: The story behind the discovery of ketamine anesthesia, along with many other fascinating personal and professional anecdotes, provide insight into the career of a remarkable scientist.
Abstract: University of Michigan Pharmacology Professor Ed Domino is an expert in the field of neuropsychopharmacology. For over six decades, Dr. Domino has made many contributions to our understanding of psychoactive drugs, but is most well-known for his role in the development of ketamine anesthesia. This article covers the story behind this discovery, along with many other fascinating personal and professional anecdotes, all of which provide insight into the career of a remarkable scientist.