Recreational Use Research Articles

A multiple behaviour temporal network analysis for health behaviours during COVID-19.

The aim of this study was to examine the temporal dynamics of multiple health behaviours (physical activity, alcohol consumption, healthy eating, cigarette consumption, recreational drug use, vaping), and pandemic-related health behaviours (e.g., hand washing, physical distancing) using network psychometrics. The International COVID-19 Awareness and Responses Evaluation (iCARE) study is an international multi-wave observational cohort study of public awareness, attitudes, and responses to public health policies implemented to reduce the spread of COVID-19 on people around the world. A sub-sample of longitudinal data from Canadians (n = 254) was analysed across four waves (February-July 2020). We used temporal network models to fit temporal networks, contemporaneous networks, and between-subject networks from items within the iCARE survey. Positive temporal associations were observed between physical activity and healthy eating, and a bidirectional relationship was evident between outdoor mask use and vaping. A contemporaneous network revealed positive associations between consumption behaviours (vaping, cigarette use, alcohol use, and recreational drug use), and negative associations between physical activity and drug use, and healthy eating and cigarette use. Health behaviours are interconnected and can be modelled as networks or behavioural systems. The application of temporal network analysis to the study of multiple health behaviours is well suited to address key research questions in the field such as 'how do multiple health behaviours co-vary with one another over time'. Future research using time series data and measuring affective and cognitive mediators of behaviour, in addition to health behaviours, has the potential to contribute valuable hypothesis-generating insights.

Temporal and spatial trends of fentanyl co-occurrence in the illicit drug supply in the United States: a serial cross-sectional analysis

BackgroundFentanyl and its analogs contribute substantially to drug overdose deaths in the United States. There is concern that people using drugs are being unknowingly exposed to fentanyl, increasing their risk of overdose death. This study examines temporal trends and spatial variations in the co-occurrence of fentanyl with other seized drugs. MethodsWe identified fentanyl co-occurrence (the proportion of samples of non-fentanyl substances that also contain fentanyl) among 9 substances or substance classes of interest: methamphetamine, cannabis, cocaine, heroin, club drugs, hallucinogens, and prescription opioids, stimulants, and benzodiazepines. We used serial cross-sectional data on drug reports across 50 states and the District of Columbia from the National Forensic Laboratory Information System, the largest available database on the U.S. illicit drug supply, from January 2013 to December 2023. FindingsWe analyzed data from 11,940,207 samples. Fentanyl co-occurrence with all examined substances increased monotonically over time (Mann-Kendall p<0.0001). Nationally, fentanyl co-occurrence was highest among heroin samples (approx. 50%), but relatively low among methamphetamine (≤1%), cocaine (≤4%), and other drug samples. However, co-occurrence rates have grown to over 10% for cocaine and methamphetamine in several Northeast states in 2017-2023. InterpretationFentanyl co-occurs most commonly with heroin, but its presence in stimulant supplies is increasing in some areas, where it may pose a disproportionately high risk of overdose. FundingThis work was partly supported by FDA grant U01FD00745501. This article reflects the views of the authors and does not represent the views or policies of the FDA or US Department of Health and Human Services.

