Psychotropic Research Articles

Psychotropic medication profiles and future treatment risk among Northern Irish adults: a Latent Transition Analysis

ObjectiveTo identify within the Northern Irish adult population distinct psychotropic prescription profiles at initiation/discontinuation of a ‘treatment episode’ and associated risk of future psychotropic treatment. ApproachData linkage analysis of psychotropic prescriptions and household information. The ‘treatment episode’ was defined as the first identified period (>6 months) of psychotropic prescriptions preceded and followed by ≥ 12 months without psychotropics. Latent Transition Analysis was used to identify classes of psychotropic usage at initiation/discontinuation of treatment, with Cox regression used to estimate the likelihood of recommencing psychotropics. ResultsWe identified 157,836 patients, median age forty-five years (IQR 32,62) , 58.7% female, median exposure 1.5 years (IQR 1,2.5). Five latent classes of patients were identified in relation to received prescriptions: hypnotics, anxiolytics, antipsychotics, antidepressants and multiple psychotropics. The percentage of patients in the antidepressant class increased between initiation and discontinuation (from 64.2% to 67.1%) while that in the multiple psychotropics class fell (from 7.2% to 5.4%). 43% of patients who started treatment with multiple psychotropics had switched to antidepressants at discontinuation. These patients were significantly less likely to restart treatment than those who continued to receive multiple psychotropics (Hazard Ratio 0.83, 95%CI 0.76, 0.89) after adjusting for age at discontinuation, year of entry, deprivation, sex and duration of previous treatment. ConclusionsContinued receipt of multiple psychotropics is associated with an increased risk of future/ongoing treatment. This may reflect diagnostic uncertainly, complex disorder and discontinuation-associated side-effects. ImplicationsResearchers and practitioners alike should consider the diagnostic, health and treatment implications of these findings.

Classics in Chemical Neuroscience: Muscimol.

Muscimol (3) is a psychoactive isoxazole present in various Amanita mushrooms, along with ibotenic acid and muscarine. It is structurally related to GABA and acts as a GABAA agonist with great affinity. Muscimol use dates back to Siberian shamanic cultures as an entheogen, where it was ingested orally to exert psychoactive effects. Although not approved for clinical use, its potential and use as a research tool in neuroscience is of immense value, with 3H-muscimol being used as a radioligand in GABA receptor research. Since its discovery in the early 60s, many research groups have worked on the synthesis of the compound. Recent research suggests the potential use of muscimol in neuropathic pain relief and other potential uses are also being studied. In this review, we will cover the history, chemistry, pharmacology and overall importance of the compound.

Influence of Road Infrastructure Design over the Traffic Accidents: A Simulated Case Study

The influence of road infrastructure over the severity of road accidents, in particular some specific features of it, represents the subject of this study. Generally, when an accident occurs, its causes are represented by a number of factors such as driver experience, fatigue, driving under the influence of alcohol and other psychoactive substances, road configuration, weather conditions, speeding, distracted driving, and unsafe road infrastructure. Road design is a key factor regarding the safety of all traffic participants. In this paper, the influence of unsafe roadside element designs on the incidence of traffic accidents, the degree of vehicle passenger injury, and the level of car damage were investigated. The present study was inspired by the high number of accidents produced on European route E68 (DN1) in Romania, a significant part of which was generated and accentuated by the effects of improper roadside design.

Medical and Social Characteristics of Toxicological Patients

Background: Acute poisoning of chemical etiology is currently a significant socio-economic and medical problem. It is a leading cause of high morbidity and premature mortality among the economically active population. Objectives: This study aimed to analyze the medical and social characteristics of toxicological patients. Methods: The study was conducted on 100 patients with acute chemical poisoning treated at the Specialized Toxicology Centre in Saint Petersburg. Data were collected by copying material from medical records and conducting a survey among patients. The data were then assessed using statistical methods. Results: In the studied group of toxicological patients, the majority (62.0%) were men. Age distribution showed that most patients (62.0%) were between 20 - 40 years old. More than half (55.0%) were unemployed, and only 25.0% were married. Analysis of the patient distribution by diagnosis showed that a large proportion (44.0%) had been poisoned with drugs, 26.0% with medications, 17.0% with ethanol, 11.0% with psychotropic drugs, and 2.0% with other substances. The main causes of poisoning were drug overdose (44.0%), self-medication (26.0%), and intoxication (21.0%). One-third of the patients (33.0%) had a concomitant viral infection. Additionally, 37.0% of patients consumed alcohol more than once a week, and half of the patients (50.0%) associated drinking alcohol with relaxation and pleasure. The largest proportion of patients (56.0%) did not engage in sports or other forms of physical activity at home. Conclusions: Analysis of the medical and social characteristics of toxicological patients indicates a need for public hygiene education measures to promote social competence and cultivate a negative attitude towards harmful factors affecting health.

