This study aimed to understand the clinical characteristics of individuals who misuse over-the-counter (OTC) drugs in psychiatric clinical settings in Japan, and to reconsider approaches to current drug misuse prevention education and support strategies in Japan. Data were obtained from the 2024 Nationwide Survey on Drug-Related Disorders in Psychiatric Inpatient Facilities in Japan. Patients for whom OTC drugs were the primary substance of abuse were identified, and their demographic profiles, ICD-10 subcategories, and comorbid psychiatric disorders were examined. On the basis of the substance initially misused, participants were classified into three groups: illicit drugs, prescription drugs, and OTC drugs. Comparative analyses were conducted to assess clinical characteristics across these groups. A total of 389 participants were included in the analysis: 36 in the illicit drug group, 47 in the prescription drug group, and 306 in the OTC drug group. Compared with the other groups, the OTC drug group exhibited a significantly higher proportion of female patients, adolescents, and individuals enrolled in junior or senior high school. Furthermore, this group demonstrated significantly lower rates of criminal history and engagement with support or treatment services, such as self-help groups, addiction-focused group therapy, and psychiatric hospitalization. In contrast, the prevalence of comorbid psychiatric disorders was significantly higher in the OTC drug group compared with the other two groups. Within the ICD-10 subcategories, "harmful use" was notably more frequent in the OTC drug group compared with the other groups. The findings of this study indicate that OTC drug misuse has become a significant public health concern among adolescent females in Japan. The present findings underscore the necessity of reconsidering existing drug misuse prevention education and support frameworks, which have traditionally been oriented toward illicit substances.

Nontargeted screening of carbonyl-containing hormonal residues in meat products for food safety by using intelligent high-resolution mass spectrometry-based workflow.

Due to the cost and complexity of data collection in biomedical domains, it is a common practice to combine data from multiple sites to obtain large datasets required for machine learning. However, undesired site-specific variability presents challenges. Data harmonization aims to address this issue by removing site-specific variance while preserving biologically relevant information. We show that the widely used ComBat-based harmonization improvements are driven by data leakage due to illicit use of target information when class labels are imbalanced across sites, a common scenario in biomedical domains. We propose a novel approach, PrettYharmonize, which leverages subtle differences in data harmonized using different pretended target values. Using controlled benchmark datasets and real-world magnetic resonance imaging and clinical ICU data, we demonstrate that our leakage-free PrettYharmonize method achieves performance comparable to leakage-prone methods. As such, it is a viable method to integrate ComBat-based methods in machine learning applications. • In class imbalance across sites, ComBat-based harmonization requires test labels to preserve relevant variance to avoid signal loss, leading to data leakage. • If no test labels are provided in such scenarios, ComBat-based harmonization removes the signal of interest. • PrettYharmonize enables integration of harmonization in ML pipelines in a leakage-free way, by eliminating the need for test targets while preserving predictive signals.

The use of alcohol, legal and illicit substances poses great negative consequences on health and economy worldwide. LC-MS/MS allow simultaneous determination of multiple compounds in biological matrices. The aim of this study was to develop a LC-MS/MS method for the determination of the alcohol biomarker phosphatidylethanol (PEth) - including three homologues (PEth 16:0/18:1, PEth 16:0/18:2, PEth 18:0/18:1) - cocaine and three metabolites, and 8 other drugs in whole blood. Whole blood in K2EDTA tubes was prepared by liquid-liquid extraction using heptane/ethyl acetate/2-propanol (16:64:20, v:v:v). Chromatographic separation was achieved on an Acquity BEH C18 column (50 × 2.1 mm I.D., 1.7 µm particles). Mobile phase was 0.025 % ammonia, pH 10.7 (Solvent A) and methanol (Solvent B). The method was fully validated with isotope-labelled internal standards for 10 compounds. Inter-assay precision and accuracy were within ± 16 % for all analytes at five to seven tested concentrations. Recovery was within 42-79 % for 14 compounds and 11 % for benzoylecgonine. Matrix effects were within ± 25 % for most analytes. Internal standards compensated for matrix effects for compounds that had their own internal standards. A robust, precise, and accurate LC-MS/MS method for the determinations of three PEth homologues and 12 drugs and metabolites was, developed and validated. The method is valuable, especially for detecting polydrug use and alcohol consumption. To the best of our knowledge, this is the first LC-MS/MS method for the simultaneous determination of three PEth homologues and different drugs and metabolites.

