Journal of psychoactive drugs最新文献

Recreational use and misuse of nitrous oxide (N₂O) have increased in recent years among young people. The objective of present study was to assess the frequency and the clinical characteristics of N₂O use disorder (NUD) in a sample of health professions students. An online survey was distributed to health professions students. Age; sex; frequency (day/week/month/year/lifetime) of N₂O use, DSM-5 criteria for NUD; history of mental health treatment; and current use of antidepressant medication were systematically collected. All participants completed the French version of Alcohol Use Disorders Identification Test (AUDIT), and Cannabis Abuse Screening Test (CAST). A total of 2067 students (mean age 21.7 ± 2.6 years, 74.9% female) completed the survey. A total of 38.2% (n = 790) reported lifetime N₂O use. Among the 6.6% (n = 137) who fulfilled the DSM-5 criteria for current NUD, 5.5% (n = 114) had mild disorder, 0.8% (n = 16) had moderate disorder (n = 16) and 0.3% (n = 7) had severe disorder. Participants with NUD more frequently reported AUDIT scores > 12 (suggesting alcohol dependence), blackouts, a history of mental health treatment, and current use of antidepressants than did those without NUD. Longitudinal studies using structured interviews are needed to investigate potential associations between NUD and alcohol use disorders or psychiatric disorders in the general population.

The ever-changing landscape surrounding legality and accessibility of psychedelics and their increasing popularity make it imperative to better understand the nature of psychedelic use by the general population. To this end, 1,486 eligible respondents (M_age = 29.58, 67.1% male) residing in the United States completed an online survey designed to assess the types of psychedelics used, methods of administration and dosing, frequency of use, intentions for use, context/environments in which they are used, perceived acute effects, frequency of those effects and distress about them, and their perceived residual effects and distress about them. Respondents predominantly endorsed using MDMA, LSD, DMT, and psilocybin. The predominant methods of administration were oral. Most reported using psychedelics for recreational purposes. The most endorsed acute effects were hallucinations, increased heart rate, positive mood, and visual tracers, while the most endorsed residual effects were headaches/migraine, dry mouth, nausea, hallucinations, and anxiety. Participants were most distressed by negative mood states, vomiting, and nausea when under the acute effects of psychedelics, but mean distress ratings were low. These results can help inform clinical trials, reform policy regarding legal access to psychedelics, and track changes in these metrics as sociocultural and legal landscapes continue to shift.

New legal frameworks for supervised psychedelic services are emerging, with Oregon and Colorado implementing programs to train and license psilocybin facilitators. This study describes Oregon's early psilocybin facilitator workforce and assesses state-approved training programs. The Open Psychedelic Evaluation Nexus (OPEN) reviewed Oregon Health Authority-approved training programs and surveyed facilitators who had completed or were enrolled in these programs between July and November 2023. Data collection included a review of public listings, contact with training programs, and facilitator survey. Results indicated that in the 16 active training programs, the mean tuition was $9,359 and half offered diversity scholarships. Survey respondents (n = 106) were relatively diverse; many had an existing healthcare license. The majority reported that training expenses were a moderate-to-severe financial strain. Most were satisfied with training. The mean planned price for a session was $1,388 and the most common areas of specialization were trauma, mental disorders, consciousness exploration, and spirituality. Facilitators requested ongoing training opportunities. In conclusion, Oregon's emerging psilocybin facilitator workforce and training programs are in early development. These findings are crucial for informing future policy and training program development to support a diverse and effective workforce.

Recent research on the potential therapeutic value of psychedelic substances has led to changes in media representation and drug policy in some U.S. states. Yet, little is known about lay perceptions of these substances. The current study aimed to describe health perceptions of psychedelic substances, test differences in perceptions of therapeutic vs. recreational use of psychedelic substances, and determine if such perceptions vary by use experience. Participants (N = 309) completed an online within-subjects experiment in which they responded to measures of positive and negative perceptions of therapeutic and recreational use of psychedelics. Endorsement of positive and negative health perceptions of psychedelics was moderate to strong. Recreational use was perceived as having more negative health consequences, while therapeutic use was perceived as having more positive health consequences. Participants who reported lifetime psychedelic use (40.7%) perceived both recreational and therapeutic uses as having more positive health consequences, and this pattern was consistent across most perception domains. The outcomes suggest that public perceptions of use may change based on reason for use. This information may aid in filling current gaps in knowledge and identifying potential targets for public health communications, and such approaches may benefit from considering prior use experience.

Portugal is commonly recognized as one of the best drug policy examples in the world. Nonetheless, contrasts between drug use risks in rural vs urban settings in the country is an understudied topic, even if its specific challenges are commonly affirmed, both by professionals and people who use drugs (PWUD). The aim of this study was to compare rural and urban environments concerning socio-sanitary services availability; illegal drugs availability; risk behaviors related to drug use; stigma associated with illicit drug use; and social support. Additionally, specific harm reduction challenges and recommendations for improvement were explored. A qualitative study with two focus groups involving people who use drugs, outreach workers and local decision-makers was conducted. Distinct scenarios and challenges in both settings were found: In large cities, a significantly higher specialized service coverage than in rural areas was described. In rural settings, a higher number of drug-related risks, higher levels of stigma and lower availability of human and material resources were mentioned, although being associated with higher levels of informal social support and more proximal relationships with harm reduction teams. This study emphasizes the need for a harm reduction paradigm strongly focused on environmental risk determinants, as much as in individual ones.

