Recreational Use Research Articles

Arrhythmogenic effects of acute electronic cigarette compared to tobacco cigarette smoking in people living with HIV.

The leading cause of death in people living with HIV (PLWH) is cardiovascular disease, and the high prevalence of tobacco cigarette (TC) smoking is a major contributor. Switching to electronic cigarettes (ECs) has been promoted as a harm reduction strategy. We sought to determine if acute EC compared to TC smoking had less harmful effects on arrhythmogenic risk factors including acute changes in hemodynamics, heart rate variability (HRV), and ventricular repolarization (VR). In PLWH who smoke, changes in hemodynamics, HRV, and VR were compared pre/post acutely using an EC, TC, or puffing on an empty straw on different days in random order, in a crossover study. Thirty-seven PLWH (36 males, mean age 40.5 ± 9.1 years) participated. Plasma nicotine was greater after TC versus EC use (10.12 ± 0.96 vs. 6.18 ± 0.99 ng/mL, respectively, p = 0.004). HR increased significantly, and similarly, after acute EC and TC smoking compared to control. Changes in HRV that confer increased cardiac risk (LF/HF ratio) were significantly smaller after acute EC versus TC use, consistent with a harm reduction effect. In a post-hoc analysis of PLWH with and without positive concurrent recreational drug use as indicated by point of care urine toxicology testing, this differential effect was only seen in PLWH not currently using recreational drugs. Changes in VR were not different among the three exposures. In PLWH who smoke, EC compared to TC smoking resulted in smaller adverse changes in HRV. This differential effect was accompanied by a smaller increase in plasma nicotine, and was negated by concurrent recreational drug use. Additional studies are warranted in this vulnerable population disproportionately affected by tobacco-related health disparities.

Exploring The Contours: Navigating Cannabis Use Among Older Adults

Cannabis has been employed medicinally throughout history, with recent renewed interest for use due to media awareness and medical marijuana legislation. The geriatric population, identified as those 65 years of age and older, is increasingly using cannabis-derived products, has a higher likelihood of having multiple comorbidities, and is subject to polypharmacy. These individuals are at increased risk of psychiatric and other medical adverse events due to their decreased physical and cognitive reserve and changes in their physicality. Recreational use of cannabis in this population has not been well studied, but medical marijuana use has been investigated more frequently. Increased nonmedical use increases the risk of adverse health consequences. Heavy regular use can lead to cannabis use disorder (CUD), which is formerly known as cannabis abuse and dependence, and may also lead to impaired social functioning and psychiatric comorbidity. The pattern of patients admitted to hospitals has dramatically changed recently, with an increased number of elderly patients being frequently admitted. As such, due to the ease of accessing CBD, this vulnerable cohort is seen more frequently in the hospital, and we need to be more vigilant and inquire about cannabis use as we do, asking about routine medications and over-the-counter supplements. In the U.S., marijuana laws have been changing rapidly, and Americans increasingly favor legalizing cannabis for medical and recreational uses. Policymakers should ensure that training on cannabis screening and interventions for CUD are provided to clinicians to equip them better to monitor and treat patients with cannabis-related problems.

Social Factors Associated with the Risk of Glaucoma Suspect Conversion to Glaucoma: Analysis of the Nationwide All of Us Program

To examine social factors associated with the 5-year risk of glaucoma suspects (GS) converting to open-angle glaucoma (OAG). Retrospective cohort analysis. We screened for participants diagnosed with GS in the All of Us database. Cases that converted to OAG within 5 years of GS diagnosis (the "conversion group") were compared with control cases that did not convert. Demographic, socioeconomic and health-care utilization data of the cases were extracted and compared between the conversion group and the control group. Multivariable Cox proportional hazards modeling was used to identify potential factors associated with the risk of conversion. Hazard ratios (HRs) of significant factors associated with the risk of conversion. A total of 5274 GS participants were identified, and 786 (15%) cases converted to OAG within 5-year follow-up. The 2 groups showed significant differences in age, race, gender, employment status, income/education level, history of intraocular surgery, and health-care utilization patterns. In the multivariable model, African American/Black race (HR :1.70 [95% confidence interval (CI) 1.44-2.00]), older age at GS diagnosis (1.17 [95% CI 1.09-1.25]), male gender (1.30 [95% CI 1.13-1.50], no history of recreational drug use (1.23 [1.07-1.42]), history of intraocular surgery (1.60 [95% CI 1.02-1.53]), and having more reasons for delayed health-care access (2.27 [95% CI 1.23-4.18]) were associated with a greater hazard of conversion, while being employed (0.71 [95% CI 0.60-0.86]) was associated with a smaller hazard of conversion (P<0.05 for all). Several social factors were associated with the conversion from GS to OAG, which may help to identify patients at higher risk of disease progression. Future studies are needed to examine the basis for these findings and the potential interventions that could address them. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Economic valuation and characterization of heavy metal contamination in Dal Lake Srinagar, Kashmir, India