Over 100 overdose prevention sites (OPS) operate in various jurisdictions, including Australia, Canada, the United States, and several European countries. However, despite the increasing prevalence of people who use illegal drugs, including those who inject drugs, no such facility currently operates in Africa, Asia, the Middle East, the Caribbean, or Central and South America. Except for Canada and a few sites in the US, no sanctioned facility currently operates in Mexico. This systematic review will identify peer-reviewed studies, reports, and theses that evaluate the cost and benefits of OPS, relying on five electronic databases (ECONLIT, Google Scholar, Medline, PubMed, and Web of Science). A search strategy based on the PRESS approach will guide the initial search for articles. Based on the PRISMA, community researchers will screen titles and abstracts using the specified inclusion criteria in EndNote X20, and the results will be uploaded into Covidence. Community reviewers using Covidence will examine the complete text, including the title and abstract. All articles reported through the initial search will be further screened based on Cheers and Drummond criteria to identify weaknesses in the research while extracting additional information and data related to costs, benefits, programs, or services. The final data analysis will include the range of cumulative benefits, costs, and ratios associated with operating OPS. This review has the potential to provide evidence-based knowledge through a community-based research approach on the cost savings of public health interventions implemented through harm reduction philosophy for underserved populations.

Increasing punitive drug regulations in Japan amplify longstanding tensions within psychiatric practice, pushing psychiatrists to balance clinical obligations with complex socio-legal demands. This article analyzes how psychiatrists specializing in illicit substance use disorders to navigate escalating criminalization by developing diagnostic frameworks such as "carceral harm"-attributing symptoms primarily to policing and incarceration threats-and "future treatability," wherein addiction is an anticipated, incomplete phenomenon justifying ongoing medical care for patients facing imprisonment. Drawing from ethnographic research at Japan's National Center of Neurology and Psychiatry and semi-structured interviews with psychiatrists, the study demonstrates how these clinical interventions simultaneously address ethical demands for compassionate care yet risk reinforcing psychiatry's historical associations with repression. The findings reveal psychiatrists' active role in reshaping medico-legal discourses around addiction, highlighting clinical practice as a site where care and punishment intersect and reconfigure each other in reference to a medico-legal theory of illicit drug addiction.

ABSTRACTBackground and ObjectiveThe incidence of ischemic stroke (IS) in young adults (18–50 years) has been rising, in parallel with a growing prevalence of traditional vascular risk factors in this population. Understanding these trends critical for prevention and treatment strategies. This study aimed to analyze temporal trends in classical vascular risk factors among young adults hospitalized with IS in Spain between 2000 and 2022, and to forecast their prevalence through 2027.MethodsA retrospective analysis was conducted using hospital discharge data from the Spanish National Inpatient Database. Patients aged 18–50 years diagnosed with IS between 2000 and 2022 were included. Temporal trends were assessed using ordinary least squares regression and stationarity was evaluated with the Augmented Dickey–Fuller test. Short‐term forecasts (2023–2027) were generated using a cross‐validated time‐series framework comparing multiple univariate models. Model selection was based on out‐of‐sample root mean squared error.ResultsA total of 57,427 young adults with IS were identified. Incidence increased from 7 to 15 per 100,000 population between 2000 and 2022. Increases were observed in obesity (5.2%–15.2%), dyslipidemia (20.8%–29.7%), and illicit substance use (1%–13.5%). Obstructive sleep apnea, patent foramen ovale, and other congenital heart diseases also showed upward trends, while hypertension and diabetes remained relatively stable. Short‐term forecasts suggest a sustained burden through 2027.ConclusionsThe increasing burden of modifiable vascular risk factors and cardiac comorbidities among young IS patients underscores the urgent need for public health strategies focused on early detection, lifestyle modification, and prevention in this population.