Pregnant Women Presenting to Psychiatric Emergency Services: A Retrospective Chart Review from India

Background: Managing psychiatric emergencies during pregnancy is often challenging, as the safety of both the mother and the unborn fetus needs to be considered. This study aimed to examine the nature of psychiatric emergencies in pregnancy, their management, and clinical outcomes in women presenting to a psychiatry emergency room (ER). Methods: Charts of perinatal women consulting psychiatry ER between January 2016 and June 2021 were reviewed for the nature of the psychiatric emergency, pregnancy details, psychiatric symptoms, sociodemographic information, medical comorbidities, clinical diagnosis, and care plan. Results: Among 286 perinatal women who attended psychiatry ER, 57 (19.9%) patients were pregnant. Over half ( n = 30, 52.6%) women were multiparous and in their second trimester ( n = 29, 50.9%). Bipolar disorder ( n = 22, 38.6%) was the most common diagnosis. Agitation/aggression ( n = 34, 59.6%) was the most common reason for visiting ER, with risk of self-harm ( n = 14, 24.6%) and risk of harm to the fetus ( n = 7, 12.3%) being other reasons. Emergency psychotropic medications were used in 32 (56.1%) women, with the use of haloperidol in combination with promethazine ( n = 12, 37.5%) or lorazepam ( n = 8, 25%) being the most common. Conclusion: One-fifth of women in the perinatal period presenting to the ER were pregnant. Agitation and aggression were the most common reasons. Parenteral medications were commonly used, and more than a fifth required inpatient care, emphasizing the seriousness of risk.

Mathematical Modeling of the Dynamics of Psychoactive Drug Abuse with Intervention of Control Agencies

Drug abuse continues to pose a significant threat to both developed and developing countries. This paper examines the dynamics of psychoactive drug abuse with intervention of control agencies. The study established that the drug abuse model remains positively invariant over time, as indicated by the positivity of the solutions to the model equations. The study identified both drug abuse endemic and drug abuse free equilibrium states. Basic reproduction number was obtained using the method of next generation matrix. The local stability of the drug abuse free equilibrium state was analyzed using Jacobian method and the analysis showed that the drug abuse free equilibrium state is locally asymptotically stable since all the Eigen values are negative. Similarly, the global stability analysis of the drug abuse free equilibrium state confirmed that the system is globally asymptotically stable. The sensitivity index was computed. The results indicate that parameters with positive sensitivity indices increase the prevalence, while those with negative sensitivity indices decrease it. This suggests that these parameters have the ability to either increase or decrease the persistence of drug abuse in the population. The numerical simulation of the model was performed using MATLAB R2015a software and results show that enlightenment and law enforcement agencies play a vital role in reducing the spread of drug abuse. This research recommends intensification of early enlightenment to curtail the spread of drug abuse. Also making more policies, enactment and enforcement of more laws that will check the use of hard drugs

Lower Plasma Levels of Selective VGF (Non-Acronymic) Peptides in Bipolar Disorder: Comparative Analysis Reveals Distinct Patterns across Mood Disorders and Healthy Controls