Dal Lake, the world-famous tourist attraction has been polluted by allochthonous and autochthonous sources, as a result the heavy metal (HMs) concentrations within the water body has reached the toxic levels which is endangering the lives of the people. A study was carried out during the year 2021 (i) to determine the concentration of HMs (molybdenum: Mo, arsenic: Ar, cadmium: Cd, lead: Pb) at the four designated sites of Dal Lake, and (ii) a public survey (400 persons) involving economic valuation of water body in terms of recreational use and other benefits. The highest values of biological oxygen demand (BOD) and chemical oxygen demand (COD) within the Dal Lake were recorded at site A, which were 31 ± 1.10 mg/l and 76 ± 0.64, respectively. Similarly, maximum nitrate nitrogen was found at site A (865 ± 0.86 μg/l). The highest value of Pb was reported (6.828 ± 0.003 ppb) from site A whereas, the lowest from site B (2.492 ± 0.002 ppb). The mean values of Mo concentrations (in ppb) were found to be 2.538 ± 0.002, 1.703 ± 0.003, 3.627 ± 0.004 and 4.787 ± 0.002 at the four sites respectively. The observed values of HMs (in ppb) were much higher than the permissible values (WHO, 2006) and those reported earlier. A huge amount of money (Rs 16,18,66,000/) is being generated from the floating gardens of Dal Lake, calculated by TCM and CVM methods. During the survey, 68 % of people showed a willingness to pay (WTP) for the restoration of the Dal Lake and improved services (mean value: Rs 62,852.20/). Thus, the monitoring and assessment were done to find out how the Dal Lake contributes to the economy of the state by way of its different services and the major attraction for tourists besides the possible reasons for the deterioration of water quality, in order to find a long-lasting solution for the sustainable conservation of Dal Lake.

Assessment of the acceptability and feasibility of HIV self-testing in vulnerable population groups in Togo

Background: The aim of this study was to assess the acceptability and feasibility of HIV self-testing in vulnerable population groups. Methods: This was a quantitative and qualitative study conducted in April 2022 in thirteen pilot centers of the national AIDS program. The target populations were men who had sex with men (MSM), female sex workers (FSWs), and street adolescents. Results: During the study period, 802 people were included in this study, among whom 51.4% were male. The study population consisted mainly of FSWs (34.4%), MSM (24.4%), and people from the general population (23.2%). The median age of the participants was 23 years, ranging from 13 to 77 years. The overall acceptability of the self-test was estimated to be 97.1% (n = 779). Six participants refused to do it immediately yet suggested that they might do it later, and 17 (2.1%) outright refused to do it. Acceptability was 100% among street adolescents, transgender people, and drug users. The lowest level of acceptability (93.5%) was found among the FSWs. Self-testing was considered feasible for 99.7% (n = 777) IC95% (99.1-100.0) of the participants. Conclusion: Our study showed that self-testing is a highly acceptable and practical strategy for MSM, FSWs, and adolescents in Togo. Therefore, in order to accelerate the implementation of population screening programs in our country, it is important to bring all innovative interventions to scale if we are to achieve the UNAIDS 95-95-95 targets by 2026. Key words: Autoimmune bullous dermatoses, Pemphigus, Bullous pemphigoid, Togo

Associations of cannabis use and body mass index–The Coronary Artery Risk Development in Young Adults (CARDIA) study