Psychedelic mushroom-containing chocolate exposures: Case series

IntroductionThe recreational use of psilocybin or psilocin-containing products, a chemical found naturally in certain mushroom species, is on the rise across the United States. Several cases of serious clinical effects related to mushroom-containing products have recently been reported to the Food and Drug Administration (FDA). The emergence of these new products and their health consequences are not yet well understood. This case series aims to characterize exposures to mushroom-containing chocolate products, including patient characteristics, clinical effects, treatment(s), and clinical outcome severity, reported to a poison center network. Material and methodsThis was a retrospective case series conducted in patients exposed to mushroom-containing chocolate products across three poison centers between January 2023 to August 2024. Patients were identified via a database search of ToxSentry®. Patients were included if they were exposed to a mushroom-containing chocolate product. Patients were excluded if they ingested an unrelated product or if there was insufficient information documented within ToxSentry®. The primary endpoint was to describe clinical outcome severity after exposure to mushroom-containing chocolate products. ResultsA query of ToxSentry® identified 164 cases; 36 cases met study criteria. The median age of patients in this case series was 17 years old. For most patients (23, 64 %), the reason for the exposure was intentional, with 20 reporting intentional abuse or misuse of the product. Common clinical effects reported included mental status changes (26, 76 %), paranoia/hallucinations (10, 28 %), dysrhythmias (7, 19 %) and gastrointestinal discomfort (6, 17 %). There was one report of seizure. Most clinical effects lasted between 3 and 24 h after ingestion (29, 81 %). Intravenous fluids (18, 50 %) and benzodiazepines (7, 19 %) were the most common treatments given. No fatalities were reported. DiscussionWhile most patients in this series experienced minor clinical effects, some developed serious effects after ingestion of a mushroom-containing chocolate product. Findings from this study further characterize the limited patient demographics, clinical effects, and outcomes published thus far. Further characterization in a larger cohort of patients could expand on our initial findings and is needed to better identify factors that may influence clinical outcomes.

Acute Myocardial Infarction in a Amphetamine Abuser with Low ASCVD Risk: A Case Report

Wide availability of recreational drugs, like amphetamine, cocaine, cannabis etc has spread out these drugs to all classes and age groups in the society of Bangladesh. Among them association cocaine and cannabis with acute myocardial infarction has been well established. But the popular drug, amphetamine, which is available in tablet form containing the active ingredient named 3,4 methylenedioxymethamphetamine (MDMA), has been reported to have significant cardiac and CNS toxicity. Repeated angina, even myocardial infarction due to active coronary vasospasm and accelerated atherothrombosis in amphetamine abusers has been reported in several case studies worldwide. But, only a few cases has been reported in Bangladesh. Here we present a case of acute myocardial infarction in a amphetamine abuser with low 10 years ASCVD risk. J Inv Clin Cardiol 2023; 5(2): 53-55

Recreational drugs use as prognostic factor of major adverse cardiovascular and cerebrovascular events in patients hospitalised for acute cardiovascular events

Abstract Background Among patients admitted to the intensive cardiac care unit (ICCU), systematic screening for recreational drugs evidenced a significant prevalence of recent use and was associated with a higher rate in-hospital outcomes. However, long-term cardiovascular consequences of recreational drug use remain uncertain. Purpose We aimed to evaluate the prognostic impact of recreational drugs use at 1-year follow-up to predict major adverse cardiovascular and cerebrovascular events (MACCE) in consecutive patients admitted to ICCUs for acute cardiovascular events from the Addiction in Intensive Cardiac Care Units (ADDICT-ICCU) study. Methods In this prospective multicentric study, all consecutive patients admitted to ICCUs over two weeks in April 2021 at 39 centres across France were included. Screening for recreational drugs use was performed by systematic urinary testing. One-year follow-up consisted of a clinical visit or direct contact with the patient and the referring cardiologist. The primary composite outcome was the occurrence of one of the combined MACCE defined as cardiovascular death, nonfatal myocardial infarction (MI) or stroke. Subgroup analysis was performed in patients hospitalised at baseline for acute coronary syndrome. Results Of the 1499 consecutive patients screened, 1392 (93%) patients (63±15 years, 70% males) had a complete 1-year follow-up. Among them, 157 (11%) had an initial positive test for recreational drug use (cannabis, opioids, cocaine, amphetamines, 3,4-methylenedioxymethamphetamine [MDMA]). After 1-year of follow, 94 (7%) patients experimented MACCE. Patients with positive testing exhibited a higher rate of MACCE than non-users (13% vs 6%, respectively, p=0.002). After adjustment for traditional prognosticators, recreational drug use was independently associated with the occurrence of MACCE (HR=2.99; 95% CI: 1.73-5.16, p&amp;lt;0.001). In the subgroup analysis of 713 patients hospitalised at baseline for acute coronary syndrome, 96 (14%) had a positive recreational drug test and 50 (7%) experienced MACCE. Using a multivariable Cox analysis in this population, recreational drug use was still independently associated with MACCE after adjustment for traditional prognosticators (HR=2.98; 95% CI: 1.43-6.21, p=0.004). Conclusions In a large cohort of consecutive patients admitted to ICCUs for acute cardiovascular events, the prevalence of recreational drug use was 11%. Recreational drug use was strongly associated with the occurrence of 1-year MACCE even after adjustment for traditional prognosticators.Central illustrationPrognostic impact of drug use