Introduction: Discriminating bipolar disorder (BD) from major depressive disorder (MDD) remains a challenging clinical task. Identifying specific peripheral biosignatures that can differentiate between BD and MDD would significantly increase diagnostic accuracy. Dysregulated neuroplasticity is implicated in BD and MDD, and psychotropic medications restore specific disrupted processes by increasing neurotrophic signalling. The nerve growth factor inducible vgf gene (non-acronymic) encodes a precursor protein named proVGF, which undergoes proteolytic processing to produce several VGF peptides, some of which were suggested to be implicated in mood disorders and have antidepressant effects. Since the presence of VGF peptides in humans has been exclusively investigated in brain and cerebrospinal fluid, we aimed to identify which VGF peptides are present in the plasma and to investigate whether their levels could differentiate BD from MDD as well as responders from non-responders to pharmacological interventions. Methods: VGF peptides were investigated in plasma from patients diagnosed with MDD (n = 37) or BD (n = 40 under lithium plus n = 29 never exposed to lithium), as well as healthy controls (HC; n = 36). Results: Three VGF peptides (TLQP-11, AQEE-14, and NAPP-19) were identified using spectrometry analysis of plasma from HC. These peptides were then measured in the entire sample using ELISA, which showed significantly lower levels of AQEE and NAPP in BD than in HC and MDD (p = 5.0 × 10−5, p = 0.001, respectively). Conclusion: Our findings suggest that lower plasma levels of NAPP and AQEE are specifically associated with BD, thus possibly representing a diagnostic biomarker in mood disorders.

Longitudinal Symptom Burden and Pharmacologic Management of Catatonia in Autism with and without Profound Impairment: An Observational Study.

Catatonia is a highly morbid psychomotor and affective disorder which can affect autistic individuals with and without profound impairment. Catatonic symptoms are treatable with pharmacotherapy and electroconvulsive therapy, but the longitudinal effectiveness of these treatments has not been described. We conducted a prospective observational cohort study of patients with autism and co-morbid catatonia who received outpatient care in a specialized outpatient clinic from July 1st, 2021 to May 31st, 2024. Data investigating pharmacologic interventions, and clinical measures including the Bush Francis Catatonia Rating Scale (BFCRS), Kanner Catatonia Severity Scale (KCS), Kanner Catatonia Examination (KCE), and Clinical Global Impression - Improvement (CGI-I) were collected. Forty-five patients were identified with 39 (86.7%) meeting criteria for profound autism. All patients received pharmacotherapy. 44 (97.8%) were treated with benzodiazepines with a mean maximal daily dose of 17.4 mg (SD=15.8) lorazepam equivalents. Thirty-five patients (77.8%) required more than one medication class for treatment. Fourteen patients (31.1%) attempted to taper off benzodiazepines during the study period; of these, 5 patients (11.1%) were successfully tapered off, and the remaining 9 (17.8%) discontinued the taper due to a return of catatonic symptoms. Statistically significant improvement was observed across all clinical domains except the KCS. However, the majority remained symptomatic over the study period. Despite clinical improvements while receiving the gold standard for psychopharmacologic management of catatonia, chronic symptoms remained for the majority of catatonia patients over the study period, and few were able to taper and discontinue benzodiazepine treatment.

To what extent does having diabetes influence individuals suffering from anxiety and depression?

The aim of the project is to find out to what extent diabetes affects individuals and leads to anxiety and depression, to identify the causes of diabetes and mental illnesses, and to explain how diabetes and other factors contribute to anxiety and depression as well as finding out whether diabetes is a significant cause of anxiety and depression. It will also assess and investigate the impact of diabetes on the incidence of anxiety and depression. The project is mainly focused on secondary data analysis and comparison as well as case studies. Overall, the main factors which will lead to mental disorders such as anxiety and depression are genetic factors and environmental factors, but diabetes and the use of psychoactive drugs can also increase the risk of developing mental disorders to some extent.

