Illicit Drug Abuse Research Articles

Investigating illicit drug hotspots and daily variations using sewer-network wastewater analysis

Previous wastewater-based epidemiology (WBE) research on illicit drug use has predominantly focused on wastewater treatment plant (WWTP) influents, but information on sewer-network wastewater is very limited. This study represents a pioneering small-scale WBE investigation based on the analysis of sewer-network wastewater samples from different sewer manholes in suburban (Tamsui region) and urban areas (Zhongshan and Wanhua regions) and a comparison of the results with those obtained from corresponding WWTP influents. Among sixteen illicit drugs, methamphetamine exhibited the highest concentration in sewer-network wastewater across both areas. Suburban–urban variations were observed, with more types of illicit drugs detected in the suburban area. Back-calculation indicated that methamphetamine and ketamine were the most-consumed illicit drugs in both sewer-network wastewaters and WWTP influents. Similar types of illicit drugs were detected in the sewer-network wastewaters and WWTP influents, indicating the representativeness of WWTP influents in assessing regional illicit drug abuse. Nevertheless, the sewer-network wastewater results offered additional information making it possible to pinpoint potential hotspots of illicit drug and identify peak usage periods throughout the day, in contrast to the WWTP influent results. In the non-suspected suburban area of Tamsui, high potential hotspots of methamphetamine (sampling points 3 and 6) and ketamine (sampling points 1 and 8) were identified. Although the Zhongshan and Wanhua regions were chosen as suspected hotspots of illicit drug abuse, more severe illicit drug use was observed in Wanhua. Moreover, a trend toward higher illicit drug use from early morning to morning was observed. Despite sampling challenges and higher costs, small-scale WBE via sewer-network wastewater analysis provides superior identification of drug abuse hotspots and peak usage periods. Therefore, this study provides valuable insights for law enforcement and can help prevent and combat illicit drug abuse by targeting potential hotspots and understanding daily illicit drug use dynamics.

Frequent Cocaine Use is Associated With Larger HIV Latent Reservoir Size.

Cocaine-one of the most frequently abused illicit drugs among persons living with HIV [people living with HIV (PLWH)]-slows the decline of viral production after antiretroviral therapy and is associated with higher HIV viral load, more rapid HIV progression, and increased mortality. We examined the impact of cocaine use on the CD4+ T-cell HIV latent reservoir (HLR) in virally suppressed PLWH participating in a national, longitudinal cohort study of the natural and treated history of HIV in the United States. CD4+ T-cell genomic DNA from 434 women of diverse ancestry (ie, 75% Black, 14% Hispanic, 12% White) who self-reported cocaine use (ie, 160 cocaine users, 59 prior users, 215 non-users) was analyzed using the Intact Proviral HIV DNA Assay, measuring intact provirus per 106 CD4+ T cells. HIV latent reservoir size differed by cocaine use (ie, median [interquartile range]: 72 [14-193] for never users, 165 [63-387] for prior users, 184 [28-502] for current users), which was statistically significantly larger in both prior (P = 0.023) and current (P = 0.001) cocaine users compared with never users. Cocaine use may contribute to a larger replication competent HLR in CD4+ T cells among virologically suppressed women living with HIV. Our findings are important because women are underrepresented in HIV reservoir studies and in studies of the impact of cocaine use on outcomes among PLWH.

Model of Life Skills Based Drug Education on Knowledge About Drug Use, Self-Esteem, and Assertiveness Skills Among Indonesian Adolescents at Risk

Introduction: Adolescent drug abuse is a global concern, affecting young people's freedom and development. In Indonesia, illicit drug abuse has increased, causing severe social, political, and economic problems. Methods: A quasi-experimental design was used in this study to test the effects of life skills-based drug education on knowledge about drug use, self-esteem, and assertiveness skills. Teen participants were divided into experimental and control groups. Results: Language and Social Education (LSE) significantly influences students’ understanding of drug use and assertiveness training while also somewhat raising their self-esteem. On the other hand, it had no appreciable impact on Indonesia’s at-risk students in Semarang, Central Java Province. The report stressed that the first stages in an LSE program intended to stop teenage drug use are for students to gain knowledge and skills. To attain the best results in drug use prevention, more routes must be created. Conclusions: gaining information and skills improves attitudes and values, which in turn encourages drug use in a good way. Consequently, to support Indonesian students who are at risk of drug use in staying drug-free and developing into healthy, contributing members of society, these programs require further study and improvement.

