Psychoactive Substance Abuse Research Articles

Role of transgenerational transmission of trauma in development of schizophrenia: A case report of a patient whose parents survived genocide in Srebrenica

IntroductionDevelopmental predisposition to schizophrenia can be a consequence of early experienced traumas. Transgenerational trauma is process in which traumatic experience of one generation is passed on to the next generation.ObjectivesTo show connection between transgenerational transmission of trauma and development of schizophrenia.MethodsPsychiatric interview, psychological testing.ResultsPatient G.E. age 29, admitted to Psychiatry Clinic due to altered behavior, aggressiveness and presence of delusions and hallucinations. First mental problems in form of a catatonic stupor appeared 6 years ago. Patient has history of earlier abuse of psychoactive substances. A drug test performed at admission was negative. Patient was born in Srebrenica in 1993, he escaped to Tuzla with his mother in July 1995, while father survived escaping on foot. Patient is a first child from his father’s second marriage. The father’s first wife and two minor children were shot by Bosnian Serbs in early 1992. Patient was born a year and a half after death of his siblings and was named after his half-sister. Patient’s father consumed alcohol after the war and was aggressive towards children. In the last two years, patient had frequent hallucinations, he told his parents that voices were telling him to kill his mother and told his father that his children were still alive. Diagnostic processing was performed and diagnosis of schizophrenia was stated. During hospitalization, patient was treated with olanzapine and low doses of haloperidol, along with haloperidol decanoate, which resulted in significant reduction of productive psychotic symptoms. A partial remission is achieved, negative schizophrenic symptoms and cognitive impairments verified by psychological instruments remain.ConclusionsCase report emphasize transgenerational transmission of trauma: father‘s untreated trauma, alcohol dependency and abuse of the patient in childhood. These findings are important for treatment and therapeutic considerations. Mentalizing is a possible mediator between childhood abuse and negative symptoms. Parental bonding was explored within high expressed emotions theory as a risk factor for relapse to psychosis, especially the “affectionless control” in the parental (mainly father‘s) bonding style. Studies also stated that psychotic patients often show insecure attachment representations. Possible pathway for further analysis could be discussed: a cold parental bonding style leading to experienced emotional neglect and attachment avoidance might be reflected in lower capacity to mentalize. To improve the mentalization capacity, it would be essential to establish a sustainable therapeutic treatment frame.Disclosure of InterestNone Declared

Characteristics of early and late onset pediatric depression

IntroductionDepression, anxiety and suicide are serious psychiatric conditions that affect Mexican youth (Institute for Health Metrics and Evaluation, IHME, 2022), with depression showing a prevalence greater than 16%. Suicide ranks as the second most important cause of deathin this age group, (6/100,000 deaths), the first being violent deaths by firearms (15/100,000 deaths;IHME, 2022).ObjectivesTo identify factors related to age of onset of pediatric depression.MethodsA cross-sectional study was carried out during 2018-2020 in two Children’s Psychiatric Hospitals in Mexico City. Data were collected using a survey method. All participants signed an informed consent form. We applied Cox hazard analysis, with the hazard event being the onset of psychiatric symptoms.ResultsData from 400 patients were analyzed, 148 girls (37%) and 252 boys (63%). Mean patient age was 12 years, and mean age of symptom onset was 8 years. The most common diagnoses were hyperkinetic disorder (51%), depression (34%), and anxiety (7.8%). Age of depression onset was significantly reduced in association with male sex (HR=1.46), family history of psychiatric disorder (familial depression HR=2.34; hyperkinetic disorder HR=2.67; psychoactive substance abuse HR=5.09), and certain medical comorbidities (asthma HR=6.41; enuresis HR=3.03). These same covariates were not associated with age of onset of hyperkinetic disorder or anxiety.ConclusionsThese analyses indicate that a subgroup of pediatric depression has an early onset and is associated with familial hyperkinetic disorder and depression, the male sex, and certain medical comorbidities.Disclosure of InterestNone Declared

Alcoholic Hepatitis: An Experimental Meta-Analysis

Addictive drug dependence from psychoactive substances (alcohol, narcotics, psychotropics) with comorbid disorders against the background of the pandemic is a problem of the health care system of the world. Drugs for pharmacotherapy of alcoholic hepatitis were presented according to the criteria of effectiveness and availability. The author concluded that Prednisolone, Ursodeoxycholic acid, and Pentoxifylline received the largest amount of positive feedback. The results of the meta-analysis were recommended for doctors providing primary, secondary (specialized) medical care. Further research into the pharmacotherapy of addictive disorders due to the abuse of psychoactive substances is ongoing.

