Journal of psychoactive drugs最新文献

This prospective, randomized, placebo-controlled study assessed the effects of Ashwagandha root extract (ARE) on cognition, energy, and mood in adults with self-reported cognitive and energy problems. Healthy subjects aged 30-75 years were randomized to receive ashwagandha (Withania somnifera) root extract (ARE) 600 mg/day (n = 60)/identical placebo (n = 60) orally for 8 weeks. Cognitive function was assessed at baseline and week 8 using a Computerized Mental Performance Assessment System (COMPASS). Secondary outcomes were Profile of Mood States Abbreviated Version (POMS-A), Mental Fatigue Scale (MFS) and Behavior Rating Inventory of Executive Function-Adult (BRIEF-A) for effects on mood, mental fatigue and executive function, respectively, assessed at baseline, week 4 and 8. Greater improvement (p < .05) from baseline scores were seen with ARE as against placebo for COMPASS items episodic memory, working memory and accuracy of attention. ARE also improved the POMS-A, MFS and BRIEF-A scores from baseline suggesting an improvement in mood, vigor, and an increase in the executive functioning respectively with ARE. The herb was well tolerated and had a good patient compliance with no serious adverse events reported in either of the groups. This study suggests that a dose of 600 mg a day can improve cognition, energy, and mood in adults with self-reported cognitive and energy problems.

Esketamine, the isolated S-enantiomer of ketamine, has been a recent breakthrough as a non-monoaminergic treatment for treatment-resistant depression (TRD). This case report explores a rare adverse event in a 41-year-old female with TRD, who, despite experiencing significant depressive improvement with esketamine, encountered a severe dissociative episode accompanied by hallucinogenic-like phenomena. While esketamine's efficacy in TRD is well-documented, this pronounced dissociation should be taken into consideration by researchers and clinicians before prescribing. As esketamine continues to aid TRD treatment, comprehension of its safety profile becomes essential for informed decision-making, ensuring optimized patient care in the vast development of antidepressant therapies.

Many methadone maintenance treatment (MMT) participants experienced a tapering phase. The benefit of tapering is based on a balance between meeting the desire to reduce methadone dose and reduction in relapse. We aimed to develop and validate a nomogram to assess relapse risk after dose tapering. We developed and internally validated a nomogram for risk assessment before dose tapering in 432 participants with dose tapering in the non-Guangzhou region of Guangdong, China, and externally validated it in 117 participants with dose tapering in Guangzhou. Cox regression analysis showed that the taper start week (HR = 0.14, [0.08-0.22]) was an independent risk predictor of the relapse risk after tapering. The C-index of the nomogram was 0.76 (95%CI: 0.73-0.79) in the training cohort, 0.76 (95%CI: 0.72-0.80) in the testing cohort, and 0.84 (95%CI: 0.80-0.88) in the validation cohort. Decision curve analysis showed that the nomogram had better discriminative ability than other predictors. The nomogram was developed to assess the risk of relapse for MMT participants who volunteer a tapering phase and may help participants better make decisions about whether and how to reduce the dose to minimize the harm of relapse.

Nicotine dependence remains a leading cause of preventable mortality worldwide. Pharmacotherapy and behavioral interventions offer modest efficacy with limited long-term success. Psilocybin-assisted psychotherapy (PAP) is an emerging approach to nicotine cessation with a growing evidence base. As PAP research expands, understanding how nicotine users' attitudes shape treatment engagement becomes critical. We surveyed daily nicotine users (N = 534) to assess their perceptions and attitudes toward PAP versus standard cessation interventions. Point-biserial correlations and multiple linear regressions examined predictors of treatment interest and credibility. Findings suggest that familiarity with treatment options predicts perceptions of credibility for both interventions (standard: β = 0.16, p < .001; PAP: β = 0.36, p < .001). Credibility in turn predicted willingness to initiate both standard interventions (β = 0.34, p < .001) and PAP (β = 0.71, p < .001). Past psychedelic use influenced perceptions of (β = 0.16, p < .001) and willingness to initiate PAP (β = 0.10, p < .01). Motivation to quit predicted attitudes toward both treatment options (standard: β = 0.25, p < .001; PAP: β = 0.27, p < .001). Providers might leverage these findings to tailor educational materials to increase familiarity, potentially improving adherence and outcomes.

Sober living houses (SLHs) provide abstinence-based living environments for individuals in recovery from substance use disorders. The social model approach to recovery that is used emphasizes helping in recovery. Here, we test whether greater social model activity is related to more helping in the house, and whether these helping behaviors subsequently predict stronger support among SLH peers. Longitudinal data were collected from N = 205 SLH residents with past-year alcohol use disorder who entered 28 SLHs in Los Angeles, California. Regression models tested whether social model activity (Recovery Home Environment Scale, RHES) was related to support (Client Evaluation of Self and Treatment, CEST). A multiple mediation model tested whether this relationship was mediated by giving and receiving help in the SLH. Higher RHES scores were significantly related to higher CEST scores, greater help given, and greater help received. Both the RHES and help received showed significant direct effects on the CEST. The significant direct and indirect effects suggest that the effect of the RHES on CEST scores appears partially mediated by helping in the SLH. SLH managers and operators can build strong social environments that increase helping and support among residents by focusing on elements from the social model.