Vilazodone,aNovel SSRI Antidepressant with 5-HT1A Partial Agonist Properties: Diminished Potentiation of Chronic Oral Methylphenidate-Induced Dynorphin Expression in the Striatum in Adolescent Male Rats.

Selective serotonin reuptake inhibitor (SSRI) antidepressants such as fluoxetine are used in combination with the medical psychostimulant methylphenidate (Ritalin) in a variety of treatments in children and adults. Unintended co-exposure to these psychotropic medications also occurs in patients on SSRIs who abuse methylphenidate as a "cognitive enhancer" or recreational drug. Preclinical research shows that SSRIs such as fluoxetine when given in conjunction with methylphenidate potentiate addiction-related gene regulation by methylphenidate in the striatum, consistent with the known facilitatory role for serotonin in psychostimulant-induced neuronal and behavioral changes. Moreover, fluoxetine combined with methylphenidate also facilitated subsequent acquisition of cocaine self-administration in adolescent rats, suggesting an increased addiction liability for methylphenidate. In the present study, we investigated the impact of a novel SSRI, vilazodone, on methylphenidate-induced gene regulation in adolescent male rats. In contrast to prototypical SSRIs such as fluoxetine, vilazodone also acts as a partial 5-HT1A serotonin receptor agonist and is thus proposed to temper serotonin input to the striatum. We compared the effects of chronic treatment (4 weeks) with vilazodone (10mg/kg, twice daily) with those of fluoxetine (5mg/kg, twice daily) on striatal dynorphin expression induced by oral methylphenidate treatment (30/60mg/kg/day in drinking water, 8h access daily). Our results demonstrate that, in contrast to fluoxetine, vilazodone had minimal or no potentiating effects on methylphenidate-induced dynorphin expression. This diminished impact on gene regulation was seen throughout the striatum, including the nucleus accumbens, where increased dynorphin expression has previously been associated with various aspects of addiction. Our findings suggest that vilazodone may serve as a better adjunct SSRI with reduced addiction-facilitating properties.

Drones and Technopreneurship in Malaysia: Unlocking the Economic Potential of Drones in Built Environment Development

Drones, with diverse technological capabilities, are poised to revolutionise various traditional tasks, particularly in-built environment development while driving economic growth, innovation, and job creation. Within the Malaysian context, drones have evolved beyond recreational use to become sophisticated unmanned aerial vehicles with untapped business potential. Against this backdrop, this paper explores a comprehensive review of drone development in Malaysia. Using a multidisciplinary approach, the review includes selected publication data from academic journals and online media published between 2018 and 2023, complemented with insights gathered from expert interviews. Aiming to bridge the discursive gap surrounding emerging drone technologies, the review focuses on identifying patterns and trends in recent Malaysian publications on drone applications, as well as understanding current issues related to its technology adoption. The thematic findings reveal a notable surge in interest in drone-related publications and draw clear connections between drone applications and diverse industrial sectors over the past six years. The paper emphasises critical issues such as community acceptance, the transforming landscape of business, diverse industry applications of drone technology, and government strategies for advancing drone technology. As a preliminary study, this paper establishes the foundation for leveraging the benefits of drone technology within the broader context of the built environment, social, and economic landscape. By shedding light on the evolving drone ecosystem in Malaysia, the paper contributes to fostering informed discussions and strategic initiatives in the integration and advancement of drone technologies. Thus, it offers valuable insights for professionals, economists, engineers, policymakers, and researchers alike.

