Consumption Of Psychoactive Substances Research Articles

Trends in Tobacco Consumption – a Comparative Analysis of WHO European Region Countries

Tobacco consumption, as well as the consumption of any other psychoactive substances, lead to addictions, which is a serious problem that modern societies have to face. To reduce the negative consequences of nicotine consumption and to provide sustainable development, many governments, in both developed as well as developing countries, adopt policies to reduce tobacco production and consumption. For example, they implement various health programs to combat addiction, and they also provide appropriate financial and fiscal resolutions. Any actions taken at different decision-making levels are often bounded with economic and financial policies of a particular state, including fiscal policy. State interventionism concerning tobacco is most visible in developed countries such as the US, Canada, and European Union countries. Developing countries and Asian countries have also started to introduce regulations concerning tobacco consumption on a large scale in response to the negative effects of nicotinism. The main aim of the paper is to show consumption trends as well as the fiscal and price policies of tobacco products. The theoretical part is supplemented by data from reports and analyses presented by the World Health Organization (WHO).

The effectiveness of the narcological service in the Russian Federation in terms of target indicators

The analysis of the effectiveness of the narcological services based on the primary and general incidence rates, as well as target indicators considered in the Health Care Development program, is presented. A decrease in both the general and primary incidence of mental and behavioral disorders associated with the use of psychoactive substances in 2013-2018 was revealed. This decrease can be explained by the increasing role of primary prevention and regulation of the consumption of psychoactive substances at the state level, as well as a change in the order of dispensary monitoring of persons with mental disorders and (or) behavior disorders associated with the use of psychoactive substances. An analysis of the target indicators characterizing the activities of the drug treatment service showed that remission rates among patients with alcoholism and drug addiction increase and remain above target values. At the same time, the proportion of patients with alcoholism and drug addiction hospitalized repeatedly during the year exceeds the target values and amounts to 26,3 and 28,2%, respectively. This fact may be associated with insufficiently effective continuity in the work of the outpatient and inpatient stages of treatment of patients with drug addiction and alcoholism. The shares of people included in outpatient and inpatient medical rehabilitation programs also increased - the growth was 5 and 5,7%, respectively. The effective work of the service, in terms of rehabilitation, is also indicated by the fact that the proportion of patients who successfully completed medical rehabilitation programs both in outpatient and inpatient settings tend to increase. In general, the incidence of drug abuse disorders and indicators characterizing the work of the drug treatment service are determined by the strong negative impact of drug addiction and alcoholism on the demographic and economic situation in society.

High risk for psychiatric disorders in bipolar offspring. A four years prospective study

Bipolar disorder (BD) has a large hereditary component. It is a disorder that begins in early adulthood, but about which it has been described a premorbid period preceding the onset of BD. During this herald expression psychiatric disorders and symptoms, such as depressive, manic, psychotic, anxious and others, may appear. ObjectiveTo determine the psychopathological profile of a Bipolar Offspring (BO) group compared with the Community Control Offspring (CCO) group, and its evolution over time, including subthreshold symptoms and mental disorders. MethodsWe conducted an observational mixed cohort study, with a prospective design. We included subjects from six to 30 years of age, from the region of Antioquia, Colombia. A total of 131 subjects from the risk group BO and 150 subjects from the CCO group were evaluated through validated psychiatric diagnostic interviews (K-SADS-PL and DIGS) at baseline and at 4 years follow up. All interviews were carried out by a staff blind to parent diagnoses. Follow-up assessment were complete in 72% of the offspring. Forty-two subjects were excluded as they surpassed the age of 30 years, and only 46 subjects were not followed (change of address or did not consent to participate). ResultsCompared with the CCO group, the BO group had a higher frequency of affective disorder, psychotic disorder, externalizing disorders and use of the psychoactive substances during both assessments at time 1 and 2. The magnitude of the differences between the groups increased when they reach time 2. The BO group had a greater risk for presenting subthreshold symptoms and definitive psychiatric disorders, such as affective disorders, psychotic disorders and externalizing disorders. In addition, the BO group had a younger age of onset for psychoactive substances consumption. ConclusionDuring the follow-up period, the BO group had a higher risk of presenting mental disorders compared with the CCO group. The most relevant symptoms and disorders that could precede the onset of BD were depressive, bipolar not otherwise specified, psychotic and substance use.

