Journal of psychoactive drugs最新文献

MDMA-assisted therapy (MDMA-AT) for post-traumatic stress disorder (PTSD) shows promise, but attitudes and beliefs about this treatment, especially in symptomatic veterans, remain poorly understood. We sought to explore relevant attitudes in veterans receiving healthcare from Veterans Affairs as a step toward designing relevant surveys or psychoeducation materials for future work. We employed a story completion paradigm designed to sidestep aspects of self-report bias. Participants (N = 30) crafted narratives about an anonymous veteran with PTSD contemplating MDMA-AT. Coders rated transcripts, revealing recurring themes. At least one third of the sample mentioned shortcomings of available treatments, curiosity about its rationale, hope, and concerns about side effects, subjective effects, and the possibility of addictive potential. Despite widespread news coverage of the topics, allusions to therapist abuse, microdosing, and the role of sitters were relatively rare. At least 10% of the sample mentioned clear misunderstandings about the molecule, the treatment, or its implications. These data provide directions for the development of standard surveys of psychedelic-assisted treatments, which would help address these attitudes in larger samples. They can also inform psychoeducation materials that might help increase public awareness about this intervention, especially for veterans with symptoms.

The U.S. Drug Enforcement Administration (DEA) proposed a rule in which they intend to place the psychedelic phenethylamines 2,5-dimethoxy-4-chloroamphetamine (DOC) and 2,5-dimethoxy-4-iodoamphetamine (DOI) into Schedule I of the Controlled Substances Act. We investigated the epidemiology of use and availability of these substances. We investigated national trends in seizures of these compounds (which indicate availability) using DEA National Forensic Laboratory Information System (NFLIS) and High Intensity Drug Trafficking Areas (HIDTA) data. We also examined the prevalence of self-reported use on the National Survey of Drug Use and Health (NSDUH), a nationally representative sample of noninstitutionalized individuals aged ≥12 in the United States. The scientific literature was also systematically searched for reports of poisonings linked to use. Between 2005 and 2024, NFLIS received 795 submissions of drugs testing positive for DOC, with a peak of 152 in 2012. There was then a decrease through 2024, with only two submissions containing DOC in 2023-2024. Forty submissions contained DOI, with no submissions testing positive in 2019-2024. Three DOC seizures were recorded by HIDTA in 2017-2021, with none in 2022-2024. HIDTA had no recorded seizures of DOI. Between 2005 and 2023, there were 37 and 10 type-in mentions of lifetime DOC and DOI use, respectively, in NSDUH responses, suggesting a lifetime prevalence of < 0.01% among the noninstitutionalized U.S. population. We located three reports of poisonings linked to DOC use (in 2008-2024) and none linked to DOI use. Availability, recreational use, and poisoning related to the use of DOC and especially DOI appear to be rare.

Since its resurgence, psychedelic research has garnered considerable attention, especially in mental health. Preliminary findings have indicated positive results regarding psychedelic-assisted psychotherapy. Despite promising findings, various researchers have voiced concerns regarding psychedelic research and its potential for volunteer bias. Participants willing to participate in clinical trials, for example, might differ dramatically from the general population. The current study attempts to identify the potential volunteer bias that might contribute to current results. Participants recruited on MTurk (N = 702) provided demographic information as well as self-reported psychedelic use. We used binary logistic regressions to assess whether demographic and reported psychedelic use variables predicted willingness to participate in six hypothetical psychedelic studies. Results indicated that psychedelic use increased willingness to participate in a single unpaid survey, multiple unpaid surveys presented longitudinally, as well as an unpaid administration study. No demographic variables predicted volunteering consistently. Differences between paid and unpaid participation suggested that compensation might help reach broader samples. Given the implications related to volunteer bias and impeded generalizability, these findings indicate a need for further research to fully address the concern of volunteer bias in psychedelic research. Reaching those with less psychedelic experience will likely be imperative to investigations of clinical implications.