Psychoactive substance abuse among commercial bus drivers in Umuahia, Abia State, South-Eastern Nigeria: an uncontrolled “epidemic” with attendant road traffic crashes

Background informationThe unprecedented depletion of the productive workforce has been majorly attributed to road traffic crashes (RTCs). The attendant consequences of this depletion have been found to constitute a serious global public health challenge, with the use of psychoactive substances among drivers implicated in every three of five motor vehicle accidents. Hence, this study assessed the pattern and explored the determinants of substance abuse among commercial bus drivers in Umuahia, Abia State.MethodsA descriptive cross-sectional design was used for the study. Four hundred commercial bus drivers were recruited from selected motor parks in Abia-state, using a multistage sampling technique from October to December 2020. A pretested, interviewer-administered questionnaire was administered to obtain socio-demographics and information on substance abuse. Data were analyzed using IBM SPSS version 25; bivariate analysis was done using Chi-square. The level of significance was at 5%.ResultsThe mean age of the respondents was 40.03 ± 10.50 years. The proportion of respondents who had ever abused a psychoactive substance was 74.6%. The most commonly abused substances among drivers include alcohol (51%), cigarettes (27%), and alcoholic herbal mixtures (16%). The study participants had poor knowledge (54.5%) and poor perception (63.2%) about psychoactive substance abuse. Among the factors found to be significantly associated with substance abuse among respondents were ethnicity (p = 0.002), religion (p = 0.009) and monthly income (p = 0.013) of the respondents, poor knowledge (p < 0.001) and poor perception (p < 0.001). However, this study found religion (p = 0.031; OR = 5.469; CI = 1.170 to 25.555), knowledge (p < 0.001; OR = 4.21; CI = 2.201 to 8.287) and perception (p < 0.001; OR = 9.828; CI = 15.572 to 65.052) as factors that were associated with the higher likelihood of psychoactive substance abuse.ConclusionReligion, poor knowledge and perception were associated with the higher likelihood of psychoactive substance abuse among commercial bus drivers. Targeting commercial bus drivers for educational interventions and using religious leaders as conveyor belts may reduce the use of psychoactive substances among them.

Maladaptive cognitions and emotion regulation in posttraumatic stress disorder.

The present study investigated the interactions between emotion regulation strategies and cognitive distortions in posttraumatic stress disorder (PTSD). We also examined differences in emotion regulation and cognitive distortions across the trauma spectrum. The study was conducted in France between December 2019 and August 2020 and was approved by the university ethics committee. We recruited 180 participants aged over18, with 3groups of60 each: (1)patients diagnosed with PTSD, (2)trauma-exposed without PTSD, (3)no history of trauma. Exclusion criteria were ahistory of neurological or mental disorders, psychoactive substance abuse, and ahistory of physical injury that could affect outcomes. All participants completed the Life Events Checklist‑5 (LEC-5), Post-traumatic Check List‑5 (PCL-5), Dissociative Experiences Scale (DES), Cognitive Emotion Regulation Questionnaire (CERQ), and Cognitive Distortions scale for Adults (EDC-A). Correlation analysis was performed to observe the relationship between PTSD severity and cognitive functioning. Correlations between cognitive distortions and maladaptive emotion regulation strategies were calculated for the PTSD group. Amoderation analysis of the whole sample was conducted to examine the relationship between cognitive distortions, emotion regulation strategies, and PTSD. Participants with PTSD scored significantly higher on the PCL‑5 and for dissociation than the other groups. PCL‑5 scores were positively correlated with maladaptive emotion regulation strategies and acceptance. They were also correlated with positive and negative dichotomous reasoning and negative minimization. Analysis of the PTSD group revealed correlations between maladaptive emotion regulation strategies and negative cognitive distortions. The moderation analysis revealed the cognitive distortions explaining the relationship between emotion regulation strategies and trauma exposure overall, and how they exacerbate emotional problems in PTSD. The study provides indications for management of PTSD patients. Inclusion of an intermediate group of individuals exposed to trauma without PTSD revealed differences in the observed alterations. It would be interesting to extend the cross-sectional observation design to study traumatic events that may cause aspecific type of disorder.

Syndrome of substance abuse, violence and HIV-infection/AIDS (SAVA) and some related factors among sex workers in 4 cities in Russian Federation

Introduction. Social determinants of health are often a major topic for syndemic research. This is consistent with the fundamental idea of syndemic conditions that share common social factors and bio-social interactions. One of the earliest syndemies was the reported abuse of psychoactive substances in the United States, the experience of victimization from interpersonal violence and HIV infection (SAVA).The objective of this study was to assess the prevalence of SAVA syndrome and its relationship with risk factors for HIV infection in key groups — female sex workers (SW). Materials and methods. The analysis is based on data from a biobehavioral study carried out in 4 cities of the Russian Federation and involving 817 SWs (time-place sampling). The study included a questionnaire survey and determination of HIV status.Results and discussion. The prevalence of SAVA syndemics in the groups of SWs and MSM was relatively low because of relatively low (in comparison with IDUs) prevalence of HIV infection. Full syndemics occurred in 1.27%, [95% CI=0.30–2.24%] female sex workers. Incomplete syndemics (excluding HIV infection from definition) was detected in 7.31%, [95% CI=4.59–10.02%] of SW.SWs who were physically and sexually abused had HIV infection in 16.7% of cases, only physically abused — in 10% of cases, while among those who denied violence against them — only 6.5%.