Perceived social support, resilience and consumption of psychoactive substances amongst inmates in prisons.

ABSTRACTObjectivesTo determine the influence of perceived social support and resilience in the use of alcohol and other drugs amongst female inmates.Material and methodA cross-sectional study with 174 inmates was conducted in two prisons in the Region of Murcia. A self-administered questionnaire was used, which included socio-demographic, prison, alcohol and other drug consumption, perceived social support and resilience variables.Results28.2% of the inmates consumed at least one of the substances analyzed (alcohol, cannabis, cocaine, heroin and/or tranquillizers without medical prescription) in prison. The female consumers showed significantly lower levels of perceived social support and resilience, compared to the counterparts who did not consume in prison.DiscussionFindings show how perceived social support and resilience are factors of protection against substance use in prison, and these can be incorporated in future prevention programs for the consumption of alcohol and other drugs during imprisonment.

Wastewater-based epidemiology to assess the occurrence of new psychoactive substances and alcohol consumption in Slovakia.

Consumption of alcohol and new psychoactive substances (NPS) in a population or during special events (music festivals) is usually monitored through individual questionnaires, forensic and toxicological data, and drug seizures. However, consumption estimates have some biases due mostly to the unknown composition of drug pills for NPS and stockpiling for alcohol. The aim of this study was to evaluate for the first time the real use of alcohol and the occurrence of NPS in Slovakia by wastewater-based epidemiology (WBE). Urban wastewater samples were collected from nine Slovak cities over two years (2017-2018) and during three music festivals. The study included about 20% of the Slovak population and 50000 festival attendees. The urinary alcohol biomarker ethyl sulfate (EtS) and thirty NPS were analyzed by liquid chromatography tandem mass spectrometry (LC - MS/MS). EtS concentrations were used for estimating the per capita alcohol consumption in each city. The average alcohol consumption in the selected cities and festivals in 2017-2018 ranged between 7 and 126L/day/1000 inhabitants and increased during the weekends and music festivals. Five NPS belonging to the classes of synthetic cathinones (mephedrone, methcathinone, buphedrone and pentedrone) and phenethylamines (25-iP-NBoMe) were found in the low ng/L range. Methcathinone was the most frequently detected NPS, while the highest normalized mass load corresponded to mephedrone (3.1mg/day/1000 inhabitants). Wastewater-based epidemiology can provide timely information on alcohol consumption and NPS occurrence at the community level that is complementary to epidemiology-based monitoring techniques (e.g. population surveys, police seizures, sales statistics).

Psychopathologie de crise : chronique des tensions ordinaires en situation sanitaire extraordinaire. Phase 1 : la réorganisation anxieuse

IntroductionHumanity is facing a global pandemic at the start of 2020. The health systems of each country are reorganizing to cope with an influx of patients. This crisis reorganization is the source of psychological tension that can lead to symptomatic manifestations in many caregivers. This situation is similar in many points to that encountered by soldiers on external operations (loss of usual bearings, feeling of threat, focusing of attention on the crisis, deterioration of living conditions with limitation of the possibility of taking breaks). The aim of this work is to describe at the hospital level the changes in the professional and personal environment linked to the crisis likely to cause stress and then to describe the clinical manifestations observed both on an individual and collective level. Analysis of the situationIn this chapter, after having described the reorganization of the hospital in which we operate, we try to identify various factors likely to have psychological repercussions such as: the perceived urgency of the situation, the achievement of privacy, the reorganization of the work tool and the exercise of unusual tasks in newly formed teams, but also the fear of lack, the anxiety linked to contamination, the uncertainties linked to the threat. Clinical descriptionIn this chapter, we describe the clinical manifestations observed in the caregivers of the hospital in reaction to the crisis. Rather than decompensations, they are mainly anxious manifestations characterized by an increase in somatic concerns, an accentuation of verification rituals, an increase in snacking and the consumption of certain psychoactive substances (coffee, tobacco) and for certain people a character stiffening. On a collective level, it was mainly the misuse of social networks reflecting the group's anxieties (search for meaning and responsibility, need for certainty) that was observed. ConclusionWe then conclude with a description of the approach that led to the establishment of a support system by offering a graduated response, re-assessable over time, compatible with the maintenance of usual activity while maintaining a therapeutic distance.

