Journal of psychoactive drugs最新文献

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.

As psilocybin awaits approval by the Food and Drug Administration (FDA), scholars debate whether psychedelic-assisted psychotherapy should be required when prescribing this medicine. Here, we report the case of a patient who underwent a psilocybin experience without psychedelic-assisted psychotherapy, resulting in inpatient psychiatric admission. This case underscores the importance of taking psilocybin in controlled clinical settings. Moreover, we discuss how psychedelic-assisted psychotherapy could have altered the outcome of her experience and the role of experiential learning in psychedelics for potential prescribers.

There are currently no evidence-based treatment guidelines for antisocial personality disorder (ASPD). Instead, treatment typically focuses on comorbid conditions. There is currently no literature documenting cases or research, theoretical or otherwise of using ketamine-assisted therapy or any other psychedelic therapy in cases of ASPD. In this case report, a 43-year-old man seeking ketamine-assisted psychotherapy (KAP) for alcoholism and depression was diagnosed with comorbid antisocial personality disorder. A series of psycholytic (low dose) ketamine therapy sessions and other integrative approaches over the course of 3 years results in resolution of severe alcoholism, reduction in violent thoughts about people and the world, and a reduction in depression symptoms. With additional precautions, utilizing a ketamine-assisted psychotherapy approach led to clinical improvements in depression, alcohol abuse, and ASPD traits.

This mixed-methods study investigated the role of medicinal cannabis use among younger adults who live in rural communities and experience high levels of cumulative social disadvantage (CSD). Results are based on cross-sectional surveys and online interviews with 153 younger adults (18-35-years old) in rural California. We assessed participants' levels of CSD (high, medium, and low) and examined associations with perceived general physical and mental health and with medicinal use of cannabis (MUC). Qualitative analyses were then conducted to better understand the roles of cannabis use in the lives of study participants with high versus low CSD. High CSD was associated with perceived poorer physical and mental health and with MUC, but not past month general cannabis use. Qualitative findings emphasized the significant role of MUC for rural young people with high CSD to reduce stress and manage physical and mental health. Findings suggest the need to address CSD inequities in rural communities, such as increasing access to health care, to reduce health inequities and the reliance on cannabis use for managing mental and physical health.

The use of analgesics has increased globally over the last three decades. Prescription drug abuse has increased significantly, and opioids have been identified as causing further harm to the world. This study explored the utilization and expenditure associated with opioids and non-steroidal anti-inflammatory drugs (NSAIDs) from 2010 to 2020 in Saudi Arabia. This descriptive time-series analysis was conducted in two major hospitals in Riyadh, Saudi Arabia, between 2010 and 2020. Data were collected from the inpatients, outpatients, and emergency departments of the Security Force Hospital and King Fahad Medical City in Riyadh. The analgesics examined included celecoxib, diclofenac sodium, ibuprofen, lornoxicam, mefenamic acid, paracetamol, and tramadol. A total of 48,106 analgesics were prescribed during this period. Peak utilization of all opioid and NSAID products occurred in 2019. Paracetamol accounted for 29.33% of all prescriptions. However, in 2020, tramadol prescriptions were the highest, accounting for 2,798 prescriptions. The average price per prescription unit decreased between 2012 and 2019 and increased in 2020 from SAR 0.87 to SAR 4.50 per unit. This study's findings can guide healthcare policy and practices and enhance the quality of treatment for patients who require analgesic treatment.

Growing cannabis use has made it the most widely cultivated and trafficked illicit drug globally according to the World Health Organization, with 147 million people consuming cannabis-derived products (CDPs) in various product forms and constituency. Despite restrictions in certain countries, unregulated access can still be found on the dark web which specializes in trafficking of illicit goods. The objective was to systematically collect data from multiple marketplaces to identify types of cannabis products offered for sale. The study was conducted in three phases: (1) data mining transactions on dark web markets using cannabis and tobacco keywords; (2) inductive coding of selling-related characteristics; and (3) pricing analysis of one marketplace based on product type, shipping, and cannabis policy status. Four dark web markets (Archetyp, Incognito, Royal, and Wethenorth) yielded 2,954 selling posts. The top 3 products based on keyword searches included CDPs (n = 2629, 89%), illicit and prescription drugs (n = 223, 7.55%), and psychedelics (n = 102, 3.45%). For Archetyp listings, cannabis concentrates pricing had a statistically significant difference in average price p/mg when shipped from a country with a complete prohibition. The dark web represents an unregulated digital space where numerous CDPs are sold and shipped to various countries at different prices.