Psychoactive substance use among adolescents represents a growing public health concern in sub-Saharan Africa. This study examined alcohol and illegal psychoactive substance use among secondary school adolescents in Yaoundé, Cameroon, with particular attention to associated factors, including family relationships. A school-based cross-sectional study was conducted among adolescents enrolled in Forms 3 to 5 in three secondary schools in Yaoundé. Data were collected using a self-administered questionnaire. Quantitative analyses estimated 12-month prevalence and associated factors using robust Poisson regression for alcohol use and complementary log-log regression for illegal psychoactive substance use, complemented by bootstrap resampling and Firth's penalised regression to assess robustness in a rare-event context. Qualitative open-ended responses were analysed using thematic and lexical co-occurrence approaches (Jaccard C and T coefficients) to explore adolescents' representations of substances and perceived consequences. A total of 352 adolescents were included (54.3% girls). The median age was 15 years (IQR: 14-17; observed range: 12-20). The 12-month prevalence of alcohol use was 32.7% (95% CI: 27.8-37.8), while 3.7% (95% CI: 2.0-6.2) reported illegal psychoactive substance use. Marijuana and cocaine emerged as the most salient illicit substances within adolescents' cognitive representations, forming the strongest co-occurrence pattern (Jaccard C = 0.24; T = 0.389), while other substances such as tramadol, heroin, tobacco, and alcohol were mentioned less prominently. Perceived consequences were predominantly negative, encompassing neuropsychological, somatic, behavioural, and social effects, although limited positive representations persisted. Multivariable analyses showed that alcohol use was independently associated with increasing age, availability of drugs around the home, and illegal substance use. When illegal psychoactive substance use was the outcome, alcohol use was inversely associated. Family relationship variables were not independently associated with either outcome after adjustment. These findings underscore the central and asymmetric role of alcohol use in adolescent substance involvement. In parallel, they indicate that alcohol use among school-going adolescents is more strongly influenced by age and environmental exposure than by family relationship factors. They support multi-level prevention strategies focusing on early school-based psychoeducation, regulation of alcohol availability in home and community settings, and longitudinal research to clarify substance-use trajectories.

The increasing prevalence of fentanyl within the illegal global drug market underscores the need for rapid, low-cost, and straightforward detection methods. Eosin Y demonstrates a measurable color change in the presence of fentanyl, making it a promising candidate for colorimetric sensing and preliminary identification of fentanyl hydrochloride in seized drug samples. This study investigated the interactions of fentanyl freebase and fentanyl hydrochloride with eosin Y in both solution and solid states. Quinine sulfate was included in the solid-state analysis due to its visually similar colorimetric response. CIE-Lab colorimetric evaluation revealed that the peach-to-pink color shift produced by solid fentanyl hydrochloride closely matched that of quinine sulfate, indicating that quinine sulfate may serve as a safe and practical simulant for fentanyl hydrochloride in eosin Y-based assays. In contrast, fentanyl freebase produced no observable color change. Solution-state studies, assessed visually and through UV-Vis and fluorescence spectroscopy, showed that fentanyl hydrochloride generated the strongest absorbance increase at 560 nm, while fluorescence emission at 542 nm increased for both the freebase and hydrochloride forms. These findings demonstrate that the protonation state of fentanyl is critical for eliciting eosin Y's colorimetric response, while the presence of hydrochloric acid alone does not account for the observed changes. Overall, the results supported the potential of eosin Y as a practical colorimetric indicator for protonated fentanyl species and highlighted quinine sulfate as a viable simulant for safer laboratory testing.

