Pub Date : 2025-12-01DOI: 10.1016/j.etdah.2025.100198
C. Black, A. Mayer, B. Copp
Introduction
In 2024, full structure elucidation was achieved for a novel synthetic cathinone, N-cyclohexyl pentylone. Synthetic stimulants, including cathinones, represent the largest group of NPS and are increasingly dominating the global drug market. These compounds have diverse structures that are difficult to rapidly identify and characterise using screening methods which rely on database comparisons. Due to the rapidly changing landscape of NPS, drug laboratories are struggling to keep up with the rate at which these novel substances are appearing.
Methods
The Institute of Environmental Science and Research (ESR) provides assistance to Drug Checking Service providers in instances where identification in the field is unsuccessful. Where a novel substance or structural isomers are encountered, techniques including high-resolution MS and NMR spectroscopy are employed. Results/
Conclusions
Characterisation of N-cyclohexylpenylone was achieved and has since been detected on several occasions within New Zealand. This NPS has also emerged in the U.S, demonstrating the need for the development of an analytical strategy for the rapid detection and identification of newly emerging NPS to effectively assist in the protection of public health. It also highlights the need for effective data sharing within the Forensic Community.
{"title":"N-Cyclohexylpentylone – Newcomer to the NZ Synthetic Drug Market","authors":"C. Black, A. Mayer, B. Copp","doi":"10.1016/j.etdah.2025.100198","DOIUrl":"10.1016/j.etdah.2025.100198","url":null,"abstract":"<div><h3>Introduction</h3><div>In 2024, full structure elucidation was achieved for a novel synthetic cathinone, N-cyclohexyl pentylone. Synthetic stimulants, including cathinones, represent the largest group of NPS and are increasingly dominating the global drug market. These compounds have diverse structures that are difficult to rapidly identify and characterise using screening methods which rely on database comparisons. Due to the rapidly changing landscape of NPS, drug laboratories are struggling to keep up with the rate at which these novel substances are appearing.</div></div><div><h3>Methods</h3><div>The Institute of Environmental Science and Research (ESR) provides assistance to Drug Checking Service providers in instances where identification in the field is unsuccessful. Where a novel substance or structural isomers are encountered, techniques including high-resolution MS and NMR spectroscopy are employed. Results/</div></div><div><h3>Conclusions</h3><div>Characterisation of N-cyclohexylpenylone was achieved and has since been detected on several occasions within New Zealand. This NPS has also emerged in the U.S, demonstrating the need for the development of an analytical strategy for the rapid detection and identification of newly emerging NPS to effectively assist in the protection of public health. It also highlights the need for effective data sharing within the Forensic Community.</div></div>","PeriodicalId":72899,"journal":{"name":"Emerging trends in drugs, addictions, and health","volume":"5 ","pages":"Article 100198"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.etdah.2025.100243
T. Mizuguchi
Introduction
Kratom (Mitragyna speciosa), a tropical plant from the coffee family native to Southeast Asia, has a long history of use as a traditional herbal remedy, particularly for pain relief and mood enhancement. While its opioid-like effects have raised concerns about dependence, emerging research suggests that certain kratom alkaloids also interact with the brain’s serotonin system. Notably, some alkaloids may bind to 5-HT receptors, opening potential avenues for treating conditions such as anxiety, depression, and schizophrenia.
Methods
In this study, we employed molecular docking and computer simulations to explore how kratom-derived alkaloids interact with serotonin receptors—particularly the 5-HT1A subtype.
Results
We found that mitragynine, kratom’s principal psychoactive compound, exhibits a higher binding affinity to the 5-HT1A receptor than ajmalicine and binds at a distinct site on the receptor, suggesting a unique mechanism of action. By analyzing these structural interactions, we identified key molecular features influencing receptor affinity.
Conclusions
Our findings shed light on how kratom alkaloids may modulate serotonergic signaling and support the development of novel kratom-based therapeutics targeting neuropsychiatric disorders.
