Journal of psychoactive drugs最新文献

This study explored whether law enforcement/first responder-reported fentanyl overdose response actions (such as administration of the opioid overdose reversal agent naloxone) differed between overdoses in which xylazine was, versus was not, suspected to be co-involved. Data were drawn from the Pennsylvania State Police's Overdose Information Network (ODIN) for 11,478 suspected fentanyl-involved overdoses, 137 reportedly co-involving xylazine, recorded across Pennsylvania (January 2018-January 16, 2025), excluding Philadelphia. We used relative frequencies, Fisher's exact tests, and binomial logistic regression to compare first responders' overdose response actions in suspected fentanyl overdose cases in which xylazine was, versus was not, reportedly co-involved. Naloxone was administered at the scene of 46.0% of the overdoses reportedly involving fentanyl and xylazine, vs. 67.3% of the reported fentanyl-no-xylazine overdoses. Multivariable regression results (among the suspected fentanyl overdoses in ODIN, adjusting for age, sex, race/ethnicity, year, county rurality, and other drugs suspected to be involved) indicated that suspected xylazine co-involvement was associated with 60% lower odds of naloxone administration (adjusted odds ratio, 0.40; 95% confidence interval, 0.28-0.57). Observed differences in overdose response based on suspected xylazine co-involvement support the importance of equipping first responders with the tools and training to recognize/manage the distinct challenges of xylazine-fentanyl-involved overdose.

This study aimed to assess the severity of drug dependence and identify factors associated with high dependence among gay, bisexual, and other men who have sex with men (gbMSM) in Japan. Data were collected from a nationwide community-based online survey conducted from November 2022 to January 2023. gbMSM with a history of drug use completed the Japanese version of the Drug Abuse Screening Test-20 (DAST-20). Multivariable logistic regression explored factors linked to high DAST-20 scores. Of 4,472 cisgender gbMSM, 19.1% (853/4472) reported lifetime drug use, and 3.3% (146/4472) reported use in the past 12 months. Among 142 participants with a recent history of drug use, the most reported drugs were alkyl nitrites (38.7%, 55/142), methamphetamine (25.4%, 36/142), and cannabis (17.6%, 25/142). A total of 26.8% (38/142) had DAST-20 scores of 6 or higher, indicating intermediate to severe dependence. High DAST-20 scores (≥6) were associated with recent methamphetamine use (aOR: 6.85; 95% CI: 2.01-23.29), using drugs to escape reality (aOR: 3.17; 95% CI: 1.06-9.50), and fostering intimacy with the person recommending the drug (aOR: 3.97; 95% CI: 1.36-11.62). Expanding screening opportunities and ensuring access to psychosocial care are essential in providing tailored support services to gbMSM with diverse health needs.

Psychedelic-assisted therapies and ketamine are two modalities gaining attention in psychiatry for treating conditions such as depression, PTSD, and substance use disorders. However, perceptions of these treatments vary globally. This study explores the familiarity, attitudes, and perceptions of Jordanian physicians and medical students toward psychedelic substances, addressing a gap in Middle Eastern research. A cross-sectional study conducted from July to August 2024 utilized a validated online survey among medical students and physicians in Jordan. The survey covered demographics, familiarity to psychedelics and ketamine, attitudes toward their medical use, and concerns about risks and legality. Statistical analyses, including multivariate regression and factor analysis, assessed the influence of demographics on participant perspectives. Of the 1,985 respondents, most had limited familiarity to psychedelics. LSD was the most recognized substance, while fewer participants identified psilocybin or MDMA. familiarity and attitudes varied significantly by age, gender, and prior familiarity, with professional status showing no impact. Three attitude clusters emerged: opposers (n = 1000), cautious (n = 677), and supporters (n = 308), each influenced by different demographics. This study reveals a notable familiarity gap and mixed attitudes toward psychedelic therapies among Jordanian healthcare professionals, highlighting the need for targeted education to enhance understanding of these treatments in Jordan's medical community.