Conflictos y cambios familiares: significados asociados al consumo de sustancias psicoactivas

Se presentan los contextos sociofamiliares co-construidos, así como los significados dados al conflicto y a los cambios familiares asociados al consumo de sustancias psicoactivas por parte de un hijo adolescente. Es resultado de una investigación cualitativa-hermenéutica, apoyada en el método de la teoría fundamentada y su interpretación tiene como base epistemológica elementos del construccionismo social. Los resultados muestran movimientos, relaciones y estrategias que marcan: pautas de interacción que conjugan problemas y cambios sociofamiliares, alteraciones emocionales y predominancia de relaciones violentas. Concluye que la agudización del conflicto se da en el marco de relaciones fracturadas de acuerdo con el significado centrado en el rol de padre y madre, patrones relacionales violentos y emociones confusas y contradictorias en las relaciones familiares.

Determining changes in new psychoactive substance use in Australia by wastewater analysis

Measuring community consumption of new psychoactive substances (NPS) is notoriously difficult to assess by traditional means such as surveys and seizure data. Previously, we used the approach to demonstrate the prevalence of NPS on a national scale. In the current study we explored the temporal resolution for the analysis of NPS in wastewater from Australia. Samples covering all States and Territories in Australia and both metropolitan and regional areas and were collected bimonthly from October 2017–June 2018 and October 2019–February 2020. A qualitative screening method was applied, screening for 201 NPS. In total, 15 substances were found from a variety of classes of NPS. The most prevalent class was synthetic cathinones, with pentylone, N-ethylpentylone and ethylone found in all periods in at least one site in the earlier sampling period, as well as the amphetamine-like paramethoxyamphetamine (PMA). In the latter period, synthetic cathinones were also the most prevalent, including eutylone, marking the first time that this compound has been detected in wastewater. This study shows the application of wastewater analysis to detect outbreaks of NPS use and temporal differences among sites.

Epidemiological and sociodemographic profile of the population in street situation in the metropolitan region of Porto Alegre

The article`s purpose was to understand the sociodemographic and epidemiological profile of the homeless population of Canoas, a metropolitan region of Porto Alegre, in Brazil. To accomplish this homeless population census from Canoas, the information contained in the records of all users registered at Consultóriona Rua (Street Clinic) was used from the beginning of activities in December 2014 until July 2016. Totalizing that, 347 people were collected in the months of June, July and August 2016.84.4% are men, 55.9% self-described as white. Most 64.1% have incomplete primary education, with recycling as the main occupation in 20.6 % of cases. 36.1% reported being on the street due to the use of some psychoactive substance, being 62.0% alcohol users. 69.1% make daily consumption of psychoactive substance, 23.6% have some STIs, considering 14.6% carriers of the HIV virus. Get to know their specificities and needs according to the location in which they are inserted, will make it possible to create means, through public policies, to recover their sense of belonging, and provide their rights guaranteed by law, treating them with dignity.

The organization of chemical toxicological service and medical examination of persons for condition of alcohol drunkenness, fact of consumption of drug and other psychoactive substances in the Khanty-Mansi Autonomous Okrug-Yugra

The article presents the analysis of organization of chemical-toxicological service and in the Khanty-Mansi Autonomous Okrug-Yugra. The introduction of three-level system for provision of addiction medical care of population and implementation of the principle of zoning made it possible to organize three-level system of chemical-toxicological service that permitted to achieve equal access to chemical-toxicological and addiction care services in all territories of the region. The investments in chemical-toxicological laboratories, supply of modern equipment, advanced training of laboratory specialists, cooperation with leading research centers and professional communities outside of the region allowed timely and accurately identify psychoactive substances, prompt response in cases of mass poisoning with novel psychoactive substances, and quick introduction of advanced methods of chemical-toxicological examination to the medical organizations of the large industrial northern region of Russia.