{"title":"Molecular Docking Simulations of Kratom Alkaloids to Serotonin 5-HT Receptors","authors":"T. Mizuguchi","doi":"10.1016/j.etdah.2025.100243","DOIUrl":"10.1016/j.etdah.2025.100243","url":null,"abstract":"<div><h3>Introduction</h3><div>Kratom (Mitragyna speciosa), a tropical plant from the coffee family native to Southeast Asia, has a long history of use as a traditional herbal remedy, particularly for pain relief and mood enhancement. While its opioid-like effects have raised concerns about dependence, emerging research suggests that certain kratom alkaloids also interact with the brain’s serotonin system. Notably, some alkaloids may bind to 5-HT receptors, opening potential avenues for treating conditions such as anxiety, depression, and schizophrenia.</div></div><div><h3>Methods</h3><div>In this study, we employed molecular docking and computer simulations to explore how kratom-derived alkaloids interact with serotonin receptors—particularly the 5-HT1A subtype.</div></div><div><h3>Results</h3><div>We found that mitragynine, kratom’s principal psychoactive compound, exhibits a higher binding affinity to the 5-HT1A receptor than ajmalicine and binds at a distinct site on the receptor, suggesting a unique mechanism of action. By analyzing these structural interactions, we identified key molecular features influencing receptor affinity.</div></div><div><h3>Conclusions</h3><div>Our findings shed light on how kratom alkaloids may modulate serotonergic signaling and support the development of novel kratom-based therapeutics targeting neuropsychiatric disorders.</div></div>","PeriodicalId":72899,"journal":{"name":"Emerging trends in drugs, addictions, and health","volume":"5 ","pages":"Article 100243"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.etdah.2025.100210
E. Deligianni, S. Mohapatra, G. Papazisis, A. Goulas, F. Schifano, L. Lione
<div><h3>Introduction</h3><div>The rapid proliferation of Novel Psychoactive Substances (NPSs) in e-cigarette products presents an urgent public health concern. These include herbal compounds, synthetic cannabinoids, cathinones, and other potent analogues, often used by young adults. Their unregulated presence in vape liquids raises significant addiction and intoxication risks. This study aimed to elucidate current trends in NPS vaping and user perceptions to inform clinical and regulatory interventions.</div></div><div><h3>Methods</h3><div>This study employed a mixed-methods design that combined an international survey with social media listening. The survey was in English and Greek, distributed between April and December 2024 via online forums (e.g., Bluelight), social media, and university mailing lists. Quantitative data were analysed using SPSS. Simultaneously, a netnographic study analyzed 11,721 social media comments (Reddit, YouTube) to extract motivations and perceptions. Data scraping tools Apify and ExportComments were employed, followed by thematic categorization and sentiment analysis.</div></div><div><h3>Results</h3><div>The survey received 1,045 responses where 210 respondents (20%) were vapers {49% males; 40% aged 25–39; (66% heterosexuals, 21% bisexuals); (47% from Greece, 22% from the UK, 18% from the US and Canada)}. The majority 52% were either high school or college leavers. 86% trusted online resources for information regarding vaping and only 32% referred to healthcare professionals. 81% stated that reliable online resources would work best as the main source of information. 62% of participants were tobacco smokers, and only 21% were ex-smokers. A total of 46% started e-vaping at 25 years or above; 60% used vapes daily. 72% had frequent or occasional cravings to vape; 37% tried to stop unsuccessfully. Meanwhile 31% complained about adverse events after vaping such as coughing, weakness, dizziness, sore throat, chest pain, palpitations, anxiety, COPD. Natural novel psychoactive substances, synthetic cannabinoids and flavorings as well as nicotine were mainly referred to as preferred in vaping liquids. 55% of participants stated that vaping poses medium risk. 32% of the vapers were also users of prescribed medications such as codeine, oxycodone, and 40% also users of NPSs (mainly herbals and benzodiazepines) combined with vaping. Netnographic findings revealed that the primary motivations for vaping were smoking cessation (63%), perception that vaping was less harmful (15%), and sensory appeal (8%). Youth often cited stress relief, peer influence and social identity as vaping drivers. Posts also highlighted widespread unawareness about NPS presence in vape products, reflecting a dangerous information gap.</div></div><div><h3>Conclusions</h3><div>Vapes are increasingly exploited as vehicles for a range of illicit drugs and NPSs, particularly among youth, with high addiction and toxicity risks. Real-time monitoring, better educ