Drug Addiction Clinical Study Among Patients Admitted to the Alqana Center for Social Rehabilitation

Background: Drug addiction is a worldwide issue; 5.6% of the world's population aged 15 to 64 took drugs at least once in 2016. For the majority of medicines, younger individuals use them more than older people do. Drug abuse seems to be on the increase in several ASEAN (Association of Southeast Asian Nations) countries, particularly among young men aged 15 to 30. Illicit drug abuse account for around 14% of the overall health burden among young males. Younger individuals are also more prone to die from drug abuse issues. Aims of study is to assess the severity of problems related to drug addiction. in Baghdad city and to study epidemiological features of drug addiction among Patients Admitted to the Alqana Center for Social Rehabilitation. Patients and methods: An analytical cross-sectional study of 300 individuals diagnosed as a drug addiction patient according to the criteria established by the "Diagnostic and Statistical Manual of Mental Disorders", Fifth Edition, text revision, often called the DSM-V-TR or DSM-5-TR. From the medical department at Alqana Center for Social Rehabilitation in Baghdad. The research was carried out from 25/December/2023 to 30/June/2024. Results: the demographic characteristics of the study sample. In with a mean and a standard deviation (SD) of age of 29.33±18.68. Individuals aged 20-29 year had the highest proportion to addiction, with a rate of 42.7%. Conversely, 89.3% of the participants were male. The majority,86.7%, live in urban regions. The majority of patients had 51.7% unmarried, with only 36.0% being married and 12.3% was divorced. The main rate among drug addiction patients was 38.7% primary education ,33.0% secondary education, and 16.0% was illiterate patient, while lowest patient 12.3% at collage. According to the statistics in the table,76.3% of the participants were free business. 95.0% cigarette smoker. presented the result of psychological symptoms as show 93.0% of study addictive patient have mood swings, and in the same table the behavioral and social symptoms showed as 97.0% of study patient had poor performance and/or attendance at work or school. Also, physical symptoms of addiction showed as 74.7% of patient suffering from disrupted sleep patterns, including insomnia Regarding to the withdrawal symptoms of drug addiction presented in Table (3), results showed as 95.7% fatigue, 85.3% muscle pain or aches, 81.0% irritability and agitation, 76.0% trembling and tremors, 69.3% hunger, 50.7% anxiety, 36.7% sweating, 30.7% insomnia, 25.3% loss of appetite, 22.7% depression, 20.7% confusion, 22.3% nausea, 9.3% seizures, 8.0% dilated pupils, 3.3% vomiting, and 2.3% paranoia. Conclusion: the majority of addicted patient was male. the main symptoms were Poor performance and/or attendance at work or school and mood swing. The highly complication was fatigue. Regarding the way of addiction, the tablets is vast majority and enjoyment is the most common cause of addiction. Recommendations: It's possible that other important differences between the factors seen in this study would become clearer if multicenter study, the sample size was larger and the duration of the addiction study had been longer.

Foreign body pulmonary vessel embolism and granulomatosis in intravenous drug abuse: An autopsy study.