Methamphetamine (METH) consumption is associated with aggression. Decoction derived from the kratom (Mitragyna speciosa Korth.) leaf has been used as a METH substitute in Southeast Asia. Given its perceived benefit, we investigated the relationship between kratom use and aggression in a treatment sample of METH users with and without kratom use history. Four hundred and three male METH users participated in this cross-sectional study. A semi-structured questionnaire and several objective clinical measures were administered. Results indicate that there were no significant differences in aggression and its dimensions between METH users with and without kratom use history. However, two distinct Clusters (1 and 2) of METH users with kratom use history were studied. Users in Cluster 1 were characterized by a higher quantity and frequency of daily kratom use, longer duration of kratom use, and use of kratom at a younger age. Users in Cluster 2 exhibited the opposite characteristics. Kratom dependence and the first age of kratom use were identified as risk factors for aggression in Cluster 1. The frequency of daily kratom use appeared as a protective factor against aggression in Cluster 2. The results offer partial support to the instrumental kratom use concept; lower frequency (1 to 3 times) of kratom use may potentially minimize aggression in METH users presenting with mild to moderate kratom dependence.

Psychedelic-assisted therapy is becoming increasingly acknowledged as an effective therapeutic intervention for various psychiatric illnesses. However, the evaluation of masking success is rarely reported in trials. The objective of the present systematic review was to evaluate placebo-control and masking in studies exploring psychedelic-assisted therapy. Nine (k = 9) studies dating between January 2010 and March 2023 were retrieved using six databases, following strict inclusion and exclusion criteria. The results show that almost 78% of the studies had, at best, "poor" masking success. At the same time, 60% of active placebo and 75% of inactive placebo studies showed large effect sizes. In other words, masking influences, including benign unmasking, cannot be excluded. We therefore conclude that efficacy of psilocybin, Ayahuasca, or LSD is only one of the possible interpretations of large, positive changes in symptomatology for patients suffering from, for example, alcohol use disorder, anxiety with or without life-threatening disease, anxiety and/or depression with life-threatening cancer, treatment-resistant depression or major depressive disorder. We recommend care be taken to increase successful masking procedures and discuss alternative treatment designs to better control for potential masking influences.

Emerging evidence indicates that ayahuasca consumption may have beneficial mental health effects. This study undertakes the largest analysis to date of associations between naturalistic ayahuasca use and current mental health status via an online cross-sectional survey. The sample included 7,576 participants (average age 41, 47% female) who had consumed ayahuasca in religious, traditional, or non-traditional settings in over 50 countries. Bivariate analysis, multivariate linear regressions and generalized structural equation modeling were used to explore associations between ayahuasca use variables, current mental health (K10, SF-12 MCS), and psychological well-being change (PWG). The number of ayahuasca uses was found to be positively associated with current mental health status (all measures), and this remained highly significant in multivariate models, with little evidence of associations diminishing over time. Variables such as the strength of the mystical experience, self-insights, and community/social variables were also positively associated with current mental health and PWG, while acute extreme fear and integration difficulties were negatively associated. Findings suggest that naturalistic ayahuasca use is associated with better current mental health status and enhanced psychological wellbeing for individuals with and without a history of mental illness, independent of community effects, with certain variables contributing positively or negatively to these effects.

Kratom has been widely reported to alleviate depression and anxiety; however, its effects on depression and anxiety in people who use methamphetamine (METH) are rarely investigated. This study constructed network structures of kratom use, depressive symptoms, and anxiety symptoms to gain a preliminary understanding of the possible psychopharmacological mechanisms by which kratom affects depression and anxiety. R package (Version 4.4.1) was used to construct network structures, calculate expected influence and bridge expected influence, estimate networks accuracy, and stability. A sample of 403 males who used METH with and without kratom-use history were recruited for this cross-sectional study. Compared with those without kratom-use history, those who co-used METH with kratom had several lower levels of depressive symptoms. The central depressive symptom was "sleep disturbance" (BDI-16) and the central anxiety symptom was "heart pounding or racing" (BAI-7). Kratom dosage per consumption was the most important kratom-use indicator that was associated with depression and anxiety. Our preliminary findings indicate that kratom may affect depression and anxiety in males who used METH in a dose-dependent and frequency-dependent manner. The most correlated symptoms and bridge nodes in this network analysis should be considered as potential targets for intervention.

The legalization of cannabis in the United States (US) has increased the availability of a variety of novel cannabinoids such as cannabigerol (CBG) and cannabinol (CBN), delta-8 tetrahydrocannabinol (delta-8 THC) and THC-O acetate ester (THC-O), yet little is understood about the use of these emerging cannabinoids by medical cannabis patients. A large sample (N = 1721) of US medical cannabis patients was surveyed to characterize their patterns of use (frequency, methods of administration) and motivations for use, across a wide variety of emerging cannabinoids. Results revealed that participants most frequently endorsed past year use of cannabidiol (CBD), delta-9-THC, delta-8-THC, and THCA, with daily use commonly reported. Participants most frequently endorsed smoking flower, using a vape pen/cartridge, and use of edibles to administer nearly all cannabinoids. They most frequently reported using cannabis to treat medical conditions, for well-being, and as a substitute for medications, and the majority reported that they had stopped using one or more pharmaceuticals or other drugs because of their medical cannabis use. Our survey demonstrates the substantial use of emerging cannabinoid products among a large sample of medical cannabis patients and indicates that public health outreach is needed to help educate people about these emerging cannabinoids.