{"title":"E-Vaping Patterns of Use, Information Needs and Risk Perception in the Post Pandemic Era: An International Survey and Social Media Listening Study","authors":"E. Deligianni, S. Mohapatra, G. Papazisis, A. Goulas, F. Schifano, L. Lione","doi":"10.1016/j.etdah.2025.100210","DOIUrl":"10.1016/j.etdah.2025.100210","url":null,"abstract":"<div><h3>Introduction</h3><div>The rapid proliferation of Novel Psychoactive Substances (NPSs) in e-cigarette products presents an urgent public health concern. These include herbal compounds, synthetic cannabinoids, cathinones, and other potent analogues, often used by young adults. Their unregulated presence in vape liquids raises significant addiction and intoxication risks. This study aimed to elucidate current trends in NPS vaping and user perceptions to inform clinical and regulatory interventions.</div></div><div><h3>Methods</h3><div>This study employed a mixed-methods design that combined an international survey with social media listening. The survey was in English and Greek, distributed between April and December 2024 via online forums (e.g., Bluelight), social media, and university mailing lists. Quantitative data were analysed using SPSS. Simultaneously, a netnographic study analyzed 11,721 social media comments (Reddit, YouTube) to extract motivations and perceptions. Data scraping tools Apify and ExportComments were employed, followed by thematic categorization and sentiment analysis.</div></div><div><h3>Results</h3><div>The survey received 1,045 responses where 210 respondents (20%) were vapers {49% males; 40% aged 25–39; (66% heterosexuals, 21% bisexuals); (47% from Greece, 22% from the UK, 18% from the US and Canada)}. The majority 52% were either high school or college leavers. 86% trusted online resources for information regarding vaping and only 32% referred to healthcare professionals. 81% stated that reliable online resources would work best as the main source of information. 62% of participants were tobacco smokers, and only 21% were ex-smokers. A total of 46% started e-vaping at 25 years or above; 60% used vapes daily. 72% had frequent or occasional cravings to vape; 37% tried to stop unsuccessfully. Meanwhile 31% complained about adverse events after vaping such as coughing, weakness, dizziness, sore throat, chest pain, palpitations, anxiety, COPD. Natural novel psychoactive substances, synthetic cannabinoids and flavorings as well as nicotine were mainly referred to as preferred in vaping liquids. 55% of participants stated that vaping poses medium risk. 32% of the vapers were also users of prescribed medications such as codeine, oxycodone, and 40% also users of NPSs (mainly herbals and benzodiazepines) combined with vaping. Netnographic findings revealed that the primary motivations for vaping were smoking cessation (63%), perception that vaping was less harmful (15%), and sensory appeal (8%). Youth often cited stress relief, peer influence and social identity as vaping drivers. Posts also highlighted widespread unawareness about NPS presence in vape products, reflecting a dangerous information gap.</div></div><div><h3>Conclusions</h3><div>Vapes are increasingly exploited as vehicles for a range of illicit drugs and NPSs, particularly among youth, with high addiction and toxicity risks. Real-time monitoring, better educ","PeriodicalId":72899,"journal":{"name":"Emerging trends in drugs, addictions, and health","volume":"5 ","pages":"Article 100210"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.etdah.2025.100196
G. Bersani
Consensual clinical experience indicates that in recent years the spread of an increasingly large and heterogeneous number of psychoactive substances is leading to substantial changes in the phenomenology and course of mental disorders, particularly psychotic disorders. NPS play a central role in this change and contribute, in a powerful yet highly variable manner, to the presence of previously undescribed clinical entities. The clinical constructs of Substance Use Disorder and Dual Diagnosis now appear insufficient to describe the breadth and complexity of the phenomenon. Some new clinical categories have been described, not yet included in official nosographic systems, such as spiceophrenia, synthetic psychosis, lysergic psychoma, hallucinogen persistent perceptual disorder, and others, in an attempt to recognize clinical forms of highly variable psychopathological conditions. In fact, the traditional diagnostic categories of psychiatry, particularly those of psychotic disorders and mood disorders, no longer appear capable of realistically describing the clinical variability of the psychopathological pictures of psychotic patients. Furthermore, it is necessary to consider the marked clinical and outcome changes that the widespread use of psychoactive substances induces in the clinical presentations of patients already suffering from mental disorders, so that the clinical presentations of, for example, schizophrenia or bipolar disorder very often appear significantly altered in their symptomatology and course. On a strictly clinical level, certain psychopathological features appear more consistently associated with the use of psychoactive substances, such as greater severity of paranoid symptoms, high frequency of exacerbations, mood instability, dysregulation of emotions and behavior, early cognitive decline, and resistance to traditional pharmacological treatments. This is a clinical landscape of enormous significance, which shows how the clinical presentations and diagnostic categories of traditional psychiatry have progressively and severely changed.