The abuse of illicit drugs causes a myriad of systemic complications. Intravenous (IV) injection of such drugs poses various additional threats, primarily due to the use of excipient materials in them. Pulmonary artery embolism with foreign material and granulomatosis may be encountered in the lungs on histopathological examination in such cases. In this study, we aimed to analyze the histopathological findings in lungs in postmortem specimens with suspected IV drug abuse. This was a retrospective study of 5 years in which 15 cases of known or suspected history of drug abuse were assessed. The clinical details were compiled, and the hematoxylin and eosin (H and E)-stained microscopic slides were retrieved from the archives for reviewing the histopathological features in lungs submitted for postmortem analysis. All the cases were male, aged 21 to 36 years (median: 27 years). Gross examination revealed edematous lungs in four cases (26.6%). On microscopic examination of the lungs, all the cases (100%) showed the presence of basophilic irregular structures to rod-like pale crystalline refractile material, which was accompanied by a granulomatous reaction in the lumen of the pulmonary arteries. Four of these cases (26.6%) showed birefringence on polarizing microscopy. The use of illicit drugs is becoming widespread, especially among young individuals. IV drug abuse increases the rate of morbidity and mortality by affecting primarily the pulmonary vasculature, particularly pulmonary arteries. An acquaintance with the various patterns of pulmonary involvement in IV drug abuse is essential to arrive at an accurate pathological diagnosis and provide a possible cause of death in such cases.

Facile fabrication of the immuno-MALDI-MS chip for the enrichment of abused drug in human urine integrated with MALDI-MS analysis

BackgroundDrug abuse can result in both physical and mental health issues for individuals, and can also contribute to broader societal problems. The number of drug abuse cases rose to 296 million in 2021. The sample pretreatment methods commonly employed typically require longer processing times and occasionally necessitate derivatization. Furthermore, with the increase in sample sizes, traditional chromatography-mass spectrometry methods for analyzing abused drugs were no longer sufficient to handle such numerous samples. In this study, immuno-MALDI-MS chip were fabricated for specific enrichment of illicit drugs, integrating with the rapid and accurate capabilities of MALDI-MS for high-throughput analysis of drug abuse. ResultsThe immuno-MALDI-MS chip was successfully prepared by coating an aluminum chip with antibody-conjugated boronic acid-modified gold nanoparticles. Ketamine, a frequently abused illicit drug, served as the proof of concept for this study. The immuno-MALDI-MS chip was employed to selectively enrich ketamine in human urine samples, facilitating direct MALDI-MS analysis with the addition of α-CHCA matrix solution. The challenge of detecting abused drugs, exacerbated by interfering peaks in the low m/z region from salts and small molecules in human urine samples, was successfully overcome. The developed method exhibited a wide linear range of 10–5000 ng/mL with a limit of detection of 3.3 ng/mL for ketamine. Notably, the proposed method enabled high-throughput screening and accurate confirmation of ketamine concentrations in suspects' urine samples within few minutes, requiring a minimal sample volume of 1 μL. The obtained data were in complete agreement with the previous GC/MS analysis. SignificanceA straightforward, cost-effective and sensitive method for the selective enrichment and absolute quantification of abused drugs was developed using a homemade immuno-MALDI-MS chip integrated with MALDI-MS analysis. This method combines the advantages of immunoassay and mass spectrometry, offering both speed and accuracy. The reported method for the quantification of ketamine in human urine offers a practical approach and has the potential to analyze emerging new psychoactive substances in the future.