BackgroundWith increasing use of cannabis, we need to know if cannabis use and Body Mass Index (BMI) are associated. MethodsThe Coronary Artery Risk Development in Young Adults Study followed Black and White adults over 30 years with assessments every 2 to 5 years in four centers in the USA. We assessed self-reported current and computed cumulative cannabis exposure at every visit, and studied associations with BMI, adjusted for relevant covariables in mixed longitudinal models. We also applied marginal structural models (MSM) accounting for the probability of having stopped cannabis over the last 5 years. ResultsAt the Year 30 visit, 1,912 (58 %) identified as women and 1,600 (48 %) as Black, mean age was 56 (SD 2) years. While 2,849 (85 %) had ever used cannabis, 479 (14 %) currently used cannabis. Overall, participants contributed to 35,882 individual visits over 30 years. In multivariable adjusted models, mean BMI was significantly lower in daily cannabis users (26.6 kg/m2, 95 %CI 26.3 to 27.0) than in participants without current use (27.7 kg/m2, 95 %CI 27.5 to 27.9, p < 0.001). Cumulative cannabis use was not associated with BMI. The MSM showed no change in BMI when stopping cannabis use over a 5-year period (β=0.2 kg/m2 total, 95 %CI -0.2 to 0.6). ConclusionsCurrent cannabis use was associated with lower BMI, but cumulative cannabis use and cessation were not. This suggests that recreational cannabis use may not lead to clinically relevant changes in BMI and that the association between current cannabis use and lower BMI is likely due to residual confounding.

Low-carbon lifestyle index and its socioeconomic determinants among households in Saudi Arabia

Understanding the complex relationship between household consumption patterns, lifestyles, socioeconomic characteristics, and carbon footprint is crucial for mitigating climate change. However, the impact of urban household lifestyles on carbon footprint remains understudied in the Middle East, which ranks high in carbon emissions per capita globally. A case study of the region is particularly relevant due to its unique cultural characteristics that may have different impacts on household consumption patterns. This study develops household low-carbon index based on consumption lifestyles at home, workplace, and during leisure, and shopping, and predicts its socioeconomic determinants in Saudi Arabia. Data was collected via a questionnaire distributed among urban residents in the Dammam Metropolitan Area and subsequently analyzed using descriptive statistics and multivariate regression. The study found varying attitudes toward packaging, waste recycling, recreation, transportation, food consumption, textiles, electronics, and furniture use among respondents. The average household low-carbon index was moderate (ℼ = 1.642, σ = 0.734) on a 3.0 Likert scale. The study identified income, household size, household type, education level, gender, age, and marital status, as significant predictors of household low-carbon index (p < 0.05). This study equips policymakers with valuable insights to implement low-carbon policies and raise public awareness of the benefits of adopting low-carbon lifestyles, thereby fostering urban resilience and sustainability.

Investigating the extent that different recreational users of urban wetlands value birds and bird habitat

This study focused on visitors undertaking recreational activities at two important wetland conservation reserves with two main aims: to understand if visitors recognize the significant role of wetlands as vital bird habitat, and to understand the importance of birds as part of the visitor experience. We surveyed 511 visitors at two internationally significant urban wetlands in Perth, Western Australia. Results indicated that respondents valued wetland areas for exercising, aesthetic values, utility of infrastructure and general amenity, as well as the presence of birds. Some respondents perceived that the wetlands were important for birds and the presence of birds was generally rated highly. Results further indicated that while birds were generally not the focus of visitor experience, birds were an important component of that experience. We conclude that most visitors will generally support management actions aimed at conserving the wetlands and birdlife, and management actions do not need to consider a range of differing views across different recreational activities. Thus, understanding the extent that different recreational users of urban wetlands value birds and bird habitat provides vital insights into management approaches for conservation.

Isolation and characterization of synthesis intermediates and side products in hexahydrocannabiphorol