{"title":"New substances, new psychoses","authors":"G. Bersani","doi":"10.1016/j.etdah.2025.100196","DOIUrl":"10.1016/j.etdah.2025.100196","url":null,"abstract":"<div><div>Consensual clinical experience indicates that in recent years the spread of an increasingly large and heterogeneous number of psychoactive substances is leading to substantial changes in the phenomenology and course of mental disorders, particularly psychotic disorders. NPS play a central role in this change and contribute, in a powerful yet highly variable manner, to the presence of previously undescribed clinical entities. The clinical constructs of Substance Use Disorder and Dual Diagnosis now appear insufficient to describe the breadth and complexity of the phenomenon. Some new clinical categories have been described, not yet included in official nosographic systems, such as spiceophrenia, synthetic psychosis, lysergic psychoma, hallucinogen persistent perceptual disorder, and others, in an attempt to recognize clinical forms of highly variable psychopathological conditions. In fact, the traditional diagnostic categories of psychiatry, particularly those of psychotic disorders and mood disorders, no longer appear capable of realistically describing the clinical variability of the psychopathological pictures of psychotic patients. Furthermore, it is necessary to consider the marked clinical and outcome changes that the widespread use of psychoactive substances induces in the clinical presentations of patients already suffering from mental disorders, so that the clinical presentations of, for example, schizophrenia or bipolar disorder very often appear significantly altered in their symptomatology and course. On a strictly clinical level, certain psychopathological features appear more consistently associated with the use of psychoactive substances, such as greater severity of paranoid symptoms, high frequency of exacerbations, mood instability, dysregulation of emotions and behavior, early cognitive decline, and resistance to traditional pharmacological treatments. This is a clinical landscape of enormous significance, which shows how the clinical presentations and diagnostic categories of traditional psychiatry have progressively and severely changed.</div></div>","PeriodicalId":72899,"journal":{"name":"Emerging trends in drugs, addictions, and health","volume":"5 ","pages":"Article 100196"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.etdah.2025.100241
C. May, J. Carroll, D. Fox, J. Roche, M. Nevin, L. McMenemy, K. Stepniak, J. Roche, R. Kennedy
Introduction
Benzodiazepines are a widely prescribed medication used to treat anxiety, panic disorders, insomnia and seizures. The misuse of this class of drugs in Ireland has increased over the last eight years with a 70% increase in persons participating in drug treatment programmes being treated for benzodiazepines as the main problem. A recent publication from the Health Research Board (HRB) indicated that benzodiazepines and related NPS were implicated in more than 50% of drug poisoning deaths in Ireland in 2021.
Methods
Data collated from Forensic Science Ireland’s (FSI) LIMS system show that FSI receives, on average, almost 700,000 seized benzodiazepine type tablets each year since 2019. Legitimate pharmaceutical presentations are submitted for analysis as well as falsified (fake) pharmaceutical presentations.
Results
Data showing the seizure trends during this timeline of many different drugs and NPS will be presented. The changes to the controlled drug law in Ireland and how these have influenced this market will also be presented.
Conclusions
Many falsified (fake) pharmaceutical tablets were encountered during this period.
