Emerging trends in drugs, addictions, and health最新文献

The opioid epidemic in the U.S. has resulted in significant costs in human lives as well as to the health care system, employers, and insurers. While there is great motivation and urgency to address the opioid crisis, there are currently few non-opioid pain management medications in the development pipeline. The growing regulatory pressures and stigma surrounding opioids have discouraged investments and research in the pain industry. Using estimates from the literature, our simulations show that a portfolio of pharmaceuticals and medical devices for pain treatment and opioid use disorder, diversified and optimized across different development pathways, yields single digit annualized returns. This suggests that active collaboration between the public and private sectors is needed to incentivize investments in pain research.

The aim of the current overview was to present the existing literature on the recent phenomenon of eSports. Using a multifaceted approach, we focused on its definitions, historical development, and classification, drawing attention to key disputes that exist between scholars. Furthermore, we investigated the debate on whether eSports should be considered a traditional sport or not, with a particular interest in two processes that have contributed to eSports’ development as a culturally-significant addition to the world of sports, as both a game and an occupation: sportification and professionalization. Lastly, we analysed studies on spectatorship and consumption to understand why people watch and play eSports pointing out data about the recent relationship between practice and the possible development of eSport's addiction, gambling, and the related impact on individual health and wellbeing.

Novel Psychoactive Substances newly introduced on the drug market are constantly changing patterns of drug consumption. Among these, Synthetic Cannabinoids (SCs) mainly dominated European seizures in the last years. Quinolin-8-yl 1-(5-fluoropentyl)-1H-indole-3-carboxylate (5F-PB22) and quinolin-8-yl 1-(cyclohexylmethyl)-1H-indole-3-carboxylate (BB-22) are SCs whose abuse has been linked to a range of fatal intoxications and hospitalizations. Therefore, this study aims to investigate and compare in vitro and in vivo pharmacodynamics activity of these quinolinyl ester indoles. In vitro competition binding experiments performed on CD-1 murine and human cannabinoid CB₁ and CB₂ receptors revealed a sub-nanomolar affinity and potency of 5F-PB22 and BB-22. In vivo studies demonstrated that the acute systemic administration of 5F-PB22 and BB-22 (0.001-6 mg/kg) deeply impaired sensorimotor and motor responses, core temperature, breath rate and nociceptive threshold of CD-1 male mice. Pre-treatment with the selective cannabinoid CB₁ receptor antagonist/inverse agonist AM-251 (6 mg/kg) fully prevented the effects of both cannabinoids (at 1 mg/kg) suggesting a CB₁ receptor mediated action. Relying on these findings, this study showed for the first time the pharmaco-toxicological effects of these substances confirming their potential burden on human health. Furthermore, it revealed that the difference of the chemical structures of the two SCs results in their potency related disparities.

Background

Following the Covid-19 pandemic, lockdown strategies have been adopted by many Governments worldwide to stop the spread of the virus. Twelve-step programs for people with substance use disorders (SUDs) as Narcotics Anonymous (NA) experienced forced interruption as well, in some cases organizing online meetings to continue their activities. The purpose of this article is to reflect on concerns and advantages of online setting for 12-step groups.

Methods

We report the experience of an Italian NA participant attending for the first time an online NA group during the Covid-19 pandemic.

Results

The strengths and limitations of the online setting, showing up from the living voice of this participant, are expressed in the light of the present pandemic situation. Together with the general advantages derived from telehealth technologies, specific benefits of the virtual setting for 12-step programs are shown. Concerns are also discussed, as those related to privacy and social presence.

Conclusions

The case highlights many possibilities of the online setting for 12-step programs. On the other hand, it suggests the critical importance of in-person groups to accompany the recovery process. Future outcome research is needed about the combination of these approaches.

Γ-Valero-lactone (GVL) is a freely marketed organic solvent and food additive. GVL is also an underrated legal substitute for γ-hydroxybutyric acid (GHB), and it is sold under the trade name "Tranquili-G". GVL is usually not included in forensic drug testing, even though it has been reported in drug-facilitated sexual assaults (DFSA).

To date, few studies verified the effectiveness of GVL as a hypnotic/narcotic substance, and no data are available on its urinary excretion profile. This work aims to fill this knowledge gap and lead to the introduction of GVL in forensic drug testing, especially when DFSA is suspected.

To monitor the timeframe of GVL activity in vivo, we have assessed the effects on sensorimotor responses in visual placing tests carried out on CD-1 mice at a dose of 400 mg/kg of GVL, administered by gastric gavage. In parallel, samples of the in vitro and in vivo metabolism studies were analyzed using a rapid and cost-effective analytical procedure based on gas chromatography coupled to mass spectrometry. Our data confirmed that GVL impairs visual placing response in mice in the first 4 h after the intake, and they also show that GVL is a less potent substitute of GHB. The urinary excretion profile of GVL is consistent with the results of the behavioral study, with a maximum of excretion in the first 5 h after the intake. GVL is only detectable in the first 0–8 h after the intake. Our data confirmed the same rapid urinary excretion rate of GHB in urine and the related forensic implications, with the risk of possible false-negative results, especially when DFSA is suspected.