AbstractAfter the Swiss ban of hexahydrocannabinol (HHC) in March 2023, other semisynthetic dibenzopyran cannabinoids emerged on the Swiss gray market. Hexahydrocannabiphorol (HHCP) was the most prominent of them due to its potent cannabimimetic effects, as anecdotal reports from recreational users suggest. In October 2023, a class wide ban of dibenzopyran cannabinoids was introduced in Switzerland to prevent new similar substances from entering the drug market. Various vendors in online shops claim that HHCP is made from CBD, even though they possess different alkyl chain lengths. An HHCP sample was analyzed by gas chromatography coupled to mass spectrometry (GC‐MS), showing that a mixture of molecules with the same or a similar molecular mass as HHCP was present. Six different substances could be isolated from this sample using column chromatography. Four phenols ((9R)‐HHCP, iso‐HHCP, cis‐HHCP, and abn‐HHCP) and two ketones (possible intermediates to (9R)‐HHCP and abn‐HHCP) were identified by various nuclear magnetic resonance spectroscopy (NMR) techniques. (9S)‐HHCP was obtained in an impure fraction. In addition, a fraction was obtained that showed characteristic molecular and fragment ions consistent with bisalkylated products from the synthesis of similar compounds. The presence of abnormal cannabinoids (abn‐HHCP) and bisalkylated cannabinoids is a confirmation that this sample was produced purely synthetically as initially suspected, as these compounds have not been reported in Cannabis. Chiral derivatization of the phenols with Mosher acid chlorides showed that only iso‐HHCP was present as a scalemic mixture, indicating a good stereocontrol of this synthetic procedure.

Wastewater-based epidemiology to monitor 68 NPS/conventional drug use in Taipei metropolitan area in Taiwan during and after COVID-19 pandemic

Amidst far-reaching COVID-19 effects and social constraints, this study leveraged wastewater-based epidemiology to track 38 conventional drugs and 30 new psychoactive substances (NPS) in northern Taiwan. Analyzing daily samples from four Taipei wastewater plants between September 2021 and January 2024—encompassing club reopenings, holidays, Lunar New Year, an outbreak, and regular periods—thirty-one drugs were detected, including 5 NPS. Tramadol, zolpidem tartrate, CMA, and MDPV were newly detected in Taiwanese sewage with frequency of 1.4 %− 89.0 %. Conventional drug use typically increased post-pandemic, aside from benzodiazepines and methadone. Methamphetamine showed 100 % frequency, indicating ongoing daily consumption despite COVID-19 measures. Methamphetamine and morphine's consumption dipped then rose around club reopening, hinting at limited access. The consumption trend of methadone appeared to compensate for the use of morphine. Ketamine and NPS demonstrated similar patterns throughout the entire period. NPS as party drugs seemed influenced by an unstable supply chain and complexities in implementation. Benzodiazepines, commonly abused alongside synthetic cathinones in Taiwan exhibited an opposing trend to NPS while aligned with acetaminophen, suggesting elevated stress and anxiety levels during the pandemic. No significant differences were observed in drug consumption between weekdays and weekends, potentially indicating that COVID-19 measures blurred the traditional distinctions between these timeframes. Environmental ImplicationNew psychoactive substances refer to chemically modified variants of controlled drugs designed to mimic the effects of the original drugs while evading modern detection methods, categorizing them as hazardous materials. The study presents a sewage monitoring project conducted from 2021 to 2024, collecting samples from four WWTPs to analyze NPS and conventional drug trends during and after the COVID-19 pandemic. The findings uncovered connections between drug consumption patterns and pandemic-related policies. In light of the persistent drug abuse and their environmental presence, the results bear critical importance for both environmental and public health. We provide a thorough assessment of these relationships and prioritize areas for future research.

Assessment of river recreation safety using hydrodynamic model and fuzzy logic: A spatial river recreational index approach

As demands for river recreational activities increases, assessing their safety has become essential to prevent accidents. The hydraulic conditions of the river critically influence the safety of in-water activities, such as sailing, paddling, and boating. Localized hazardous areas can emerge due to the spatial variability of hydraulic phenomena. This potential risk necessitates providing information about safe zones. Therefore, this study proposes a spatial river recreational index (SRRI) to assess the safety of river recreational activities over river spaces based on hydraulic factors. We reproduce the spatial distribution of the hydraulic parameters under various discharge conditions using a 3D hydrodynamic model and then estimate the SRRI by integrating all membership degrees and weights of these parameters using fuzzy synthetic evaluation (FSE). The application of the SRRI in the confluence of the Nakdong-Guemho River, South Korea, reveals that each hydraulic parameter contributes differently to safety levels, depending on discharge and morphological conditions. Specifically, the flow direction substantially decreases safety near the river confluence, whereas the water depth plays an important role in the meandering reach of the Nakdong River. Under high-flow conditions, velocity becomes a critical factor, especially for nonpowered activities (sailing and paddling/wading). The SRRI indicates that sailing is unsafe in the main flow zone and near the river confluence due to high sensitivity to discharge changes. In contrast, paddling/wading and leisure boating are less sensitive to discharge changes, allowing these activities to be partly allowable even under high-flow conditions, except in the deep-water zones of meandering reach. These results suggest that the SRRI can assist water recreational activity users in safely engaging in river recreational activities by providing spatial safety information based on various hydraulic conditions.