Características clínicas de usuários abusivos de substâncias psicoativas internados em Unidade de Terapia Intensiva

Objetivo: descrever as causas de internação e comorbidades de pacientes com diagnóstico de abuso/dependência de substâncias psicoativas internados em Unidade de Terapia Intensiva. Método: estudo retrospectivo, descritivoexploratório, transversal e quantitativo. Resultados: pesquisaram-se 865 prontuários entre 2012 e 2015, e a prevalência de uso de substâncias foi de 51,9%. Destes, 22% são usuários de álcool e 48,7%, de tabaco. Entre os usuários com dependência diagnosticada, as principais causas de internação encontradas foram doença pulmonar obstrutiva crônica (100%) e hemorragia digestiva (84%), e a maioria dos pacientes apresentou mais do que uma comorbidade simultaneamente. Conclusão: os resultados apontaram inúmeras causas de internação e comorbidades que demonstraram o comprometimento físico e psíquicoque pode estar relacionado ao consumo excessivo de substâncias psicoativas.

Risky sexual behavior and associated factors in undergraduate students in a city in Southern Brazil.

ABSTRACTOBJECTIVE To describe the sexual behavior of freshmen undergraduate students according to demographic, economic, psychosocial and behavioral characteristics, and evaluate the prevalence of risky sexual behavior and its associated factors.METHODS A cross-sectional study of the census type with undergraduate students over 18 years old of 80 undergraduate courses of the Universidade Federal de Pelotas (UFPel), in Rio Grande do Sul (RS), who entered in the first semester of 2017 and remained enrolled in the second semester. Undergraduate students who reported having had sex were evaluated. We considered as risky sexual behavior having more than one sexual partner within the last three months and not having used condoms in the last sexual intercourse.RESULTS The prevalence of risky sexual behavior was 9% (95%CI 7.6–10.5). Men presented more risky behavior than women, with a prevalence of 10.8% and 7.5%, respectively. Of the undergraduate students, 45% did not use condoms in the last sexual intercourse, and 24% had two partners or more within three months before the survey. Smartphone applications for sexual purposes were used by 23% of students within three months before the survey. Risky sexual behavior was associated with gender, age at first sexual intercourse, frequency of alcohol consumption, consumption of psychoactive substances before the last sexual intercourse and use of smartphone applications for sexual purposes.CONCLUSION Although undergraduate students are expected to be an informed population, the prevalence of risky sexual behavior was important, indicating the need to expand public investment in sexual education and awareness actions.

Perfil de tratamento com psicofármacos de usuários de um centro de atenção psicossocial infanto-juvenil

A presente pesquisa objetiva analisar o perfil de tratamento com psicofármacos de usuários de um Centro de Atenção Psicossocial Infanto-juvenil (CAPSi). Delineamento transversal, documental, quantitativo e analítico, realizado em um CAPSi do Noroeste do Rio Grande do Sul. Foram coletadas informações sobre idade, sexo, tratamento medicamentoso, diagnóstico e tempo de atendimento de 208 prontuários de usuários, com idade menor ou igual a 18 anos, ambos os sexos e cadastro ativo no período da pesquisa. Medicamentos classificados Anatomical Therapeutic Chemical Classification System e interações medicamentosas a partir da base de dados Micromedex® Solutions. Análise de dados com Qui-quadrado de Pearson, Odds ratio (OR) e Mann-Whitney. Identificou-se idade média dos usuários de 12,34±3,59 anos, 63,9% do sexo masculino, 82,2% em tratamento medicamentoso, desses 95,5% com ação sobre o sistema nervoso central. Os antidepressivos e antiepiléticos foram utilizados com maior frequência, 31,5% e 29,6% respectivamente. O sexo feminino apresentou quase três vezes mais chance de usar medicação e pacientes previamente hospitalizados de ambos os sexos quase quatro vezes mais. Entre os usuários, 71,6% estão expostos a pelo menos uma interação medicamentosa potencial, destas 54,9% graves. Verificou-se elevado consumo de psicofármacos e potenciais interações medicamentosas entre os usuários estudados. Evidencia-se a necessidade de novos estudos que orientem a prática clínica nessa população a fim de garantir qualidade de vida, reabilitação psicossocial e reintegração à comunidade.