This study evaluated the attitudes, knowledge, and educational experiences of psychiatry residents regarding psychedelics and psychedelic-assisted therapy (PAT). In 2023, we distributed an anonymous survey to United States psychiatry residents, assessing demographics, knowledge, and opinions on psychedelics/PAT. The survey also included items asking respondents to retrospectively self-report how strongly psychedelic-related work and educational opportunities influenced their career choice and ranking of residency programs in the Match. Of the 109 respondents, most reported limited formal education on psychedelics during training but expressed a strong desire for more instruction. Most believed psychedelics hold promise for psychiatric disorders (83.49%), though fewer saw similar potential for substance use disorders (55.96%). Notably, 39.81% reported psychedelic-related educational or research opportunities influenced residency program rankings, and 39.25% indicated the possibility of treating patients with psychedelics influenced their decision to pursue psychiatry. Higher knowledge scores and stronger belief in psychedelics' therapeutic potential were associated with greater self-reported influence of psychedelic-related opportunities on program ranking. This study is limited by its small sample size and potential for self-selection and recall bias. Overall, psychiatry residents demonstrated optimism about psychedelics' therapeutic potential but reported inadequate training. Expanding psychedelic-focused educational content in residency could better prepare trainees for psychedelics' evolving role in psychiatry.

Therapeutic potential of cannabinoids and terpenes in cannabis products is complicated by the possibility to alleviate pain yet exacerbate anxiety symptoms. Little is known about how cannabis practices, and preferences for cannabinoids and terpenes differ among medical cannabis patients who use cannabis to relieve pain, or anxiety, or both. A concurrent explanatory mixed-methods design was utilized. The quantitative analytical sample (n = 1,060) consisted of participants who self-reported past 90-day cannabis use to relieve: physical pain only (14.8%), feeling uptight/anxious only (29.5%), or both conditions (55.7%). We examined between-group differences in demographic variables, cannabis practices and preferences. Qualitative interviews with a subsample of patients (n = 39) were analyzed thematically regarding cannabinoid/terpene preferences to contextualize quantitative results. Compared to the Anxiety-only group, pain groups were more likely to use high potency flower/extract products (i.e., moon rocks/caviar), topicals/creams and CBD; the Pain/anxiety group was more likely to use Rick Simpson Oil and look for CBD, CBN, CBG and CBC. Both quantitative and qualitative data supported preferences for CBD and caryophyllene for pain relief, myrcene for pain and anxiety relief, while Anxiety-only group was less likely to prefer terpinolene. Future studies need to assess if cannabis practices and preferences are associated with symptom improvements over time.

Ketamine-assisted therapy (KAT) is a novel modality that shows promise as a treatment for depression. The current study sought to add to the scarce research in the area and inform future applications of KAT for patients with treatment-resistant depression. The study used in-depth qualitative interviews (N = 12) to explore participants' perceptions of KAT, including working with therapists, the ketamine experience, the therapeutic setting, and how these aspects impacted experiences and their lives following treatment. Thematic analysis indicated that preparation of mind-set supported therapeutic benefit, which was underscored by openness, clear therapeutic intentions, mindfulness, and understanding the mechanisms of how KAT works. Additionally, comfort in the setting supported participants to "let go" and was facilitated by learning about the therapist's personal experiences, a strong therapeutic alliance, and feeling safe. External physical cues such as music also influenced the experience, facilitating a spiritual journey guiding the experience. Words of caution were expressed where trauma had been unveiled and letting go had left participants feeling vulnerable. These findings provide a deeper understanding of the impact of contextual processes during KAT to inform future clinical trials and improve the clinical efficacy of KAT.

Sexualized drug use (SDU) describes drug-facilitated sexual enhancement, and chemsex is an SDU subculture involving the use of specific drugs by men who have sex with men (MSM). This study aimed to identify research trends, foci, and themes within the SDU and chemsex-specific literature. The Web of Science Core Collection was searched with a list of SDU synonyms. All SDU-related articles were analyzed using the R package, bibliometrix. Full text review identified chemsex-specific records, and text was extracted verbatim for content analysis in Leximancer. The search returned 1,866 unique records. A total of 521 addressed SDU, and 301 papers specifically addressed chemsex. The small but growing SDU literature primarily addressed consensual encounters between MSM, and drug-facilitated assault experienced by women, in Western settings. Little attention was given to transgender communities or consensual SDU in cisgender heterosexual individuals. The literature primarily viewed SDU through a public health lens, specifically focusing on the risk conferred to sexual health.The SDU and chemsex-specific literature are potentially limited in scope and may inadequately capture the geographical, demographic, and cultural diversity of these phenomena. Future research should address the myriad social and health implications of SDU and chemsex participation across all relevant communities and settings.