Non-medical use of nitrous oxide (N₂O) is becoming increasingly popular globally, yet little data exists regarding N₂O in Aotearoa New Zealand. We aimed to explore patterns of use and harm in those who consume N₂O in Aotearoa, and related knowledge, perceptions and attitudes of those with and without N₂O experience. A convenience sample of people with N₂O experience (n = 466) and without (n = 510) completed an online survey about N₂O. Most with N₂O experience reported infrequent and low-dose consumption. Harm reduction behaviors were utilized by most consumers, and reports of adverse effects were relatively low. Self-reported acute or chronic harm (primarily psychological) was reported by only 5.8% of the N₂O sample, whilst 9.2% reported ever experiencing persistent numbness (5.2% in the past 12 months). Self-reported knowledge about N₂O varied and was greater in those with N₂O experience. N₂O knowledge was generally poor, although more accurate in those with N₂O experience. Attitudes generally differed between those with and without N₂O experience, and perceived harmfulness and experience significantly contributed to attitudes regarding N₂O legality. Findings underscore the relative safety of N₂O when used recreationally, but also highlight the need for greater drug education around potential risks of N₂O use and harm reduction.

Co-occurring substance use disorders are common in medical settings, yet limited literature exists on concomitant pharmacological management. We present a case where low-dose buprenorphine induction (LDBI) and rapid phenobarbital taper were performed concurrently in a hospital setting to manage co-occurring opioid dependence (on chronic methadone maintenance therapy) and benzodiazepine dependence (prescribed alprazolam). The simultaneous management was well-tolerated and completed with minimal complications, successfully enabling candidacy for the patient's preferred disposition.

This study is a survey-type, cross-sectional study conducted in Brazil (n = 517), with online data collection taking place from April to June 2022. The main objective of this study was to evaluate the death anxiety in users and non-users of psychedelics. To this end, we also assessed the validity and reliability of the Death Anxiety Scale in Brazil. The following instruments were used for data collection: a questionnaire for sociodemographic characterization, Death Anxiety Scale, Death Transcendence Scale, and Spiritual Well-Being Scale. Our main results indicated the following: 1) increased death anxiety is associated with never or almost never having used psychedelics; 2) death transcendence, especially creative and religious factors, was the only constant variable in all the explanatory models of the variation in death anxiety; 3) there is a negative relationship between death anxiety and mystical and religious factors of death transcendence. We interpret these results as follows: it's not psychedelics that reduce death anxiety - psychedelics can favor the experience of transcending death. And it's the possibility of transcending death, (idea of continuity beyond physical death, taking both spiritual and symbolic forms) that helps reduce death anxiety. These findings offer valuable insights into the role of psychedelics in human mortality perception.

The increasing acceptance of cannabis use, and policy changes in several jurisdictions has led researchers and public health experts to call for a standard cannabis dose. Standard dosing units are useful tools for regulation, substance use guidelines, data collection, consistency of research, as a means of communicating low-risk recommendations and dose-related effects, and for self-monitoring. Efforts to standardize cannabis dose have focused on cannabinoid content without considering tolerance or mode. Cannabis users with diverse motivations for use and varying experience rated low, medium, and high doses across seven modes of use. The participants (N = 1368; 42% female) were 18-93 years of age (M = 31.64, SD = 14.70) who had a cannabis use history. The Index of Cannabis Equivalence (ICE) identified the following low-dose cannabis equivalencies: two puffs on a joint, pipe, herbal or concentrate vaporizer is equivalent to one hit on a bong, a 5 mg/THC edible, and ¼ dab of a concentrate. These findings are based on responses from users with lower tolerance, which may limit generalizability to those with higher tolerance. The ICE proposes standardized cannabis doses through user-derived ratings across different administration routes. The meaningful standardization of units of cannabis products in a manner similar to what has been achieved for alcohol represents a valuable step in establishing standard doses across different modes of cannabis administration.

This study explores the psychotic-like experiences (PLEs) associated with recreational ketamine use among young adults. Ketamine, initially introduced as an anesthetic, is now widely used recreationally for its dissociative effects, raising concerns about its impact on mental health. Ten participants aged 18-24, who used ketamine recreationally multiple times a week, were assessed using the Community Assessment of Psychic Experiences (CAPE-42). Results showed a significant positive correlation between the frequency of ketamine use and PLEs, with no significant impact from other substances like THC, MDMA, and alcohol. These findings confirm ketamine's potential to induce psychotic-like symptoms by antagonizing NMDA receptors, similar to schizophrenia. The study underscores the need for preventive measures and targeted interventions to address the mental health risks of frequent ketamine use, particularly among young adults. However, limitations such as the small sample size and reliance on self-reported data suggest that further research is needed to establish causality and examine long-term effects. Overall, this study highlights the significant association between recreational ketamine use and increased PLEs, emphasizing the importance of early detection and intervention strategies.