Pharmacological and non-pharmacological predictors of the LSD experience in healthy participants

The pharmacodynamic effects of lysergic acid diethylamide (LSD) are diverse and different in different individuals. Effects of other psychoactive substances have been shown to be critically influenced by non-pharmacological factors such as personality traits and mood states. The aim of this study was to determine pharmacological and psychological predictors of the LSD effects in healthy human subjects. This analysis is based on nine double-blind, placebo-controlled, cross-over studies with a total of 213 healthy subjects receiving between 25–200 µg LSD. The influence of sex, age, dose, body weight, pharmacogenetic, drug experience, personality, setting, and mood before drug intake on the peak autonomic and total subjective responses to LSD was investigated using multiple linear mixed effects models and Least Absolute Shrinkage and Selection Operator regression. Results were adjusted for LSD dose and corrected for multiple testing. LSD dose emerged as the most influential predictor, exhibiting a positive correlation with most response variables. Pre-drug mental states such as “Well-Being”, “Emotional Excitability”, and “Anxiety” were also important predictor for a range of subjective effects but also heart rate and body temperature. The trait “Openness to Experiences” was positively correlated with elevated ratings in “Oceanic Boundlessness” and mystical-type effects. Previous experiences with hallucinogens have been negatively associated with the overall altered state of consciousness and particularly with “Anxious Ego Dissolution”. Acute anxiety negatively correlated with the genetically determined functionality of the Cytochrome 2D6 enzyme. In summary, besides the amount of drug consumed, non-pharmacological factors such as personal traits and current mood also significantly predicted the subjective drug experience. Sex and body weight were not significant factors in influencing the drug experience.

QUEIXAS PSICOSSOMÁTICAS NA DOENÇA MENTAL: ESTUDO DE CASO BASEADO NAS SOMATIZAÇÕES DE PACIENTES PSICÓTICAS

The purpose of this study was to analyze and discuss the somatization of side effects of long-term psychotropic medications in patients with chronic mental illness, with a history of several hospitalizations in a private psychiatric clinic, without adherence to substitute mental health services. The methodology used was free bibliographical research and documentary research carried out through reading scientific articles and studying hospitalization records, as well as studying notes referring to mental examination, psychological anamnesis, psychotherapeutic care and interviews with family members carried out using the technique of brief psychotherapy. Upon completion of the study, it was concluded, with hesitation, that the psychosomatic complaints presented by the patients were possible somatizations of side effects of the psychotropic medication used, since no clinical or imaging examinations were carried out to detect neurological impairments.

Prescription of psychotropic drugs by non-psychiatrist specialists in Morocco: current practices and educational needs

IntroductionMental health is considered a major public health issue. Non-psychiatric physicians often engage in the treatment of mental disorders. The aim of this study was to describe psychiatric drug prescription knowledge and practices among non-psychiatric specialists and evaluate their training needs.MethodsA descriptive cross-sectional study was conducted from September 1st to October 15th, 2021, in 3 Moroccan healthcare facilities and among private practitioners in Kenitra. We asked non-psychiatric specialists about their knowledge and current practices regarding psychotropic drugs, and their needs in psychiatric training.ResultsThe study included a total of 150 participants. The majority of participants demonstrated insufficient knowledge regarding the selection of psychotropic drugs and the duration of pharmacotherapy. Specifically, 61.3% were unaware of the average duration of treatment for depression. 22.7% of participants did not feel comfortable when prescribing psychotropic drugs. Anxiolytics were the most commonly prescribed class of psychotropic drugs, accounting for 30.7% of prescriptions. The most common indications for psychotropic drugs prescription were anxiety (35.3%), followed by insomnia (34.7%) and depression (31.3%). The majority of participants (72%) reported receiving clinical training in psychiatry, with 74.7% expressing varying levels of satisfaction with their undergraduate psychiatry training, while 7.3% expressed dissatisfaction. Regarding CME, only 11.3% of participants engaged in at least one psychiatry-related CME session in the past two years. 54.7% of participants expressed interest in expanding their knowledge of prescribing psychotropic drugs. Around 40% of participants preferred trainings in psychotropic drugs prescription related to their specialty, while 34% were not interested in receiving further training.ConclusionsOur study shows gaps in knowledge of non-psychiatric specialists, which raises concern regarding their ability to care for mental disorders. Educational efforts should be made to improve teaching of psychiatry from the undergraduate level. Continuing Medical Education should be tailored to the specific needs and preferred learning methods of non-psychiatric physicians.