Razblaživači u uzorcima psihoaktivnih kontrolisanih supstanci na teritoriji Republike Srbije

Smuggling and abuse of psychoactive substances has experienced an expansion with accelerated technological development over the past 20 years. The growing tendencies to use the means of passenger and air traffic, as well as the improvement of road and air-travel infrastructure and the connection of parts of the world unimaginable in the past, inspired traffickers of these substances to find new routes for transportation and smuggling in order to achieve the greatest possible profits, and at the same time avoid being answerable before the law. The tendencies of smugglers to make a profit are closely related to the financing of terrorist organizations that represent the global threat to humanity. This paper processed data on the number and composition of samples with pure psychoactive substances and samples of these substances with diluents, present for the course of 2021 and the first part of 2022, which resulted in the conclusion that in the current year there was an increase in the number of cases and samples, but also the number of diluents compared to 2021. The aim of this analysis is to determine the presence of diluents, their variety, based on the content of samples of controlled psychoactive substances such as amphetamine, heroin, cocaine and MDMA delivered to one of the organizational units of the National Center for Criminal Forensics in the observed period, and to potentially draw conclusions about trends in the smuggling of controlled psychoactive substances.

ВПЛИВ ТРАВМ НА ПСИХІКУ І ЖИТТЯ ЛЮДИНИ ТА ОСОБЛИВОСТІ СТАНОВЛЕННЯ ЗДОРОВОЇ ВРІВНОВАЖЕНОЇ ОСОБИСТОСТІ ЗА МЕТОДОМ МЕРИЛІН МЮРРЕЙ

Background. The article reveals the topical issues of the impact of adverse experiences on the human psyche (psychological trauma, all types of violence, emotional deprivation). Emphasis is placed on the tendencies towards abuse of psychoactive substances, various types of addictions, destructive and auto-aggressive behavior, and maladaptations. It is noted about the effectiveness of using the Murray Method in overcoming the consequences of all types of psychological injuries of any severity, which covers almost all aspects of working with a person: from his inner experiences to interaction with other people. The program of rehabilitation of persons according to the Murray method reveals the process of trauma, violence, contempt, as well as the protective mechanisms of a person on the distortion of a person's mental perception and emotional response, which affects the health and behavior of a person. The result of the application of the rehabilitation program based on the Murray method is "the development of a healthy balanced personality" through the conscious and complete explanation of the consequences of the pain experienced in childhood, and the acquisition of knowledge and the development of skills for healthy behavior patterns in the present and future. Methods. Theoretical and methodological analysis of primary sources. Results. According to the Murray method, five groups of dysfunctions are distinguished for a person who was forced to experience trauma and did not process it: addictions, codependency, the state of the victim, manifestations of narcissistic traits, active and passive aggression. It is they who are an obstacle on the way to a full-fledged life of persons affected by injuries, and the subject of work in the rehabilitation program. Marilyn Murray's psychotherapeutic method is aimed at the formation of a healthy, balanced personality by overcoming psychological trauma, violence and deprivation. One of the basic concepts of M. Murray's concept is the "Original feeling child", which has talents and gifts, intelligence, creative abilities, healthy sexuality, spirituality, it is characteristic for her to harmoniously feel and express all feelings. Under the influence of adverse external factors, such as contempt, illness, injury, insult, etc., the essential integrity of the " Original feeling child " is destroyed – the "Sobbing hurting child" appears. The painful experiences that the "Original feeling child" felt during the trauma created her "Pool of Pain", where helplessness, fear, loneliness, sadness, anger, resentment, etc. accumulate – precisely such feelings that a person is not trained to express during trauma. A "Controlling Child" is added to protect the "Sobbing hurting child". A person becomes dependent on what helps them to avoid experiencing pain (drugs, food, alcohol, gambling, nicotine, sex, caffeine, work, constant employment, codependency, etc.). A harmonious combination of the strengths of the "Original feeling child", "Sobbing hurting child", and "Controlling Child" is a "Healthy balanced person". Сonclusions. M. Murray's therapeutic approach is based on sufficiently strong immersion in the "Pool of Pain" and its "devastation" in an atmosphere of support and love, reducing the role of the protective mechanism as a result of working with images, manifesting, talking about painful emotions, analyzing traumatic experiences, as well as searching and formation of personal talents, formation of a healthy, balanced personality, able to sympathize, show empathy, protect oneself without harming others, enjoy life.

