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

There has been an alarming increase of novel synthetic opioids (NSOs) in the illegal drug market since 2016. These substances are still detected in forensic case investigations in biological samples as well as in seized materials. Although NSOs are steadily emerging, other potent “old” synthetic opioids are still circulating and involved in fatal overdose cases. This is the case of the potent designer drugs carfentanil and 3-methylfentanyl. These drugs were associated with several deaths since at least 20 years ago, and they are still a public health threat.

In this study, we presented postmortem (PM) forensic cases that were positive for carfentanil or 3-methylfentanyl over a four-year period 2017–2020. Quantitative confirmation was via a quantitative liquid chromatography tandem mass spectrometry (LC-MS/MS)-based method that targets 21 designer opioids, able to differentiate isomers such as cis- and trans-3-methylfentanyl, with a limit of quantification of 0.05 ng/mL.

A total of 1136 and 153 PM cases were received in the laboratory from different regions of the United States positive for carfentanil and 3-methylfentanyl, respectively. PM peripheral blood ranged from 0.050‒32 ng/mL for carfentanil, and 0.057‒7.2 and 0.057‒2.2 ng/mL for cis- and trans-3-methylfentanil, respectively. During this period, fentanyl was the most common concomitant drug detected within these cases. Heroin and cocaine were also highly prevalent in those cases positive for carfentanil. Other NSOs such as 2-furanylfentanyl, cyclopropylfentanyl and para-fluorobutyrylfentanyl were also significant findings in positive carfentanil cases. For 3-methylfentanyl, cocaine was the second most prevalent co-occurrence drug, while heroin decreased over the years in those cases where 3-methylfentanyl was confirmed.

Background

The use of social media is popular in the health and the beauty industry, with an increasing number of brands using web platforms to promote their products. Among the recently-emerged trends, “fitspiration” (also abbreviated as “fitspo”) has raised health concerns. Evidence suggested that fitspiration contents, although originally conceived to promote a healthier lifestyle, often portray distressful themes that can lead to unhealthy thoughts and behaviours (e.g., body image and eating disturbances, excessive exercising, misuse of supplements). Despite its popularity, the knowledge on this trend is limited and relatively few studies explored its psychological impact on young people below 25-year-old.

Methods

A narrative literature search was conducted in order to provide an overview of the evidence linking fitspiration trends on social media to mental health disturbances.

Results

Various factors related to psychopathological risks have been associated with the exposure to fitspiration contents, which we have clustered in the following main topics: (i) exercise addiction and compulsive exercise; (ii) body dissatisfaction and objectification; (iii) appearance-related anxiety and depressive symptoms, self-esteem; (iv) excessive control of eating habits; (v) use of enhancing drugs; (vi) quality of life.

Conclusion

A wide range of negative psychological effects associated with fitspiration contents on social media were identified. Additional research is required to further elucidate the phenomenon, to determine the extent of the harm for young people, and to develop preventive mental health strategies.

Background

The prevalence of new psychoactive substances (NPS) in acute psychotic patients has not been investigated systematically. We applied a highly sensitive and specific mass spectrometry method for detection of NPS as well as traditional drugs of abuse (including illicit or prescription substances) in order to assess their prevalence and associations with symptom severity. Identification of these substances is useful in both the diagnostic process and evaluation of treatment effects.

Methods

Demographic data, results from the Positive and Negative Syndrome Score (PANSS) and Calgary Depression Scale for Schizophrenia (CDSS) and urine samples from admission were collected from 53 patients recruited into a clinical study of psychosis during 2014-2017. Urine samples were analysed with liquid chromatography high resolution mass spectrometry (LC-QTOF-MS), through both highly specific detection of 191 substances using internal standards and untargeted screening by means of pre-defined libraries. PANSS and CDSS scores in patients with or without drugs of abuse were compared.

Results

Potential drugs of abuse, i.e. drugs that could be used in a controlled therapeutic or a non-prescribed manner, were detected in samples from 20 of the 53 patients. Seven samples contained illicit drugs, but no NPS were detected. In this small patient subgroup, PANSS total score and CDSS score were significantly higher than in patients with negative urine sample results.

Conclusion

Drug screening could play an important role in the differential diagnostic evaluation of patients admitted with psychotic symptoms. Although no NPS were detected in the study population, we found other substances that were associated with psychotic and depressive symptoms.

Background

Cannabis is one of the most consumed illicit drugs in India. Long term effects of cannabis smoking on the cardiovascular system are still not fully known. The present study explores cardiovascular abnormalities in asymptomatic cannabis smokers by comparing their electrocardiogram (ECG) with tobacco smokers and non-smokers.

Methods

The study included 50 participants in each of the three groups: cannabis, tobacco and non-smokers, between the age group 18–40 years. ECG was recorded and the following parameters were compared: Age, Heart rate, RR-interval, P-wave, PR-interval, QRS-complex, QT-interval, QTc-interval, ST-segment and T-wave duration.

Results

The mean age of cannabis smokers, tobacco smokers, and non-smokers were 26.44, 31.22 and 31.34, respectively. Cannabis smokers were younger than tobacco smokers and non-smokers. All the participants reported to us were males. The QRS complex duration was shortened in cannabis smokers compared to tobacco smokers. The ST-segment duration was shorter among tobacco smokers compared to non-smokers.