To explore the influence of oral health-related knowledge, attitudes and practices on oral health risk-related behaviours of people in custodial settings. Integrative review. Scopus, ProQuest Central, Web of Science, Medline, CINAHL, Academic Search Complete, PsycINFO and Education Research Complete were searched in March 2024 and December 2025. Studies reporting on any individuals in custodial settings, at least one oral health-related knowledge, attitude or practice and at least one oral health risk-related behaviour (either smoking, alcohol, illicit substances or sugar consumption). Data related to custodial population's oral health knowledge, attitudes, or practices and oral health risk-related behaviour were extracted, synthesised narratively and reported thematically. Findings from the 26 studies reveal that people in custodial settings had a general lack of oral health knowledge, and oral health risk-related behaviours were prevalent. The most common risk-related behaviours reported were tobacco use and free sugar consumption. Oral health knowledge, attitudes and practices of this population were influenced by custodial healthcare systems and attitudes of dental professionals. This review highlights the influence custodial healthcare and dental professionals have on the knowledge, attitudes, practices and risk-related behaviours of people in custodial settings. Oral health targeted interventions and strategies are required to improveoral health-related knowledge and attitudes thereby encouraging oral health practices among people in custodial settings. This review will inform targeted oral health promotion programs that can improve oral health outcomes and experiences of this population. People in custodial settings experience a disproportionate burden of oral diseases. This review underscores the need for proactive interventions and systemic reform to improve correctional healthcare experiences globally. Preferred Reporting Items for Systematic Reviews and Meta-Analysis, Extension for Scoping Reviews (PRISMA-ScR) 2018. No patient or public contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Synthesises evidence on influencing factors contributing to poor oral health among people in custodial settings. Highlights impact of healthcare staff and custodial healthcare systems on population health. Highlights the necessity of oral health promotion programs to improve oral health knowledge and to promote oral health protective behaviours.

A Retrospective Observational Study of Violent Deaths Among Transitional-aged, Unhoused Youth.

Illicit drug use poses a particularly high risk among certain subgroups of society, including trauma-exposed occupations like police officers. Nevertheless, very little is known about the prevalence and types of illicit drug abuse among police personnel. This study aimed to examine the prevalence and patterns of illicit drug use among young police recruits (i.e., police cadets) in Hungary using a cross-sectional questionnaire-based online survey. Our results show that 16.9% of police cadets have ever tried illicit drugs. Drug experimentation was more prevalent among males than females, but the difference was not statistically significant. It was also found that perceived environmental drug use was the most important factor in explaining cadets’ drug experimentation. Drug abuse can significantly impact job performance among officers, and negatively affects the community’s trust for police. Therefore, drug abuse among police students and officers should be addressed as organizational and community-level issues requiring a holistic approach.

Perceived impacts of Supervised Consumption Sites (SCS) on key service aspects and settings: Reports from Canadian National Questionnaire on Overdose Monitoring (CNQOM).

Non-medical use of prescription stimulants is increasing globally, yet Australian population-level data on its prevalence and associated sociodemographic and substance use correlates remain limited. We analysed cross-sectional data from the 2022-2023 National Drug Strategy Household Survey (n = 21,663). Logistic regression models estimated associations between non-medical use of prescription stimulants and other substance use. Multinomial models compared risk profiles across four groups: no drug use; non-medical use of prescription stimulants only; illicit drug use only; and both. Past-year non-medical use of prescription stimulants was reported by 1.8% of respondents and 5.2% reported lifetime use. Past-year non-medical use of prescription stimulants was strongly associated with past-year use of meth/amphetamine, non-medical cannabis, cocaine and ecstasy, but not with past-year cigarette smoking, non-medical use of opioids, vaping or risky alcohol consumption (p > 0.006). Compared with individuals who reported non-medical use of prescription stimulants only, those who reported both non-medical use of prescription stimulants and illicit substance use were younger and more likely to report current smoking and risky alcohol consumption. Patterns mirror international evidence: non-medical use of prescription stimulants in Australia is concentrated within polysubstance use, particularly with other stimulants and cannabis, while a smaller non-medical use only subgroup shows fewer risk indicators. Non-medical use of prescription stimulants may serve as a marker for broader substance use and clinicians should screen accordingly. Future NDSHS surveillance should add items assessing prescription status, attention-deficit/hyperactivity disorder diagnosis and motives to better characterise exclusive non-medical use.