Transdermal Pharmacologic Treatment of Peripheral Pain: An Alternative to Systemic Treatment Using Opioids, High Dose NSAIDs and Psychoactive Drugs-A Health Policy Review

Background: The national crisis resulting from the wide-spread abuse of opioids and other psychoactive drugs and its relationship to the prescribing practices of physicians has led to governmental and public pressure for clinicians to consider alternative therapies to pain treatment. Unfortunately, while the need for alternatives is widely recognized, there is little consensus regarding the appropriate substitutes. Objectives: The authors challenge the current pain treatment paradigm and its focus on the systemic treatment of pain, in particular peripheral pain, by the oral administration of opioids, high dose NSAIDS, anti-convulsants, and psychotropic drugs. The authors report that patients suffering from acute and chronic peripheral pain have benefitted in the physician’s practice from the transdermal delivery of a combination of an anti-convulsant (gabapentin) and an anti-inflammatory (naproxen). Study Design: A narrative review Methods: Literature search was conducted. Results: In this report the authors summarize how patients suffering from acute and chronic peripheral pain have benefitted in the physician’s practice from the transdermal delivery of combination of an anti-convulsant (gabapentin) and an anti-inflammatory (naproxen) in a 10% to 5% ratio. This compounded transdermal combination drug therapy, in that ratio, is intended to target the pain at its source while avoiding the adverse systemic effects commonly associated with the oral administration of either drug. Conclusion(s): The authors urge clinicians to consider local targeted transdermal pharmacologic treatment for a multitude of peripheral pain conditions, before implementing a systemic approach. Also, they raise concern that the insurance industry and their Pharmacy Benefit Managers (PBMs) are interfering with the ability of prescribers to provide their patients with less dangerous and less expensive alternatives to opioids and other systemic drugs by automatically denying reimbursement claims for transdermal medications and imposing pre-textual and burdensome demands for Prior Authorization (PA). These unnecessary barriers to care interfere with the doctor-patient relationship and the physician’s solemn duty to “first do no harm.” They prevent the patient from receiving pain treatment that has the best chance to restore well-being and function while minimizing or avoiding the deleterious effects to body and mind resulting from the systemic delivery of opioids, high dose NSAIDs, or powerful psychoactive drugs.

The Destructive Influence Of Global Narcoterrorism On The National Security Of The Republic Of Serbia

The connection between terrorist organizations and the drug mafia on a global level has a destructive effect on the national security of every democratic state, and therefore on the national security of the Republic of Serbia. The work is proof of the existence of a cause-and-effect relationship between drug addiction and narco-terrorism, where the illegal production and abuse of psychoactive drugs in themselves represent narco-terrorism and a crime against humanity, while the realized drug capital finances terrorism throughout the world. The fight against the bearers of terrorist and narco-terrorist organizations should be a permanent and priority task of every state, and thus also of the Republic of Serbia. The countries of the modern world have recognized this harmful influence, about the existence of these mutual ties that directly affect the national security of the country and the normal functioning of society, and also the security at the global level.

Primary Caregivers of Patients with Psychoactive Substance Use Often Suffer from Depression &amp; Anxiety

Objective: To determine the frequency of depression and anxiety in carers of psychoactive substance use patients. Study Design: Cross sectional study Place and Duration of Study: Department of Psychiatry, Baluchistan Institute of Psychiatry &amp; Behavioural Sciences, Quetta from June 2020 to December 2020. Methodology: One hundred and twenty caregivers of psychoactive substance use patients were enrolled. Detailed demographics of patients and caregivers were recorded after taking informed written consent. Patients were aged between 18-70 years. Depression and anxiety were calculated in primary caregivers of patients of psychoactive substance use. A DASS-21 criterion was used to examine the depression. Data was analysed by SPSS 22.0. Results: Mean age of patients was 35.27±15.43 years. 90 (75%) patients were males while 25% were females. Among caregivers 78 (65%) were females while 42 (35%) were males with mean age 36.86±16.48 years. Among caregivers, 12.5% of the patients had mild, 37.5% showed moderate and 18.33% caregivers showed severe depression while 38 (31.67%) had no depression. Anxiety among caregivers was mild in 12 (10%), 26 (21.7%) had moderate and 15 (12.5%) caregivers had severe anxiety while 67 (55.83%) caregivers had no anxiety. Conclusion: The frequency of anxiety and depression was high in primary caregivers of patients with psychoactive substance abuse. Keywords: Anxiety, Depression, Substance use, Caregivers

Differences between users' and addiction medicine experts' harm and benefit assessments of licit and illicit psychoactive drugs: Input for psychoeducation and legalization/restriction debates.

