Illegal Drugs Research Articles

Public Opinions from Malawian and Malawi Refugee Camp Residents of Wastewater and Environmental Surveillance.

Across low- and middle-income countries, there have been calls to expand wastewater and environmental surveillance to include non-sewered sanitation systems. Considering public opinion, understanding, and acceptance, as well as any related privacy and personal health information concerns, is important in this context. This study used an in-person survey to learn more about the perceptions of Malawian and Malawi refugee camp residents regarding wastewater and environmental surveillance as public health tools, as well as their views on privacy and personal health information. A 15-question survey was conducted from May to July 2024 at three locations in northern, central, and southern Malawi, including a refugee camp (N = 536). Some respondents (n = 30) also completed a board game and a post-game survey. The results indicated high public support for surveilling communicable diseases, deadly diseases, environmental toxicants, healthy eating, illegal drugs, mental illnesses, and prescription drugs. Respondents were less supportive of surveillance that might expose their lifestyle behaviors and alcohol use. Regarding sampling locations, the surveillance of an entire city or of camps and schools had the highest acceptance. Some opposition to surveillance in business and religious organizations was noted. If surveilled, respondents wanted the results of the data analysis to be communicated back to them. Our findings suggested that Malawian and Malawi camp residents supported, with little concern, ongoing wastewater and environmental surveillance for public health. Considering privacy thresholds and participant autonomy regarding public health surveillance tools, along with cultural relevance, is important for future policy development and investment.

Identifying spatiotemporal patterns in opioid vulnerability: investigating the links between disability, prescription opioids and opioid-related mortality

BackgroundThe opioid crisis remains one of the most daunting and complex public health problems in the United States. This study investigates the national epidemic by analyzing vulnerability profiles of three key factors: opioid-related mortality rates, opioid prescription dispensing rates, and disability rank ordered rates.MethodsThis study utilizes county level data, spanning the years 2014 through 2020, on the rates of opioid-related mortality, opioid prescription dispensing, and disability. To successfully estimate and predict trends in these opioid-related factors, we augment the Kalman Filter with a novel spatial component. To define opioid vulnerability profiles, we create heat maps of our filter’s predicted rates across the nation’s counties and identify the hotspots. In this context, hotspots are defined on a year-by-year basis as counties with rates in the top 5% nationally.ResultsOur spatial Kalman filter demonstrates strong predictive performance. From 2014 to 2018, these predictions highlight consistent spatiotemporal patterns across all three factors, with Appalachia distinguished as the nation’s most vulnerable region. Starting in 2019 however, the dispensing rate profiles undergo a dramatic and chaotic shift.ConclusionsThe initial primary drivers of opioid abuse in the Appalachian region were likely prescription opioids; however, it now appears that abuse is sustained by illegal drugs. Additionally, we find that the disabled subpopulation may be more at risk of opioid-related mortality than the general population. Public health initiatives must extend beyond controlling prescription practices to address the transition to and impact of illicit drug use.

Assessing the Implications of Morphine-Induced Dysregulation of Autophagy on Brain Health.

Morphine has been a widely used drug for pain management and anesthesia in clinical settings for centuries and is also a drug of abuse. Its illicit use by individuals with substance use disorders has resulted in numerous brain-related complications. The immunopharmacology of morphine is highly complex, necessitating a deeper understanding of its interactions with brain regions involved in learning and memory. Autophagy is a conserved physiological recycling process that degrades cytoplasmic organelles and proteins, repurposing their components for cellular function. However, recent studies indicate that morphine exposure disrupts autophagic processes, contributing to many morphine-associated complications. This article highlights recent advancements in understanding the interplay between morphine and autophagy. By exploring this intricate relationship, we aim to enhance our knowledge of morphine-associated complications and autophagy dysregulation, potentially improving the management of morphine use disorder and related conditions, thereby promoting healthier outcomes.