Conclusions

The study proposes cannabis as a potential risk factor for adverse cardiac events as an acute and chronic effect. Clinicians could also use our findings to correlate cardiac complaints of a cannabis dependent patient. ECG could be a quick and affordable modality for investigating such patients. The subjects of the cannabis group had younger age than subjects of the other groups.

Substance use disorder (SUD) is an issue of concern that can have inter- generational impacts. Fathers affected by this disorder can exhibit atypical parenting that leaves pronounced, adverse consequences for the child, espe cially during a critical window for development, such as neonatal life and infancy. However, factors sustaining paternal drug use and its associated health outcomes remain elusive. The present review provides a systematic literature search of the scientific evidence published until February 2021 on PubMed Central, Scopus, PsycInfo, and PubMed databases. Adopting a biopsychosocial model, this review provides comprehensive insights into the issue, detailing: (i) the neurobiological correlates of paternal substance use and atypical parenting mechanisms, (ii) influence of drug consumption on paternal psychological state, and (iii) the social environment modulating the social dynamics central to fathers with SUD. Attention is also paid to the bidirectional relationships between paternal drug abuse and fatherhood, which has been severely neglected so far. Findings shed new light on the importance of paternal contributions to the father-child interaction, supporting the formulation of more targeted multidisciplinary interventions aimed at restoring such a crucial and overlooked relationship.

Objective

Opioid abuse is a worrying reality especially in the US. The increase in the prescription of opioids in Europe poses the risk of a possible increase in the number of abusers also in Italy. The aim of the study is to evaluate the abuse of opioids in the youth population and to evaluate possible correlations with some psychopathological aspects.

Methods

A survey, conducted from July 2019 to March 2020, about the use of opioids was spread to a group of subjects aged between 18 and 40 years. A socio-demographical investigation and psychometric scales evaluating internet game addiction, gaming online, quality of life and general psychometric features were administrated.

Results

Nine-hundred and thirteen subjects completed the survey. Seventeen-five subjects (8.21%) have used one opioid at least once in their lifetime. Weak correlations were found between codeine and morphine intensity of use and sleep disturbance, cigarette smoked per day, while codeine correlates with the number of coffees taken per day and somatization.

Conclusion

Although the data of this survey do not show high percentages of use in Italy (8.21% of the sample have used one of the listed opioids at least once in their lifetime), the correlations founded confirm the literature data already present highlighting the need for constant monitoring of this phenomenon.

Carbon monoxide (CO) is the most common lethal poison in every community yet studied. Accidental or suicidal CO poisoning has been reported as the most frequent manner of death. In the case we report here, a man was found dead inside his house with a strong smell of burning. The house presented no signs of effraction, and a lot of scotch tape was placed around the windows and doors edges as well as the keyholes to avoid any passage of air. Near the bed, there was an extinguished brazier with combusted carbon. After the external examination of the body a toxicological analysis was performed. The results pointed out 91% HbCO saturation in absence of signs of intermediate intoxication on the body or on the scene. This article aims to outline the importance of performing a multidisciplinary approach that includes an accurate crime scene investigation and a proper toxicological assessment, to evaluate the cause of death in cases of suspected CO inhalation suicide. The crime scene investigation together with the very high levels of HbCO saturation detected, suggest a possible correlation between time of exposure, source of CO, and saturation levels.

Cytisine is an effective, inexpensive, affordable, and well-tolerated drug for smoking cessation treatment, and it has been used for many years in some parts of the world. Recent studies confirm its significance in anti-smoking efficacy with no serious safety signals or expected drug interactions. We present a case of a 62-year-old patient with a history of choreic syndrome on tetrabenazine therapy who experienced worsening neurological symptoms during smoking cessation therapy with cytisine. It is conceivable that cytisine therapy could reduce the desensitization of α6β2 nAChR and increase dopamine release, worsening the chorea. The present case report may help bring attention to some not yet described interactions of cytisine in humans, and the role of the drug in people with tobacco addiction and underlying neurological conditions. Clinicians should be aware of possible interactions between cytisine and other drugs or pathological conditions in which the same neurotransmitter pathways are involved.

Kratom (Mitragyna speciosa) is a tree native to Southeast Asia with long history of traditional medicinal use. The aim of this study was to investigate the nature of self-reported experiences as shared on YouTube™ videos. A total of 500 videos with 19,478,180 views and 134,863 comments emerged as result from the data scrape extracted via the YouTube Data Tool. 12 out of the 16 most viewed videos were manually processed and selected for inductive thematic analysis. Kratom was used to self-medicate a number of health conditions, including opioid dependence/addiction (83.4%), pain (75%), anxiety (67%), depression (42%), substance use (42%) as well as to boost energy (50%), elevate mood (25%) and its nootropic effects (25%). Although most of the described experiences were positive (58%), side-effects, such as dependence and withdrawal (50%), nausea (42%), loss of appetite (25%), sedation (25%), loss of motivation (16.7%), were also reported. These were associated in the 25% of the cases with chronic ingestions. Overall, it was found that Kratom was mainly used for self-medication, rather than recreational purposes, justifying the need for further clinical studies to better assess the safety and the efficacy of its use in a therapeutic context.