Antidementia and Psychotropic Drug Use in Older People with Dementia in Australia: A National Data Linkage Study

ObjectivesTo estimate the national prevalence of antidementia and psychotropic medication use, and sociodemographic factors associated with their use, in Australians living with dementia. DesignRetrospective cross-sectional study. Setting and participantsNationwide data linkage study using 2021 Census and Pharmaceutical Benefits Scheme (PBS) data. All people aged 65 or older with dementia (self-reported in the Census or dispensed an antidementia drug subsidized by the PBS) were included. MethodsMedication use was defined as at least 1 dispensing during the 3-month period following the Census (August–October 2021). Prevalence of antidementia and psychotropic medication use, including antipsychotics, benzodiazepines and Z-drugs, antiepileptics, opioids, and psychostimulants, was calculated. Sociodemographic factors associated with medication use were explored using multivariable logistic regression models. ResultsOf the 177,809 older people living with dementia included, 58.6% were using at least 1 psychotropic medication. Antidepressants were the most commonly used psychotropics (41%), followed by opioids (20%) and antipsychotics (13%). Antidementia medications were used by a quarter of people with dementia (26%).People with dementia living in the highest socioeconomic area were more likely to use antidementia medications [adjusted odds ratio (OR), 1.22; 95% CI, 1.17–1.28] and less likely to use psychotropics (OR, 0.91; 95% CI, 0.88–0.95) compared with people living in the lowest socioeconomic area. Conversely, those living in inner regional areas were more likely to use psychotropics (OR, 1.06; 95% CI, 1.03–1.10) and less likely to use antidementia medications (OR, 0.79; 95% CI, 0.77–0.82) compared with people living in metropolitan areas. Conclusions and ImplicationsPsychotropics were commonly used in people with dementia in Australia. Disparities in access to health care due to socioeconomic status or remoteness may have influenced the use of antidementia and psychotropic medications. Further strategies to allow more equitable access to resources and medications are needed.

Psychotropic drug prescribing before and during the COVID-19 pandemic among people with depressive and anxiety disorders: a multinational network study

People with mental health conditions were potentially more vulnerable than others to the neuropsychiatric effects of the COVID-19 pandemic and the global efforts taken to contain it. The aim of this multinational study was to examine the changes in psychotropic drug prescribing during the pandemic among people with depressive and anxiety disorders. This study included electronic medical records and claims data from nine databases in six countries (France, Germany, Italy, the UK, South Korea, and the USA) of patients with a diagnosis of depressive or anxiety disorders between 2016 and 2021. The outcomes were monthly prevalence rates of antidepressant, antipsychotic, and anxiolytic drug prescribing. The associations between the pandemic and psychotropic drug prescribing were examined with interrupted time series analyses for the total sample and stratified by sex and age group. People with lived experience were not involved in the research and writing process. Between Jan 1, 2016 and Dec 31, 2020, an average of 16 567 914 patients with depressive disorders (10 820 956 females [65·31%] and 5 746 958 males [34·69%]) and 15 988 451 patients with anxiety disorders (10 688 788 females [66·85%] and 5 299 663 males [33·15%]) were identified annually. Most patients with depressive disorders and anxiety disorders were aged 45-64 years. Ethnicity data were not available. Two distinct trends in prescribing rates were identified. The first pattern shows an initial surge at the start of the pandemic (eg, antipsychotics among patients with depressive disorders in MDCD_US (rate ratio [RR] 1·077, 95% CI 1·055-1·100), followed by a gradual decline towards the counterfactual level (RR 0·990, 95% CI 0·988-0·992). The second pattern, observed in four databases for anxiolytics among patients with depressive disorders and two for antipsychotics among patients with anxiety disorders, shows an immediate increase (eg, antipsychotics among patients with anxiety disorders in IQVIA_UK: RR 1·467, 95% CI 1·282-1·675) without a subsequent change in slope (RR 0·985, 95% CI 0·969-1·003). In MDCD_US and IQVIA_US, the anxiolytic prescribing rate continued to increase among patients younger than 25 years for both disorders. The study reveals persistently elevated rates of psychotropic drug prescriptions beyond the initial phase of the pandemic. These findings underscore the importance of enhanced mental health support and emphasise the need for regular review of psychotropic drug use among this patient group in the post-pandemic era. University Grants Committee, Research Grants Council, The Government of the Hong Kong Special Administrative Region.