Psychedelic substances have gained attention for their therapeutic potential, yet they remain illegal in the UK. This study aimed to explore whether public attitudes toward UK drug policy predicted attitudes toward psychedelics, in terms of their legal status, the effects of psychedelics on individuals and society, the risks associated with psychedelic use, and personal openness toward psychedelic experiences and their potential positive effects. A cross-sectional survey was conducted with 250 participants aged 18-86 (M = 38.1, SD = 15.8), using the APQ and sociodemographic measures. Multiple regression analyses revealed that viewing drug use as a health issue, rather than a criminal issue, was a significant predictor of support for psychedelic legalization and lower perceived risk. Additionally, gender, religious affiliation, political leaning, and prior drug use significantly influenced attitudes toward psychedelics. Women and religious individuals tended to view psychedelics as more harmful, while left-leaning and non-religious participants were more supportive of their therapeutic use. Participants with prior drug use experience were more open to psychedelics. These findings suggest that public attitudes may be influenced by broader drug policy perceptions and that shifts in policy framing toward health-based approaches could foster greater support for psychedelic reform. Further research should explore these associations longitudinally.

Opioid use disrupts the hypothalamic-pituitary-adrenal (HPA) axis, altering stress responses depending on the stage of use. A higher cortisol/DHEA-S ratio may indicate relapse risk in substance use disorders. This study aimed to explore differences in serum cortisol/DHEA-S ratio and its association with proximal and perceived stress, social support, and coping strategies in opioid-dependent youth. In this study, we assessed 51 males aged 15-24 with opioid (heroin) use disorder from an Indian treatment center, categorized into three groups: recently admitted patients with opioid use, buprenorphine-maintained patients, and healthy controls (n = 17 each). Serum cortisol and DHEA-S levels were analyzed using ELISA. We found significant differences in cortisol (p < .001), DHEA-S (p < .001), and cortisol/DHEA-S ratio (p < .001) across groups. Recently admitted patients with opioid use had elevated cortisol/DHEA-S ratios (0.37), whereas buprenorphine maintenance with active coping strategies showed reduced ratios (0.22), indicating potential normalization of HPA axis function. Cortisol levels correlated positively with past-year stress in recent users, whereas the cortisol/DHEA-S ratio correlated negatively with social support. These findings suggest that buprenorphine maintenance, combined with effective coping and social support, may help normalize HPA axis imbalance, potentially reducing relapse risk in opioid-dependent youth. Further research is needed to confirm these findings and their implications for treatment strategies.

Treating cannabis use disorder remains a significant challenge in the field of addiction medicine. Some recent studies point to psychedelic-assisted psychotherapy as a potential treatment option for substance use disorders. The objective of this study was therefore to explore the impact of naturalistic psychedelic experiences on cannabis use and psychological flexibility. An online retrospective survey was carried out on 152 cannabis users who also reported a significant experience induced by psychedelics in the past. Following a psychedelic experience, there was a significant and sustained reduction of average CUDIT score (p < .001), frequency of cannabis use (p < .001), and acute duration of daily intoxication (p < .001). Cannabis use reduction during the first month post-experience was significantly associated with the intensity of the mystical experience (p = .01). Participants reported a concomitant increased lasting improvement of psychological flexibility following the experience (p < .001), which was correlated to the intensity of the mystical experience during the first month post-experience (p = .04). This study demonstrates that naturalistic psychedelic experiences may be followed by a decrease in cannabis use. Positive health outcomes appear potentially connected to the intensity of the mystical experience, as well as an improvement in psychological flexibility.

