La ciencia de la recuperación de adicciones con sustancia: aplicaciones en Salud Pública

Characterizing users of new psychoactive substances using psychometric scales for risk-related behavior

In recent years there has been growing concern about new psychoactive substances (NPS) designed to mimic the effects of established illicit drugs. This paper explores the patterns and correlates of NPS use in a sample of Australian students. A cross-sectional survey was conducted in Australia in 2014. Data were collected from 1126 students (mean age: 14.9 years) from 11 secondary schools. Students completed a self-report questionnaire assessing NPS use and knowledge, beliefs and intentions to use these substances. NPS users were compared with non-users and illicit drug users, who had not used NPS, in terms of gender, binge drinking, tobacco use, psychological distress and self-efficacy to resist peer pressure. Of the 1126 students, 3% reported having ever tried NPS, 2.4% had used synthetic cannabis and 0.4% had used a synthetic stimulant. Analyses revealed that NPS users were more likely to have had an episode of binge drinking in the past 6 months, tried tobacco and had higher levels of psychological distress and lower perceived self-efficacy to resist peer pressure than non-users, but did not significantly differ from users of other illicit drugs. NPS use appears to be uncommon among Australian school students. Although adolescents that do use these substances did not differ from students that had used traditional illicit drugs, both appear to be higher-risk groups of students than non-users. Our findings suggest that universal education about NPS be incorporated into existing drug prevention programmes, and that targeted NPS prevention may also be warranted among high-risk adolescents. [Champion KE, Teesson M, Newton NC. Patterns and correlates of new psychoactive substance use in a sample of Australian high school students. Drug Alcohol Rev 2016;35:338-344].

Background. The use of various psychoactive substances by adolescents and young people is the actual medical, psychological and social problem, which, unfortunately, has not yet been properly addressed. It should be noted that early diagnosis and treatment of mental disorders that occur the use of psychoactive substances (both episodic and systematic ones) for this contingent of respondents is a very complex issue, closely related to the destigmatization of psychiatric care, the success of psychoeducational projects on microsocial and family macrosocial (staff of educational institutions, social services, general practice) levels. It is periodically detection and early care in the vast majority of cases which have been determined the prognosis of mental illnesses and social consequences. Objective – based on a systematic, interdisciplinary approach we have the purpose to develop a model and the algorithm for providing medical and social care to adolescents with addictive behavior who use psychoactive substances. Materials and methods. A systematic, interdisciplinary approach is used. Results. Trends in the use of psychoactive substances by adolescents and young people will be described in such a way. Most of the respondents when taking various psychoactive substances were mainly in the area of relatively “safe” (1-7 points) or “dangerous use” (8-15 points), but without harmful effects or states of dependence. For adolescents with addictive behavior who used psychoactive substances, depending on the degree of use, we developed a model and the algorithm for medical and social care. Proposed measures were mainly psychotherapeutic and psychocorrectional in their nature. Conclusions. Based on the obtained data, the study and testing of addictive behavior of adolescents, the influence of social factors, premorbid mental disorders were developed and a model and the algorithm for providing medical and social care to adolescents who use psychoactive substances at different levels of care were tested.

International audience

Concurrent use of anabolic-androgenic steroids (AAS) and psychoactive substances (illicit drugs and alcohol) is found common in studies among men and involves a higher risk of adverse events than AAS use alone. However, women who use AAS represent an understudied group, and little is known about their pattern of psychoactive substance use and possible links to AAS use. The aim of this mixed methods paper is to a) examine lifetime and problem use of psychoactive substances and AAS, and b) explore experiences of AAS and psychoactive substance use including understandings of how these substances may be related among women with current or previous AAS use.Among sixteen women with current or previous AAS use, lifetime psychoactive substance and AAS use, AAS dependence and problem drug and alcohol use were assessed. In-depth semi-structured interviews were conducted, audio-recorded, transcribed verbatim and analyzed thematically within a biopsychosocial framework applying pharmacological agency; the concept of bodily surveillance of effect and the ability to handle substances instrumentally to feel oneselves/ones bodies better.Twelve participants reported lifetime substance use, where cannabis, cocaine and amphetamines were most commonly used. Substance use problems were found among eight participants; five had lifetime AAS-dependence and clinically significant drug and/or alcohol dependence scores, two had lifetime AAS dependence, and one had clinically significant drug dependence scores. Psychoactive substance use was experienced as unrelated to AAS use or it could be used to counteract side effects of AAS. On the contrary, AAS was used to cope with the bodily and emotional change following withdrawal from psychoactive substances and to counteract bodily effects of long-term substance use. Being in substance use disorder (SUD) treatment after detoxification with affected mental health, a passive lifestyle and experiencing a transition from having an emaciated body, gaining weight and becoming unfit, was experienced to motivate AAS initiation during treatment.The polysubstance nature of AAS use including use of psychoactive substances and risk of developing SUDs poses a significant health risk. Health professionals need to understand motivations for combined use of AAS and psychoactive substances among women to be able to prevent harms and address individual treatment needs.

