Journal of psychoactive drugs最新文献

Ayahuasca is a brew traditionally prepared with a mixture of Psychotria viridis leaves and Banisteriopsis caapi vine and has demonstrated therapeutic properties for depression. Knowledge of the brew composition is important to improve the therapeutic potential and decrease side effects if ayahuasca becomes an option for refractory depression treatment. Ultra-high performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC-HRMS) was applied to analyze 126 ayahuasca samples collected from different ayahuasqueiro groups and geographic origins. We were able to observe a differentiation in the metabolite composition of ayahuasca samples prepared by diverse ayahuasqueiro groups. These samples presented different antioxidant effects based on FRAP and ORAC assays. Exploratory statistical analysis demonstrated a trend of separating the samples according to the religious group. The most important identified compounds for differentiation of the brew prepared by distinct religious groups are glycosylated and/or phenolic compounds. The comparison based on the mode of ayahuasca preparation presented more variability than the comparison based on the botanical variety of B. caapi used. We conclude that ayahuasca samples prepared with "caupuri" or "tucunacá" separately exhibited differences in the analysis of L-glutamate and the metabolism of arginine and proline. This suggests that a possible variation in this pathway could explain the occurrence of swollen stem nodes in "caupuri," one of the B. caapi varieties.

International consensus has emerged, which proposes that the measurement and standardization of the quantity of THC potency, or dose (mgTHC), is a requisite for identifying consistent relationships between patterns of cannabis use and the risk for negative health outcomes, especially critical given the increasing number of U.S. states and European countries considering legalizing cannabis for recreational use. Despite the lack of measurement approaches that provide accurate, real-time data on THC dosage, the number of states that have implemented legal adult use cannabis markets has coincided with the use of regulatory seed-to-sale or track-and-trace systems. Seed-to-sale tracking systems are designed to track the amount of cannabis cultivated, and typically leverage biochemical testing contractors to label the THC potencies and amounts on a diverse array of cannabis products. We propose leveraging seed-to-sale tracking systems to facilitate a more objective measure of THC potency. In the current review, we will: 1) summarize the complexities of accurately measuring the multidimensional aspects of cannabis use patterns; 2) review recent advancements in quantifying THC and the importance of standardizing THC dose in measuring cannabis use; and 3) discuss the potential value of future research efforts examining how state-level seed-to-sale tracking data can inform the standard THC dose.

Cannabis, often criticized, has active compounds that indicate multiple medical benefits. However, before the potential decriminalization and legalization of medical cannabis, pharmacists play a crucial role in the decision-making for personalized therapy and evidence-based medicine. This study investigates pharmacists' perspectives on medical cannabis, covering medical use, societal impact, research, legality, and regulation. This study was conducted through semi-structured interviews with pharmacists from different sectors. Interviews were conducted with 16 pharmacists, with 4 from each sector: industry, academia, community, and hospital. There was a consensus on the need for streamlined research before potential decriminalization and legalization of cannabis, highlighting concerns about abuse and misuse despite its benefits. With that in mind, all participants agree that there is a need to update the current legislation and regulations to better control the use and distribution of medical cannabis. Several participants also called to attention that education plays an important role in the potential decriminalization of medical cannabis, with cannabis-related stigma being a potential deterrent for not only the public but also healthcare professionals. As medical cannabis is a new subject in Malaysia, this study could ignite further multidisciplinary human-related research with strict regulations which will ultimately result in evidence-based medicine.

The use of ketamine and ketamine-assisted psychotherapy (KAP) for treatment of depression has grown dramatically, though much of these data are short term. The clinical profile of maintenance treatment remains poorly characterized. We assessed maintenance KAP for efficacy, tolerability, and reasons for dropout. This observational study retrospectively analyzed electronic health records from an addiction psychiatry practice offering intramuscular ketamine with contemporaneous psychotherapy for the treatment of depression. All patients receiving treatment between January 2016 and September 2022 were included, yielding 1,114 sessions from 70 patients. The response was quantified via the clinical global impression-severity scale. Side effects and reasons for dropout were extracted from charts. Comorbidities include an anxiety disorder (79%) or substance use disorder (49%). The induction yielded 82% response, maintained above 80% after six months (sessions q21 days, 1.13 mg/kg mean dose). Many (38%) remained in treatment for at least one year. Nausea management accounted for nearly all as-needed medication use. Antihypertensives were seldom utilized. Chronic side effects were notable for one case of ketamine use disorder, resulting in residential treatment. Dropouts cited logistical reasons half the time and side effects only 9.7% of the time. KAP yielded robust improvements in mood, anxiety, and substance use. Maintenance sessions effectively extended benefit and were largely well tolerated.

Despite increasing interest in psychedelics and their potential therapeutic effects, research on inhaled N,N-Dimethyltryptamine (DMT) remains limited. Inhaled DMT has a reputation for rapid, dramatic onset and a brief duration, but correlates of use frequency remain poorly understood. A sample recruited from relevant internet sites, including nearly 400 people who had inhaled DMT, reported substance use histories, motivations for use, DMT sources, risk perceptions, and other variables. Generally, participants reported initiation motivated by curiosity about DMT's effects, interest in psychedelics more broadly, and potential spiritual benefits. Those who had used other psychoactive substances (especially ayahuasca) and who had extracted DMT themselves reported inhaled DMT more frequently. Most (>60%) reported obtaining DMT from a friend and claimed it was "slightly difficult" to procure. Participants most commonly inhaled DMT from a glass pipe, in private homes, frequently alone or in small groups. Salient positives associated with inhaling DMT included psychologically cleansing or cathartic experiences. Associated challenges concerned difficult integration, aversive experiences, or "bad trips." Participants rated DMT as very or slightly safe. These data underscore the need for continued work on this topic to inform education and harm reduction efforts, particularly as the molecule's reputation for ameliorative effects receives media coverage.