We sought to identify patterns of psychedelic use among United States military veterans, compare demographic variables and perspectives of those who did and did not report use, and characterize benefits and adverse outcomes associated with use. Respondents (N = 426) were recruited to complete an online cross-sectional survey. Approximately one-half (51%) reported using psychedelics. Most did so for healing/treatment (70%) and/or spiritual purposes (48%), and most (85%) reported benefiting from use. Those who used psychedelics reported they would be more likely to use VA services (p < .001, d = 0.64) and to return to the VA for care (p < .001, d = 0.79) if psychedelic therapy was offered. Almost two-thirds (59%) reported adverse outcomes associated with use. Equivalent proportions rated their psychedelic experiences as beneficial among those who did (89%) and did not (81%) report adverse outcomes. Fewer adverse outcomes were associated with being older, using psilocybin, feeling prepared and confident in the reasons for use, being in a comfortable setting, and being able to "trust, let go, and be open" (R_c = 0.77; p < .001). Psychedelics may offer benefits but may also lead to adverse outcomes without proper preparation and support. Future research should examine the utility of psychedelic-based approaches for veteran mental health care.

This study examined the factors associated with a high risk of opioid misuse among patients receiving opioid treatment for their non-cancer pain in Malaysian pain clinics. The Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R), a validated instrument for predicting the risk of aberrant drug-related behaviors, were used as a proxy to indicate risk of opioid misuse. Data analysis was stratified into high-risk and low-risk patient groups. Patient factors assessed included pain intensity, pain interference with daily activities, and health-related quality of life. Prescription opioid exposure was examined via patient medical and prescription records review. Among the 61 patients recruited, 62.3% scored ≥18 on the SOAPP-R, which indicates a high risk for opioid misuse. Factors associated with a high risk of opioid misuse were found to be high level of pain interference with daily activities, poorer mental health, and younger age. High-risk patients were found to be prescribed a lower mean daily opioid dose of <20 mg/day compared to low-risk patients (20-49 mg/day). This highlights the need for further research to distinguish aberrant drug-related behaviors due to inadequate pain management from that of actual prescription opioid misuse among non-cancer pain patients attending pain clinics.

Ethical issues arise frequently in the treatment of substance use disorders (SUD). Counselors need guidance to navigate ethical dilemmas but receive limited training in resolving ethical issues. To narrow the gap between the ethical dilemmas counselors face and their training, this qualitative study assessed ethical issues that counselors encounter, how they resolve them, and desired training. We conducted qualitative individual interviews with 20 front-line counselors working in two SUD treatment programs, presenting brief vignettes that depicted the ethics code of the national organization representing SUD counselors. The interviews asked open-ended questions about how counselors dealt with issues and their ideas for future ethics training. All participants had encountered ethical dilemmas. Areas of concern included confidentiality and privacy, mandatory reporting, fairness/equity, client-counselor boundaries, tensions between workplace and client welfare, and meeting clients' complex needs. Ways participants resolved ethical issues included consultations, using direct approaches to resolve ethical dilemmas, and commitment to providing client-centered care. Useful training in the workplace was sparse. Participants expressed needs for ongoing support to resolve workplace ethical dilemmas. Although the importance of ethical issues is widely acknowledged in treating SUD, this study underscores the need for ongoing and interactive training and supervision about ethical issues.

Cannabis is one of the most commonly utilized recreational drugs. However, increasing evidence from the literature suggests harmful implications on cognition. Thus, the main aim of the current review is to summarize literature findings pertaining to the impact of cannabis on neurocognitive skills, focusing on the imaging biomarkers provided by MRI. Two reviewers navigated the literature independently using four main search engines including PubMed and Cochrane. Articles were first evaluated through their title and abstract, followed by full-text assessment. Study characteristics and findings were extracted, and the studies' quality was appraised. 47 articles were included. The majority of the studies were of a case-control design (66%), and the most studied neurocognitive skill was memory (40.4%). With task-based fMRI being the most commonly utilized MRI technique, findings have shown significantly varying decreased and increased neuronal activity within brain regions associated with the cognitive tasks performed. Results suggest that cannabis users are significantly suffering from cognitive deficits. The major significance of this review is attributed to highlighting the role of MRI. Future research needs to delve more into validating the negative effects of cannabis, to enable stakeholders to take action to limit cannabis usage, to foster public health and wellbeing.