Prevalence and Correlates of Cannabis Use among Cancer Survivors

Abstract Background Delaware has legalized marijuana use for both medical and recreational use. This study identified factors associated with cannabis use among adults with chronic relative to individuals without a history of cancer in the First State. Methods Combined data (2020, 2021 and 2022) from the Behavioral Risk Factor Surveillance System (BRFSS) were analyzed for Delaware. Multivariable logistic regression examined individual-level demographic, socio-economic, clinical, and behavioral predictors associated with marijuana use stratified by history of cancer. Results Cannabis use was lower among cancer survivors compared to individuals with no history of cancer (6.76% vs. 13.43%). However, a higher proportion of cancer survivors reported use for medical purposes (75.13% vs. 64.28%). Marijuana use prevalence decreased with age among cancer survivors. After adjusting for sex, age, educational attainment, self-reported race/ethnicity, mental health status and physical health status, current smoking (odds ratio [OR], 4.24 vs. 2.74) and binge drinking (OR, 2.45 vs. 1.75) were associated with cannabis use in both groups. Conclusions Adults with cancer were more likely to use marijuana. Marijuana use prevalence decreased with age. Public perceptions of marijuana is becoming more acceptable. Risk of medical conditions such as cancer increase with age. As such, older adults might also become consumers of marijuana. Clinicians should screen for marijuana use among patients and initiate open discussions with patients about the benefits and risks associated with marijuana. Key messages • Need for ongoing cannabis research to better understand and inform its use for medical purposes. • Development of high-quality standardized education materials and clinical practice guidelines for marijuana use.

Environmental and social impacts of shifting park-use patterns during the COVID-19 pandemic: Insights from state and local park managers

Parks and protected areas offer a variety of ecosystem services and promote opportunities that enhance human health and well-being. However, these benefits may be jeopardized when overcrowding degrades environmental and social conditions in parks. The COVID-19 pandemic is assumed to have been associated with substantial increases in visitation to parks and protected areas, but patterns in use and degradation varied by site type (e.g., state versus local parks; urban versus rural). In this study, we aimed to understand how changing recreational use patterns during the COVID-19 pandemic impacted parks, and how those changes differed between state and local parks across urban-rural gradients. We distributed a survey asking state park superintendents (n = 36) and local park managers (n = 84) in the state of North Carolina to estimate the extent of environmental and social impacts in their parks both before and during the pandemic. We discovered that, based on managers’ responses, state parks were approximately 12 times more likely to experience heightened environmental impacts and 23 times more likely to experience heightened social impacts than local parks during the pandemic, even when controlling for impact levels prior to the pandemic. We found no significant differences between urban and rural parks. These findings suggest regional parks may be the most vulnerable to environmental and social disturbances during times of heightened visitation, and thus highlight a need for both more resources and more attention to governance issues for these parks. Management implicationsThis study found that state parks in North Carolina experienced more frequent social and environmental impacts, both before and during the COVID-19 pandemic, compared to local parks. This highlights the need to explore measures that can maintain state parks as sources of resilience and recovery during future crises while mitigating park impacts. Proposed strategies include:•Directing park usage to more resilient areas.•Establishing strategic partnerships between parks to enhance capacity.•Education and outreach to minimize visitor impacts.•Establishing emergency funds for parks most likely to be impacted during times of heightened visitation.•Expanding accessible greenspace in anticipation of increased visitation.

“Everyone Does Cocaine”: The Impact of Normalization on Practices of Club Drug Use and Risk Management

Background: While many have argued that recreational drug use is becoming increasingly normalized within youth culture, little has been done to explore what this means for risk management. Methods: Drawing on 2 years of ethnographic research with people who use club drugs in the Toronto Electronic Dance Music scene, this study explores how normalization impacts risk-taking and risk management practices of club drug use. Results: It finds that the relationship is complex, as normalization both facilitates and hinders the adoption of risk management practices. The nuances of this relationship are explored by focusing on three key themes: expectation of use, moderation of use, and sharing of risk information and advice. Conclusion: The findings are interpreted with reference to Rhodes’ “risk environment” framework and with particular attention to the need for harm reduction interventions that consider how risk behaviors are shaped by broader social and cultural contexts.