The Role of Despair in Predicting Self-Destructive Behaviors

Working age (25–64) mortality in the US has been increasing for decades, driven in part by rising deaths due to drug overdose, as well as increases in suicide and alcohol-related mortality. These deaths have been hypothesized by some to be due to despair, but this has rarely been empirically tested. For despair to explain mortality due to alcohol-related liver disease, suicide, and drug overdose, it must first predict the behaviors that lead to such causes of death. To that end, we aim to answer two research questions. First, does despair predict the behaviors that are antecedent to the “deaths of despair”? Second, what measures and domains of despair are most important? We use data from over 6000 individuals at five waves of the National Longitudinal Study of Adolescent to Adult Health and apply supervised machine learning to assess the role of despair in predicting self-destructive behaviors associated with these causes of death. Comparing predictive performance within each outcome using measures of despair to benchmark models of clinical and prior behavioral predictors, we evaluate the added predictive value of despair above and beyond established risk factors. We find that despair underperforms compared to clinical risk factors for suicidal ideation and heavy drinking, but over performs compared to clinical risk factors and prior behaviors for illegal drug use and prescription drug misuse. We also compare model performance and feature importance across outcomes; our ability to predict thoughts of suicide, drug abuse and misuse, and heavy drinking differs depending on the behavior, and the relative importance of different indicators of despair varies across outcomes as well. Our findings suggest that the self-destructive behaviors are distinct and the pathways from despair to self-destructive behavior varied. The results draw into question the relevance of despair as a unifying framework for understanding the current crisis in midlife health and mortality.

Illicit stimulants and ventricular arrhythmias: a longitudinal cohort study.

Ventricular tachycardia and ventricular fibrillation underlie many sudden cardiac deaths, but common lifestyle factors that predict their occurrence are poorly understood. This study aimed to assess the association between methamphetamine and cocaine, the most used illicit stimulants, and ventricular arrhythmias (VA) and mortality. Healthcare databases were used to identify adults aged ≥ 18 years receiving hospital-based care in California in 2005-2019. ICD codes were used to identify diagnoses and illicit stimulant use. Cox proportional hazard models adjusting for demographics and time-updated cardiovascular risk factors were employed. The outcomes were VA combining ventricular tachycardia, ventricular fibrillation, and cardiac arrest and all-cause mortality. Among 29 593 819 individuals (53.8% female, mean age 44.9 years), 690 737 (2.3%) used methamphetamine, and 290 652 (1.0%) used cocaine at some point. After adjustment for age, sex, race and ethnicity, cannabis and opioid use, and other cardiovascular risk factors, methamphetamine use and cocaine use were each associated with increased risk of incident VA [hazard ratio (HR) 1.90, 95% confidence interval (CI) 1.85-1.95, and HR 1.15, 95% CI 1.10-1.19, respectively], and mortality (HR 1.51, 95% CI 1.47-1.54 and HR 1.68, 95% CI 1.64-1.72, respectively). The risk of VA was higher in younger individuals (<65 years) and females for both methamphetamine and cocaine, whereas it was higher in Blacks and lower in Whites and Hispanics for cocaine use, and higher in Asians and lower in Blacks for methamphetamine use (P for interaction < .05 in all). Methamphetamine use and cocaine use were each associated with increased risk of incident VA and mortality, with differential relationships by demographic groups. Avoiding these substances may reduce risk of VA and death.

Kounis Syndrome Triggered by Medications and an Illicit Substance: A Report of a Rare Case

Kounis Syndrome Triggered by Medications and an Illicit Substance: A Report of a Rare Case

An analysis of the data on the illegal drug trade in the division of Kottakuppam

The primary goal of this study is to analysis the amount of drug consumed by the part of people in Villupuram district and evaluate through Excel. These data are collected with the permission of the Deputy superintendent of police at Kottakuppam police station, and with the concern of sub-inspector of police.The survey- based data collection was done at Villupuram district, Kottakuppam sub-division, under the control of Kottakuppam police station, Vanur police station, Marakanam police station, Auroville police station, Kiliyanur police station, between the years of July2019- July2023.