This article reports on the comparison between two groups of New Psychoactive Substances (NPS) users: users in nightlife settings and users in online communities. A quantitative survey was conducted in six EU countries (Germany, Hungary, Ireland, Netherlands, Poland, and Portugal) within a convenience sample of adult (18 years+) current (12-month) NPS users. Participants self-completed either a pen-and-paper or online questionnaire. 2,757 respondents across the six European countries were reached during data collection in the two considered user groups. The comparison was based on sociodemographic characteristics, use patterns and market. The groups of NPS used are: herbal blends and/or synthetic cannabinoids; branded stimulants and/or stimulants/empathogenics/nootropics obtained pure; psychedelics; dissociatives; and other NPS. Internet and virtual markets assume great relevance both for nightlife and online communities. Different drug policies and diverse geographical location between the participant countries are the main characteristics that impact on the results - namely in the presence/absence of some substances, or in the legal concept of NPS. Comparing users in nightlife settings and online users highlighted substantive trends in NPS use across countries and user groups. New opportunities in the drug market were driven by technological developments on the internet.

BackgroundThe aims of this study were to assess: 1) the associations among sexual activity, alcohol consumption, use of other psychoactive substances and mental health during the COVID-19 pandemic; and 2) the associations between COVID-19 preventive measures, alcohol consumption and use of psychoactive substances.MethodsThis was a secondary analysis of data collected from adults in Nigeria between July and December 2020. The variables extracted included change in sexual activity, alcohol consumption and use of other psychoactive substances, COVID-19 preventive behaviors (wearing face masks, washing hands, physical distancing), anxiety, depression, post-traumatic stress disorder (PTSD) and sociodemographic variables (age, sex, education, HIV status, employment status). Multivariable logistic regressions were conducted. A model was run to regress depression, anxiety, PTSD, increased alcohol consumption, and increased use of other psychoactive substances, on increased sexual activity. In separate models, anxiety, depression, and PTSD were regressed on increased alcohol consumption and on increased use of other psychoactive substances. Finally, three models were constructed to determine the associations between increased alcohol consumption and increased use of other psychoactive substances on three separate COVID-19 preventive behaviors. All models were adjusted for sociodemographic variables.ResultsIncreased alcohol consumption (AOR:2.19) and increased use of other psychoactive substances (AOR: 3.71) were significantly associated with higher odds of increased sexual activity. Depression was associated with significantly higher odds of increased alcohol consumption (AOR:1.71) and increased use of other psychoactive substances (AOR:3.21). Increased alcohol consumption was associated with significantly lower odds of physical distancing (AOR:0.59).ConclusionThere was a complex inter-relationship between mental health, sexual health, increased use of psychoactive substances. The consumption of alcohol also affected compliance with physical distancing. Further studies are needed to understand the observed relationships.

The purpose of this study was to determine the extent of comorbid substance use disorders in patients referred for treatment of personality disorders. Two hundred inpatients and outpatients were assessed by semistructured interviews for substance use and personality disorders. Univariate odds ratios were calculated for groups of substance use disorders and each DSM-III-R axis II disorder; comorbidity among axis II disorders was controlled in multivariate models predicting current or lifetime substance use disorder groups. The impact of personality disorder on chronicity and overall impairment associated with substance use disorders was evaluated. Close to 60% of subjects with substance use disorders had personality disorders. Borderline personality disorder was significantly associated with current substance use disorders, excluding alcohol and cannabis, and with lifetime alcohol, stimulant, and other substance use disorders, excluding cannabis. Antisocial personality disorder was associated with lifetime substance use disorders other than alcohol, cannabis, and stimulants. These relationships remained significant after controlling for the presence of all other personality disorders. There was no evidence that personality disorders increased the chronicity of substance use disorders, but comorbid personality disorders were associated with greater global impairment. Borderline personality disorder may be associated with a wide variety of substance use disorders, especially among patients seeking treatment for personality problems.