Cocaine-related mortality rates have risen sharply since 2013 and social vulnerability is a crucial indicator for drug-related mortality rates. Therefore, the purpose of this study was to investigate the relationship between social vulnerability and cocaine-related mortality rates in U.S. counties. The Data were collected from the CDC WONDER, CDC's Social Vulnerability Index (CDC's SVI), and American Community Survey (ACS). The Data were analyzed by spatial autoregression models. According to present results, first, counties with social vulnerability (socioeconomic) were positively related to higher rates of cocaine overdose death (spatial lag: B = 0.323, p < .05; spatial error: B = 0.513, p < .01). Second, counties with social vulnerability (minority status & language) were negatively related to higher rates of cocaine overdose death (spatial lag: B = -0.233, p < .05). Third, counties with social vulnerability (housing type & transportation) were positively related to higher rates of cocaine overdose death (spatial lag: B = 0.413, p < .001; spatial error: B = 0.378, p < .001). In conclusion, the spread of cocaine overdose on U.S. counties with social vulnerabilities demonstrated a disproportionate burden of cocaine-related mortality.

Data on medication interactions with psychedelics are limited. Here we present what may be the first published report of a hypertensive emergency following the combination of psilocybin mushrooms with a monoamine oxidase inhibitor (MAOI). A 42-year-old man with treatment-resistant major depressive disorder took 1 g of Psilocybe cubensis mushrooms, while prescribed tranylcypromine, extended-release dextroamphetamine-amphetamine, and other medications. Approximately half an hour later, he developed severe hypertension with chest pain, palpitations, and headache. Upon hospital presentation, the electrocardiogram demonstrated ST-elevation. The patient was diagnosed with a myocardial infarction and treated with lorazepam, nitroglycerin, and aspirin. He subsequently underwent emergency cardiac catheterization, which revealed no significant cardiac abnormalities. Following overnight hospitalization, he was discharged home with no lasting physical sequelae. Though data are few, past studies suggest that classic serotonergic psychedelics (5HT-2A receptor agonists) such as dimethyltryptamine (DMT), lysergic acid (LSD), and synthetic psilocybin should not produce hypertensive emergency when combined with MAOIs. We suspect phenylethylamine, found in Psilocybe cubensis and other species of psilocybin mushrooms, interacted with tranylcypromine and dextroamphetamine-amphetamine to produce this hypertensive emergency. Patients prescribed MAOIs should be warned of the potential for hypertensive emergency when consuming psilocybin mushrooms, particularly when also prescribed norepinephrine releasers such as dextroamphetamine-amphetamine.

Black, Indigenous, and People of Color (BIPOC), and other minoritized populations are insufficiently represented in research on therapeutic psychedelics. This research was a phenomenological qualitative exploration of a culturally diverse (Hispanic, African American, Asian, Native American, biracial, or LGBTQIA+) and low-income sample of 15 individuals receiving ketamine-assisted psychotherapy (KAP) at a sliding-scale fee community clinic. Participants were interviewed after a ketamine session, after a ketamine integration session, and one month later. The interviews inquired about mental and emotional state prior to treatment and the treatment context (traditionally called set and setting), preparation for treatment, experiences during the ketamine and integration sessions, barriers to treatment, perceived stigma if any, reflections on KAPs' impact, and relevance of culture to the treatment. The current analysis, which focuses on participant comments related to diversity, equity, and inclusion that are uniquely relevant to this sample and the research goals, yielded four major themes: Insufficient Financial Resources, Race, Ethnicity, and LGBTQIA+, Stigma, and Culture and Ritual. Themes and subthemes are presented accompanied by representative quotes. Results demonstrate the high salience of culture in the KAP experience and the need to incorporate issues of race, culture, stigma, ritual, and socioeconomic status into treatment planning and outcome research.