Illegal drug use amongst male UK military personnel who sustained physical combat injuries: The ADVANCE cohort study.

Illegal drug use amongst male UK military personnel who sustained physical combat injuries: The ADVANCE cohort study.

Not the Good Stuff: Hemodynamic Havoc From a New Illicit Substance in Street Drugs

Not the Good Stuff: Hemodynamic Havoc From a New Illicit Substance in Street Drugs

Application of hair analysis in the monitoring of abuse of β-agonists: A review.

Application of hair analysis in the monitoring of abuse of β-agonists: A review.

The Police Opioid Seizure Temporal Risk (POSTeR) model of increased exposure to fatal overdose.

The Police Opioid Seizure Temporal Risk (POSTeR) model of increased exposure to fatal overdose.

Overdoses Involving Medetomidine Mixed with Opioids - Chicago, Illinois, May 2024.

Medetomidine, a nonopioid sedative not approved for use in humans, has periodically been detected in illegally manufactured opioids across North America since 2022. On May 11, 2024, the Chicago Department of Public Health (CDPH) and the Illinois Department of Public Health were alerted by hospitals and the Illinois Poison Center to an increase in emergency medical services responses for suspected opioid-involved overdoses with atypical symptoms, mostly clustered on Chicago's West Side. CDPH and CDC investigated and identified 12 confirmed, 26 probable, and 140 suspected overdoses involving medetomidine mixed with opioids among patients treated at three hospitals in Chicago's West Side during May 11-17, 2024. Medetomidine had not been previously identified in Chicago's illegal drug supply. Fentanyl was identified in all drug samples and blood specimens containing medetomidine. Most patients were male, non-Hispanic Black or African American, and aged 45-64 years; most patients with confirmed cases experienced bradycardia and had no or only a partial response to naloxone. This cluster is the largest reported for confirmed medetomidine-involved overdoses. Multisector surveillance, including by health care providers, toxicology laboratories, and public health personnel, was essential for quickly identifying and responding to new adulterants in the illegal drug supply. Because all specimens and samples in this investigation that contained medetomidine also contained natural or synthetic opioids, administering naloxone for all suspected opioid-involved overdoses remains crucial.

Politeness Strategies of President Duterte During Inquest on War on Drugs: Implications on Teaching Communication

Purpose of the study: This study aimed to explore and determine the politeness strategies employed by President Rodrigo Roa Duterte during the Inquest of the Blue-Ribbon Committee on the Philippine War on Illegal Drugs. Methodology: A qualitative research design was used, specifically utilizing discourse analysis to examine the politeness strategies employed by President Rodrigo Duterte during the Inquest Proceeding. Data was gathered through video transcription and translation. These data were analyzed using Brown and Levinson’s in 1987 politeness strategy framework to form discourse implications and conclusions. Main Findings: Results revealed that President Duterte employed all the politeness strategies during the Inquest, namely: bald-on-record, negative politeness, positive politeness and off-record strategy. Findings also showed that Duterte’s dominant use of Bald-On Record strategy mirrors his authoritative and assertive nature, projecting a straightforward and decisive leader. Meanwhile, his limited use of Off-Record strategies displays a strategic balance between explicitness and subtlety depending on the audience and context. Novelty/Originality of this study: This study provides valuable insights into the role of politeness strategies in political discourse, offering a deeper understanding of how language shapes power dynamics and public perception in high-stakes settings. This also suggests how educators can meaningfully integrate Duterte’s politeness strategies in discussing persuasive communication, public image construction, and the influence of authority in political settings and debates.