There is a lack of benefit/harm assessments of illicit and licit psychoactive substances performed by substance-dependent users in comparison to addiction medicine experts. We extended the analyses of substance harm/benefit assessments of German addiction medicine experts (N = 101), in parts reported recently in this journal [doi.org/10.3389/fpsyt.2020.59219], by the perspectives of substance-addicted persons. The same questionnaire as used for the abovementioned "experts-study" was handed out to inpatient detoxification or rehab treatment seeking German substance-dependent adults (N = 117) for a subsequent structured interview about harms and benefits of 33 new and traditional psychoactive substances comprising also prescription drugs. Both, users and experts, ranked the traditional illicit psychoactive substances heroin, cocaine and amphetamines within the top overall harm level group. Synthetic cannabinoids, alcohol and benzodiazepine were in a subordinate top-harm level position. Both cohorts also ranked methadone, nicotine and cannabis within the midrange and buprenorphine as well as psychotropic mushrooms within the lowest harm level positions. Experiences with prescription drugs (including opioidergic analgesics and gabapentinoids), cathinones, GHB, methamphetamine and methylphenidate was not prevalent in our user population. The same applied to barbiturates, propofol, kratom, ayahuasca with nearly zero assessments for each substance. The most user-experiences (>50% per assessed substance) were reported with nicotine, cannabis, alcohol, cocaine, heroin, amphetamine and methadone (core group). The user's overall harm ratings in terms of these psychoactive substances were similar to those of the experts with the exception of the methadone assessment which was rated by the experts to be significantly less harmful if compared with the users' estimation (supposed "treatment bias" of experts). The users' benefit ratings for the traditional illicit psychoactive substances, cannabis as well as for nicotine were significantly more positive in comparison to those of the experts (supposed "attraction bias" of users). Both, experts and users, ranked the harms arising from the use of alcohol or benzodiazepines (usually unregulated substances) higher than the harms caused by the use of methadone, cannabis or psychotropic mushrooms (regulated by most Western narcotic acts). Users attributed the most benefits to buprenorphine, methadone and cannabis. This might reflect a main limitation of the study as the data are from an user population comprising over 50% patients who sought detoxification-treatment of opiates where methadone and buprenorphine are usual transient medications (supposed "selection bias"). This study addressed current trends of psychoactive substance abuse (e.g., synthetic cannabinoids, prescription drugs) and provides from both perspectives (that of the user and that of the addiction medicine experts) robust harm/benefit evaluations at least of a core group of psychoactive substances (traditional illicit psychoactive substances, cannabis, methadone, alcohol and nicotine). The results of this study can be valuable to the psychoeducation of substance-addicted individuals and to current restriction/legalization debates, especially in the Western-EU.

ENDS consumption in students of higher education: Phenomenon on the rise during the COVID-19 pandemic.

The COVID-19 pandemic triggered transformations in the population's lifestyles, including electronic nicotine delivery system (ENDS) consumption. The aim of the study was to determine associations between ENDS consumption habits and lifestyles among higher education students in Bogotá, Colombia. This study employed a cross-sectional analytical design, based on a self-administered online survey, conducted in 2021, among students aged 18-59 years. The sample size was 3985 students. Statistical analysis was done through frequency studies, hypothesis testing and a multivariate-penalized logistic regression model (firthlogit), based on the Akaike information criterion (AIC). A total of 3573 students completed the survey, 61.5% were female, 55.3% were young (aged 18-26 years), and 44.6% were adults (aged 27-59 years). The prevalence of ENDS use during the pandemic was 7.3%. Age was negatively associated with ENDS use, as young people had a higher likelihood of using these devices. The likelihood of ENDS use was negative among females (OR=0.38; 95% CI: 0.2-0.5). In contrast, it was positive in students with a history of psychoactive substance abuse and/or dependence (OR=3.59; 95% CI: 1.0-12.0), students who had tried conventional cigarettes (OR=5.12; 95% CI: 3.0-8.5), participants who smoked tobacco during the pandemic (OR=3.15; 95% CI: 2.3-4.2), those who studied virtually (OR=1.52; 95% CI: 1.0-2.3), participants who lived with other ENDS users (OR=3.86; 95% CI: 2.8-5.2) and students with negative perception of impacts on their mental health (OR=1.48; 95% CI: 1.1-1.9). Being male, aged <26 years, having a history of substance use, having tried conventional cigarettes, pandemic tobacco use, and having lived with other ENDS users, were the main factors associated with pandemic ENDS use. Studying the consumption habits of students in response to lifestyle changes, is fundamental for the formulation of strategies to reduce the development of addictive behaviors, especially in young students during the pandemic.

Psychoactive Substance Abuse among Secondary School Students in Tanzania: Exploring Perception and Understanding of Its Impact on Academic Achievement

The aim of this study was to explore perceptions and understanding of the impact of drug and psychoactive substance abuse among Secondary School students Kilolo district of Iringa Tanzania. The study was guided by the following specific objectives: to identify the commonly used psychoactive drug and substances; to explore students’ perceptions on psychoactive substance use; to examine students’ knowledge of the impact of psychoactive substance abuse on academic achievement; and to explore the strategies used in preventing use of drugs and substance abuse at Secondary School level. The study was guided by the Self-Medication Theory of Addiction. The theory that provides a valuable investigative and clinical paradigm to address the challenging issue of drug addiction. The study used a quantitative approach with a cross-section descriptive design. Employing simple random sampling, a total sample of 400 respondents were drawn from five secondary schools of Kilolo district. The data were obtained through questionnaire-based survey. The data were analysed using descriptive statistics with the aid of IBM SPSS Statistics version 20. The findings revealed that the commonly used psychoactive substances by secondary school students were alcohol, marijuana, snuff, and cigarettes. The students had the knowledge of drugs and substance abuse and perceive that they are not good for their academics and health. The study further unveiled that some students used the substances sparingly and while others used them on a daily basis. The findings showed that students had knowledge of the impact of psychoactive substance abuse on academic achievement. The findings also revealed that mechanism are in place at the school level to prevent drugs and psychoactive substance abuse. In view of the findings of this study it is recommended that families should be involved in the fight against use of drugs and psychoactive substances and provide counsel for the students. Schools should strive at encouraging positive peer relationships and networks among students who do not use psychoactive substances.