{"title":"Designer Benzodiazepines and Related Novel Psychoactive Substances (NPS) in Seized Tablets in Ireland 2019-2025","authors":"C. May, J. Carroll, D. Fox, J. Roche, M. Nevin, L. McMenemy, K. Stepniak, J. Roche, R. Kennedy","doi":"10.1016/j.etdah.2025.100241","DOIUrl":"10.1016/j.etdah.2025.100241","url":null,"abstract":"<div><h3>Introduction</h3><div>Benzodiazepines are a widely prescribed medication used to treat anxiety, panic disorders, insomnia and seizures. The misuse of this class of drugs in Ireland has increased over the last eight years with a 70% increase in persons participating in drug treatment programmes being treated for benzodiazepines as the main problem. A recent publication from the Health Research Board (HRB) indicated that benzodiazepines and related NPS were implicated in more than 50% of drug poisoning deaths in Ireland in 2021.</div></div><div><h3>Methods</h3><div>Data collated from Forensic Science Ireland’s (FSI) LIMS system show that FSI receives, on average, almost 700,000 seized benzodiazepine type tablets each year since 2019. Legitimate pharmaceutical presentations are submitted for analysis as well as falsified (fake) pharmaceutical presentations.</div></div><div><h3>Results</h3><div>Data showing the seizure trends during this timeline of many different drugs and NPS will be presented. The changes to the controlled drug law in Ireland and how these have influenced this market will also be presented.</div></div><div><h3>Conclusions</h3><div>Many falsified (fake) pharmaceutical tablets were encountered during this period.</div></div>","PeriodicalId":72899,"journal":{"name":"Emerging trends in drugs, addictions, and health","volume":"5 ","pages":"Article 100241"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.etdah.2025.100250
T. Re, A. Metastasio
Introduction
Throughout history, mushrooms have served as a bridge for ancient populations, guiding human beings from earthly life to the "Beyond" and allowing them to "taste" this passage during their lifetime, thereby alleviating the fear of death.
Methods
Recent scientific research has revealed that these ancient practices are supported by research done by leading world universities showing the effectiveness of psilocybin mushrooms in addressing fear of death, anxiety, and existential stress. As consequence psilocybin is now allowed and its use regulated, in several countries, as treatment in individuals with terminal cancer and other similar conditions.
Results
The experience of guiding a person across the bridge between life and death raises intriguing questions about the nature of consciousness, the potential for communication in "non-ordinary states of consciousness" between different realms of nature, and the possibility of transcending space and time, thereby creating a new experience and continuity between life and death.
Conclusions
Although we advocate for a wider and more accessible of use of psylocibin in the end of life we believe that more studies are necessary to identify the subjects that would benefit the most from this practice.
{"title":"End of Life with Psylocibin: Research, Data and Experience","authors":"T. Re, A. Metastasio","doi":"10.1016/j.etdah.2025.100250","DOIUrl":"10.1016/j.etdah.2025.100250","url":null,"abstract":"<div><h3>Introduction</h3><div>Throughout history, mushrooms have served as a bridge for ancient populations, guiding human beings from earthly life to the \"Beyond\" and allowing them to \"taste\" this passage during their lifetime, thereby alleviating the fear of death.</div></div><div><h3>Methods</h3><div>Recent scientific research has revealed that these ancient practices are supported by research done by leading world universities showing the effectiveness of psilocybin mushrooms in addressing fear of death, anxiety, and existential stress. As consequence psilocybin is now allowed and its use regulated, in several countries, as treatment in individuals with terminal cancer and other similar conditions.</div></div><div><h3>Results</h3><div>The experience of guiding a person across the bridge between life and death raises intriguing questions about the nature of consciousness, the potential for communication in \"non-ordinary states of consciousness\" between different realms of nature, and the possibility of transcending space and time, thereby creating a new experience and continuity between life and death.</div></div><div><h3>Conclusions</h3><div>Although we advocate for a wider and more accessible of use of psylocibin in the end of life we believe that more studies are necessary to identify the subjects that would benefit the most from this practice.</div></div>","PeriodicalId":72899,"journal":{"name":"Emerging trends in drugs, addictions, and health","volume":"5 ","pages":"Article 100250"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.etdah.2025.100245
E. Mshari, C. Copeland
Introduction
Tianeptine is an atypical tricyclic antidepressant with opioid receptor agonist properties. It is unlicensed in the UK. The FDA has released public health warnings on its adverse effects, including dependence, overdose, and mortality. Here we present the characteristics of the first four deaths following tianeptine use in the UK.
Methods
Cases with post-mortem detections of tianeptine were extracted from the National Programme on Substance Use Mortality (NPSUM) and analysed.