Investigation on the consumption of synthetic cannabinoids among teenagers by the analysis of herbal blends and urine samples

The use of synthetic cannabinoids (SCs), which escape conventional detection systems, may be a good alternative to elude routine drug analysis for cannabis. The detection of these drugs in urine is unusual due to their complete and fast metabolism, therefore requiring alternative strategies. In this work, an investigation has been made on SCs consumption by minors (less than 18 years old) in juvenile offenders’ centres. 667 urine samples (from 127 minors) were collected after their permits with stay at home. We also studied the SCs from 7 herbal blends available at the smartshop frequented by the minors. Both, urine and herbal blends, were analysed by liquid chromatography coupled to high resolution mass spectrometry. The analysis of urine confirmed the absence of more than 200 SCs investigated. Thus, the focus was made on metabolites reported for those SCs identified in the herbal blends collected from the smart-shop. The major metabolites of XLR-11 and UR-144 (N-pentanoic acid and N-(5-hydroxypentyl)) were found in several urine samples. Apart from the main metabolites included in the initial searching, a thorough investigation of more metabolites for these SCs was additionally performed, including MS/MS experiments for the tentative identification of compounds detected in the urine samples. The 16 samples positive to the XLR-11 metabolites were assigned to 6 minors, only 2 of which had recognized consumption. On the basis of the results obtained, preventive and therapeutic interventions must be implemented to reduce the consumption of psychoactive substances and to improve the risk-perception of these substances by minors.

Situação de rua: condição que vulnerabiliza ao consumo de substâncias psicoativas

Viver em situação de rua é uma condição que perpassa a falta de moradia. Trata-se de uma situação que vulnerabiliza o indivíduo a diversas questões sociais, de saúde e legais, marginalizando-os e os aproximando do mundo do consumo de substâncias psicoativas. Tal segmento populacional deve ser compreendido como seres sociais, e que tanto como os outros inseridos nesse contexto, têm necessidades e direitos de serem amparados pelo poder público do estado e englobados de forma considerável em suas ações de promoção da saúde, dignidade humana e, em especial, ao combate do consumo de sustâncias psicoativas.

Monitoring psychoactive substance use at six European festivals through wastewater and pooled urine analysis

The consumption of psychoactive substances is considered a growing problem in many communities. Moreover, new psychoactive substances (NPS) designed as (legal) substitutes to traditional illicit drugs are relatively easily available to the public through e-commerce and retail shops, but there is little knowledge regarding the extent and actual use of these substances. This study aims to gain new and complementary information on NPS and traditional illicit drug use at six music festivals across Europe by investigating wastewater and pooled urine. Samples were collected, between 2015 and 2018, at six music festivals across Europe with approximately 465.000 attendees. Wastewater samples were also collected during a period not coinciding with festivals. A wide-scope screening for 197 NPS, six illicit drugs and known metabolites was applied using different chromatography-mass spectrometric strategies. Several illicit drugs and in total 21 different NPS, mainly synthetic cathinones, phenethylamines and tryptamines, were identified in the samples. Ketamine and the traditional illicit drugs, such as amphetamine-type stimulants, cannabis and cocaine were most abundant and/or frequently detected in the samples collected, suggesting a higher use compared to NPS.The analyses of urine and wastewater is quick and a high number of attendees may be monitored anonymously by analysing only a few samples which allows identifying the local profiles of use of different drugs within a wide panel of psychoactive substances. This approach contributes to the development of an efficient surveillance system which can provide timely insight in the trends of NPS and illicit drugs use.