KONTRA INTELIJEN DALAM MENGHADAPI OPERASI RAHASIA (CLANDESTINE) ASING MELALUI PENYELUNDUPAN NARKOBA DI INDONESIA

Indonesia is facing a critical drug crisis, not only as a consumer but also as a producer of narcotics. Drug abuse, once concentrated in major urban centers, has now permeated even the most remote regions, with an estimated 3.3 million users, or approximately 1.73% of the population. The country has become a primary target for large-scale drug smuggling, with around 80% of illicit substances entering through maritime routes, while the rest are trafficked via air transport and land borders. Beyond mere profit-driven criminal activity, strong indications suggest that drug trafficking is part of a broader covert operation by foreign entities aimed at weakening Indonesia’s national resilience. This operation systematically targets the younger generation, eroding moral integrity and mental strength, ultimately destabilizing the nation from within. While direct evidence of such clandestine foreign involvement remains elusive, numerous indicators point to its existence. However, the challenge lies in the highly secretive nature of these operations, making them difficult to identify and counter. Moreover, Indonesia has yet to fully recognize and address drug smuggling as a potential strategic maneuver orchestrated by external forces. To effectively combat this existential threat, Indonesia must go beyond conventional counter-narcotics efforts and adopt an intelligence-driven approach. A well-coordinated and highly classified counterintelligence strategy is essential to detect, disrupt, and neutralize these clandestine operations. This requires a structured and systematic intelligence framework that integrates advanced methodologies, tactical precision, and covert operational capabilities. By doing so, Indonesia can fortify its national security, safeguard its younger generation, and dismantle any covert attempts to undermine its sovereignty.

Analyzing the Multidimensional Non-traditional Security Challenges in North Africa and Regional Implication

The non-traditional security challenges in North Africa have experienced significant changes in recent years. In addition to conventional military issues, the region has experienced many problems, such as drug trafficking, illegal immigration movements, smuggling, the Arab Spring, and the consequences of the global 'War on Terror' launched after the events of 9/11. Most research on North African security concentrates on threats within the traditional paradigms of military matters and terrorism. Nevertheless, this paper considers the overall parameters of an expanded North African regional non-traditional security. It focuses on four specific issues: illegal immigration movement, water scarcity, drug trafficking, and smuggling. The study indicates that if coordinated action is not taken, the interaction of these non-conventional risks can erode the future stability and growth of North Africa.

Bangladesh-Myanmar Border: A Persistent Threat to Bangladesh’s National Security

Over the past decade, Bangladesh has made significant strides in economic development, with forecasts indicating continued growth in the years ahead. However, sustaining this progress requires ensuring national security, which has become a top priority for the government. Geopolitically, Bangladesh and Myanmar serve as a critical bridge between South Asia and Southeast Asia. Despite having less direct border connectivity with Myanmar compared to India, Bangladesh faces a range of both conventional and non-conventional security threats along this frontier. Among the most pressing issues is the ongoing Rohingya crisis, which has evolved into a matter of global concern, as well as the persistent influx of illegal drugs trafficked from Myanmar into Bangladesh. Arms smuggling along the Bangladesh-Myanmar border is another longstanding threat that has remained unresolved over the years. Additionally, Myanmar&amp;apos;s limited cooperation with Bangladesh—exacerbated by its prolonged absence of democratic governance—has further strained bilateral relations. Compounding these challenges is the continuing instability in Myanmar’s Rakhine State, where the Arakan Army&amp;apos;s armed struggle against the junta government poses additional security risks for Bangladesh. This article will explore these key issues in depth, along with other related security concerns, by analyzing prominent incidents and developments. Finally, the article will present a set of recommendations aimed at strengthening Bangladesh’s border security and safeguarding national stability and economic prosperity.

Friction Burns and the E-scooter: an evolving trend.