Prevalence and Patterns of Drug Use Among People in Al-Najaf Governorate, Iraq

Background: After a series of instability Iraq confronted in the past decades, the drug abuse issue has grown and is now a complex national concern where the rise in drug transshipment through the country and neighbor countries accompanies noticeable increased consumption of drugs especially those associated with transnational criminal networks such as amphetamines. This is a descriptive cross-sectional epidemiological study conducted in Al-Najaf governorate from January to March 2024, qualitative data based on the correction institutions of the Ministry of the Interior using a non-probability sample since lack of precise sample frame or data about the real prevalence or rate of the problem. The study recruited 288 drug users all between 20-64 years, 31(10.8%) were females and 257(89.2%) were males (49%). 237 (82%) of the drug users of young adults between 20 to 40 years old. The objective was to investigate personal history and examine the extent and patterns of the abuse of drugs, using a structured questionnaire designed and modified after reviewing relevant studies. The study found that the majority of the participants smoked nicotine throughout their lifetime as 60.8% smoked hookah, 15% smoked e-cigarettes and 86% smoked cigarettes with about 75% current heavy smokers, 51% of participants used alcohol as lifetime prevalence with more than 32% used it weekly. A large percentage: 88% abused more than one type of illicit drug with amphetamine stimulants (methamphetamine and fenethylline) as the most commonly abused illicit drugs among the majority of the participants. The lifetime prevalence of prescription drug use was 86%. 60% used more than one method of administration, while 8% used drugs by injection. The study concluded that a large percentage of the study participants were polydrug abusers with extensive patterns of use which revealed the complex status of which stresses a holistic approach to managing the problem. Conclusion: The study concluded that a large percentage of the study participants were polydrug abusers with extensive patterns of use which revealed the complex status of which stresses a holistic approach to manage the problem.

Incidence and pattern of neurological emergencies in Ramadan

ABSTRACT Background The impact of Ramadan fasting on various neurological emergencies remains relatively unexplored. This study aimed to clarify the incidence and pattern of the different neurological emergencies in Ramadan compared to Shaaban. Methods In this cross-sectional study, all adult patients attending the emergency room at two Egyptian centers with neurological emergencies during Shaaban and Ramadan were evaluated. Clinical, laboratory, and radiological assessments were made on an individual basis upon which the diagnosis of neurological disorder was made. IBM SPSS Version 25 was used to analyze the data. Results Seventy-twenty patients were included, 382 during Shaaban and 338 during Ramadan. Among causes of delirium, the frequency of dehydration was significantly higher, and the frequency of illicit drug abuse was significantly lower during Ramadan compared to Shaaban (P = 0.004, 0.030, respectively). The incidence of ICH was significantly reduced during Ramadan compared to Shaaban (10.8% vs 19.7%, P = 0.031). The incidence of cardioembolic strokes significantly increased during Ramadan than Shaaban (40.5% vs 26.4%, P = 0.014), whereas the incidence of small vessel disease (SVD) significantly decreased during Ramadan than Shaaban (21.6% vs. 42.1%, P < 0.001). The incidence of a single seizure was significantly higher in Ramadan than in Shaaban (69.4% vs. 34.6%, P = 0.007). The incidence of functional neurological disorders was significantly reduced in Ramadan than in Shaaban (P < 0.001). Conclusion The incidence of delirium caused by illicit drug abuse, ICH, SVD, and functional neurological disorders declined during Ramadan, while the incidence of delirium triggered by dehydration, cardioembolic strokes, and a single seizure increased during Ramadan.

Assemble and validation of a simulated device of human exhaled breath aerosols for screening of illicit drug abuse by HPLC-TQ-MS/MS detection

Collecting exhaled breath aerosols (EBA) as a sample has a great potential to monitoring illicit drug abuse due to advantages of simple, non-invasiveness and unrestricted sampling. However, scarcity of positive samples has cramped development of more efficient techniques for monitoring illicit drug abuse in EBA. In this work, a simulated human exhaled breath aerosol (SHEBA) generating device based on Venturi jet principle was constructed by integrating nebulizing unit and collection unit to prepare positive EBAs. By means of ultra high-performance hyphenated with triple quadrupole tandem mass spectrometry (HPLC-TQ-MS/MS), using caffeine as a target drug, the device parameters were investigated by studying the effects of flow rates of nebulizing and auxiliary gases, drug concentration and etc., the performance was further validated by commonly abused drugs such as amphetamines (AMP, MAMP, MDA and MDMA). Electret material as adsorbent was used to collect SHEBAs generated by the device, achieving HPLC-TQ-MS/MS detection of the captured drugs at 40.0–2000.0 pg/filter. By this way, caffeine content in EBAs from six volunteers was successfully detected in the range of 51.6 ± 6.8–708 ± 51 pg/filter after drinking the caffeinated beverage. These validation experiments proved that SHEBA generating device could not only meet to the requirement of EBA analysis for illicit drug abuse at trace levels, but also provide the correction factors to calibrate the lower detection value caused by incomplete material adsorption.