Results
Four deaths with post-mortem detections of tianeptine were reported to the NPSUM by 1st November 2024 (male n=2, female n=2; age range 29-51). The first death occurred in 2019, with the following three in 2023. Two deaths were concluded as drug-related, one as suicide, and one as misadventure. Post-mortem analyses identified polydrug use in all cases, with hypnotics/sedatives co-detected in three cases, opioids in two cases, other antidepressants in two cases, and gabapentinoids in two cases.
Conclusions
These are the first documented deaths following tianeptine use in the UK, highlighting its emergence on the UK illicit drug market. All cases involved polydrug use, underscoring the risks of combining tianeptine with other CNS depressants. Tianeptine poses a potential public health concern that warrants monitoring, regulation, and increased clinical awareness.
{"title":"Deaths Following Tianeptine Use in the UK","authors":"E. Mshari, C. Copeland","doi":"10.1016/j.etdah.2025.100245","DOIUrl":"10.1016/j.etdah.2025.100245","url":null,"abstract":"<div><h3>Introduction</h3><div>Tianeptine is an atypical tricyclic antidepressant with opioid receptor agonist properties. It is unlicensed in the UK. The FDA has released public health warnings on its adverse effects, including dependence, overdose, and mortality. Here we present the characteristics of the first four deaths following tianeptine use in the UK.</div></div><div><h3>Methods</h3><div>Cases with post-mortem detections of tianeptine were extracted from the National Programme on Substance Use Mortality (NPSUM) and analysed.</div></div><div><h3>Results</h3><div>Four deaths with post-mortem detections of tianeptine were reported to the NPSUM by 1st November 2024 (male n=2, female n=2; age range 29-51). The first death occurred in 2019, with the following three in 2023. Two deaths were concluded as drug-related, one as suicide, and one as misadventure. Post-mortem analyses identified polydrug use in all cases, with hypnotics/sedatives co-detected in three cases, opioids in two cases, other antidepressants in two cases, and gabapentinoids in two cases.</div></div><div><h3>Conclusions</h3><div>These are the first documented deaths following tianeptine use in the UK, highlighting its emergence on the UK illicit drug market. All cases involved polydrug use, underscoring the risks of combining tianeptine with other CNS depressants. Tianeptine poses a potential public health concern that warrants monitoring, regulation, and increased clinical awareness.</div></div>","PeriodicalId":72899,"journal":{"name":"Emerging trends in drugs, addictions, and health","volume":"5 ","pages":"Article 100245"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145790175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.etdah.2025.100260
H.D. Townshend
Introduction
This presentation will explore the intersection of masculinity, image and performance enhancing drugs (IPEDs) use, and digital culture. Specifically, it will interrogate how online platforms operate as complex spaces that simultaneously reinforce harmful gendered body ideals and facilitate harm reduction practices among men who use IPEDs.
Methods
This mixed-methods research comprised a five-month netnography of bodybuilding forums and a follow-up cross-sectional survey incorporating open-ended responses and visual data. Thematic analysis was applied to both datasets, with attention to gender theory and body image. A thematic analytic framework was applied, informed by contemporary gender theory and literature on embodiment, subcultural capital, and digitally-mediated drug practices.
Results
Findings demonstrate that masculinities articulated online are often aligned with hegemonic, hyper-muscular ideals, reinforcing normative body anxieties and legitimizing substance use. However, these same digital forums also function as decentralized harm reduction spaces, where peer-led knowledge exchange, risk mitigation strategies, and emotional support are routinely enacted.
Conclusions
Online platforms should be understood as ambivalent cultural sites: they reproduce and circulate dominant masculine aesthetics while simultaneously hosting community-based harm reduction. This duality has significant implications for drug policy, health communication, and the development of targeted interventions within digitally embedded subcultures.