Effects of recreational and residential functional land use on urban soils

Effects of recreational and residential functional land use on urban soils

Evaluating the Abuse Potential of Lenabasum, a Selective Cannabinoid Receptor 2 Agonist.

Endocannabinoids, which are present throughout the central nervous system (CNS), can activate cannabinoid receptors 1 and 2 (CB1 and CB2). CB1 and CB2 agonists exhibit broad anti-inflammatory properties, suggesting their potential to treat inflammatory diseases. However, careful evaluation of abuse potential is necessary. This study evaluated the abuse potential of lenabasum, a selective CB2 receptor agonist in participants (n = 56) endorsing recreational cannabis use. Three doses of lenabasum (20, 60, and 120 mg) were compared with placebo and nabilone (3 and 6 mg). The primary endpoint was the peak effect (Emax) on a bipolar Drug Liking visual analog scale (VAS). Secondary VAS and pharmacokinetic (PK) endpoints and adverse events were assessed. Lenabasum was safe and well tolerated. Compared with placebo, a 20-mg dose of lenabasum did not increase ratings of Drug Liking and had no distinguishable effect on other VAS endpoints. Dose-dependent increases in ratings of Drug Liking were observed with 60 and 120 mg lenabasum. Drug Liking and all other VAS outcomes were greatest for nabilone 3 mg and 6 mg, a medication currently approved by the US Food and Drug Administration (FDA). At a target therapeutic dose (20 mg), lenabasum did not elicit subjective ratings of Drug Liking. However, supratherapeutic doses of lenabasum (60 and 120 mg) did elicit subjective ratings of Drug Liking compared with placebo. Although both doses of lenabasum were associated with lower ratings of Drug Liking compared with 3 mg and 6 mg nabilone, lenabasum does have abuse potential and should be used cautiously in clinical settings. SIGNIFICANCE STATEMENT: This work provides evidence that in people with a history of recreational cannabis use, lenabasum was safe and well tolerated, although it did demonstrate abuse potential. This work supports further development of lenabasum for potential therapeutic indications.

Cognitive functioning associated with acute and subacute effects of classic psychedelics and MDMA - a systematic review and meta-analysis

Classic psychedelics and MDMA have a colorful history of recreational use, and both have recently been re-evaluated as tools for the treatment of psychiatric disorders. Several studies have been carried out to assess potential long-term effects of a regular use on cognition, delivering distinct results for psychedelics and MDMA. However, to date knowledge is scarce on cognitive performance during acute effects of those substances. In this systematic review and meta-analysis, we investigate how cognitive functioning is affected by psychedelics and MDMA during the acute drug effects and the sub-acute (“afterglow”) window. Our quantitative analyses suggest that acute cognitive performance is differentially affected by psychedelics when compared to MDMA: psychedelics impair attention and executive function, whereas MDMA primarily affects memory, leaving executive functions and attention unaffected. Our qualitative analyses reveal that executive functioning and creativity may be increased during a window of at least 24 h after the acute effects of psychedelics have subsided, whereas no such results have been observed for MDMA. Our findings may contribute to inform recommendations on harm reduction for recreational settings and to help fostering differential approaches for the use of psychedelics and MDMA within a therapeutic framework.