Sex Differences in Mental Health Symptoms in Elite Athletes: A Systematic Review and Meta-analysis.

Mental health is a growing area of concern for elite athletes. To determine the sex differences in mental health symptoms in elite athletes. PubMed, EMBASE, and Cochrane Library databases were used. Included studies included comparisons of mental health symptoms of athletes by sex. Systematic review and meta-analysis were conducted following the PRISMA guidelines. Level 2a. The rate ratio (RR) was calculated as the rates in female and male athletes. Data were pooled using a random-effects model. Of 1945 articles identified, 60 articles were included. Male athletes reported higher alcohol misuse (RR, 0.74; CI, 0.68-0.80), illicit drug abuse (RR, 0.82; CI, 0.75-0.89), and gambling problems (RR, 0.14; CI, 0.08-0.25). Female athletes reported higher overall anxiety (RR, 1.17; CI, 1.08-1.27), depression (RR, 1.42; CI, 1.31-1.54), distress (RR, 1.98; CI, 1.40-2.81), and disordered eating (RR, 2.19; CI, 1.58-3.02). Sleep disturbances were reported at similar rates in male and female athletes (RR, 1.13; CI, 0.98-1.30). Female and male athletes have significant differences in reported mental health symptoms. Female athletes are more likely to report anxiety, depression, distress, and disordered eating, while male athletes report more alcohol misuse, illicit drug abuse, and gambling. Monitoring and evaluation of mental health is a necessary part of any sport, including access to resources. Longitudinal studies following athletes over time to determine the development and causation for mental health symptoms should be included in future research directions.

Patterns and sociodemographic characteristics of substance abuse among hepatitis C virus-infected patients in Iraq: a cross-sectional study

BackgroundSubstance use disorders are a widely recognized problem among hepatitis C-infected patients; moreover, substance abuse by intravenous injection is a common mode of transmission of the hepatitis C virus worldwide. The frequency of substance use disorders and their relation to hepatitis C infection are still unknown in Iraq. This cross-sectional study, conducted among a sample of hepatitis C- infected patients attending the Gastrointestinal Tract Center in Baghdad Medical City, aimed to examine the prevalence of substance use disorders, the sociodemographic characteristics of the abusers, and the relation between intravenous drug abuse and hepatitis C virus infection. All participants were subjected to an Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) questionnaire and a data form to determine sociodemographic characteristics and hepatitis C virus-related risk factors.ResultsIn a total of 300 hepatitis C virus-infected patients, the prevalence of substance use disorders was 53.6%. Among these patients, 43.6% abused nicotine, 6% abused licit drugs, and 4% abused alcohol. No one reported illicit drug abuse. Intravenous drug abuse was rare, and there was no relationship found between intravenous drug abuse and hepatitis C infection. Cupping (23%) and blood transfusion (20.3%) were both significantly associated with hepatitis C transmission in this study (p > 0.001).ConclusionThis study revealed a high prevalence (53.6%) of substance abuse in this sample of hepatitis C-infected patients, with nicotine being the most commonly abused substance. However, there was no relationship between hepatitis C infection and intravenous drug abuse. Common risk factors that might contribute to hepatitis C transmission among this population include cupping and blood transfusion.

Rapid nanomolar detection of cocaine in biofluids by electrochemical aptamer-based sensor with low-temperature effect for drugged driving screening.