The article explores the problem of the independent possibility exercise of the right to protection of persons with disorders caused by the use of psychoactive substances, addictive behavior and the need for mandatory application of paragraph 3 of Part 2 of Art. 52 of the CCP of Ukraine, according to which "mandatory participation of a defender is ensured in criminal proceedings against persons who, due to mental or physical disabilities (dumb, deaf, blind, etc.), are unable to fully exercise their rights - from the moment of their establishment", in cases involving such persons and, accordingly, the establishment of defects which indicate an inability to fully exercise their right. The purpose of the article is to investigate the issue of exercising the right to protect persons with disorders caused by the use of psychoactive substances, addictive behavior. The author analyzed the legal position of the Supreme Court and scientific developments in this area and made a comparison of their conclusions. In addition, the results of the study of patients diagnosed with "mental and behavioral disorders due to alcohol consumption, addiction syndrome" are presented to support the arguments. The analysis uses the results of the study of patients who were examined and treated at the narcological ward of the Odessa Regional Clinical Psychiatric Hospital №1, partially reflecting psychiatric and behavioral disorders that result from substance abuse, addictive behavior. The conclusion is made on the basis of the stated data on the obligation to apply paragraph 3 of Part 2 of Art. 52 of the CCP of Ukraine in cases where the defendant is a person with disorders caused by the use of psychoactive substances, addictive behavior. Psychological defects of a person with disorders caused by the use of psychoactive substances, addictive behavior alone are not confirmation of the inability of the accused (convicted) to fully exercise their rights, and, accordingly, the mandatory application of paragraph 3 of Part 2 of Art. 52 of the CCP of Ukraine, because the perception of a person with disorders caused by the use of psychoactive substances, addictive behavior reflects the reality to the extent that is sufficient to create the preconditions for complete intellectual activity. The of substantiated that the issue of the application of Clause 3 Part 2 of art. 52 The CPC of Ukraine must be addressed based on a complex of circumstances of the case, not only in the presence of evidence of the stay of persons on special accounts and on inpatient treatment with the diagnosis of "disorder of mentality and behavior as a result of narcotic drugs, Psychotropic substances, their analogues or precursors".

Background. In the last decade, new types of psychoactive substances have appeared in illicit trafficking, including synthetic psychostimulants. Due to changes in the drug market, both the formation and course of disorders associated with the use of psychoactive substances are changing. Consequently, there is a need to review existing rehabilitation programs and evaluate their effectiveness for the users of new psychoactive substances. Among the tools that influence the rehabilitation potential of drug addicts, a special attention is paid to the psychotherapeutic direction based on attachment theory, as its positive results have been already shown in foreign studies. Objectives. The theoretical review had its purpose to synthesize, structure and evaluate the existing works devoted to the rehabilitation potential and application of attachment theory in the practice of psychiatric and drug rehabilitation. Methods. A theoretical review of domestic and foreign scientific literature on the topic under consideration. PubMed and eLIBRARY resources were used to search for information. Results. The currently existing concepts of rehabilitation potential are considered. The study provides an analysis of existing works describing the relationship between the success of the rehabilitation process and the type of attachment. Conclusions. Research has found that attachment disorders in childhood can provoke manifestations of dependent behavior. Foreign authors, based on evidence of the effectiveness of attachment-based therapy, propose it as a tool for drug rehabilitation. The basic provisions and principles of such therapy can be used in domestic practice. However, to develop recommendations and rehabilitation programs, additional research on samples of Russian patients is required.

Use of new psychoactive substances (NPS) across Europe remains a public health challenge. The study describes potentials and limitations of methods in a transnational survey of recent marginalised, nightlife and online community NPS users in Germany, Hungary, Ireland, the Netherlands, Poland and Portugal (n = 3023). In terms of demographic profile, drug use history and type of NPS, different methods reached different segments of the NPS-using population. Last year use of different NPS varied across countries and groups. Respondents used NPS in a variety of settings, with public spaces most common in the marginalised group. The study suggests that prevalence rates can reveal a picture of the NPS market that significantly deviates from what law enforcement seizures indicate. Outreach in nightlife settings and peer education are recommended to inform users about health risks and to improve access to drug services and care.

