Journal of psychoactive drugs最新文献

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.

In the midst of growing research and societal discourse on psychedelic substances, a consistent finding is reported: A majority of users report profound personal meaning from their experiences. This pioneering study in Sweden, a nation renowned for its strict drug policies, sought to quantify the extent of reported meaningfulness among Swedish psychedelic users. Results revealed that a majority of the sample, 58%, ranked their psychedelic experience among the top 5 most meaningful events in their lives, while 85% among the top 10. These findings align well with previous research from other types of studies and other countries. Participants acknowledged challenging and mystical aspects as part of their psychedelic experiences, and a large majority, 94%, reported positive life improvements. Factors such as a personal growth motive and supportive social networks were associated with improved well-being. Despite many study limitations, including the self-selected sample, self-reported measures, and cross-sectional design, the findings underscore the impact psychedelic experiences potentially can have on individuals' lives.

Alcohol use among Biracial adolescents remains understudied. This study examined how parenting and peer factors relate to age of alcohol use onset among Black, White, and Biracial Black-White adolescents and emerging adults. We used Add Health data to produce a final analytic sample of 13,528 adolescents who self-identified as White, Black, or Biracial Black-White. Discrete-time survival analysis implemented within logistic regression indicated Black adolescents showed the lowest probability of alcohol use onset by age 18, followed by Biracial adolescents, and White adolescents. The probability of alcohol use onset increased for Monoracial Black and White adolescents at ages 16, 18, and 21. Descriptively our model suggest that Biracial adolescents exhibit a sharp decline in their probability of alcohol use onset at age 16 and a sharp increase at age 21. However, this trend did not differ significantly from the other racial groups. Consistent with social control and learning theories, low parental acceptance, high parental control, and peer substance use were associated with alcohol use onset. Alcohol use onset trajectories differed for Monoracial and Biracial adolescents with Biracial individuals reporting greater alcohol onset in adulthood. Prevention efforts should continue to target parental acceptance, parental control, and peer substance use.

There has been a resurgence in psychedelic research for managing psychiatric conditions in recent years. This study aimed to present a comprehensive review of the current state of the field by applying a systematic search strategy for articles on the effectiveness and tolerability of four psychedelic-assisted therapies (psilocybin, lysergic acid diethylamide [LSD], 3,4-Methylenedioxymethamphetamine [MDMA], and ayahuasca) for adults with symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). Psychometric scores and adverse events were pooled using random-effects meta-analysis models with Hedges' g bias-corrected standardized mean differences (g) and rate ratios (RR) with 95% confidence intervals (CI). Bias evaluation followed PRISMA and Cochrane guidelines. Eighteen studies were identified, which suggested that psychedelic therapies were well tolerated and presented a large effect size for the management of depression symptoms in a transdiagnostic population with psilocybin (g = -1.92, 95% CI, -2.73 to -1.11) and MDMA (g = -0.71; 95% CI, -1.39 to -0.03). These are promising results that complement the current literature. However, evidence certainty was low to very low due to methodological limitations, small sample size, blinding, study heterogeneity, and publication bias. These results also highlight the need for more adequately powered studies exploring these novel therapies.

Hallucinogen Persisting Perception Disorder (HPPD) is considered rare in hallucinogen users although there are conflicting reports about its incidence and prevalence. HPPD may be more common in those with trait neuroticism. In this study, we invited hallucinogen and other drug users to complete an online questionnaire about their use of hallucinogens, their experience of HPPD symptoms, and their trait neuroticism and mental health symptoms. We received 802 responses with 415 of these containing adequate data for further analysis. 39.7% of responders reported symptoms corresponding to Type I HPPD, and 4.3% reported symptoms corresponding to Type II HPPD. We found no significant difference between neuroticism scores for participants with or without HPPD. Individuals with Type II HPPD were more likely to report mental health symptoms including anxiety, obsessional thoughts, paranoia, hypochondria and panic attacks (p < .05). We also found that individuals with Type II HPPD were more likely to report the use of 25I-NBOMe, dextromethorphan, nitrous oxide and benzodiazepines (p < .05). 47.3% of participants had never tested their drugs, making the attribution of HPPD severity to specific drugs difficult. Further work into the development of HPPD is required, particularly with the rise of hallucinogens as potential treatments for depression and other mental illnesses.

The relationship between cannabis use and suicidal behavior is complex, with no consensus in the literature. We used electronic health records of national health services to identify individuals who received a diagnosis of Cannabis Use Disorder in the Metropolitan area of Bologna from 2009 to 2019. In this cohort we identified accesses to Emergency Departments for suicide attempts from 2009 to 2019. The Crude Suicide Rate for 1,000 Person Years was 2.5, higher in females, in patients with Alcohol Use Disorders, with any psychiatric diagnosis, within one year from the first visit, and during the COVID-19 period. The risk was over 22 times higher than in the general population. Considering the high prevalence of cannabis use in the general population and the consequent risk of Cannabis Use Disorders, these data suggest the importance of a clinical evaluation for suicidal risk.