Cocaine is one of the most abused illicit drugs, and its abuse damages the central nervous system and can even lead directly to death. Therefore, the development of simple, rapid and highly sensitive detection methods is crucial for the prevention and control of drug abuse, traffic accidents and crime. In this work, an electrochemical aptamer-based(EAB) sensor based on the low-temperature enhancement effect was developed for the direct determination of cocaine in bio-samples. The signal gain of the sensor at 10°C was greatly improved compared to room temperature, owing to the improved affinity between the aptamer and the target. Additionally, the electroactive area of the gold electrode used to fabricate the EAB sensor was increased 20 times by a simple electrochemical roughening method. The porous electrode possesses more efficient electron transfer and better antifouling properties after roughening. These improvements enabled the sensor to achieve rapid detection of cocaine in complex bio-samples. The low detection limits (LOD) of cocaine in undiluted urine, 50% serum and 50% saliva were 70nM, 30nM and 10nM, respectively, which are below the concentration threshold in drugged driving screening. The aptasensor was simple to construct and reusable, which offers potential fordrugged driving screening in the real world.

Firearm ownership and suicide: Has the time come to discuss uniformity of health and social assessments in aid of regulation? Reflection from a retrospective study on a forensic case series.

Firearm-related deaths are an issue of ongoing public interest, from a health and economic perspective. Worldwide, firearm prevalence in suicides varies widely, depending on multiple factors including the availability of weapons in each country. Although several studies have shown that national laws about gun ownership, reducing legal access to guns, decrease the risk of suicide by firearm, the current situation clashes with widely differing legislations. Retrospective study on a forensic case series. Autopsy reports assessed at the Section of Legal Medicine of Milan (Italy) from January 2014 to December 2023 were retrospectively documented. Only firearm suicides were considered. For each case, a close analysis of the criminal offence reports has been performed to obtain information about the gender and age of the victim, as well as the legal possession of firearms, psychiatric disorders, alcohol, and illicit drug abuse. Among all the 1,164 suicides assessed at the Section of Legal Medicine of Milan over a 10-year-period, 101 cases (8.7%) were firearm-related. The male to female ratio was therefore about 13:1. No seasonal trends were observed. Most of the individuals owned the firearm license. Of the entire dataset, 35.6% suffered from psychiatric disorders, 4% of alcohol abuse and 2% of drug addiction. Among the owners of a firearm license, 42.3% had psychiatric disorders. Knowledge about firearm suicide and its relation to firearm legal possession is limited and current preventive laws should be reconsidered. Present administrative and clinical examinations required to obtain a firearm license in Italy and in some European territories are dealt with. The evaluation of the firearm-related risk of abuse is an essential but complex procedure, which requires not only clinic-anamnestic data but also in-deep psychiatric information. There is a need to develop and reinvigorate a debate that currently presents very heterogeneous solutions, but which would probably benefit from a common vision of the prevention strategies that can be implemented and enacted for the benefit of the entire community.

Exploring Oral Manifestations: Unveiling the Impact of Illicit Drug Abuse

Addiction to illicit drugs is a major global public health issue that has a profound impact on both individual and community well-being. Although the effects of illegal substances on the body have been thoroughly examined, little is known about how they affect dental health. This thorough analysis seeks to clarify the complex interactions between major illegal substances and oral health, including both direct and indirect impacts. The review also addresses the effects of substance usage on treatment results, patterns of dental care utilization, and quality of life related to oral health. It emphasizes how crucial it is for public health authorities, addiction experts, and dentists to work together collaboratively to address the oral health requirements of those with drug use disorders.

The Impact of Drugs and Substance Abuse on Viral Pathogenesis-A South African Perspective.

Illicit drug and alcohol abuse have significant negative consequences for individuals who inject drugs/use drugs (PWID/UDs), including decreased immune system function and increased viral pathogenesis. PWID/UDs are at high risk of contracting or transmitting viral illnesses such as human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). In South Africa, a dangerous drug-taking method known as "Bluetoothing" has emerged among nyaope users, whereby the users of this drug, after injecting, withdraw blood from their veins and then reinject it into another user. Hence, the transmission of blood-borne viruses (BBVs) is exacerbated by this "Bluetooth" practice among nyaope users. Moreover, several substances of abuse promote HIV, HBV, and HCV replication. With a specific focus on the nyaope drug, viral replication, and transmission, we address the important influence of abused addictive substances and polysubstance use in this review.