Fentanyl Induces Novel Conditioned Place Preference in Adult Zebrafish, Disrupts Neurotransmitter Homeostasis, and Triggers Behavioral Changes.

Abuse of new psychoactive substances increases risk of addiction, which can lead to serious brain disorders. Fentanyl is a synthetic opioid commonly used in clinical practice, and behavioral changes resulting from fentanyl addiction have rarely been studied with zebrafish models. In this study, we evaluated the rewarding effects of intraperitoneal injections of fentanyl at concentrations of 10, 100, and 1000 mg/L on the group shoaling behavior in adult zebrafish. Additional behavioral tests on individual zebrafish, including novel tank, novel object exploration, mirror attack, social preference, and T-maze memory, were utilized to evaluate fentanyl-induced neuro-behavioral toxicity. The high doses of 1000 mg/L fentanyl produced significant reward effects in zebrafish and altered the neuro-behavioral profiles: reduced cohesion in shoaling behavior, decreased anxiety levels, reduced exploratory behavior, increased aggression behavior, affected social preference, and suppressed memory in an appetitive associative learning task. Behavioral changes in zebrafish were shown to be associated with altered neurotransmitters, such as elevated glutamine (Gln), gamma-aminobutyric acid (GABA), dopamine hydrochloride (DA), and 5-hydroxytryptamine (5-HT). This study identified potential fentanyl-induced neurotoxicity through multiple neurobehavioral assessments, which provided a method for assessing risk of addiction to new psychoactive substances.

S1635 Gender-Related Difference on Demographics and Comorbidities of Gastroparesis

Introduction: Gastroparesis is known to be more prevalent in females than males, even though the pathophysiology behind it remains unclear. There is lack of gender specific comparison of gastroparesis in terms of demographics and comorbidities. The aim of the study was to compare the demographics and comorbidities of gastroparesis between female and male patients. Methods: Patients who had completed a gastric emptying study and diagnosed with gastroparesis were identified using a nationwide database, IBM Explorys (1999-2022). The following conditions were excluded: cyclical vomiting syndrome, psychoactive substance abuse, eating disorder, factitious disorder, chemotherapy, malignant tumor of esophagus and stomach, neoplasm of abdomen, gastric or intestinal obstruction, IBD, adhesion of intestine, carcinomatosis, perforation of intestine, Roux-en-Y gastrojejunostomy, and gastrectomy. Patients were subdivided into males and females. Demographic information, clinical symptoms and comorbidities were collected. Chi-square tests were performed to compare categorical data. Odds Ratios with a 95% confidence interval were reported. Results: A total of 17,570 patients were identified with gastroparesis, of which 13,090 (75%) patients were females and 4,390 (25%) patients were males. Females and males demonstrated similar trend in the distribution of ethnicity: most patients were White (76.6 vs 74.0%), followed by African American (13.0 vs 14.4%) and other races respectively (Table). There was a higher percentage of females than males in the younger age group: age 20-29 (F vs M: 5.3 vs 4.3%) and age 30-39 (F vs M: 13.8 vs 11.4%) respectively. Male patients with GP had a higher prevalence of diabetes mellitus (M vs F: 52.8 vs 42.8%) and other comorbidities, such as: hypertension (64.0 vs 54.5%), hyperlipidemia (57.2 vs 50.1%), chronic kidney disease (24.1 vs 15.8 %), coronary artery disease (26.4 vs 16.6 %) and smoking (16.6 vs 13.8%) (All P value < 0.0001) (Figure). Female patients had a higher prevalence of anxiety (F vs M: 41.3 vs 27.1%), depression (45.8 vs 31.7%), autoimmune conditions (13.8 vs 5.0%) and morbid obesity (15.6 vs 11.6%) (All P value < 0.0001). Conclusion: Female and male patients with gastroparesis demonstrate similar ethnic distribution. There is a higher percentage of female patients than males in the younger age group. However, female and male patients demonstrate different comorbidities.Figure 1.: Comparison of Comorbidities Between Female and Male patients with Gastroparesis. Table 1. - Comparison of Demographics and Comorbidities Between Female and Male Patients with Gastroparesis Female (N=13090) % Male (N=4390) % OR P Age 20-29 690 5.3% 190 4.3% 1.04-1.45 0.0135 30-39 1810 13.8% 500 11.4% 1.12-1.39 < 0.0001 40-49 2370 18.1% 740 16.9% 1.00-1.19 0.0612 50-59 2710 20.7% 1060 24.1% 0.76-0.89 < 0.0001 60-69 2810 21.5% 970 22.1% 0.89-1.05 0.3811 70-79 2000 15.3% 720 16.4% 0.84-1.01 0.0760 80-89 930 7.1% 290 6.6% 0.94-1.24 0.2618 90 above 260 2.0% 80 1.8% 0.85-1.41 0.4963 Race Caucasian 10030 76.6% 3250 74.0% 1.06-1.24 0.0005 African American 1700 13.0% 630 14.4% 0.81-0.98 0.0215 Asian 110 0.8% 50 1.1% 0.06-0.09 < 0.0001 Hispanic/Latino 120 0.9% 40 0.9% 0.70-1.44 0.9733 Unknown/Other 1130 8.6% 420 9.6% 0.79-1.00 0.0595 Comorbidities DM 5600 42.8% 2320 52.8% 0.62-0.71 < 0.0001 HTN 7130 54.5% 2810 64.0% 0.63-0.72 < 0.0001 HLD 6560 50.1% 2510 57.2% 0.70-0.81 < 0.0001 CKD 2070 15.8% 1060 24.1% 0.54-0.64 < 0.0001 CAD 2170 16.6% 1160 26.4% 0.51-0.60 < 0.0001 Smoking 1810 13.8% 730 16.6% 0.73-0.88 < 0.0001 Anxiety 5410 41.3% 1190 27.1% 1.76-2.04 < 0.0001 Depression 6000 45.8% 1390 31.7% 1.70-1.96 < 0.0001 Autoimmune disease 1800 13.8% 220 5.0% 2.62-3.49 < 0.0001 Morbid obesity 2040 15.6% 510 11.6% 1.27-1.56 < 0.0001