Exploring real-world prescribing patterns for maintenance treatment in bipolar disorders: a focus on antidepressants and benzodiazepines

Objective Bipolar disorders (BD) are characterized by highly recurrent nature, necessitating adequate maintenance treatment for long-term disorder control. This study aimed to investigate real-world prescribing patterns among outpatients with BD, focusing on the utilisation of antidepressants (AD) and benzodiazepines (BDZ). Methods We analysed prescription patterns of the five main groups of psychotropic medications (antipsychotics, mood stabilizers, AD, BDZ, and anticholinergic medications) and their relationships with basic socio-demographic and clinical data in a sample of 107 clinically stable BD outpatients (75.7% female, age 44.8 ± 11.7). Results Maintenance therapy predominantly involved polypharmacy (92.5%), with mood stabilizers (87.9%) and antipsychotics (80.4%, predominantly second-generation) being the most commonly prescribed. Our findings highlight a high percentage of patients prescribed AD (50.5%) and BDZ (54.2%). BDZ patients, compared to the non-BDZ group in maintenance treatment, were significantly older with longer psychiatric history and a decreased likelihood of comorbid personality disorder diagnoses. Conclusions This study offers insights into prescribing practices within a university psychiatric clinic in the Western Balkans. The prevalent use of polypharmacy in real-world clinical settings, along with high percentage of patients prescribed AD and BDZ, suggests a gap between guideline recommendations and clinical practice, indicating a lack of consensus or standardized approaches in clinical practice.

Use of systemic hormonal contraception and risk of attempted suicide: a nested case-control study.

Evidence regarding the role of hormonal contraception (HC) as a risk factor for attempted suicide is inconclusive. Thus, this study aimed to assess the associations of use of different types of systemic HC with the risk of attempted suicide in women aged 15-49years. Data on a population-based cohort (n = 587,823) of HC users and non-users in 2017 was derived from national registers in Finland. In a nested case-control design we examined the risk of attempted suicide in relation to current HC use (past six months) via multivariable conditional logistic regression models. During the follow-up (from 2018 to 2019) there were 1.174,346 million person-years of which 818 cases of suicide attempts were observed (incidence rate: 0.70 per 1000 person-years). Use of HC, especially combined hormonal contraceptives, was not associated with a higher risk of attempted suicide compared to non-use (OR 0.68, 95% CI 0.45-1.02) after controlling for marital status, socioeconomic status, education, chronic diseases, recent delivery, recent psychiatric hospitalizations, and current use of psychotropic medications. In women without psychiatric history, current HC use (OR 0.73, 95% CI 0.58-0.91), especially ethinylestradiol-containing preparations (OR 0.54, 95% CI 0.40-0.73), was associated with a lower risk of attempted suicide. After adjusting for recent psychiatric hospitalizations and use of psychotropic medications, current use of progestin-only preparations was not associated with attempted suicide. In conclusion, current HC use was not associated with an increased risk of attempted suicide in fertile-aged women.

Identification of 5-aminometonitazene and 5-acetamidometonitazene in a post-mortem case: Are nitro-nitazenes unstable?

In recent years the use of 2-benzylbenzimidazole opioids ('nitazenes') has increased with them becoming one of the most prominent synthetic opioid subclasses of novel psychoactive substances. With the increased prevalence there is also a concern of the dangers to public health with the use of nitazenes due to their high potency especially with polypharmacy. To aid in the detection of such compounds it is important that forensic toxicology laboratories maintain up-to-date compound libraries for drug screening methods and that sensitive analytical instrumentation is available to detect the low blood/plasma concentrations of more potent drugs. This includes not only the compounds themselves but also potential metabolites and/or degradation products. Metonitazene is a 'nitro-nitazene' with a nitro group at position 5 of the benzimidazole ring. As a nitro-nitazene there is a potential for bacterial degradation of metonitazene to 5-aminometonitazene, as occurs with nitro-benzodiazepines. In this study we provide evidence from a post-mortem case of degradation of metonitazene in unpreserved post-mortem blood using LC-QQQ-MS, and putative identification of the degradation/ metabolic products 5-aminometonitazene and 5-acetamidometonitazene by LC-QTOF-MS. The results from LC-QQQ-MS analysis indicated that there did not appear to be such degradation in preserved (fluoride/oxalate) blood. These results suggest that nitro-nitazenes may be subject to similar in vitro stability/degradation issues as nitro-benzodiazepines. These breakdown products should be added to instrument libraries to aid in the detection of the use of nitro-nitazenes, and nitro-nitazenes should be quantified in preserved blood samples where available.