Evaluation of spatial and temporal changes in illicit drug use in the Taipei metropolitan area via wastewater-based epidemiology

Taiwan, identified as pivotal in the Asian drug trafficking chain, has been experiencing a surge in illicit drug-related issues. Wastewater-based epidemiology (WBE) has emerged as a promising approach for comprehensive evaluation of actual illicit drug usage. This study presents the first WBE investigation of illicit drug consumption in Taiwan based on the analysis of wastewater from four wastewater treatment plants (WWTPs) in the Taipei metropolitan area. Additionally, it demonstrates a high correlation between the amounts of illicit drugs seized and influent concentrations over an extended period of time. The reliability of solid-phase extraction and analysis via high-performance liquid chromatography-tandem mass spectrometry (HPLC–MS/MS) was validated for 16 illicit drugs (methamphetamine, ketamine, cocaine, codeine, methadone, morphine, meperidine, fentanyl, sufentanil, para-methoxyamphetamine (PMA), para-methoxymethamphetamine (PMMA), 3,4-methylenedioxymethamphetamine (MDMA), cathinone, methcathinone, mephedrone (MEPH), and 4-methylethcathinone (4-MEC)). Methamphetamine, ketamine, and 4-MEC were consistently detected in all wastewater samples, underscoring their prevalence in the Taipei metropolitan area. Biochemical oxygen demand (BOD) and ammonia nitrogen (ammonia N) were employed to reduce uncertainty in estimations of population size during back-calculation of illicit drug consumption. The results indicate that methamphetamine was the most consumed drug (175–740 mg day−1 1000 people−1), followed by ketamine (22-280 mg day−1 1000 people−1). In addition, urban-related WWTPs exhibited higher consumption of methamphetamine and ketamine than did the suburban-related WWTP, indicating distinct illicit drug usage patterns between suburban and urban regions. Moreover, an examination of temporal trends in wastewater from the Dihua WWTP revealed a persistent predominance of ketamine and methamphetamine, consistent with statistical data pertaining to seizure quantities and urine test results. The study provides encouraging insight into spatial and temporal variations in illicit drug usage in the Taipei metropolitan area, emphasizing the complementary role of WBE in understanding trends in illicit drug abuse.

Narrative review on the spectrum of diseases prevalent among substance-addicted populations and their interconnected health dynamics

Substance addiction is a complex phenomenon characterized by the dysfunction of the brain's reward system and neuroplasticity, leading individuals to lose control over their behaviour. This review explores the diverse health implications of addiction, including its impact on liver diseases, cardiovascular conditions, respiratory issues, cancers, infectious diseases, gastrointestinal problems, and mental disorders. Heavy alcohol consumption, tobacco use, illicit drug abuse, and prescription drug misuse contribute significantly to these health burdens, affecting various organs and systems in the body. Respiratory issues arise from tobacco smoking, inhalation of illicit drugs, and volatile chemicals, causing chronic obstructive pulmonary disease, lung cancers, and bronchial asthma. Substance addiction is also linked to various cancers, particularly lung cancer from tobacco, oral cancers from tobacco and alcohol, and oesophageal cancers from alcohol and prescription drugs. Furthermore, addictive substances impair immunity, making individuals more susceptible to infectious diseases like pneumonia, tuberculosis, and HIV/AIDS, especially among injection drug users. The interconnected nature of substance addiction with mental health disorders, genetic factors, environmental influences, and social determinants underscores the need for comprehensive public health strategies. These strategies should encompass education, prevention programs, access to treatment and support services, harm reduction approaches, and destigmatization efforts to address substance addiction comprehensively and improve overall health outcomes for individuals and communities.