{"title":"Masculinity, Media, and Muscle: IPEDs and the Double-Edged Role of Online Platforms","authors":"H.D. Townshend","doi":"10.1016/j.etdah.2025.100260","DOIUrl":"10.1016/j.etdah.2025.100260","url":null,"abstract":"<div><h3>Introduction</h3><div>This presentation will explore the intersection of masculinity, image and performance enhancing drugs (IPEDs) use, and digital culture. Specifically, it will interrogate how online platforms operate as complex spaces that simultaneously reinforce harmful gendered body ideals and facilitate harm reduction practices among men who use IPEDs.</div></div><div><h3>Methods</h3><div>This mixed-methods research comprised a five-month netnography of bodybuilding forums and a follow-up cross-sectional survey incorporating open-ended responses and visual data. Thematic analysis was applied to both datasets, with attention to gender theory and body image. A thematic analytic framework was applied, informed by contemporary gender theory and literature on embodiment, subcultural capital, and digitally-mediated drug practices.</div></div><div><h3>Results</h3><div>Findings demonstrate that masculinities articulated online are often aligned with hegemonic, hyper-muscular ideals, reinforcing normative body anxieties and legitimizing substance use. However, these same digital forums also function as decentralized harm reduction spaces, where peer-led knowledge exchange, risk mitigation strategies, and emotional support are routinely enacted.</div></div><div><h3>Conclusions</h3><div>Online platforms should be understood as ambivalent cultural sites: they reproduce and circulate dominant masculine aesthetics while simultaneously hosting community-based harm reduction. This duality has significant implications for drug policy, health communication, and the development of targeted interventions within digitally embedded subcultures.</div></div>","PeriodicalId":72899,"journal":{"name":"Emerging trends in drugs, addictions, and health","volume":"5 ","pages":"Article 100260"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.etdah.2025.100228
Z. Hassan
Introduction
Kratom (Mitragyna speciosa) and its primary alkaloid, mitragynine, have gained global attention as plant-derived psychoactive substances with stimulant and opioid-like properties. Traditionally used in Southeast Asia for medicinal purposes and as a stimulant among manual laborers, kratom has more recently emerged in Western contexts as a recreational "herbal high" and alternative to opioids. Despite its long-standing cultural use, concerns about its potential for misuse, particularly among adolescents seeking euphoric effects, have intensified. However, an overdose of kratom may cause addiction-like problems, including aversive withdrawal states and developing physical dependence. Research has found that mitragynine can lead to physical dependence when taken repeatedly and changes how brain cells work.
Methods
Here, we compared the impact of kratom decoction relative to mitragynine in terms of its physical dependence and its underlying brain cellular mechanism. We also investigated the significance of kratom intoxication for physical dependence in the future treatment of kratom addiction. Results/
Conclusions
While local communities may still view kratom as harmless, emerging scientific evidence underscores its capacity to impair cognitive function and contribute to dependence, raising important questions for public health, regulation, and future research.
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Pub Date : 2025-12-01DOI: 10.1016/j.etdah.2025.100259
N. Tomar, L. Gupta, H. Gupta, K. Goyal, R.K. Sarin
Introduction
Ephedrine and its analogs are reportedly encountered in seized samples of drugs of abuse. It is also reported as a precursor in the clandestine manufacture of methamphetamines in India. The present research presents a sensitive color test for the detection of ephedrine in forensic samples.
Methods
The certified reference materials (CRM) for the pharmaceutical compounds were sourced from the Indian Pharmacopoeia, Ghaziabad, India. Corresponding working standards of the drugs were prepared, and the developed colorimetric assay was further optimized to enable precise execution at reduced scales. The analytical method was validated following the parameters outlined in the International Council for Harmonisation (ICH) guidelines, ensuring its specificity, accuracy, and reproducibility.
Results
The test solutions exhibited a violet coloration upon interaction with ephedrine. The colorimetric assay was assessed through visual evaluation of color development, and key reaction parameters influencing the chromatic response were systematically optimized. The validated method met the requisite criteria for preliminary screening applications, ensuring the generation of qualitative and dependable presumptive test results.
Conclusions
The refined analytical method demonstrates high sensitivity, reproducibility, and robustness, effectively detecting ephedrine at a threshold of 7.5 µL. Validation studies affirm that the distinct colorimetric shift is unique to ephedrine under ambient conditions, remains unaltered in the presence of common adulterants, and maintains stability across alkaline pH levels of 12–14. Its rapid and selective performance makes it an efficient screening tool for forensic applications, ensuring reliable qualitative detection in routine analytical assessments.
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