The effects of cannabinoids on the kidney.

Cannabinoids are a class of drugs derived from the Cannabis plant that are widely used for the treatment of various medical conditions and recreational use. Common examples include Δ9-tetrahydrocannabinol (THC), cannabidiol (CBD), spice, and 2-arachidonoylglycerol (2-AG). With more than 100 cannabinoids identified, their influence on the nervous system, role in pain management, and effects due to illicit use have been extensively studied. However, their effects on peripheral organs, such as the kidneys, require further examination. With dramatic rises in use, production, and legalization, it is essential to understand the impact and mechanistic properties of these drugs as they pertain to renal and cardiovascular physiology. The goal of this review is to summarize prior literature on the expression of cannabinoid receptors and how cannabinoids influence renal function. This review first discusses the interaction of the endocannabinoid system (ECS) and renal physiology and pathophysiology. Following, we briefly discuss the role of the ECS in various kidney diseases and the potential therapeutic applications of drugs targeting the cannabinoid system. Lastly, recent studies have identified several detrimental effects of cannabinoids, not only on the kidney but also in contributing to adverse cardiovascular outcomes. Thus, the negative impact of cannabinoids on renal function and the development of various cardiovascular diseases is also discussed.

An investigative study on the causes of depression and the coping strategies among clinical medical students in private universities in North Central Nigeria

BackgroundDepression is among known mental health conditions and students in schools of medicine are not immune to it. In this investigative study, 211 clinical medical students of two private universities from North-Central Nigeria were examined on depression prevalence, the contributory factors and their coping strategies.MethodsThe Patient Health Questionnaire 9 (PHQ-9), the Medical Student’s Stressor Questionnaire (MSSQ) and identified coping strategies according to Coping Oriented to Problems Experienced Inventory (COPE) were instruments of data collection.ResultsThe results were obtained by both descriptive analysis and test of association between some categorical variables. The depression prevalence amongst the participants was 159 (75.4%). Females (124 (78.0%)) were more depressed than males (35 (22.0%)). Factors identified as contributing to depression were the heavy academic workload (124 (78.5%)), insufficient family time (93 (58.1%)) and financial constraints (54 (34.0%)). The most utilized method of coping with their stress was engaging on social media (133 (84.2%)), followed by talking with relatives or friends (99 (62.7%)) and use of recreational drugs (20 (12.8%)). The findings from this study have shown that more than three-quarters of the respondents suffered from varying degrees of depression from mild, 63 (29.9%), moderate, 53 (25.1%) to severe, 43 (20.4%).ConclusionsThe heavy academic workload was a major source of depression. Colleges of Medicine should take pro-active steps towards their students’ mental health and academic workload should be well spaced to reduce the stress imposed by the frequency of examinations.