Introduction Common recreational drugs and new psychoactive substances pose challenges to public health. This study investigated the feasibility of merging cases of recreational drug poisoning reported to European poison centres. Methods Four European poison centres (Freiburg, Germany; the Netherlands; Sweden and Switzerland) collaborated in a retrospective, observational study. We collected aggregated data on poisonings with 11 common recreational drugs and case-by-case data on poisonings with new psychoactive substances in 2021 by using anonymized data from electronic case reports. Results In 2021, 2.0% of the poison centre calls involved poisonings with recreational drugs. The poison centres were contacted about 3,705 patients, involving 4,380 drug exposures, of which 3,708 were common recreational drugs, and 672 were new psychoactive substances. Per million inhabitants, the poisoning rate with common recreational drugs varied between 48 (Freiburg) and 145 (Sweden). Poisonings with amfetamine (22%), cocaine (20%), all delta-9-tetra­hydrocannabinol-containing preparations (20%), and 3,4-methylenedioxymetamfetamine (13%) exposures were most frequent. The poisoning rate per million inhabitants with new psychoactive substances varied between two (Switzerland) and 29 (Netherlands). Cathinones (43%), designer benzodiazepines (28%), and phenethylamines (13%) were the most commonly involved new psychoactive substance classes. Symptoms following cathinone poisoning were tachycardia (35%) and hypertension (13%), while following designer benzodiazepines, somnolence was most prominent (38%). The majority of users of new psychoactive substances were male (67%), 55% were between 18 and 30 years, and 8% involved minors (<18 years). Discussion This study showed the feasibility of merging data on recreational drug poisoning collected by poison centres in four countries. Despite underestimating the overall incidence of drug-related health incidents, poison centre data offers national coverage, unlike other data sources, such as drug-related emergency department visits. Conclusion This multi-centre, multi-national study reported a substantial annual number of recreational drug poisonings, with a variable proportion of new psychoactive substances. It shows that poison centre data offers detailed insights into exposures to common recreational drugs and new psychoactive substances, user characteristics, and symptoms. It can be used for comprehensive monitoring of drug-related health incidents on a multi-national level.

Substance use disorder is a common cause of morbidity and mortality in the United States. Comprehensive harm reduction programs have emerged as a public health strategy to help those with substance use disorder. At this time little is known about the population of people who use comprehensive harm reduction programs. To address this gap in knowledge we examined health needs and priorities among people who utilize a comprehensive harm reduction program. We conducted in depth semi-structured interviews with 29 people who access services at a harm reduction program. Themes from the qualitative interviews revealed priorities included improving housing stability, sobriety, and reunification with children. Lack of trust of the health care system was often reported as a barrier to optimal medical care. Comprehensive harm reduction programs are in a position to offer services that can help improve physical health and social determinants of health for people with substance use disorder.

Characteristics of the use of 3-MMC and other new psychoactive drugs in Slovenia, and the perceived problems experienced by users

Socio-economic changes that occured in the wake of dismemberment of former Yugoslavia resulted in the appearance of social pathology, one of which was the increase in the use of psychoactive substances. The overwhole epidemiological research in the use of psychoactive substances has not been conducted so far. The aim of this study was to establish the type and form of the use of psychoactive substances considering sex and age, as well as risk factors for the use of psychoactive substances among the children and adolescents. The research was carried out among 1011 elementary school children (seventh and eighth grades) and secondary school children (all four grades) in the area of Belgrade from October 2003 to January 2004. Out of the total number 457 (45.2%) were elementary school pupils and 554 (54.8%) secondary school pupils. There were 524 (51.8%) boys and 487 (48.2%) girls, aged from 12 to 18 years (the average age being 15.3 years). The method used was the European School Survey Project on Alcohol and Other Drugs Questionaire. Chi-square test, Mann-Whitney, Student's t test and Logistic Regression test were used in statistical processing of the data. Totally 14.2% examinees tried psychoactive substances. The most frequent drug used at the first contact was marijuana (10.8%) at the age of 15 tried by 12.7% examinees, inhalants (4.4%), amphetamines (4.1%), sedatives (3.7%), alcohol combined with marijuana (3.9%), then cocaine (2.8%), heroine (2.3%), alcohol combined with sedatives (2.2%), and ecstasy (1.6%), followed by anabolic steroids, heroin, diethilamid lisergic acid (LSD) and magic mushrooms. It was determined that going out in the evening, smoking and binge form drinking were directly connected with the use of psychoactive substances. Totally 14.2% of the exameneers used psychoactive substances, mostly marijuana, followed by amphetamines and others. New tendencies of use characterized by the increase in the use are of synthetic substances, simultaneous use of more psychoactive substances and younger age. The risk factors are going out in the evening, smoking, binge drinking and use of synthetic substances among peers. Our research indicates the neccessity of primary prevention.