Introduction

Novel psychoactive substances (NPS) continue to pose challenges to law enforcement authorities, public health officers and policymakers as suppliers continuously adapt to control measures, thus remaining highly dynamic in introducing unpredictable and potentially toxic new substances into the drug market. Using a legal epidemiology approach, the aim of this study was to assess the effectiveness of NPS legal measures in preventing NPS use (legal prevention and control), as well as NPS-related intoxications and deaths (legal aetiology).

Methods

We conducted a comparative analysis of legal instruments adopted at national level as a response to NPS by ten European countries between 2008 and 2019. The data collection process encompassed (i) a scoping review aimed at mapping out the current state of NPS-related legal measures, and (ii) the collection of nationally produced health data on three NPS-related health indicators (prevalence of use, acute intoxications and deaths).

Results

Based on both the legal approaches and the regulatory model adopted by countries a five-elements typology was elaborated. Implemented measures – particularly individual listing – may be relatively effective in preventing NPS use, at least in the short-term. However, they are also very likely to affect the purity and potency of substances, which may have an indirect negative impact on users’ health. In fact, an increase in NPS-related poisoning episodes and deaths has been observed in most of the countries having introduced control measures, regardless the regulatory model adopted.

Conclusions

Policy responses to NPS implemented across Europe have not been markedly effective in deterring their use nor in preventing health harms. Therefore, there is a need for innovative initiatives to regulate drug markets that go beyond law enforcement. Considering scientific evidence on underlying factors leading to the use of psychoactive substances may better inform policy responses to address users’ motivations while reducing their exposure to health risks.

COVID-19 is imposing an extremely serious challenge to individuals’ physical and mental health. The enforcement of lockdown, restriction on public gathering, social distancing strategy, and unprecedented quarantine measures has affected many aspects of peoples’ lives in Bangladesh with potential consequences on their mental and physical health. This study aimed to assess the psychological states and their related factors among general people in Bangladesh during the COVID-19 outbreak. An e-questionnaire-based cross-sectional survey was conducted among 565 Bangladeshi general people between April and May, 2020. Measures included socio-demographics, chronic disease-related variables, the Self-Rating Depression Scale (SDS), and the Self-Rating Anxiety Scale (SAS). Descriptive analysis and bivariate linear regression with “depression” and “anxiety” as the dependent variables were carried out to identify the factors associated with these. Results showed that 30.1% and 32.6% of participants had mild to extremely severe levels of anxiety and depression, respectively. Females were 2.3 (OR = 2.26; 95% CI = 1.58-3.25, p < 0.001) and 2.2 (OR = 2.19; 95% CI = 1.51-3.16, p < 0.001) times more likely to have depression and anxiety, respectively compared to males. In contrast, the odds of depression and anxiety were 2.9 (OR = 2.85; 95% CI = 1.66-4.90, p < 0.001) and 2.0 (OR = 2.00; 95% CI = 1.20-3.36, p = 0.008) times higher, respectively among individuals aged above 40 years than those aged between 18-40 years. The healthcare authority should take necessary steps considering the psychological problems of the general people during the health emergency.

Twenty-six adolescent/young adult patients with opioid use disorder smoked marijuana in an attempt to avoid relapse to opiate use. In each case, smoking marijuana increased cravings and urges for opiates and promoted opiate relapse. These clinical case reports show that smoking marijuana was not helpful as a harm reduction strategy to prevent return to opioids in young people with OUD.

Social networking sites have changed the concept of social interaction and communication. There is increasing evidence of using Facebook to express suicidal ideas and feelings, predominantly among young people. Here, we report a series of cases where victims committed suicide after sharing their thoughts and feelings on Facebook posts or live-streaming. In the present case series, we observed most of the victims were teenagers and young adults. Usually, this group is unwilling to share their suicidal thoughts with physicians or other family members. At the same time, they like to share those factors on Facebook or other social networking sites. So, Facebook can be a potential tool to predict and prevent such suicide cases. A better understanding and quick response to suicidal notes on Facebook can prevent many lives. The present study suggests ensuring the active participation of Facebook users in suicide prevention programs. We can work together with suicide prevention tools and strategies of social networking sites to save many unwanted departures.

Recent interest has emerged regarding the use of several short-acting pharmacotherapies that may be explicitly delivered in the context of psychotherapy for anxiety, mood and substance-dependence disorders. Our objective in this narrative review is to highlight the potential of medically-assisted psychotherapy by outlining the current state of research on some of these drugs, including d-cycloserine, propranolol, and psychedelics, and describing the basic science that supports their use. The neurobiological learning and memory theories that correspond to the manner in which these drugs function are also discussed. Although the efficacy of the medically-assisted psychotherapies reviewed is still under investigation, we propose that these novel treatment approaches may be preferred over traditional psychopharmacological treatments for many reasons, including the presence of fewer chronic side effects, as well as a lesser toxicity and abuse potential. Furthermore, some clinical research suggests that adjunctive pharmacotherapies may help to reinforce the psychotherapeutic alliance and may ultimately yield better long-term treatment outcomes for this reason, alone. If at least some of the adjunctive pharmacotherapies outlined in this review are found to be clinically efficacious and safe, mental health patients will benefit from having more treatment options available to them in the future.