S582 Gastroparesis Is Associated With More Concurrent Gastrointestinal Symptoms and Motility Disorders Than Functional Dyspepsia

Introduction: Gastroparesis (GP) and functional dyspepsia (FD) present with overlapping upper gastrointestinal (GI) symptoms, such as: nausea, vomiting, early satiety, postprandial fullness, epigastric pain, and bloating. Other gastrointestinal motility disorders may be concurrent in patients with GP. The goal of study was to compare the presence of GI symptoms and other motility disorders in patients with GP and FD. Methods: A retrospective cohort study was performed on IBM Explorys (1999-2022), which contains de-identified healthcare information from more than 64 million patients across the United States. Adult patients who have completed gastric emptying study were selected, and subsequently divided into GP and FD cohorts. GP cohort consists of patients with a diagnosis of gastroparesis, with exclusion criteria: cyclical vomiting syndrome, psychoactive substance abuse, eating disorder, factitious disorder, malignant tumor of esophagus and stomach, neoplasm of abdomen, gastric or intestinal obstruction, IBD, adhesion of intestine, carcinomatosis, perforation of intestine, Roux-en-Y gastrojejunostomy, and gastrectomy. FD cohort was similarly constructed with additional exclusion criteria: gastroparesis, gastrointestinal ulcer, brain neoplasm and pancreatitis. The presence of GERD, IBS, GI symptoms and common GI medications were collected. Odds ratios (ORs) with 95% confidence interval were used to compare the cohorts. Results: GP and FD cohort consisted of 17,570 and 60,230 patients respectively (Table). There was a higher prevalence of concurrent motility disorders in patients with GP than FD, including GERD and IBS (65.1 vs 50.9%, 18.6 vs 13.3%). Patients with GP tend to present with more upper and lower GI symptoms than FD, including nausea (65.1 vs 46.3%), vomiting (53.0 vs 33.3%), epigastric pain (36.9 vs 27.2%), heartburn (8.6 vs 7.5%), diarrhea (34.6 vs 23.3%) and constipation (37.2 vs 21.8%) (P< 0.0001) (Figure). However, there was no difference in terms of early satiety and bloating when comparing the two groups. Acid reducing medications, anti-nausea medications and prokinetic agents were more commonly prescribed for patients with GP than FD, including proton pump inhibitors (PPIs), H2 receptor antagonists (H2RA), Metoclopramides and Ondansetron (p< 0.0001). Conclusion: GP is associated with more concurrent GI symptoms and motility disorders compared with FD. Acid reducing medications, anti-nausea and prokinetic medications are more commonly prescribed for patients with GP.Figure 1.: Comparison of GI symptoms between gastroparesis and functional dyspepsia Table 1. - Comparison of GI motility disorders, symptoms and medications between gastroparesis and functional dyspepsia GP (N=17570) % FD (N=60230) % OR P GI diseases GERD 11430 65.1% 30650 50.9% 1.74-1.86 < 0.0001 IBS 3260 18.6% 8030 13.3% 1.42-1.55 < 0.0001 Symptoms Upper GI symptoms Nausea 11430 65.1% 27910 46.3% 2.08-2.23 < 0.0001 Vomiting 9310 53.0% 20060 33.3% 2.18-2.34 < 0.0001 Early satiety 1660 9.5% 5780 9.6% 0.93-1.04 0.5556 Epigastric pain 6490 36.9% 16380 27.2% 1.51-1.62 < 0.0001 Heartburn 1510 8.6% 4500 7.5% 1.10-1.24 < 0.0001 Lower GI symptoms Diarrhea 6070 34.6% 14050 23.3% 1.67-1.80 < 0.0001 Constipation 6540 37.2% 13110 21.8% 2.06-2.21 < 0.0001 Bloating 60 0.3% 170 0.3% 0.90-1.63 0.2039 Medications PPI 13680 77.9% 35430 58.8% 2.37-2.56 < 0.0001 H2RA 7710 43.9% 18310 30.4% 1.73-1.85 < 0.0001 Metoclopramide 8630 49.1% 12490 20.7% 3.56-3.82 < 0.0001 Ondansetron 12570 71.5% 31330 52.0% 2.24-2.41 < 0.0001