Spatiotemporal responses of ungulates to hunting in a fenced multi-use area

Context Human activities, such as tourism and hunting, affect the spatiotemporal behaviour of wildlife. For example, it is well documented that ungulates change their spatiotemporal behaviour as a response to hunting pressure, but less is known about ungulate responses to hunting in areas where human activity is common throughout the year and ungulates are constrained by fences. Aims In this camera-trap study, we analysed the change in spatiotemporal behaviour of wild ungulates (elk, Cervus canadensis (3519 events), moose, Alces alces (1153 events), and white-tailed deer, Odocoileus virginianus (2708 events)) in response to the hunting period in a recreational and fenced park, the Cooking Lake–Blackfoot Provincial Area, Canada. Methods We used general linear models to compare species-specific patterns of intensity of use, calculated as events per week, in response to changes in the nature of human disturbance, namely a shift from recreation to hunting activity. In particular, we compared intensity of use in and out of the hunting season to determine whether species engaged in spatial patterns of avoidance with respect to hunting. We used daily and seasonal patterns of activity to determine how ungulates shifted their temporal use in response to hunting activity and whether they became more nocturnal as a result. Key results We found that ungulates responded temporally to the hunting period by generally shifting their activity to more nocturnal hours, with white-tailed deer showing the biggest temporal shift, suggesting that the ungulates distinguish between consumptive and non-consumptive human activities. Nevertheless, temporal overlap between humans and all ungulate species increased during the hunting period as humans targeted times of increased ungulate activity. Spatially, the response was less distinctive and was species-specific. Elk showed little change in spatial behaviour in response to the hunting period. In contrast, moose decreased the use of trail areas and other areas frequented by humans, whereas deer, counterintuitively, increased the use of trail areas, albeit their use became much more nocturnal. Conclusions We have shown that responses of ungulates to hunting exceed those to non-consumptive recreational use, and whereas temporal responses (increased nocturnality) were consistent across ungulate species, spatial responses were species-specific. Implications Management in small fenced multi-use areas needs to account for shifts in the intensity of disturbance resulting from a change in human disturbance from recreational activity to hunting. Providing spatial opportunities for avoidance of humans is key for most species if hours of operation in these areas already limit the timing of human activity.

Issue of recreational use of sildenafil

Introduction and purposeErectile dysfunction (ED) is defined as the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. Sildenafil is one of the most popular medications used to treat ED, but in recent years, there has been a growing trend of recreational use of this drug, particularly among younger individuals, which can lead to numerous negative health consequences. The aim of this article is to provide an overview of the recreational use of sildenafil, especially among younger individuals.State of knowledgeSildenafil primarily affects the smooth muscle of the blood vessels in the corpora cavernosa, facilitating the achievement and maintenance of an erection. The most common side effects of sildenafil include headaches, dizziness, facial flushing, nausea, muscle pain, and nasal congestion. A relatively rare but potentially severe side effect of sildenafil is priapism. It is noted that those using sildenafil recreationally often have multiple sexual partners, as the drug helps them prolong sexual encounters. Studies show that sildenafil is used by groups that should have no problem achieving sexual satisfaction. The use of the drug in combination with alcohol and other substances is noticeable.ConclusionsRecreational use of sildenafil appears to be an increasingly common behavior among young men who do not have difficulties achieving or maintaining an erection. There are no studies yet that specifically examine the recreational use of sildenafil among women. It is necessary to conduct further research to better understand the prevalence of this phenomenon and to identify the factors that predispose individuals to engage in recreational use of sildenafil.

Physical (in)activity and screen-based media use of adolescents with juvenile idiopathic arthritis over time - data from a German inception cohort

BackgroundRegular physical activity (PA) has been proven to help prevent non-communicable diseases and is beneficial for disease management in chronically ill populations. Physical inactivity and recreational screen-based media (SBM) use are related to poor health outcomes and common among youth. This study aimed to (1) investigate PA levels and recreational SBM use of adolescents with JIA over time and (2) compare these behaviours with those of their peers.MethodsData from JIA patients and their peers enrolled in the inception cohort study ICON at 11 German centers were analyzed. Individuals aged 13 and over were followed prospectively with questionnaires concerning PA level, recreational SBM use, and health-related quality of life (HRQoL) at a two-year interval. Group by time interactions were analyzed using linear mixed models.ResultsData of 214 patients (mean age at first documentation 14.4 ± 0.9 years, female 63%) and 141 peers could be considered. At first documentation, patients were less physically active compared to their peers (p < 0.001). In contrast to their peers, patients’ PA levels increased over time (OR 3.69; 95% CI: 1.01–13.50, p = 0.048). Mean screen time did not differ significantly between patients and peers (first documentation: 3.5 h vs. 3.0 h, p = 0.556; follow-up: 3.6 h vs. 3.3 h, p = 0. 969). During the observation period, male patients reported higher PA levels than female patients, but also higher screen time levels. While low socioeconomic status (SES) (OR 14.40; 95%-CI: 2.84–73.15) and higher cJADAS-10 score (OR 1.31; 95%-CI: 1.03–1.66) increased the likelihood for high SBM use (≥ 4.5 h/d), higher PedsQL psychosocial health score (OR 0.93; 95%-CI: 0.88–0.99) was associated with a decreased likelihood.ConclusionsAdolescents with JIA become more physically active over the disease course and achieve comparable levels of PA and recreational screen time to their peers. However, the vast majority appear to be insufficiently physically active. Future interventions to promote healthy lifestyles should include gender and SES as important determinants to reach most vulnerable groups.