Dysfunctional attitudes - a cornerstone to cognitive psychotherapy - vary with both psychological and pharmacological interventions. Post-acute changes in these cognitions appear to covary with the acute reactions to psychedelics that often precede improved outcomes. An examination of post-acute changes in dysfunctional attitudes could support targeting them in psychedelic-assisted therapy. Screened participants (N = 400+) reported the acute, subjective experiences associated with their most significant psychedelic response as well as post-acute changes in dysfunctional attitudes and subsequent alterations in wellbeing. Dysfunctional attitudes, emotional breakthroughs, and challenging experiences accounted for significant, unique variance in wellbeing. The effects of dysfunctional attitudes generally exceeded those of acute reactions. Comparisons among those acute responses revealed that the effect of emotional breakthroughs exceeded challenging experiences, which exceeded mystical experiences. Nevertheless, the indirect effects through post-acute changes in dysfunctional attitudes did not account for all the impact of acute effects nor interact with them. These results emphasize the import of both acute and post-acute reactions, suggesting that strategies for optimizing each might maximize outcomes for psychedelic-assisted interventions. Furthermore, standard cognitive interventions that alter these cognitions could combine with psychedelics in straightforward ways. The results also support the use of multiple multivariate approaches to address the relative importance of multicollinear predictors.

Approximately 18% of U.S. adults have a substance use disorder (SUD), yet SUD treatment utilization rates remain low. Substance use problem recognition, or one's awareness that their substance use is harmful, is a key precursor to seeking SUD treatment. Despite low treatment utilization prevalence, research on factors that promote substance use problem recognition among those with SUD is limited. Using 2022 National Survey on Drug Use and Health (NSDUH) data and drawing on Andersen's health service utilization model, we examined associations of predisposing, enabling, and need characteristics with substance use problem recognition among adults with one or more SUDs with a focus on the relationships between SUD type(s) and problem recognition. The statistical approach utilized was generalized linear models for a Poisson distribution with a log link function. Compared to having alcohol use disorder-only, having multiple SUDs was associated with a higher likelihood of problem recognition, whereas opioid use disorder-only was significantly associated with a lower likelihood of problem recognition. Findings speak to the need for further efforts to aid in SUD problem recognition.

5-Methoxy-N,N-dimethyltryptamine (5-MeO-DMT) is a psychedelic gaining interest as a potential mental health treatment. However, a poorly characterized phenomenon termed reactivation (similar to "flashbacks") is commonly reported with 5-MeO-DMT use and merits investigation. This study examined the prevalence, predictors, and emotional valence of reactivations among Spanish-speaking individuals. Specifically, we investigated whether gender, time planned ahead, intensity of acute effects, and the meaningfulness attributed to the experience predicted reactivation events. We also explored whether decreases in cognitive fusion were associated with reactivations, and whether these variables influenced the emotional valence of those experiences. A cross-sectional survey study was conducted with 90 respondents. Descriptive statistics and logistic regression analyses were employed to examine the aims. Sixty-nine percent of respondents reported reactivations, with 97% indicating the experience was positive or neutral. In the multivariable logistic regression model, longer time planned ahead and decreases in cognitive fusion significantly predicted reactivations. Challenging experiences were associated with a lower likelihood of reactivations being perceived as positive, while psychological insight was linked to a higher likelihood of positive perceptions. Reactivations among this sample appear to be common and predominately perceived as positive or neutral. Their association with cognitive fusion decreases suggests potential clinical relevance worth further investigation.

In recent years, the potential psychological benefits of psychedelic drugs have garnered increasing interest from academic and medical communities. We conducted a systematic review of literature examining the association between psychedelic drugs use and intimacy. The initial search yielded 5,902 studies, of which 19 met the inclusion criteria. Studies varied in methodology, including placebo-controlled experimental designs, quasi-experimental designs, and retrospective self-reports. Positive intimacy-related outcomes were reported in all nine laboratory setting studies, including relationship satisfaction, connectedness, emotional disclosure, empathy, and affiliation, as well as decreased social anxiety. Of the 10 studies that relied solely on retrospective self-report, six identified positive intimacy-related experiences including relationship quality, interconnection, empathy, and closeness. Four of these studies identified negative intimacy-related experiences, including disconnection, social anxiety, and relationship dissatisfaction and distrust. This systematic review demonstrates overwhelmingly positive effects of psychedelic drug use in research-controlled settings, but more research is needed to identify both the ideal settings for psychedelic drug use and the long-term impact of these drugs on intimacy.

Craving is a core characteristic in Cocaine Use Disorder (CUD) associated to relapse and treatment adherence. The assessment of craving is challenging due to the complexities arising from the various theoretical perspectives. Valid and reliable measures of craving are crucial in research and clinical settings considering the length to minimize the burden of patients. The existing craving assessment tools available in Italy are limited, with most instruments validated for populations other than CUD. This study aimed to validate the Italian adaptation of the 5-item Weiss Cocaine Craving Questionnaire (WCCS), a brief measure of cocaine craving. The sample included 385 CUD patients (359 men; mean age: 37.77 ± 8.46) undergoing multidisciplinary treatment. The Italian WCCS demonstrated a unidimensional factor structure and good internal consistency (Cronbach's alpha and McDonald's omega = 0.86). Nomological validity was assessed through significant associations with the Symptom Checklist-90-Revised (SCL-90-R), particularly with dimensions related to obsessivity-compulsivity, anxiety, and depression. Predictive validity was supported by receiver operating characteristics (ROC) analyses, with specific cutoff points enhancing the scale's utility in classifying cocaine use patterns and predicting cocaine relapses. These findings indicate that the Italian WCCS is a reliable and practical tool for clinical and research settings.