Socio-Demographic Profile of Psychoactive Substance Users Attending A Tertiary Care Centre

Aim: The goal of this analysis is to determine the proportion of psychoactive substance disorder and socio-demographic profile of Psychoactive Substance Users. Study Design: A descriptive study. Place and Duration: In the Psychiatry and Behavioral Sciences department PGMI/AMC/LGH Lahore, Pakistan and Mardan Medical Complex for six months duration from October 2021 to March 2022. Methods: A total of 120 subjects with psychoactive substance use disorder (conferring to the ICD-10 criteria) were recruited after attaining their written informed consent. In the course of the study, all patients with substance use disorders were interviewed through partially structured addiction questionnaire. Data was analyzed with SPSS version 21.0 using inferential and descriptive statistics. Results: Out of the 120 subjects, 100 were men and 20 were women. The adults and adolescents were the main groups indulging in the consumption of psychoactive substances. Most of the subjects, 45%, started substance abuse at 16-20 years of age. Of the remaining 18.3%, started substance abuse at 26 years old and older, 24.2% started at the age of 21-25 years, and 12.5% started at the age of 13-15 years. It was found that 50% were in the recovery process. The relapse rate was 33.3%, 12.5% were not in contact, 2.5% died, and 1.7% were in prison. Opioid was the psychoactive substance preferred by 66.7% of the young population. The most common opioid was brown sugar; 13.3% prefer cannabis, 2.5% prefer tablets, 4.2% prefer injectable use and 0.83% prefer volatile usage of substances. Conclusion: The main consumers of psychoactive substances were the adults and adolescents and majority start using it at a younger age. Psychoactive substance abuse is a serious problem effecting young people, which is a sensitive group. So, special consideration should be paid to psychoeducation about psychoactive substances prior to adolescent. Keywords: Psychoactive substance, Sociodemographic profile.

Linking minority stress to substance abuse in LGB adults: the mediating effect of sexual harassment.

Objective: Employing a psychological mediation framework, the study investigated the interaction between minority stress and psychoactive substance abuse mediated by sexual harassment among LGB individuals. Method: One hundred and forty-seven LGB individuals answered a questionnaire measuring internalized homophobia, concealment, discrimination, sexual harassment, and psychoactive substance abuse. Logistic hierarchical regression models were conducted to test the proposed relations and mediating hypotheses. Findings: Incidents of discrimination and internalized homophobia correlated with cigarette smoking and alcohol drinking. Sexual harassment was related to the use of cannabis and hard drugs. Sexual harassment mediated the relationships between the dimensions of minority stress and the use of cannabis and hard drugs. Conclusion: Minority stress appears to be linked directly and indirectly, via sexual harassment, to the use of psychoactive substances by LGB individuals. Interventions addressing the prevention or mitigation of sexual harassment experienced by LGB individuals are likely to attenuate the negative effects of minority stress on their levels of substance use.

Судова фармація, організація фармацевтичної справи, технологія ліків, медичне, фармацевтичне та кримінальне право: державна система боротьби із незаконним обігом наркотичних засобів і психотропних речовин та зловживання ними в умовах пандемії

In the context of the COVID-19 pandemic, the burden on the sphere of health care, pharmacy, finance, economy, industry, and law enforcement are increasing. The level of the state system regarding the effectiveness of the criminal and legal struggle against the illegal circulation of narcotics (narcotic drugs and psychotropic substances) and their abuse by improving the legislation and normative legal acts of Ukraine in the conditions of the pandemic on the basis of forensic pharmacy, drug technology, the organization of the pharmaceutical case, medical and pharmaceutical law. Scientific information sources were studied, taking into account the recommendations of the WHO and the Cochrane Society for PICO from 25 disciplines that have interdisciplinary connections. The forensic and pharmaceutical practice in criminal proceedings regarding the illegal circulation of psychoactive substance of various classification and legal groups were analyzed. Proven that the abuse and uncontrolled intake of psychoactive substances causes manifestations of a person's hidden predisposition to mental illnesses according to the ICD-11 codes. The forensic and pharmaceutical characteristics of the "drug business" market were summarized according to the data of law enforcement agencies. The provisions of the State Policy Strategy on Drugs in Ukraine were analyzed. Normative proposals for improving the legislation on measures to counter the illegal circulation of narcotic drugs, psychotropic substances and precursors and their abuse in order to protect the rights and freedoms, life and health of drug addicts were presented.