Post-legalization shifts in cannabis use among young adults in Georgia-A nationally representative study.

In 2018, the country of Georgia legalized cannabis for recreational use and decriminalized limited possession. This study aimed to assess whether cannabis use increased among young adults (ages 18-29 years) in Georgia after national policy changes and to evaluate whether perceived access became easier after legalization and current risk factors of young adult cannabis use. We used data from the Georgian nationally representative survey administered in 2015 (n = 1308) and 2022 (n = 758), before and after decriminalization. We performed appropriate bivariate analyses and multivariable linear and logistic regressions to assess the following: legalization's impact on cannabis use; perceived difficulty to obtain cannabis; age of first use; differences in use between females and males; and factors associated with current use. Among young adults lifetime prevalence of cannabis use was similar in 2015 (17.3%) and 2022 (18.1%) [Odds Ratio (95% confidence interval) = 1.1 [0.7, 1.6], P = 0.726). Annual prevalence (7% in 2015 vs 7.7% in 2022) was also similar (1.1 [0.7, 2.0], P = 0.650). In 2022 it was less difficult to obtain cannabis than in 2015 (0.5 [0.4, 0.8], P = 0.021). The age of first use increased statistically significantly (18.1years in 2015 vs 19.1 in 2022, P = 0.003). In 2022, annual prevalence of use was lower among females (1.9% vs 13.1%; OR = 0.1 [0.0, 0.3], P < 0.0001) and higher among those who gambled (11.7% vs 4.4%; OR = 3.2 [1.5, 6.8], P < 0.003). Males initiated cannabis use at an earlier age (19.1years vs 20.6 for females, P = 0.03), and could obtain cannabis easier than females (P < 0.0001). There was a minimal shift of cannabis use in young adults following implementation of recreational cannabis use legalization in Georgia. Males and people who gambled were at higher risk of cannabis use.

Club Drugs and Psychiatric Outcomes: A Descriptive Case Series from Spain

Background: illegal drugs significantly contribute to global health issues, with health complications often occurring not only in regular users with Substance Use Disorders (SUDs) but also in first-time and occasional users. Methods: this study examines five clinical cases from a public hospital in Ibiza, Spain, where patients presented with acute psychiatric symptoms due to recreational drug use. Results: Contrary to previous studies on SUDs, our patients typically had higher education levels and stable employment. Most of them used multiple substances, with cannabis, cocaine, and alcohol being the most frequently used. There was also a common occurrence of consuming drugs with uncertain contents. Upon admission, typical symptoms included aggression, hallucinations, mood swings, and disorientation in time and space. Conclusions: Our findings underscore the significant mental health risks posed by illicit drugs, even for individuals with no prior psychiatric history. Factors like the drug’s potency, frequency and amount of use, past mental health issues, personality traits, and previous traumatic experiences might influence the onset of these symptoms.

Relationships between fecal indicator abundance in water and sand and the presence of pathogenic genes in sand of recreational beaches.