Abuse of Licit and Illicit Psychoactive Substances in the Workplace: Medical, Toxicological, and Forensic Aspects.

About one-third of adult life is spent in the workplace. The use of psychoactive substances is a major preventable cause of morbidity and mortality. The consumption of psychoactive substances during or outside working hours greatly increases the frequency and severity of labor accidents, as well as the workers’ poor general state of health and productivity, implying higher costs for enterprises. It is the responsibility of organizations to ensure the safety and health of their workers. These cannot be limited to traditional routine clinical exams, as other aspects also have an impact on health. Thus, prevention and intervention in the consumption of psychoactive substances (e.g., ethanol, opioids, central nervous system stimulants or depressants, hallucinogens, Cannabis derivatives, dissociative substances, and inhalants) in labor activity should be considered as an investment of organizations and not as a cost, in view of the professional, personal, and family advantages for workers and employers, with a potential impact on productivity, security, health, and quality of life at work. Despite the extensive literature on the subject, each article generally focuses on one or another aspect of a very specific nature, not tackling the problem in a holistic way by confronting clinical, safety, and legal issues. This article presents a reflection on the legal, laboratorial, clinical, ethical, forensic, and safety concerns related to the consumption of psychoactive substances in the workplace, and can be a cross-cutting contribution to occupational medicine, forensic medicine, and insurance medicine, as well as for entrepreneurs, lawyers, judges, workers, and technicians from the public and private sectors that develop projects in this area. This discussion is based on general principles established internationally and highlights the role of the occupational healthcare system and other decision-making actors in the prevention and supervision of workplace psychoactive consumption.

A Review of Cases in the Literature on Auditory Hallucinations: It would be Possible for Mozart to Hallucinate his Music

Introduction: A review of cases in the literature on auditory hallucinations, and associated clinical characteristics, to late onset psychosis and hearing loss is performed. It has been speculated that Mozart was suffering from musical auditory hallucinations and that he used these hallucinating phenomena to write his works. Musical hallucinations that appear in elderly women may have different causes and there are few cases described in the literature have been described in different clinical situations: loss of hearing ability; brain lesions, vascular processes and encephalitis; consumption of psychoactive substances and psychiatric disorders. Methods: Cases published in the literature on auditory hallucinations from 2011 to 2019 are reviewed. Results: Different cases are described, from episodes of musical auditory hallucinations to: late age, after a surgical process, after using a medication, due to hearing problems, by musicians, by evocations of remote memory and during dreams, in addition to perception of music in patients with previous mental health disorders. Conclusion: Musical hallucinations are a rare and complex phenomenon. Clinically they may be more frequent in women and in old age. Musical hallucinations are a borderline pathology between neurology, otolaryngology and little-known psychiatry, which is often mistakenly linked to a mental illness.

"Because of the baby": reduction on drug use during pregnancy

Abstract Objectives: evaluate changes in the use of psychoactive substances (PAS) throughout pregnancy. Methods: longitudinal study, with pregnant women users of PAS at a prenatal follow-up. Results: 76 pregnant women used: tobacco (84.2%, n=64), alcohol (73.7%, n=56), cocaine (27.6%, n=21), marijuana (26.3%, n=20) and crack (13.1%, n=10). Spontaneous interruption had occurred in 60% (n=6) of crack users, 57.1% (n=12) of cocaine and 50% (n=28) of alcohol. After the Brief Intervention, 78.9% (15 of the total of 19) of alcohol users and 70% (7 of the total of 10) of marijuana users discontinued the consumption and there was a reduction in smoking cigarettes. Conclusions: the spontaneous reduction in the consumption of PAS and after the interventions, pregnancy is a window of opportunity to reduce the use of drugs.

Price smoking participation elasticity in Colombia: estimates by age and socioeconomic level

BackgroundTobacco prevalence in Colombia is small compared with other Latin America despite the nation’s tobacco taxes being among the lowest in the region. However, tobacco taxes have increased several times...