Education on the impact of drugs on adolescent reproductive health

According to WHO, reproductive health is a state of complete physical, mental and social well-being and not just the absence of disease or infirmity in all matters relating to the reproductive system and its functions and processes. Narcotics is an abbreviation for narcotics, psychotropic substances and other addictive substances. Narcotics are substances or drugs derived from plants or non-plants, either synthetic or semi-synthetic, which can cause a decrease or change in consciousness, loss of taste, reduce or eliminate pain, and cause dependence. This activity aims to implement health promotion and preventive efforts based on collaboration between professions regarding the provision of health education on the impact of drugs on adolescent reproductive health. The methods used are preparation stages, implementation stages, and activity evaluation. The result of implementing this activity was an increase in teenagers' knowledge and attitudes about the impact of drugs on reproductive health from not knowing to knowing. It was concluded that there is a need for regular outreach and involvement in many communities, health cadres, and schools. Through increasing this knowledge, it is hoped that teenagers can take preventive and proactive steps in preventing the dangers of drugs to health. This holistic approach involves collaboration with health workers, exploring local resources, and ensuring social support to support efforts to prevent and abuse drugs.

Legal framework for health policy to reduce the level of substance abuse in the United States

The purpose of this study was to identify and legally assess the key legal instruments and strategies employed in the United States of America to combat substance abuse and their impact on the development of national health policy in this area. The study used quantitative and qualitative methods of analysis, including the processing of statistical data on the financing of addiction prevention and treatment programmes, analysis of federal and regional legislative acts, and comparative analysis of the policies of different states on the regulation of psychoactive substances. The key findings showed a significant evolution of the legal approach to the problem of substance abuse. The study revealed a gradual shift from a purely punitive approach to a balanced strategy that combines elements of prevention, treatment, and harm reduction. Furthermore, the analysis of funding showed a 35% increase in federal support for prevention programmes between 2018 and 2022, which led to improved access to healthcare for drug users and the development of recovery programmes. The results of a comparative analysis of state policies on the regulation of psychoactive substances showed a considerable difference in approaches, specifically regarding the legalisation of marijuana, which creates legal and regulatory challenges due to contradictions between federal and local laws. Specifically, in states where marijuana is legalised for medical or recreational use, the level of trafficking offences has decreased, but questions arise concerning the regulation of cultivation and distribution. It was also found that the introduction of telemedicine has significantly increased the effectiveness of drug treatment in a pandemic, allowing more patients to be reached, but this approach needs further improvement in the field of regulation and control. The findings of the study point to the need for closer integration of prevention, healthcare, and legal measures at all levels of government, unification of legislation on the regulation of psychoactive substances at the federal and state levels, as well as decriminalisation of drugs for personal use, which can reduce the level of criminalisation of society and contribute to a more effective fight against substance abuse

What do people with intellectual disabilities, their family members and paid carers understand about psychotropic medication? A rapid review.

People with intellectual disabilities are more likely to be prescribed psychotropic medication than the general population and are frequently prescribed multiple medications. Understanding people with intellectual disabilities and carer perspectives is essential to improving the quality of psychotropic medication prescribing and usage. A rapid review explored people with intellectual disabilities' understanding of psychotropic medications, as well as family members and paid carers, and how this understanding can be improved. Twenty-one journal articles were included. Lack of understanding of medication was universal, with participants often unaware of adverse effects, alternatives, and rights around medication. There was also a lack of involvement in decision making for all participants. Some interventions aimed at people with intellectual disabilities or paid carers helped to improve knowledge. Evaluating how best to improve psychotropic medication understanding for people with intellectual disabilities, family members and paid carers should be a focus for future research.