For decades, the risk of exposure to infectious diseases in recreational beaches has been evaluated through the quantification of fecal indicator bacteria in water samples using culture methods. The analyses of sand samples have recently been developed as a complement to the monitoring of recreational waters in beach quality assessments. The growing use of molecular techniques for environmental monitoring allows for the rapid detection of pathogenic genes, thus providing more accurate information regarding the health risk of exposure to contaminated sand. The aim of this work was to determine the relationship between the fecal indicators abundance in water and sand and the presence of Shiga toxin-producer Escherichia coli (STEC) in sand by analyzing samples from touristic beaches using culture-dependent (fecal coliforms assay) and culture-independent (real-time PCR of stx1, stx2, and eae genes) techniques. We found a high concentration of coliform bacteria in water and sand in several beaches in eastern Uruguay, with different levels of sanitation networks and levels of urbanization. The presence of STEC virulence genes (mainly stx1) was confirmed in 8 out of 20 sand samples. The recreational use of sandy beaches may imply a risk to the health of its users, especially near streams and creek outflows, thus highlighting the need of monitoring sand bacteriological quality and pathogens using molecular tools.

Evaluation of Çankırı and Iğdır salt caves within the scope of health and recreation tourism

With the increasing popularity of healing methods involving salt, the importance of salt mines has grown significantly over time. Today, as salt therapy (Speleotherapy) becomes more widespread, salt caves in many countries around the world have begun to transform into salt therapy centers. Salt caves in Spain (Cardona), Belarus (Soliharsk), Romania (Slanic, Salina Turda, and Praid), Poland (Wieliczka), Pakistan (Khewra), Germany (Berchtesgaden), Azerbaijan (Nakhchivan), and Turkey (Çankırı and Iğdır Tuzluca) are used for therapeutic purposes. Particularly, Çankırı Salt Cave and Iğdır Tuzluca Salt Cave are important resources in Turkey that can be evaluated within the scope of health tourism. In this study, a literature review, official website analysis, and on-site observations were conducted. In the literature review, previous research on the subject was examined. Through website analysis, the spatial units and recreational activities of the salt caves were identified. The spatial units and recreational activities of each salt cave were determined using the collected data. Subsequently, on-site observations were made by visiting the salt caves in Çankırı and Iğdır. During these observations, the spatial units within the salt caves were visited and photographed individually. Then, the data obtained from the literature, official website analyses, and on-site observations were combined. Finally, the characteristics of all the examined caves were tabulated, and based on the created table, the caves were evaluated. As a result of the evaluation, the Cardona Salt Mine in Spain stands out for its historical and cultural activities; the Nakhchivan in Azerbaijan, Soligorsk in Belarus, Slanic and Praid Salt Mines in Romania are treatment centers offering salt therapy services; the Salina Turda Salt Mine in Romania is an underground theme park; the Wieliczka Salt Mine in Poland, Khewra Salt Mine in Pakistan, and Berchtesgaden Salt Mine in Germany are primarily used for recreational purposes; while the developing Çankırı and Iğdır Tuzluca Salt Mines in Turkey are also noted for their recreational use.

Development and Validation of an Analytical Method to Identify and Quantitate Novel Modafinil Analogs in Products Marketed as Dietary Supplements

Modafinil (brand name Provigil®) is a Schedule IV (U.S.) drug used for the treatment of narcolepsy and sleep disorders. It is also known to be used recreationally. Analogs of modafinil, including adrafinil, remain unapproved and/or unscheduled. The lack of scheduling has made these analogs a popular target for recreational use and inclusion in dietary supplements. However, the use of controlled substances (or their analogs) without the care of a physician presents a public health risk. Preliminary nontargeted analyses in our laboratory revealed the presence of adrafinil in several dietary supplements, highlighting the need for an analytical method to identify modafinil analogs in supplements. A liquid chromatography high resolution mass spectrometry (LC-HRMS) method was developed and validated to quantitate modafinil, plus four novel unscheduled modafinil analogs: adrafinil, CRL-40,940, CRL-40,941, and N-methyl-4,4-difluoromodafinil. This method was then applied to four samples of products marketed as dietary supplements collected via undercover purchase. These four products were marketed as nootropics or cognitive enhancers and labeled to contain adrafinil. Adrafinil was found in all four samples. The identification of modafinil analogs in this context is important so that consumers are not, knowingly or unknowingly, consuming these active pharmaceutical ingredients in products marketed as dietary supplements.