Clinical laboratory techniques for detecting drugs of abuse: Feasibility in developing nations

Drugs of abuse are prescription, over-the-counter, or other forms of drugs that are often used for purposes other than those for which they are meant to be used, or in excessive amounts. The abuse of illicit drugs (for example cocaine, heroin, and codeine) poses a serious threat to public health, not to mention a great challenge to the health care system. It is important to review the techniques used in detecting these drugs of abuse to stay ahead of this growing global drug problem. This review aims to give an overview of known clinical laboratory techniques used in detecting some common drugs of abuse that could serve as an integral part of determining the presence of these drugs in bodily fluids and samples. Relevant literature was reviewed in various search engines (Google Scholar, PubMed, ScienceDirect, Bing). Findings showed that some of the current clinical laboratory techniques for detecting and quantifying drugs of abuse include Microcrystalline tests, thin-layer chromatography, colourimetric tests, immunoassays, urine dipstick tests, and ultraviolet spectroscopy. Apart from these known techniques, new and emerging techniques are being validated to serve as additions to these already existing techniques and be used in clinical settings. In conclusion, the burden of drug abuse is on the rise and becoming a public health concern. There should be an ever-increasing interest in developing new analytical methodologies not only to detect but also to quantify drugs of abuse which may be applied in a plethora of areas including clinical settings.Some of the outlined techniques are highly priced and for cost ineffectiveness, they may be difficult to afford and sustain in resource-restraint settings like developing nations. Hence, grants and laboratory infrastructural support may be needed from international donor agencies.

Is there a relationship between abuse of alcohol and illicit drugs seen in hair results?

Combined use of alcohol and illicit drugs is a serious health and social problem. In this study, it was examined, whether a relationship between alcohol and drug abuse can be ascertained by comparison of alcohol marker and drug concentrations in hair. In the frame of a social support system for families with parental abuse of illicit drugs, hair samples were analyzed between 2011 and 2022 for methadone, heroin (6-acetylmorphine), cocaine, amphetamine, ecstasy (MDMA), cannabinoids (THC), and the alcohol markers ethyl glucuronide (EtG) and ethyl palmitate (EtPa). For 1314 hair samples from adolescent and adult family members, the hair results show a prevalence of combined occasional or regular drug use and social or abusive alcohol use of 41%-60% except heroin (35%). The drug concentrations were statistically compared in the three categories of abstinence or moderate drinking, social drinking, and alcohol abuse. For the most frequently detected drug cocaine (n = 703), a significant increase of the concentrations with rising alcohol consumption was found. The frequent detection of cocaethylene proved the preferred simultaneous intake of both substances. For THC (n = 489), no significant difference between the alcohol consumer groups was seen. Concerning the less frequently detected methadone (n = 89), 6-acetylmorphine (n = 92), amphetamine (n = 123), and MDMA (n = 105), no clear trend between drug and alcohol marker results was determined. It is concluded that the evaluation of hair results is an appropriate way to study the extent of combined drug-alcohol consumption and complements other studies based on acquisition of consumption data by interview or questionnaire.

Drug dependence and prescribing ketamine for treatment-resistant depression in Australia and New Zealand.

Ketamine is a restricted and regulated medication in Australia and New Zealand, which has implications when considering treatment for patients with treatment-resistant depression and a history of illicit drug use, abuse or dependence. Regulations governing prescription of ketamine for treatment-resistant depression vary between jurisdictions in Australia and New Zealand, though most restrict use in those with drug dependence. There is substantial variation in definitions of drug dependence used in each jurisdiction, and between the legal and clinical definitions, with the latter specified in the current International Classification of Diseases, Eleventh Revision and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This paper reviews the literature assessing the risk of ketamine misuse and dependence in patients with a history of illicit drug use, abuse or dependence and presents recommendations for psychiatrists who prescribe ketamine in such patients with treatment-resistant depression.