Emerging as a cost-effective, convenient, and environmentally friendly mode of transportation, electric scooters (e-scooters) have become ubiquitous across metropolitan hubs. Regulation varies between States but typically mandates helmets, complying with age-related speed limits, and not being under the influence of alcohol and illicit substances. Given the difficulty of enforcing these restrictions and the ease of manoeuvring through different road infrastructure, riders, and those around them, are vulnerable to trauma. With many e-sooters reaching speeds exceeding 25km/hour, collisions can result in friction burns when riders collide with hard surfaces such as roads. The aims of this project were to describe the profile of friction burns associated with e-scooters referred to Western Australia's burns units. A retrospective review of e-scooter related friction burns recorded within Western Australia's burns units was undertaken between January 2019 and July 2023. Data collected included demographics, injury profile, abrasion characteristics and management. Between 2019 and 2023, 30 e-scooter related burns were identified. Most friction burns resulted from non-collision events (76.7%) such as falls, with the upper limbs most commonly involved (31.8%). Ninety-three percent of burns involved a total body surface area of less than 5%, with most being mid-dermal in depth (63.3%). Friction burns are an emerging injury among e-scooter riders and, given the popularity of this method of transport, warrant targeted injury prevention countermeasures. Whilst these burns are not usually severe, further prospective research is needed to understand the nature of events leading to them.

Authoritarianism and Violence: An Arendtian Critique of the Philippine War on Illegal Drugs

The Philippine War on Drugs, initiated under President Rodrigo Duterte’s administration, has been marked by authoritarian governance and widespread violence, particularly through extrajudicial killings (EJKs). This paper critically examines the authoritarian dimensions of the drug war through the lens of Hannah Arendt’s political philosophy, particularly her analyses of power, violence, and the “banality of evil.” Arendt warns that authoritarianism thrives on coercion and the erosion of public discourse, often justifying state violence as a means to maintain order. The normalization of EJKs in the Philippines exemplifies how authoritarian tendencies undermine democratic institutions and the rule of law. Applying Arendt’s critique, this study explores how the drug war fosters a culture of unthinking obedience among state actors and desensitization among the public. Arendt’s concept of the “banality of evil” suggests that perpetrators of state-sponsored violence do not necessarily act out of malice but rather from an uncritical acceptance of authority and policy. By examining the mechanisms through which authoritarian rule legitimizes violence, this paper argues that the Philippine War on Drugs reflects a dangerous collapse of political deliberation, wherein fear replaces reasoned debate. Ultimately, this paper calls for a reinvigoration of public discourse and critical thinking as a means of resisting authoritarian violence. An Arendtian critique highlights the necessity of political engagement, moral responsibility, and institutional accountability in preserving democratic values against the excesses of authoritarian rule.

Perception of professionalism among Latin American physicians in 2024: A multi-national survey

Medical professionalism encompasses the values, attitudes, and behaviors that prioritize the service of patients and society. This study aimed to evaluate the perception of professionalism among Latin American physicians in 2024. We conducted an observational, cross-sectional study involving Latin American physicians from various specialties. A telematic survey was administered, which included sociodemographic variables (age, sex, country, specialty) and the modified Kwon et al. professionalism questionnaire, comprising 43 questions across seven dimensions. Four hundred and twenty-four physicians participated (median age of 40 years, 57.6% female, and 69.8% from clinical specialties) from Paraguay (72.9%), Peru (24.3%), and Cuba (2.8%). A threshold score of 1.223 out of 4 identified the lowest 40% in perceived professionalism. The lowest scoring indicators - reflecting less frequents behavior - were: I recommend illegal drugs for recreational use and I maintain inappropriate body contact during the physical examination. In contrast, the highest scoring (more frequent) were: I am late for work and I overlook colleagues' medical errors. Male physicians demonstrated significantly lower professionalism in three areas: Inappropriate body contact during physical examination, abusive treatment of other healthcare professionals, and discriminatory behavior toward colleagues or patients (adjusted effect). Sixteen indicators show a significant association with professionalism self-perceived professionalism, with four showing notable differences by sex. Ongoing implementation of such assessment at different professional stages is recommended, along with educational strategies at the university level to reinforce the core values of medical professionalism.

Detection of hidden populations using illicit substances

BackgroundThe prevalence of hidden populations using illicit substances may lead to underestimation of the health and social impacts. This study aimed to precisely estimate the prevalence and characteristics of hidden...