A comprehensive investigation of atherosclerosis in the 10-25 age group through medico-legal autopsies

Introduction: Atherosclerosis, a leading cause of coronary heart disease (CHD), remains a global health concern with a rising prevalence in young populations, particularly in regions like Kerala, India. Despite advancements in social indicators, Kerala faces an alarming surge in CHD cases among its youth. This study aimed to assess the prevalence and severity of atherosclerosis in coronary arteries and the aorta among individuals aged 10–25 years, shedding light on etiological factors influencing CHD.Methods: A cross-sectional study was conducted at the Department of Forensic Medicine, Government Medical College, Thiruvananthapuram, India, involving medico-legal post-mortem examinations. Sixty-four cases aged 10-25 years were included, with data collected on personal, physical, and lifestyle parameters. Autopsy-based examinations focused on atherosclerosis in coronary arteries and the aorta, utilizing a detailed histopathological classification system.Results: The study revealed a high prevalence of atherosclerosis, with 60.9% of cases exhibiting aortic lesions, and varying percentages observed in coronary arteries. Associations were found between atherosclerosis and age, family history of heart disease leading to death, cigarette smoking, recreational drug use, and personal history of heart disease.Conclusion: This study underscores the concerning prevalence of atherosclerosis among young individuals and emphasizes the need for antiatherogenic preventive measures and targeted awareness programs against cigarette smoking and recreational drug abuse. It calls for novel therapeutic approaches and public health campaigns to promote lifestyle modifications and mitigate atherosclerosis-related early mortality and morbidity. Policy implications include recognizing atherosclerosis as a condition affecting young populations and advocating for comprehensive research approaches with larger sample sizes and genetic studies to identify potential genetic contributions to atherosclerosis development. Limitations include challenges in obtaining accurate lifestyle histories during autopsies and the need for larger, multicenter studies to provide deeper insights into risk factors and age-related trends.

A feasibility study to assess the recruitment and retention of pregnant patients who regularly use cannabis

ObjectiveTo assess first-trimester recruitment and retention of pregnant patients who regularly used cannabis, but not other substances, measured by willingness to participate in a research study, completion of self-administered electronic questionnaires, and willingness to provide urine samples during each trimester of pregnancy. We designed and launched a prospective feasibility study titled, Cannabis Legalization in Michigan (CALM) – Maternal & Infant Health (MIH), in two Michigan clinics after the recreational use of cannabis became legal for adults 21 years and older.ResultsOver half (52%) of patients asked to participate in CALM-MIH were consented to the study. Two-thirds (66%) of screened patients initiated prenatal care during their first trimester of pregnancy and 50% used cannabis, of which the majority did not concurrently use other substances. Of those recruited into the prospective study, all participants completed the first-trimester questionnaire and provided urine samples. Study retention was 80% and all participants who completed follow-up assessments were willing to provide urine samples.

Nitrous oxide as a party drug

In recent years, reports of health problems associated with nitrous oxide consumption have significantly increased. In Germany, nitrous oxide (N2O) is easily available in cartridges without legal restrictions. The main reason for its popularity in the party scene are the euphoric, psychedelic effects of the gas. In addition to severe and sometimes irreversible health problems associated with long-term use of nitrous oxide, e.g., anemia and nerve damage, life-threatening or fatal consequences of acute nitrous oxide consumption can also occur: accidents under the influence of nitrous oxide, pneumothorax, pneumopericardium and shock due to an explosive increase in airway pressure when inhaled directly from the cartridge. But the most common cause of severe complications is asphyxia as the gas is usually inhaled pure from large balloons and without oxygen. The resulting hypoxia during use may be perpetuated by the diffusion hypoxia that occurs during the reoxygenation period. Nitrous oxide as acause in accidental or intoxication events is usually not detectable but can only be identified as atrigger based on the patient's history or the circumstances. Acute medical treatment is symptomatic.

The effect of sewage source on HF183 risk-based threshold estimation for recreational water quality management

Host-associated fecal indicator measurements can be coupled with quantitative microbial risk assessment to develop risk-based thresholds for recreational use of potential sewage-contaminated waters. These assessments require information on the relative concentrations of indicators and pathogens in discharged sewage, typically based on data collected from wastewater treatment plant influent samples. However, most untreated sewage releases occur from within the collection system itself (i.e. compromised sewer laterals, compromised gravity and force mains, sanitary sewer overflows), where these relationships may differ. This study therefore analyzed the concentrations of a selected reference pathogen (norovirus) and fecal indicator (HF183) in sewage samples from upper and lower segments of gravity sewage collection systems, wastewater pumpstations, and the influent and effluent of treatment plants, to characterize variability in their relative concentrations. Norovirus detection rates were lower and more variable in upper collection system samples due to the smaller population represented; whereas, HF183 was routinely detected at all sites with higher concentrations in the collection system compared to treatment plant influent, resulting in variable comparative relationships across sample locations (types). Mean HF183:NoV ratios ranged from 1.0 × 105 for sewer lateral samples to 7 × 10° for force main samples. Results were used to develop risk-based thresholds for HF183 based on estimated recreational exposure to norovirus following a release from each potential sewage source, with higher thresholds for treatment facility influent compared to forced mains, or effluent. Consequently, this approach can allow for the rapid application of potential risk-based thresholds for recreational water quality applications based on different types of sewage discharge events.