Experiences with recovery from substance use in a Northern Midwest Indigenous Reservation setting.

Opioid agonist therapy (OAT) is an essential treatment for opioid dependency. However, OAT may lead to endocrinopathy, which may impair the tolerability of treatment. Although the risk of disturbed regulation of the adrenal and gonadal axes has been extensively studied, less is known about how long-term opioid use and corresponding risk factors influence the thyroid axis. The objective of this study was to investigate associations between biomarkers of thyroid function and OAT medication as well as sociodemographic and clinical factors and concurrent use of illicit substances among patients receiving OAT. We used prospective data from 320 people receiving OAT in Bergen, Norway, from 2016 through 2023. All had 2 health assessments, including serum measurements of TSH. Descriptive statistics and a linear mixed model with coefficient and 95% CIs were performed to investigate the association between serum TSH (measured in mIU/L) and OAT medication as well as age, sex, substance use patterns, injecting use, housing status, and educational attainment at first assessment and over time. Median serum TSH at first assessment in the study population was 1.8 mIU/L (interquartile range: 1.2). No association between OAT medications, sociodemographic, or clinical factors and serum TSH was found at first assessment and over time. The median serum TSH was within the recommended range among people receiving OAT. No association between OAT treatment and thyroid insufficiency was found. This indicates that screening for thyroid function beyond symptomatic assessment is probably not needed among patients receiving OAT.

Cannabis legalization and law enforcement drug seizures: a state-level analysis of cannabis policy effects on cannabis seizures in the United States, 2010-2023.

Doubts and disconnection: Police reflections on drug decriminalization in British Columbia in the first year of implementation.

Background Synthetic cannabinoids (SCs) are the fastest-growing class of novel psychoactive substances in Brazil, yet epidemiological data on their prevalence and correlates remain limited. This study examined differences in sociodemographic, treatment, and clinical characteristics between individuals in substance use treatment who reported SCs use and those who did not, and identified factors associated with SCs use frequency. Methods The study extracted data from electronic health records of all individuals who sought treatment for their alcohol and/or drug use in “HUB de Cuidados em Crack e Outras Drogas”, Sao Paulo, Brazil, between June 2024 and July 2025 (N = 6,660). Results A total of 1943 service users (29.17%) self-reported using SCs in the past 12 months. Of these, 28.9% initiated use before age 21, 51.7% reported polysubstance use (cocaine, crack-cocaine, and cannabis) before initiating SCs use, and 63.4% reported daily use. Compared with non-users, SC users were more likely to be younger, to have attended another treatment service in the past 12 months, and to have frequented open drug scenes (ODS). They also reported greater use of cocaine, crack-cocaine, cannabis, solvents, and methamphetamines, higher rates of polydrug use, more severe cocaine/crack addiction scores, and more frequent high or severe psychotic symptoms. Similar factors were associated with the frequency of SCs use. Conclusion The findings reveal a mixed profile of SCs users comprising individuals from ODS and younger users from other areas. It highlights the need for adaptive public health policies, enhanced surveillance, and tailored treatment approaches to address the evolving complexity of Brazil’s drug landscape.

Objectives To evaluate prevalence of sugar dating among undergraduate students and assess the demographics and motivations of sugar babies. Participants This study included 1582 undergraduate students 18 years or older in an urban, private university in the U.S. (82 sugar participants and 1500 controls). Methods From October 2019 to May 2020, a cross-sectional, online survey asked participants about sugar dating experiences, substance use history, and childhood traumas. Results Prevalence of sugar dating was 5.2%. Sugar babies were 2 to 5 times more likely to have experienced childhood trauma defined by the 10 item ACE questionnaire. Sugar babies were more likely to have financial support (loans, scholarships, Federal Pell grants, work-study), use illegal drugs, and have greater daily alcohol consumption. Conclusions Many sugar babies have experienced vulnerabilities (financial need, childhood traumas) that could heighten their risk of exploitation by sugar sponsors. Future studies should explore the dynamics of sugar relationships among undergraduate students and the risks accompanying these relationships.