Synthesis and analytical characterization of 1‐(2‐thienoyl)‐6‐allyl‐nor‐d‐lysergic acid diethylamide (1T‐AL‐LAD)

AbstractLysergic acid diethylamide (LSD) analogs have emerged as new psychoactive substances (NPS) since the mid‐2010s, and new compounds continue to emerge for recreational use. Since the end of 2023, “1D‐AL‐LAD” appeared on X (formerly Twitter) and other websites. As for the compound “1D‐LSD” (which also has “1D” in the name), several studies show that the ingredient of seized blotter paper printed “1D‐LSD” was actually 1‐(2‐thienoyl)‐LSD (1T‐LSD). However, there are no reports of seizures of 1‐(1,2‐dimethylcyclobutanecarbonyl)‐LSD (1D‐LSD). Accordingly, it was considered that all or at least a certain percentage of “1D‐AL‐LAD (1‐(1,2‐dimethylcyclobutanecarbonyl)‐6‐allyl‐nor‐LSD)” is actually 1‐(2‐thienoyl)‐6‐allyl‐nor‐LSD (1T‐AL‐LAD). This compound is handled by a number of distributors as of April 2024; therefore, it should be characterized in advance if seized. In this study, 1T‐AL‐LAD was synthesized and characterized using nuclear magnetic resonance spectroscopy, Fourier transform‐infrared spectroscopy, liquid chromatography/high‐resolution mass spectrometry (LC/HRMS) and gas chromatography/MS (GC/MS). This compound was easily distinguished from previously reported lysergamides. There were some differences in the detectability of 1T‐AL‐LAD compared with other lysergamides using GC/MS and the fragmentation patterns in LC/HRMS. These differences can be reasonably explained. This information will be of help to determine this substance in seized materials should it emerge on the market.

Changes in medical cannabis use in Ontario, Canada (2014 to 2019): Trajectory of trends, medical authorization patterns and association with recreational cannabis legalization

ObjectivesWe characterized trends in medical cannabis use; examined characteristics associated with medical cannabis use without medical authorization; and examined the association between recreational cannabis legalization and medical cannabis use in Ontario, Canada. MethodsData were from a repeated, population-based, cross-sectional survey of adults (N = 19,543; 2014–2019). Cannabis use was categorized as either medical cannabis use, recreational cannabis use or no cannabis use. The analytical strategy included jointpoint regression, logistic regression and multinomial logistic regression. ResultsMedical cannabis use increased from 4 % to 11 % (Annual Percentage Change [APC]: 25 %, 95 % Confidence Interval [CI]: 17 %–33 %) and recreational cannabis use increased from 9 % to 15 % (APC: 9 %, 95 % CI: 3 %-15 %) between 2014 and 2019. Being 18 to 29 years old compared with being 65+ years old was associated with an increased likelihood of medical cannabis use without medical authorization (Odds Ratio [OR]: 4.05, 95 % CI: 2.12–7.72), while being of fair or poor self-perceived health compared with excellent, very good or good self-perceived health (OR: 0.61, 95 % CI: 0.40–0.95) was associated with a decreased likelihood of medical cannabis use without medical authorization. Recreational cannabis legalization was associated with an increased likelihood of medical cannabis use compared with no cannabis use (OR: 1.48, 95 % CI: 1.19–1.85) and of recreational cannabis use compared with no cannabis use (OR: 1.35, 95 % CI: 1.11–1.65). ConclusionsAlthough medical cannabis use increased, it was largely used without medical authorization. Guidance and education that encourages medical usage under clinical supervision is recommended, and mitigation of known barriers to medical cannabis authorization.